DA Form 5221-R. Child Development Services (Cds) Family Child Care (Fcc) Certification, Denial/Revocation (LRA)

DA Form 5221-R is used for Child Development Services (CDS) Family Child Care (FCC) Certification, Denial, or Revocation within the Department of the Army. This form facilitates the certification process for FCC providers, as well as any actions related to denial or revocation of certification.

The form consists of sections where the FCC provider's personal information, program details, certification status, and reasons for denial or revocation are documented. It may also include sections for appeal information and supporting documentation.

Important fields in this form include the FCC provider's information, certification status, reasons for denial or revocation, and any supporting documents. Accurate completion of this form is crucial for maintaining accurate records of FCC providers' certification status and ensuring compliance with program requirements.

Application Example: After completing training and meeting program requirements, an FCC provider submits DA Form 5221-R for certification. This form documents the provider's qualifications and program details, facilitating their authorization to offer child care services.

No additional documents are typically required to complete this form, as it captures all necessary FCC provider certification, denial, or revocation information.

There may be alternative forms or procedures for certifying child care providers, but DA Form 5221-R is specifically designed for the Department of the Army's Child Development Services and their FCC program.