Child Care Resources - Provider Update Your Referral Listing Form




< Go Back Provider Referral Listing Update Form Please fill out the form below to update your listing in our referral database of licensed child care providers in King County, WA. Child Care Center Name or Family Child Care Provider Name Phone number Zip code E-mail address UPDATES: Current Openings *Please update your openings every 3 weeks* Infant Toddlers Preschoolers School Age I have not made any other changes in the past three months. If you have made changes in the past three months, please enter them below: (If there are no new changes, please disregard this section) RATE CHANGE Infant Per week Toddlers Per week Preschoolers Per week School Age Per week Do you accept the DSHS subsidy (state) Yes No Do you offer a sliding fee scale (fee is based on family's income level)? Yes No Do you offer a reduction in cost for more that one child in a family? Yes No D you provide scholarships to help families pay for child care? Yes No SCHEDULE CHANGE New Hours am to pm New DaysM T W Th F Sat Sun Flexible with opening time Flexible with closing time Occasional Saturday care Occasional Sunday care Occasional evening care Occasional overnight care Part day care available Part week care available Evening care provided Overnight care provided School-age care with younger sibling ONLY LICENSED CAPACITY CHANGE Desired Capacity What are the ages you are licensed for? From to If you prefer to care for a narrower age group that what your license says, what is it? From to We will list this age range on your record - so this is the age range you will get calls for. UPDATE TO SCHOOLS SERVED Additional Schools Served SPECIAL NEEDS (Do you or your staff have any training and/or experience in providing the following accommodations? Please check all that apply) Behavior Supervision/Supports - Program structure beyond that needed by typical children Communication Supports - Understands/speaks sign language or accommodate assistive communication devices Diapering/Toileting Assistance - Assistance in managing toileting or diapering of an older child Eating Assistance - Support food preparation and feeding of older child or utilize feeding tube Health Monitoring - Care for child with chronic condition requiring adult intervention Medication Monitoring - Ensure child receives required medication and maintain recordkeeping Mobility Assistance - Modify environment and/or provide assistance to child with wheelchair, crutches, or compromised mobility Nursing Care - Access to a nurse for children requiring medical monitoring or intervention Physical Therapy - Physical therapy credential or provide activities to support child's PT goals Specialized Equipment - Provide and/or accommodate specialized equipment for child Other OTHER CHANGES such as address, licensed capacity, etc.