For
Child Care
Providers

Resource & Referral Program

Cleaning and Supplies for Child Care Providers (CSCP) Self-Certification Form

Funding, for providers within our service area, is available for cleaning, personal protective equipment, and other supplies for licensed and license-exempt center and home-based providers who are operating an Early Learning and Care (ELC) program and are open, or are soon to be open, to provide child care during the COVID-19 state of emergency for children of essential workers, at-risk populations, and children with disabilities or special health care needs where the child’s individualized education plan (IEP) or individualized family service plan (IFSP) includes ELC services. Please complete the form below and we will contact you regarding your eligibility.

 
Provider Type
Center:
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Home Based:
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Certification
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I understand, as a provider, that this self-certification form is a requirement to receive CSCP funds, supplies, or both to serve essential workers and/or at-risk populations during the COVID-19 pandemic. As stated on this form, my program currently is open or will be open by the date specified and the funds and/or supplies will be used solely for these restricted purposes.

 
 
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