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Triple+l d d dhITABLE E     рUTABLE G http://www.naeyc.org/accreditation/support.htmwww.nsaca.org/standardsglance I )USUS.,  _  dd !USUS.,  _X   KVs   `    @  @`  @  @  @ RVQXX#XXQRV#RVQXXREQUESTFORPROPOSALS#XXQRVY#  8  LJXXQualityEnhancementGrants#XXJL#XX 4 ForChildCareCenters#XX'#XX   2 #XX# RVQXXSIMPLIFIED #XXQRV#     RVQXXGRANTAPPLICATION #XXQRV[# f   XXAndFundingAnnouncementfor#XX#  N   XXChildCareandDevelopmentFund(_CCDF_) r  #XXC# pXXTHEKANSASDEPARTMENT 2 OF F SOCIALANDREHABILITATIONSERVICES #XXp#  Z  pXXChildrenandFamilyPolicyDivision  Z ChildCareandEarlyChildhoodDevelopmentUnit !n #XXp#  E XXAugust2001#XX  Eu# %2!  Nowavailableontheinternetatwww._srskansas.org_under Publications. )0%$  # #(Lastmodified:7/23/01)X& XXX )  XX& +'& #X& X )#&7% XX&  ,'' Vs V8XXdd8X< V  KEYtoAbbreviationsForMajorTermsUsedinThisDocument    AIPlanA ccreditation I mprovement Plan ` CC0  C hild C are <(#(# _CCDF_0  C hild C are D evelopment F und h(#(# _KACCRRA_ԀK ansas A ssociationof C hild C are R esourceand R eferral A gencies  D _KDHE_0  K S. D epartmentof H ealth& E nvironment  (#(# _KF_Ԁ0  K auffman F oundation  (#(# _NAEYC_ԄN ational A ssociationforthe E ducationof Y oung C hildren    _NSACA_ԄN ational S chool A ge C are A lliance  d   _NOGA_0  N otification o f G rant A ward @  (#(# PDI0  P rofessional D evelopment I nitiative l (#(# _QE_0  Q uality E nhancement H (#(# RIPlan R egulatory I mprovement Plan $  R&R0  R esourceand R eferral  (#(# _SSK_0  S mart S tart K ansas  (#(# _T.E.A.C.H._ԀT eacher E ducation a nd C ompensation H elps  h       `     h   QUALITYENHANCEMENT(_QE_)GRANTS#&%%&7Φ##XX%&#&%XX&7%%& D      `    #&%%&7E#ChildCareDevelopmentFund(_CCDF_)arefederalfundsunderPublicLaw104193,governedbyFederal  regulations.&7%%&InKansas,someofthe_CCDF_Ԁfundsareusedtomake#&%%&7΀#&7%%&_QE_Ԁg#&%%&7#&7%%&rants#&%%&7{#&7%%&ԀtoChildCareCenters._QE_ | grantsmaybeusedtoenableaCentertoachieveorretainaccreditationortoachieveorretain_licensure_._QE_ T grantsareusedtomakeimprovements#&%%&7#&7%%&forthingspertainingtorecognizedqualityindicatorsspecifiedin ,| regulatoryandaccreditationstandards,andincludesbutisnotlimitedto:suppliesforchildactivities, T playgroundequipment,Centerrenovation,firealarms,etc.#&%%&7C# Theintentofthis_QE_Ԁgrantcomponentisto , enhancethequalityofexistingchildcareservicesinChildCareCenterprogramslicensedby_KDHE_Ԁand  servingchildrenbirthtoage12.  &7%%&Excludedfromfundingin_QE_Ԁgrants#&%%&7#&7%%&#X& X%&7&#&7% XX&Ԁare:Staffsalaries,travel,andstafftraining,includingbonusesor < stipendsfortraining.Theseareexcludedfromfundingin_QE_Ԁgrantsbecauseother_CCDF_Ԁfundsareawarded d toagencieswhichprovidetrainingatnoorreducedcostandbecauseother_CCDF_Ԁfundsareawardedtosome <  pilot_T.E.A.C.H._Ԁprojectsadministeredby_KACCRRA_Ԁandits16memberR&Ragencies.#&%%&7Z##XX%&#&%XX  ! Centersinthenineteen(19)Counties*coveredbySmartStartKansas(_SSK_)fundsand/orinthethree(3) t"# CountiescoveredbyKauffmanFoundation(_KF_)areencouragedtocontactthemandseekthosefunds,but L#$ mayalsoapplyfor_CCDF_Ԁfunds.NOTE:_SSK_Ԁfundsareonlyforprojectsforchildrenfrombirthtoage5. $$t% Centersinanyofthe_SSK_Ԁand/or_KF_ԀCountieswhowishtoapplyfor_CCDF_Ԁfundsarerequiredtocomplete $L & theForm: AssurancesRelatedtoSpecialFundsinordertodocumenttheireffortstoseekoutthesefunds %$!' whichtotalapproximately$4Millionperyear.ThisFormenablesCentersintheother86Countiesin &!( Kansas#XX%&K#&%XXԀtohavemoreequalaccesstofundingtomakequalityimprovements.HeadStartandEarlyHeadStart '") programs (whichhaveseparatefundingstreams)arenot&7%%& eligibletoapplyfor_QE_Ԁgrants.#&%%&7L #&7%%&Ԁ#&%%&7 #&7%%& \(#*  *_SSK_ԀCounties: Sedgwick,Saline,Riley,Douglas,Johnson,Wyandotte,_Leavenworth_,Crawford, *4&- Cheyenne,Rawlins,Decatur,Sherman,Thomas,Sheridan,Graham,Wallace,Logan,_Gove_Ԁand_Trego_.  +'. *_KF_ԀCounties: Johnson,Wyandotte,and_Leavenworth_. ,'/ #&%%&7!##XX%&w#&%XX&7%%&   t-(0  <<   _Upto$25,000inQEgrantfundsmayberequestedforthefollowingpurposes:    #(U031.TomakeimprovementsrelativetotheregulationsofKDHE,theStateFireMarshall,orotherregulatory  agency,asdocumentedona RegulatoryImprovementPlan(RIPlan)formincludedwiththisRFP. ` 2.TomakeimprovementsrelativetotheaccreditationstandardsofNAEYC,NSACA,orotherrecognized 8 accreditationagency,asdocumentedonan AccreditationImprovementPlan(AIPlan)formincludedwith ` thisRFP. 8 #&%%&7Ϋ##&7%%& DUEDATE: Submitoneoriginal&9copiesoftheApplicationpostmarkedby FridayOctober26,2001.     #&%%&7g'#&7%%& TECHNICALASSISTANCE: ContactSRSbyEMailtoKJM@srskansas.orgorphone(785)3688127. L   PublicTAsessionsforprospectiveapplicantswillbeheldinseveralcommunitiesinSeptemberandOctober, ( x  2001.  P   OTHERCCDFGRANTS: ForgrantapplicationstostartorexpandaChildCareCenter,orforSpecial   ProjectsandPDIProjectsintheChildCaresystem,check4JԯO  5  www.srskansas.org6<*OP*/  7C~*ԀorcontactKJM@srskansas.org   phone(785)3688127or#&%%&7A(#&7%%&#X& X%&7Ό##&7% XX&Ԁ4  O  5  plzxj@srskansas.org6+O+by  7ke,Ԁphone(785)3686470.ForFamilyHomeProviderGrants, h  contactKACCRRA(877)6782548;SRShasprovidedKACCRRAwithCCDFfundsfortheseFamily @  HomeProviderGrants. h # # #&%%&7z+##XX%&+#&%XXFUNDINGFORQEGRANTS#XX%&-# &%XX , SRSintendstomake$500,000availableforQEGrantsinFY02andestimatesitwillaward2535grants,  withmostrangingbetween$12,000to$25,000.#XX%&U.#&%XXԀThemaximumawardis$25,000.Fundsareawardedfor  a12monthperiodoftime.  d #XX%&V/#X& XXX&7% XX&NEEDSTATEMENT,ACTIONPLAN#X& X%&760#&7% XX&#&%%&70#&7%%&,GOALS,OUTCOMES  d Theabovecomponentsoftheusualgrantapplication,typicallyprovidedinnarrativeform,arehandledwith < threeformsinthissimplifiedapplicationforaQEGrant.ThethreeformsaretheRIPlan,theAIPlan,and  theTimetableForObtainingAccreditation.ThepurposeofthesechangesintheRFPistodirectfundswhere  needforqualityimprovementisgreatestandtoreducetheburdenonapplicantsandreviewers.#X& X%&7Γ0#&7% XX&#&%%&70#&7%%& t  NeedStatement NeedisconveyedintheRegulatoryImprovementPlan(RIPlan)#&%%&7c3#&7%%&#X& X%&7!3#&7% XX&ԀandtheAccreditation $t ImprovementPlan(AIPlan).ApplicantsforQEgrantsidentify Needrelativetorecognizedregulatory P and/oraccreditationstandardsontheAIandRIPlanforms,andsecurewrittenconcurrenceofneedonthe (  formsfromanofficialattheregulatoryagencyand/ortheaccreditationagency.  !  ActionPlan,GoalandOutcomes TheactionplanforQEgrantsisincorporatedprincipallyintheRIPlan, `"# and/ortheAIPlan,andtheAccreditationTimetable.The GoalsandOutcomes arestatedorimpliedineach <#$ regulatoryandaccreditationstandardspecifiedonthePlanformsbyanapplicant,withthegoalsand $h% outcomesrelatedtosomeaspectofchilddevelopment,health,orsafety.T#X& X%&7Q4##XX XX&4#X& XXX&7% XX&hereisnorequirementforthe $@ & applicanttorestatethesegoalsandoutcomes.Basedonpaststudiesandontherecognizedlicensingand %!' accreditationstandards,agranteespostawardcompliancewithsucharegulatoryoraccreditationstandard &!( isindicativeofgoalandoutcomeachievement.#&%%&78#&7%%&#X& X%&758#&7% XX&Ԁ#&%%&79#&7%%&#X& X%&7:#&7% XX&  x'")  #&%%&7^:##XX%&:#X& XXX&7% XX&CRITERIAFORREVIEW#X& X%&7C;#v! XX& ()x$+  #X& Xv!;#&7% XX&QEGrantApplicationswillbereviewedbasedon: *P%, ! ! ) !"&'((wly0#0,XF` XX0 F ""  4=2wl3  8 '   thedeterminationwhether=Ԁ theimprovementsareneededtoretainalicenseandthusremainin *(&- business4=a=݌+'.'!'! Ќ  ""   F >2wl3  8 '   theclosenessofthedatebywhichtheapplicantneedstomaketheimprovementsinorderto#&%%&7$;#&7%%&retain ,'/ thelicenseortoobtainaccreditation>>݌`-(0'!'! Ќ   F  8.)1  F #&%%&7Γ?#&7%%&""  @2wl3  8 '   #X& X%&7;#&7% XX&theclarityofthebudgetrelativetohowtheimprovementswillleadtocompliancewithregulation  andaccreditationstandards#X& X%&7EA#&7% XX&#&%%&7Ί@#&7%%&@@݌'!'! Ќ   F ""  B2wl3  8 '   theextenttowhichtheCenterproposesadequate#X& X%&7B#&7% XX&#&%%&7[B#&7%%&ԀbuteconomicaluseoffundsBB݌`'!'! Ќ   F ""  [D2wl3  8 '   theextenttowhichtheCenterhasobtainedothersourcesofcashfundsfortheproject[DD݌8'!'! Ќ   F ""  tE2wl3  8 '   theextenttowhichtheCenterhasobtainedothersourcesofnoncash,inkind#X& X%&7ΏC#&7% XX&#&%%&7C#&7%%&ԀcontributionstEE݌`'!'! Ќ   F ""  G2wl3  8 '   theextenttowhichtheCenterhassoughtoutotherpotentialfundingoptionsGCG݌8'!'! Ќ   F ""  %H2wl3  8 '   theextenttowhichtheCenterhasprovidedtheinformationrequestedandcompliedw#&%%&7ΚF#&7%%&#X& X%&7XF#&7% XX&iththe   requirementsoftheRFP%HRH݌ '!'! Ќ   F #X& X%&7QI#&7% XX&#&%%&7I#&7%%&""  vJ2wl3  8 '   theextenttowhichtheCenterstaff,Boardmembersandparentsareparticipatingincollaborative p  childcarerelatedventures,suchasRegionalSupportTeams,ICCCommittees,PDITaskForces, H   #&%%&7WJ#&7%%&SmartStartKansasCommunityPartnerships,AccreditationProjectCommittees,andConnect  p  KansasCoalitionsinconjunctionwithRegionalPreventionCenters,#&%%&7K#&7%%&#X& X%&7J#&7% XX&Ԁetc.vJJ݌ H '!'! Ќ   F " "  M2wl3  8 '   thedegreeofprogresstheCenterisachievingonitstimetableforobtainingaccreditation#X& X%&7(M#&7% XX&#&%%&7L#MM݌ '!'! Ќ   F " "  O2wl3  8 '   theamountandnumberofaCenterspastCCDFgrantawardsanditscompliancewithgranttermsOJO݌ '!'! Ќ   F " "  @P2wl3  8 '   theextenttowhichtheCenterserveschildrenreceivingassistancefromSRS#XX%&N#X& XXX&7% XX&@PmP݌ '!'! Ќ  #&%%&7"Q##XX%&AQ#?y=XX?M==?y#X& X=?MQ##XX XX& R#&%XXREVIEWPROCESSandTIMETABLE :   SRSwillreviewapplicationsinaccordancewiththe CriteriaForReview.ReviewswillbedoneattheSRS : AreaOfficelevel,theSRSCentralOfficelevelandmayincludepersonsnotemployedbySRS.Significant  datesandactivitiesare:  8 F October26,2001ApplicantssubmitQEgrantapplicationspostmarkedbythisdaterF"F" 8 F November2,2001CentralOfficescreensapplicationsforcompleteness;mailstoAreaOfficesforlocalJF"F"  F  '    ` reviewandtoindividualsservingasstatereviewers "r 8 F December1,2001&7%%&ԀAreaOfficereviewersandstatereviewerssendcompletedreviewstoCentralOfficeJF"F" 8 F January7,2002#&%%&7ΦU#&7%%&ԀCentralOfficereviewcompleted"F"F" 8 F January9,2002#&%%&7zV#&7%%&ԀCentralOfficewillinformtheSRSSecretaryofitsrecommendationsF"F" 8 F January15,2002#&%%&7W#&7%%&ԀCentralOfficenotifiessuccessfulandunsuccessfulapplicants(byEMail)F"F"   Applicantswillbesentofficialnoticeofgrantawarddocumentssoonthereafter.  Z SUBMISSIONINSTRUCTIONS  Z  ! ! (դ8y ) !"&'(""    Y2դ  1  .3  8 F   Tobeconsideredforfunding,theapplicantmust   p SRSCC/ECD #&%%&7W#&7%%&Ԁ 2 submitonesignedoriginaland9copiesofthe#&%%&7κZ#&7%%&     p 915SWHarrison,DSOB5thFloor #&%%&7f[#&7%%&YY݌ F"F" Ќ  ݀applicationbytheduedatetotheaddressattheright:#&%%&7[#&7%%&  0 p Topeka,KS66612#&%%&7θ\#&7%%&Ԅ1570 #&%%&7%]#&7%%&  !p(#p(#  F  '    `     h   #&%%&7o]#&7%%& ""  b^2դ  2  .3  8 F   Withthe original applicationonly,twodocumentsaretobepaperclippedtoit:a)verificationof N"# nonprofitstatus,ifapplicable;andb)alistofBoardmembersandastatementindicatingthatno *#z$ Boardmembershallvoteonamatterwhichwouldinvolveaconflictofinterestforthatmember.b^^݌$R%F"F" Ќ  8 F *Theremaining 9copies oftheapplicationareԀnot`tohavetheinformationina)andb)above $* & attached.%!'F"F" Ѐ""  Ya2դ  3  .3  8 F   Thepagesoftheapplicationaretobenumberedonthebottom,centeredinthemiddleofthepage f'") startingwith theCoverSheetaspage1.Thesepagenumbersmaybehandwritten#&%%&7<^#&7%%&,ortyped.The >(#* applicationistobeputintheorderindicatedinthe ApplicantChecklistontheCoverPage.If )f$+ applicable#&%%&7b#&7%%&,theAccreditationReadinessSurvey,istobeplacedatthebackasanAppendix.Yaa݌)>%,F"F" Ќ  ""  td2դ  4  .3  8 F   The9copiesoftheapplicationaretobeprintedfronttoback(duplex)andstapledintheupperleft +&. handcorner.Donotuseorincludeseparatecovers,binders,clips,tabs,plasticinsertsorbrochures.%&7tdd݌v,'/F"F" Ќ  #&7%e##&%%&7c#Y_&7%%& v!%&7  -N)1 K K 8  K  /_KansasDepartmentofSocialandRehabilitationServices  ChildCareandDevelopmentFund#pv!f##&%pf#p%&v!p   CoverPage $ #&7%v!Sh#D%&7 QualityEnhancementGrantApplication#&7%Dh#) %&7  8 *U?ddd Xdd Xdd X(#(#,dd ,pdd ,dd ,>dd ,dd ,]dd ,dd +  9/$ \ \ dd9#&7% )_i#) %&7 LegalName&Address p  ofOrganization 2   D1+ D/dd D E/0p   ddECenter#&7% )Ek#) %&7#  )rh#)  ԀAddress(if J   different) D1+ \ /dd D E/0J   ddETelephoneandFax D1+b /dd DЀ()FAX() E/0b  ddEContactPerson&Title#&7% )fl#) %&7#  )l#)   D1+ /dd D E/0  ddEEMailAddress D1+^ /dd D E/0^  ddECenterLocatedinwhat D1+d/dd D_SRS_ԀAREA: E/0d ddECountiesServed    D1+|/dd D E/0  ddEFederalIDNumber D1+"/dd D E/0" ddETypeofOrganization U/@+(x/dd ddUPublic 7-+(x"/dd 7 3/ (x dd3  NonProfit 7-+(x /dd 7 3/ (x dd3  Private @-+(x /dd @ B/-(x  ddBAgencyFiscalYear G=+~!/dd G  FROM: @-$~" @TO: E/0~# ddEDatebywhichProject $$ WouldBeAbletoStart #&7% )n#) %&7#  )n#)   G=+%/dd G  ProjectedStartDate:#  )u#)  #&7% )u#) %&7 @-$$& @+!$'  +(,[(#(#( @F  @'  @  @`  @  @  @h *|U}d ddd pdd pdd >dd >dd ]dd ]dd U?,/ dd ,dd +  4/' dd4GrantComponentRequestedinthisApplication @( (pleasecheck( 3) onecomponent)#&7% )v##&%%&7qv#&7%%&) %&7 OU/:%)/dd ddO#&7% )y#) %&7QualityEnhancement{withRegulatory  \* ImprovementPlan(s)}#&7% )kz#) %&7#  )y#)   @-++U/dd @#&7% )z#) %&7 BU/- \, ddB#&7% ){#) %&7QualityEnhancement{withAccreditation $!t- ImprovementPlan(s)}#&7% )B|#) %&7#  )<{#)   C0+!6.U/dd C#&7% )|#) %&7 BU/-$!t/ ddBQualityEnhancement{withboth a <#0 RegulatoryandanAccreditation#&7% )}#) %&7#  )}#)   #N1 ЀImprovementPlans} C0+$ 2U/dd C(<#3   ( #&7% )~#) %&7#&7% )# #&%%&7~#&7%%&) %&7*x/U0dd/ dd / dd |U}x,[ dd ,dd +  =/(:'"5:'" dd=#&7% )%#) %&7ProjectCost X/C.'"6"/dd ddX  _CCDF_ԀFundsRequested L9+(D$7/dd L  $ K/6!(D$8 ddKTotalProjectCost L9+J*%9/dd L$ K/6!J*%: ddKForSchoolAgeChildrenOnly +&; (Age613)checkhere L9+d,'</dd L1'%+&=   1̀#&7% )_#  .l)> *+U.dd[ dd [ dd /U0(#(#,dd ,K dd +  0U/> dd0 LU/7"AU/dd ddL  ApplicantChecklist @B &%&7Check(3)belowtoensurecompletenessof C application#&7%&L##&%%&7#&7%%& &%&7 fD #&7%&%#) %&7#  )#)  ԀCoverPageandAbstract#  )·##&% # %& LU/7+TEU/dd ddL LU/7"\ FU/dd ddL)  RIPlan(ifapplicable)#  )# LU/7+\ GU/dd ddL LU/7"!HU/dd ddL )  #AIPlanandTimetablefor !I Accreditation x"J Ѐ(ifapplicable)#  ) #)  .Alsoattach <#K asAppendixanAccreditation $PL ReadinessSurvey(_NAEYC_)orSurvey $ M AtAGlance(_NSACA_)(ifapplicable)#*#  )͊# LU/7+% NU/dd ddL LU/7"&0"OU/dd ddL)  ԀOtherFundSourcesPage#  )# LU/7+&0"PU/dd ddL LU/7"8(#QU/dd ddL)  ProjectBudgetPage#  )# LU/7+8(#RU/dd ddL LU/7")$SU/dd ddL)  AssurancesandCollaborationPage#  )# LU/7+)$TU/dd ddL LU/7"*8&UU/dd ddL)  ԀSupplementalInformationPage#  )# LU/7+*8&VU/dd ddL LU/7"@,'WU/dd ddL)  Past_CCDF_ԀRecipientPage )(ifapplicable)#) ##  )# LU/7+@,'XU/dd ddL LU/7"-(YU/dd ddL)  ԀVerificationofpublic/nonprofitstatus#  )#% LU/7+-(ZU/dd ddL LU/7".@*[U/dd ddL_ )  No_conflictstatement/Board#  )Y#I;1/.@*\ U/dd ;Ѐ/4+\ (,[(X  X  p ABSTRACT: # p#XX     # XXڔ#&% Provideabriefoverviewoftheprojectbyenumeratingtheprincipalactivitiesandpurchasesbeingproposed  forfundingintheproject.Also,ifapplicable,includethenumberofchildrenwhoreceivesubsidized t paymentsfrom_SRS_ . L ________________________________________________________________________________ |$ SAMPLEABSTRACT:J# %&@#&%  T 9XX,XF` X98  TheimprovementsweplantomakearedocumentedontheattachedRI/AIPlanForms.We ,  # %&疗#&% will: ` 1.purchasenewlinoleumandhaveitinstalledinourdiningareaandkitchen        `  A 2.purchasearubberizedmaterialandhaveitinstalledforourplayground       `  A 3.purchasesomenewplaygroundequipment  \     `  A 4.havevolunteersinstallanewfencearoundtheperimeteroftheplayground  4  0  0` (#(#0A ` (#` (#    h   # %&砘#&%  A (#A (# TotalNumberofchildren# %&6#&% Ԁserved:74󀀀Numberofthosechildrenwhoaresubsidizedby_SRS_:17# %&秛# <  1   ABSTRACT:   *Ud ddd K dd K +U.(#(#,hdd ,dd +  DD  ! `#!* !&% TotalNumberofchildren# %&羝#&% Ԁserved:# %&# $`"+   $`", &% Numberofthosechildrenwhoaresubsidizedby_SRS_:# %&瞞# $&#-  " $&#. " p Authorized# pv#p ԀAgencyOfficial # pŸ# * '8%/ * p Name # pD# '8)&0 ' p # p#p Title # p# 8)&1   *(2   *(3  p Signature # p# '8,)4 ' p Date # p# 8,)5   -+6  -+7   /@-8 /_ X   p REGULATORYIMPROVEMENTPLAN  (RIPlanForm) # p#  XX   ThisformistobeutilizedbyalicensedChildCareCenterwhichisapplyingto_SRS_Ԁfor_CCDF_  ( fundsinordertomakeimprovementsrelativetotheregulationsof_KDHE_,theStateFire  Marshall,orotherregulatoryagencies.   INSTRUCTIONS: TheChildCareCenterwhichisapplyingfor_CCDF_Ԁfundsisto:# XXܝ#p   # pݥ#p ! ! (Ť886,XXXX6  ""  # p4#72Ť  1  .3  8 r   ListimprovementsonthisformthatwillbenefitchildrenatitsCenterandidentifytheregulationthat  addresseseachone.Listthemostneededimprovementfirst.Improvementsmaybeforanything m pertainingtoaregulationthatcostsmoneytoimprove,suchassuppliesforchildrensactivities, 1 P  playgroundequipment,firealarms,etc.7݌  rf!rf! Ќ    ""  ȩ2Ť  2  .3  8 r   Discussyourtentativeregulatoryimprovementplanwiththepersonwhoisyourlicensingsurveyoror   regulator.ȩ݌} rf!rf! Ќ   M(08""    2  3  .3  8 r   CompletethisRIPlanform.Ifmorethanthreeimprovementsareneeded,listthemonasecondsigned A `  form.Alsouseasecondformifimprovementsarerequiredbydifferentregulatoryagencies.Ϋ݌ $ rf!rf! Ќ    ""  J2  4  .3  8 r   Haveyourlicensingsurveyororotherregulatorcompleteandsignthebottompartofthisform.Jw݌ rf!rf! Ќ    ""  ~2  5  .3  8 r   Submitthisformalongwithyour_CCDF_Ԁapplicationto_SRS_Ԁbythegrantdeadline.~݌ rf!rf! Ќ    ""  2  6  .3  8 r   If_CCDF_Ԁapplicationisapprovedandfundedby_SRS_,maketheimprovementsperthegrantterms.p ݌Qprf!rf! Ќ    # p#ThisRegulatoryImprovementPlanisfor: 'F *Uddhdd hdd U(#(#,dd ,'dd ,dd ,dd +  $   $Date: "On " ! On !CenterName/Licensee: " " !  !Lic#(ifany): " " !  !Address: "Wv " ! Wv !Fax#0  (   (   Phone#:      p B" ,XXX,XXB# p#XX # XXE#XX PersonCompletingForm: ! *Udddd 'dd 'dd dd U(#(#,Fdd ,dd , dd , dd +  4pSr$Sr 4# XX܇#Regulation# Ap,!%"p ACosttoMake & Improvement Ap,!y'"p ABrieflyDescribe ( Improvement Ap,!y)"p ADescribeHowItWillComply * withtheRegulationXX  WM&y+"  p : ?1.?W# XXܴ#Ԁ1. =31,  ?1. ? =Ѐ$ 5+ -  ?1.?5Ѐ1. .  TJ(W v0  ?1. ?  ?1.?TЀ1. 1  ^T-W v3  ?1. : ?  @2.@^Ѐ2. =31 #("4  @2. @ =Ѐ$ 5+  #("5  @2.@5Ѐ2.  #("6  TJ($#8  @2. @  @2.@TЀ2.  #("9  ^T-$#;  @2.  @ e @3.@^Ѐ3. =31#'B&<  @3. @ =Ѐ$ 5+ #'B&=  @3.@5Ѐ3. #'B&> XX  TJ(('@  @3. @  @3.@TЀ# XXܞ#3XX . #'B&A =31((C  @3. e  @ = # XX7# .  //J ЇTo# . н# . Ԁtheregulator: IsImprovement#1(enterA,B,C,orDfromchoicesbelow)_________ Qp    r    ` IsImprovement#2(enterA,B,C,orDfromchoicesbelow)# . 6# . _________ $    r    ` IsImp# . O# . rovement#3(enterA,B,C,orDfromchoicesbelow)_________   A) Required tobemadewithinthisyeartomeetregulations  e  B) Probablywillberequired withinthreeyearstomaintaincompliance  8   C) Notneeded (Improvementnotneededfor3+years,ornotneededtomeet_regs_Ԁatall);or    D) Notapplicable (EnterDif itemblank,ornoregulationgovernsthisimprovement,etc.)# . # .    Feelfreetomakecommentsatbottomofthissheetifyouwishtoexplainyourresponse.Then, 5 T  signbelowandreturnformtoCenter.Forquestions,phone_SRS_Ԁat(785)3688127.    *UddFdd Fdd  dd dd U(#(#,dd , dd ,dd , dd +  )E d E d  )# . T#XX PrintName:# XX# .  -#! " - 6,! " 6# . G#XX Signature:# XX# .  -#! " - ;1& "   ;# . 8#XX Date:# XX# .  ) H    ) H  # . )#XX ԀPhone:# XXܧ# .  ) H   " ) H  "# . #XX NameofRegulatoryAgency:# XXu# .  %  %       r # . #p   # pm#XX # XX#p # p#XX # XXF# p v!p   #) v!##  )#Xp   ACCREDITATIONIMPROVEMENTPLAN  (AIPlanForm) # p2#XX   ** # XX#p KANSAS# p##p  **# pk#p   ( # p#&%   ThisformistobeusedbyChildCareCenterswhichapplyto_SRS_Ԁfor_CCDF_Ԁfundsinordertomake 3R improvementsthatwillcomplywiththeaccreditationstandardsof_NAEYC_Ԁor_NSACA_.  * * INSTRUCTIONS: TheChildCareCenterwhichisapplyingfor_CCDF_Ԁfundsisto:  ";"    ;.0  2  1  .3  0r(#(#  ListimprovementsonthisformthatwillbenefitchildrenatyourCenterandidentifythe  accreditationstandardthataddresseseachone.Theseimprovementsaretobeprioritized,withthe o   mostneededimprovementlistedfirst.Improvementsmaybeforanythingrelatedtoaccreditation G f  standardsandthatcostsmoneytoimprove,suchassuppliesforchildrensactivities,playground  >  equipment,facilityrenovations,etc.;.g݌  r(#r(# Ќ  ";"  ;0  2  2  .3  0r(#(#  CompletethisAIPlanform;ifmorethanthreeimprovementsareneeded,listthemonasecond   signedform.Faxform(s)to_NAEYC_Ԁor_NSACA_Ԁaskingthemtosign,andfaxform(s)backtoyou.;C݌ r(#r(# Ќ  ";"  ;0  2  3  .3  0r(#(#  Submitthisform(andits_NAEYC_ԀReadinessSurvey,or_NSACA_ԀStandardsataGlanceSurvey)   alongwithyour _CCDF_Ԁapplicationto_SRS_Ԁbythedeadline .;0݌Wvr(#r(# Ќ  ";"  ;#0  2  4  .3  0r(#(#  Ifthe_CCDF_Ԁapplicationisapprovedandfundedby_SRS_,maketheimprovementsperthegrant /N terms.# %& #XX ;#P݌&r(#r(# Ќ  # XXܕ#p [# p#XX   NameofCenter:__________________________  Address:____________________________  NameofPerson    h      p ____________________________  # XXm#XX Completingform:_________________________0  Phone:(____)________________________(#(#    r    `     h     Fax:(____)________________________T+ ,X` XX ,XXXT# XXܲ#XX   *Udddd  dd dd  dd U(#(#,Fdd ,dd , dd , dd +  4p 4 # XXW#Accreditation  Standard#XX  Ap,!"p A # XXs#CosttoMake  ImprovementXX  Ap,!"p A # XX(#BrieflyDescribeImprovementXX  Ap,!"p A # XX#BrieflyDescribeHowItWill  ComplywiththeStandardXX  WM& "  p  ?1.?W# XXܟ#Ԁ1. =31 ,!  ?1. ? =Ѐ$ 5+  ,"  ?1.?5Ѐ1.  ,#  TJ(%  ?1. ?  ?1.?TЀ1.  ,&  ^T-(  ?1.  ? e @2.@^Ѐ2. =31)  @2. @ =Ѐ$ 5+ *  @2.@5Ѐ2. +  TJ(^}-  @2. @  @2.@TЀ2. .  ^T-^}0  @2. e @  @3.@^Ѐ3. =31;"Z!1  @3. @ =Ѐ$ 5+ ;"Z!2  @3.@5Ѐ3. ;"Z!3 XX  TJ(#"5  @3. @  @3.@TЀ# XX܉#3XX . ;"Z!6 =31$2#8  @3.   @ =****************************************************79 %$8  # XX"#  XX To_NAEYC_Ԁor_NSACA_: Whiletheremaybeotherimprovementsneededtomeetaccreditation &%9 standards,aretheabovelistedimprovementsreasonablyneededinordertocomplywiththeir '&: respectiveaccreditationstandards. n(';    IfYES ,pleasesignbelowandfaxbacktotheCenter. Z)y(<   IfNO ,pleasephonetheCenterandexplainwhyyoucannotsign.Thankyou.# XX܀# J*i)= tXX # XX#XX PrintName:______________________________ @ Signature:___________________________ &,E+? Date:____________Phone:(____)___________CheckOne:_NAEYC______NSACA_____# XXI#  --A X/g HNTIMETABLEFOROBTAININGACCREDITATION# # X   Fromeither_NAEYC_Ԁor_NSACA_ # ^#  ~& # #XX ActivitiesforProgramsSeekingAccreditation J  @  @r  @  @`  @ # XXW#  @  @r # #  AGENCYNAME:_______________________CENTERADDRESS:_______________________ \ DATE:____________ 0 0 (# (#0h(#(#0h(#h(#0(#(#0p(#(#_________________________  @!  @!  @!  @!  @!  @!  @!  @!  @!  @! x p(#p(# PURSUING____NAEYC_Ԁ___NSACA_ <  - ____________________________________________  ___________________________________ L   PrintnameofCenterStaffPersonLeading h     0 p JobTitle p(#p(# ЀtheAccreditationEffortatYourCenter h      p a2   # 2a#-  |   INSTRUCTIONS: 0 Entereithertheactualdateortheestimatedtargetdateforcompletionbyeachenumerated \  activityinPartsA,B,C ԀCandhԀD. UseMonthsandYearsonly,forexample, 10/05"for "  October,2005. ThencompletePartsE.Centerspursuingaccreditationoftenfindthatit   takesfrom24yearstomakeimprovementsneededtobecomeaccredited.R (# (# e*UddFdd Fdd  dd dd Ue(#e(#,dd , dd , dd +  '22 ' ACTUALor  >  TARGET   DATE Ip42"w I _NAEYC_  8p#!>"p 8 _NSACA_  6,&>"  p 6    f A.BEGINNINGACTIVITIES  g ___________ 8 ___________ H ___________ $   ! ! (80M""  2  1  .3  8   Download ReadinessSurvey 8% 4D O  5  www.naeyc.org/accreditation/support.htm6O  7%݌&   Ќ  ""  2  2  .3  8   Complete ReadinessSurveyper ,( instructionsonsurvey*݌H)   Ќ  ""  2  3  .3  8   Develop ProgramImprovementPlan(PIP) <, aspartofReadinessSurvey*0݌ (X-   (Ќ  ! ! (88""  2  1  .3  8    Obtain StandardsataGlance 8. 4O  5  www.nsaca.org/standardsglance6O  7 ݌/!! Ќ    ""  2  2  .3  8    Complete StandardsataGlance .1 bywriting Met, PartMet,or J2  NotMetbyeach#*!݌3!! Ќ  ""  U2  3  .3  8    Develop(PIP)Plan;address Part >5 Met& NotMetitemsfrom Z6  StandardsataGlance*U݌ (7!! (Ќ    TARGET v8 DATE "89  " B.SELFSTUDYACTIVITIES  v: ___________  6; ___________ &%"A ___________ 6(%E   ! ! (88""  g2  1  .3  8   Applyto_NAEYC_ԀandpaytheSelfStudy  6F applicationfee($125$300est.)g݌R!G   Ќ  ""  2  2  .3  8   CompleteSelfStudy,consultingwith b$ "K _NAEYC_Ԁstaffasappropriate݌&%"L   Ќ  ""  2  3  .3  8   Makeprogramimprovementsindicatedby &V$N _NAEYC_ԀSelfStudy݌ (r'%O   (Ќ    ! ! (88""  2  1  .3  8    Purchasethe_NSACA_Ԁ Standardsof  6P Quality,the SelfStudyand R!Q AccreditationKit,orderformon "R Website($150est.)݌" S!! Ќ  ""  {2  2  .3  8    CompleteSelfStudy,consulting b$ "U with_NSACA_Ԁstaffasappropriate{݌&%"V!! Ќ  ""   2  3  .3  8    Makeprogramimprovements &V$X indicatedby_NSACA_ԀSelfStudy  ݌r'%Y!! Ќ  "6(%Z  "XX Ԁ*ThesetwoitemsneedtobeattachedasAppendixAtothe_CCDF_ԀGrantApplication. )'[ # XX #  Continuedonnextpage b, *^ -  -+` N  ,XwX   *Udddd  dd dd Ue(#e(#,edd , dd , dd +  ',, ' TARGET  DATE Ip42" 7 I _NAEYC_  8p#!d"p 8 _NSACA_  6,&d"  p 6    C.ACCREDITATIONACTIVITIES  `4 ___________ 0 ___________ @  ___________  `  ___________ pD ___________ D ! ! (Ť88  ""  2Ť  1  .3  8    Prepare ProgramDescription;sendto 0 _NAEYC_Ԁw/payment($300700est.)݌ J J Ќ  ""  2Ť  2  .3  8    Supplyadditionalinformationto_NAEYC_Ԁif |P! itsstaffrequestitL݌@" J J Ќ  ""  [2Ť  3  .3  8    Schedulewith_NAEYC_ԀanOnSite  $ ValidationVisit.Theseareusually  ` % conductedbytwohighlyqualifiedprogram P $ & directors.Validatorsadvise_NAEYC_Ԁonthe  ' accuracyoftheProgramDescription[݌ ( J J Ќ  ""  r2Ť  4  .3  8    Receivedecisionafter_NAEYC_ԀCommission $ + DecisionPanelreviewsallmaterialsand , decideswhetherornottoaccreditprogramr݌- J J Ќ  ""  2Ť  5  .3  8    SubmitanAnnualReportto_NAEYC_Ԁthat 4/ addressescontinuedcompliancewiththe 0 standards,whentheProgramhasreceived 1 thethreeyearaccreditation,݌  (T2 J J (! ! (դ88  ""  n2դ  1  .3  8    Prepare Applicationfor_NSACA_ 03 Accreditation&sendto_NSACA_n݌4!! Ќ  ""  2դ  2  .3  8    Supplyadditionalinformationto |P6 _NSACA_Ԁifitsstaffrequestit݌@7!! Ќ  ""   2դ  3  .3  8    Schedulewith_NSACA_ԀanOnSite  9 EndorsementVisit.Theseareusually  ` : conductedbytwohighlyqualified P $ ; programdirectors.Endorsersadvise  < _NSACA_Ԁontheaccuracyofthe  = Applicationfor_NSACA_ԀAccreditation) 8݌ p >!! Ќ  ""  f2դ  4  .3  8    Receivedecisionafter_NSACA_ $ @ CommissionDecisionPanelreviewsall A materialsanddecideswhetherornotto B accreditprogramf݌pDC!! Ќ  ""   2դ  5  .3  8    SubmitanAnnualReportto_NSACA_ E thataddressescontinuedcompliance F withthestandards,whentheProgram TG hasreceivedthethreeyearaccreditation 4 ݌  (DH!! (  TARGET pI DATE "^2J  "! ! (:88   ""  "2:  D  .3  8    OTHERSIGNIFICANTDATESANDACTIVITIES ""݌pK ! ! Ќ  IndicateothersignificantactivitiesanddatesforyourCenter(forexample,reviewofpreviously ^2L completedReadinessSurveyorofStandardsataGlance;updateandreviseProgramImprovement "M Plan;conductparent,staff,orboardmeetingrelatedtopursuingaccreditation,etc.) !N !___________ >O ___________ Q ___________ N"S  T ! ! (5h88""  G&25h  1  .3  8    G&t&݌>U J J Ќ  ""  '25h  2  .3  8    '>'݌W J J Ќ  ""  '25h  3  .3  8    '(݌N"Y J J Ќ   Z ! ! (5h88""  [)25h  1  .3  8    [))݌>[!! Ќ  ""  %*25h  2  .3  8    %*R*݌]!! Ќ  ""  *25h  3  .3  8    *+݌N"_!! Ќ   `     E.SUPPORT `  Accreditationorganizationsoftenindicatethatitisimportantfora S{  CenterseekingAccreditationtohavesupportfrom a anotherindividual.Thispersoncouldbefroma"buddy"site(alsopursuingAccreditation),ora"mentor"site(one  db whichisalreadyAccredited),orsomeoneelse.Thepersonwhoprovidesthe"support"isthekey:theyshouldbeable X!, c tovisitwithyoueverymonth,helpwithmotivationandtechnicalassistance,andingeneralbeone#  {e,#{  whoiscommitted  " d toseeingyourCenterachieveAccreditation.#  {s.#{   "!e c1,X` X7DX ,X` XXcDoyouhaveapersonwhoiswillingtofillthe supportroleforyourCenter?___YES___NO $"f  F If NO ,then_SRS_ԀwillworkwithyouandyourAccreditingbodytofindsuchaperson. %#g  F If YES ,pleaseindicatethispersonsname,phone#,employerandrole: 9& %h {XX {Name:_____________________________ u   Role:  ___Buddy#XXX{X/#{XXXX o(C'j EMail:___________________________ u     ___Mentor )^(k Employer:#XXX{Xܶ1#__________________________ u     ___Other(pleasespecify)_____________ *y)l  S{XXXXPhone#:___________________________#{ X{X!1##  {3# +*m -,    XX  /.r _ԇOTHERFUNDSOURCES# XX3#XX  , forCCDFQualityEnhancementProject   A.OTHERFUNDS :Doyouhavefundsfromothersourcesgoingintotheseimprovements?  (# XXj4#Othersourcesmayincludefundsfrom:businesses,privatefoundations,UnitedWay,SmartStartKansas,Kauffman  Foundation,yourownagency,proceedsfromfundraisers,orproceedsfromsmallerdonationsfromindividuals,etc.)  ___YES___NO d   If YES ,indicatethesources,iffederalfundsornot,andtheamountsbelow(alsoincludetheseamountsin Column2   ontheProposedProjectBudgetform):   6*Uddedd e dd dd Ue(#e(#,dd ,dd +  +f : f :  + CASHFUNDSOURCE  @  / FEDERALFUNDS 8#! " 8 3-8AMOUNT XX  2(& "   2A. $  ЀYesNo  n  Ѐ$  $   L(88! !""  :2  B  .3  8    ::݌     ЀYesNo# XXU9#XX  d  Ѐ$    ""  Z<2  C  .3  8    Z<<݌    ЀYesNo# XX<#XX  %Z %Ѐ$(   (# XX܎=#XX *~Udddd dd Ue(#e(#~,dd ,dd +  # # @  @  @l  @  @;  @  @t  @ TOTAL: # XX!>#XX  0&!|P" 0  Ӏ$6,*|P   6@8  B.NONCASHCONTRIBUTIONS :Doyouexpectanyinkind,noncashcontributionsgoinginto X theseimprovements?(Inkind,noncashcontributionsinclude:donatedlaborbyabusiness,the tH estimatedvalueofcommunityvolunteerhelp,freerent,donatedgoods,etc.)___YES___NO `4 If YES ,indicatethesource(s)andtheamountsbelow(alsoincludetheseamountsin Column3 on 8  theProposedProjectBudgetform): ( *~Udddd dd Ue(#e(#~,dd ,dd +  +! + INKIND,NONCASHSOURCE # XXܱ?#XX  8#!d8"" 8 ESTIMATEDVALUE# XXC# XX  2(&d8#"   2A. $  Z.% Ѐ$  &  L(88L! !""  E2  B  .3  8    EE݌   '  P$( Ѐ$  ) ""  F2  C  .3  8    FF݌    *  %F! + %Ѐ$( ,   (# XX]D#XX *~Udddd dd Ue(#e(#~,dd ,dd +  #"!-"! # @  @  @l  @  @;  @  @t  @ TOTAL: # XXG#XX  0&!<#"." 0  Ӏ$6,*<#"/   6I~C  # XX܃I#XX  C.COMPLETIONDATES :Listeachimprovementandtheestimatednumberofmonthsby D%$0 whichtheimprovementistobecompleted;e.g.,6monthsafterreceivingaNotificationofGrant 4&%1 Award(NOGA)fromSRS.   '%2 *~Udddd dd Ue(#e(#~,dd ,dd +  + (&3 (& +f # XXmJ#EST.#OFMONTHS(FollowingNOGA) p(D'4 NeededtoCompletetheImprovement  @  8#!)'5" 8 IMPROVEMENT 0 @ 2(&)'7"   2 (5h88L""  ! !FN25h  1  .3  8    ____MonthsFNN݌t*H)8 Ќ  ""  P݌4-,< Ќ  ""  P25h  4  .3  8    ____MonthsPQ݌.h-> Ќ  D/.? ! ! (5h88""  zR25h  1  .3  8 1   zRR݌t*H)@1!1! Ќ  ""  DS25h  2  .3  8 1   DSqS݌+*B1!1! Ќ  ""  T25h  3  .3  8 1   T;T݌4-,D1!1! Ќ  ""  T25h  4  .3  8 1   TU݌#.h-F1!1!  #Ќ  fL     XX  80 /F  /g H  w ,,   PROPOSEDPROJECTBUDGETQEGRANT , # XXU#U *NUOdddd dd Ue(#e(#, dd ,dd +    EXPENDITURE Z CATEGORIES  H   SOURCEOFFUNDING(forproposedprojectonly) @   ӀColumn1󀀀Column2󀀀Column3󀀀Column4   GrantRequestOtherFundsOtherFundsTotalProject Z  ЀCashNonCash,InKindCost(1+2+3)  H  *PUQdd dd dd NUOe(#e(#, dd ,dd ,dd ,dd ,dd +  : : Equipment& r  EducationSupplies  `4   r   r   r   r Renovations( $20,000CCDF   limit )  | P                  ContractualServices                    Other(specify)  ,    ,    ,    , !   , " TOTALEXPENDITURES V # ($25,000CCDFlimit)  D$   V %   V &   V '  V (   FromColumn1intheBudgetabove,indicategeneralcategoriesofitemsproposedtobepurchasedwiththeCCDFfunds. ) Ѐ(Examples: in PartAbelow,write Art&CraftMaterials,orGames&Puzzles,orOutdoorToys,orBalls * Ѐ&SportsEquipment,etc. X+ 8 F PartB Replacecarpet,orGroundCoverforplayground,etc.H,FG"FG" 8 F PartC Contractwithbusiness/individualforcarpetinstallation,orforgroundcoverinstallation,etc.-FG"FG" 8 F PartD WriteinanygoodsorservicesthatdonotfitinA,B,orC).FG"FG"  A.EquipmentandEducationSupplies: ^20 B.Renovations: x3 C.Contractualservices: 6 D.Other:  09 Priortothepurchaseofanitemcostinginexcessof$500,granteesmustobtainatleasttwobidsinordertoassure zN< economicaluseofgrantfunds.Copiesofthebidsmustberetainedonfile. > = Doyouanticipatepurchasinganyitemscostinginexcessof$500?___YES___NO. ! ? If YES ,pleaselistitemsandestimatedcost(Ifyouhavealreadyobtained2bids,listthelowerbidinthemiddlecolumn "^!@ andthehigherbidinthe3rdcolumn): P#$"A  ITEM0 ' 0'(#'(#0 (#(#0  (# (# m  0 (# (# u ESTIMATEDCOST(orlowerBID)0-(#(#89HIGHERBID d$#C-(#-(#  F  '       m     u $0  0(#(#0Q(#(#0}Q(#Q(#0}(#}(#0-(#(#$%r$D-(#-(#   XX  0Z/P Ї @F  @'  @  @  @  @m  @  @  @u  ASSURANCESANDCOLLABORATION# XXf#  ,  @F  @'  @  @  @  @m  @ TobecompletedbyallApplicants  ! ! (J88  ""  XX Lh2J  A  .3  8 F   IfawardedaCCDFgrant,doesyourCenteragreeto:Lhh݌pFG"FG" Ќ   (Uh88";"  ;i0 F 2Uh  1  .3  0'F(#F(#    nothaveanyemployeebeavotingmemberofitsgoverningauthority(e.g.Board)?;ij݌\'(#'(# Ќ   F  '   ___YES___NO tH ";"  ;ik0 F 2Uh  2  .3  0'F(#F(#    notallowaBoardmembertobenefitfinanciallyasaresultofaBoarddecision?;ikk݌`4'(#'(# Ќ   F  '   ___YES___NO L  ";"  ;l0 F 2Uh  3  .3  0'F(#F(#  8'(#'(#notsupplantFederal,State,localorotherexistingfundswithanyCCDFfundsawarded 8  aspartofthisapplication?___YES___NO;lm݌$  "" Ќ  ";"  ;qn0 F 2Uh  4  .3  0'F(#F(#  a.)obtainatleast2bidspriortopurchaseforitemsinexcessof$500?___YES___NO    b.)returntheseitemstoSRS,iftheCenterclosesordiscontinuesserviceswithin3yearsof   theendofthegrantperiod.___YES___NO;qnn݌ '(#'(# Ќ  ";"  ;lp0 F 2Uh  5  .3  0'F(#F(#  8'(#'(#complywiththetermsofthisRFP(RequestforProposals)?___YES___NO;lpp݌ "" Ќ  ";"  ;q0 F 2Uh  6  .3  0'F(#F(#  8'(#'(#complywiththeNotificationofGrantAward(NOGA)andtheTermsandConditions?;qq݌ "" Ќ   F  '   ___YES___NO   ";"  ;.s0 F 2Uh  7  .3  0'F(#F(#  8'(#'(#notuseCCDFfederalfundstosupportaprogramusingreligiousinstruction,otherthan l topurchasehealthorsafetyrelateditemswhichdonothaveanysectarianpurposeand X whicharerequiredbystateorlocallicensingregulations?___YES__NO;.s[s݌pD"" Ќ  ";"  ;>u0 F 2Uh  8  .3  0'F(#F(#  8'(#'(#timelysubmitquarterlyFinancialReportsandsemiannualProgramReports?;>uku݌\0"" Ќ   F  '   ___YES___NO H B.IdentifycollaborativeeffortsbeingengagedinbyyourChildCareCenterstaff(S),Board   members(B)and/orparents(P).Theseeffortsareonesnotspecificallyrelatedtotheproposed  projectinthisgrantapplicationbutaretoincludeparticipationonmoregeneralcommunityChild  CareinitiativessuchasRegionalSupportTeams,(RST),ICCCommittees,PDICommittees,  SmartStartKansasCommunityPartnerships,AccreditationProjectCommittees,ConnectKansas  CoalitionsinconjunctionwithRegionalPreventionCenters,etc. | @hCOLLABORATIVEEFFORTS/COMMITTEESNAMEOFINDIVIDUAL󀀀S,B,orP T   (example):0  SpokeatRSTPublicHearing03/05/010 (# (#0Q(#(#JaneDoe0Q(#Q(#0-(#(#Sl@-(#-(#  /.3 Ї  ASSURANCES  ,  RelatedtoSpecialFunds  ЄSmartStartKansas(SSK)andX& XXXKauffmanFoundation#XX XX&9{#Ԁ(KF)    XX  IfyouragencyislocatedinoneoftheCountiesbelow(orisotherwiseeligibleforfundingfromSSKorKF),thenthis  formneedstobecompletedaspartofthisCCDFapplication.Completethisformevenifyoudidnotpursueanyof t theapproximately$4Millionof SpecialFundsavailble d8  )  *SSKCounties: Sedgwick,Saline,Riley,Douglas,Johnson,Wyandotte,Leavenworth,Crawford,Cheyenne, ( Rawlins,Decatur,Sherman,Thomas,Sheridan,Graham,Wallace,Logan,GoveandTrego. * KF#  )C}#)  ԀCounties: Johnson,  Wyandotte,andLeavenworth.#  )k~#)  Ԁ#  )~#   ! ! (դ88""  2դ  1  .3  8 F   8'FG"FG"CircletheCountyaboveinwhichyouarelocated.݌<  'f!'f! Ќ  2.a)8 ' ForthisproposedprojectinthisCCDFapplication,haveyoucontactedyourlocalSSKCommunity   Partnershipaboutfunding?___YES___NO___ \ 'f!'f!  F 8 ' IfYES,whatwastheresult&willyouseekitsfunding?0'f!'f!IfNO, whywasntitcontacted?L f!f! f.e e m XQ}X,X` X7DXfӀb)8 ' ForthisproposedprojectinthisCCDFapplication,haveyoucontactedKFaboutfunding?___YES \0 ___NO___NotinaKFCOUNTY 'f!'f!   8 ' IfYES,whatwastheresult&willyouseekitsfunding?0'f!'f!IfNO, whywasntitcontacted?f!f! 3.a)8 ' Foranyotherprojectorreason,haveyoucontactedyourlocalSSKCommunityPartnership?___YES  ___NO'f!'f!  (Z88""  ݀2Z  b  )3  8 '   Foranyotherprojectorreas)XX {)m  XXz4   m3  zX36X4zXX6XzX3  % XX%on,haveyoucontactedKF?___YES___NO݌|P'f!'f! Ќ  ""  ݀2Z  c  )3  8    IfYEStoa)and/orb),pleaseexplain:݌@!! Ќ  4.a)8  Whatisthename,phonenumberandEMailaddressofthecontactpersonforyourlocalSSKCommunity P$  Partnership?(SRSmayinquireaboutyourCenterspotentialeligibility.)!!!   8 ' Name:____________________0'f!'f!Phone()______________EMail:_____________"f!f! ! ! (j88""  ݀2j  b  )3  8 '   Whatisthename,phonenumberandEMailaddressofthecontactpersonattheKF?(SRSmayinquire p# aboutyourCenterspotentialeligibility.)(LeaveblankifnotinaKFCounty.)G݌`4$'f!'f! Ќ    8 ' Name:____________________0'f!'f!Phone()______________EMail:_____________$%f!f! ! ! (%88""  2%  5  .3  8    8'!!DescribeyourinvolvementwiththeyourlocalSSKCommunityPartnershipand/orKFsinceJuly1, ' 2000.IncludeSSKorKFcommitteesyouhaveservedon,madepresentationsto,etc.;indicatedatesof p D( committeeservice,presentations,etc.Byanylisteditems,put SSKor KF,asappropriate.(Usethe 4! ) backoranadditionalpage,ifnecessary.) ݌! *'f!'f! Ќ  { @   @'  @ DATESSK/KF @  @  @  @  @  @ INVOLVEMENT 󀀀 #T",   (example):04/07/010 0m (# (#SSK0 m (#m (#0 (# (#0u(#(#0u(#u(#0(#(#PresentedtoSSKGrouppreparingF$#-(#(#    '       m     u     CommunityNeedpartofSSKapplication  %#. #XX Q# pXX  %$/   SUPPLEMENTALINFORMATION #XXp#pXX , #XXp# XXTobecompletedbyallApplicants @ #XX ^#  1.Addressofsitewhereprogramoperates0 u _________________________________________u(#u(#    ' 0  0 (#(#0  (# (#0m (# (#0 m (#m (#0 (# (#_________________________________________(#(# 2.Hoursofoperation0 _____________________________________________________ (# (# 3.Monthsofoperation_____________________________________________________ t 4.Currentlicensecapacity0 ________________` (# (# 5.Currentenrollment________________ x L  6.NumberofSRSchildren________________ d 8  7.Numberofchildrencurrentlyservedbyage:0to3years򀀀3years򀀀4years򀀀 P $  Ѐ5years򀀀Schoolage򀀀 <   8.Whatareyourhourlyrates? (  ЀInfant(012months)__________0 u 0u(#u(#Preschool(26years)__________ (#(# ЀToddler(12years)__________ u 0  SchoolAge(613years)__________ (#(# 9.Whatadditionalfeesarepartofyourprogram?_____________________________________    ___________________________________________________________________________  ݔ  10.Currentnumberofstaff:Fulltime______________0 Q Parttime_______________pQ(#Q(# ЀNumberofStaffwhoahaveCDA_______________ \ ЀNumberofStaffworkingtowardCDA____________ tH 11.Isalternativecareavailable XX(evenings,2ndor3rdshift,weekends,etc.)#XX X#?Yes_____No_____ L  12.DoesyourprogramparticipateintheChildandAdultCareFoodProgram(CACFP)? $   Yes_____No_____  13.Haveyourecei