Form Dshs 07-106a - Ccsp Eligibility Waitlist Letter printable pdf download

CUSTOMER SERVICE CONTACT

CENTER PHONE NUMBER

CENTER FAX NUMBER

CHILD CARE SUBSIDY PROGRAMS (CCSP)

CCSP Eligibility

CLIENT IDENTIFICATION NUMBER

DATE

Waitlist Letter

Seasonal Child Care

Working Connections Child Care

Waitlist

You are eligible for child care subsidy benefits. However, due to funding limitations the number of families receiving

subsidies is capped and there is currently a waitlist to receive these benefits. You have been placed on this waitlist

beginning:

. We will contact you in writing when space is available.

When space becomes available, names are removed from the waitlist and eligible for provider payment in order of the date

the application was received by DSHS. We cannot guarantee child care assistance by a specific date.

When the box below is checked, we approved your application and placed you on the waitlist based on your

expected wages and work schedule.

Within 60 days of this notice you must verify your actual income, or you will be removed from the waitlist on

. If removed from the waitlist you will need to reapply for child care subsidy benefits.

WAC 170-290-2240

Verification examples include: pay stubs, payroll history from your employer, or a written statement from your employer

that lists the exact gross income received since you were hired. We have also attached an Employment Verification form

which your employer can complete.

You application was waitlisted for the following approved activities:

Employment

School

Other:

Basic Food Employment and Training (BFET) / Resources to Initiate Successful Employment (RISE)

When space becomes available, we will send a notice advising you of your eligibility dates and copayment.

WAC170-290-0001 requires that families are given priority access and are not placed on the waitlist if they meet eligibility

criteria and they:



Participate in the Early Head Start-Child Care Partnership



Currently receive TANF or are curing TANF sanction;



Have a child with a verified special needs under WAC 170-290-0220; or



Are a teen parent, and



Are not living with their parent or guardian, and



Are attending high school and that high school has a school sponsored, on-site child care center.



Are homeless according to the McKinney-Vento Act



Have previously received Working Connections or Seasonal Child Care within thirty days of their application.

If you believe you meet one of the priorities, please contact DSHS at the numbers listed above.

It is important that you contact us at the numbers listed above if you move to provide us with your new address so we can

contact you when space becomes available.

If twelve months pass from the date of this notice before space is available, you will need to re-confirm program eligibility

when funding becomes available.

CCSP ELIGIBILITY WAITLIST LETTER

DSHS 07-106A (08/2016)

Form Dshs 07-106a - Ccsp Eligibility Waitlist Letter

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