LDSS-4699. Enrollment Form for Provider of Legally Exempt In-Home Child Care and Legally Exempt Family Child Care

Form "Enrollment Form for Provider of Legally Exempt In-Home Child Care and Legally Exempt Family Child Care" is a NYS Office of Children and Family Services Form used to enroll a provider of legally exempt in-home child care or legally exempt family child care. It is used by providers to demonstrate they meet the requirements of New York State regulations and are eligible to provide legally exempt child care services.

This form consists of several sections. The first section collects basic information such as the provider's contact information, business address, legal name, and type of care provided. The next section requests information about the provider's experience and education, including any applicable certifications, professional development, and training. The third section contains questions related to the provider's business, such as the type of care offered, the number of children cared for, and the hours of operation. The fourth section requests information about the provider's background, including details about any criminal history, and the fifth section collects information about the provider's liability insurance.

Important fields in this form include the provider's name, contact information, type of care provided, hours of operation, and liability insurance information. When completing the form, it is important to review all sections carefully and ensure that all required information is provided accurately. Providers should also be aware that any false or incomplete information provided on the form may result in denial of the enrollment application.

This form is typically used when a provider is interested in enrolling in legally exempt in-home or family child care in New York State. Using this form, providers are able to demonstrate that they meet the necessary requirements to provide legally exempt child care services. The form is also used to verify the provider's background, experience, and liability insurance.

When filling out the form, providers should ensure that all sections are completed accurately and thoroughly. Providers should also be aware that additional documents, such as a background check and proof of insurance, may be required when submitting the form. Additionally, providers should be familiar with the legal requirements and regulations related to legally exempt child care in New York State.

Related forms that may be used in similar transactions include the New York State Child Care Provider Enrollment Form and the New York State Child Care Provider Update Form. These forms are used to apply for