STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
REGISTRATION FEE WORKSHEET FOR
75TH PERCENTILE REGIONAL MARKET RATE (RMR) CEILING LEVEL
Child’s Name
Case #
(Check appropriate items A - D)
A)
TYPE OF CARE:
center based
family day care
(exclude exempt care)
(B)
AGE GROUP OF CHILD:
under 2 yrs
2 - 5 yrs
6+ yrs
(C) STATUS OF CARE:
part-time
full-time
(D) METHOD OF PAYMENT:
hourly
daily
weekly
monthly
(Fill-in E - H)
(E)
75th PERCENTILE RMR CEILING LEVEL:
____________________
(E)
(F)
ACTUAL CHILD CARE COST:
____________________
(F)
(G) REGISTRATION FEE AMOUNT:
____________________
(G)
(H) NUMBER OF MONTHS THE FEE WILL COVER: ____________________
(H)
PART I: DETERMINING WHETHER THE REGISTRATION FEE IS WITHIN THE 75TH PERCENTILE RMR
STEP 1): Is (F) GREATER THAN or EQUAL TO (E)?
IF YES, STOP PROCESS. THE REGISTRATION FEE IS NOT AN ALLOWABLE CHILD CARE EXPENSE.
IF NO, PROCEED TO STEP 2.
STEP 2): _____________________ (G) / _____________________ (H) = _____________________(I)
STEP 3):
A.
If (D) = monthly, go to Step 4.
B.
If (D) = weekly, _____________ (I) / 4.33
= _ _________________________(J)
C.
If (D) = daily, _______________ (J) / 5
= ___________________________(K)
D.
If (D) = hourly, ______________ (J) / 45 (F/T)
or 34 (P/T)
=____________________________(L)
STEP 4): __________________(F) + _________________(I, J, K or L) = __________________(M)
STEP 5): __________________(M) (adj. child care payment amount)
__________________(E) (75th percentile RMR ceiling level)
IF (M) IS EQUAL TO OR LESS THAN (E), the registration fee is within the 75th percentile RMR ceiling level, is an allowable
child care expense, and is federally eligible for reimbursement.
IF (M) IS MORE THAN (E) BUT (F) IS LESS THAN (E), the portion of the registration fee which is the difference between (M)
AND (E) is an allowable child care expense and is federally eligible for reimbursement.
SCC 12 (11/99)
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