STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY     CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

CALWORKS CHILD CARE REQUEST FORM AND CHILD CARE
PAYMENT RULES

NOTICE: You may be eligible for CalWORKs Stage One Child Care

The county pays for child care for children under age 13, and for children up to age 21 with disabilities.

MY CHILD CARE RIGHTS

• I have a right to receive child care services to help meet my family's needs. For example: housing
• search, domestic violence or mental health counseling, court and medical appointments, or other similar activities.
• I have a right to child care so that I can go to any Welfare-to-Work (WTW) activity or work.
• My child care will be authorized for 12 months, so that my children get stable, reliable care. I have the right to have child care in place before I need to show up for required activities or
• appointments.
• I have a right to full-time child care, unless I choose part-time care.
• I have a right to child care as a WTW volunteer, if I choose to participate in activities but don't have to.
• If I don't want child care now, I can ask for it later.

WHO CAN BE MY CHILD CARE PROVIDER?

You can choose who will take care of your child(ren You can choose a child care center, a licensed family child care provider, or a family member, friend or neighbor. If you choose a family member, friend or neighbor, they may need to get fingerprinted. Please see the TrustLine section on the back of this form.

HOW DO I ASK FOR CHILD CARE?

You can get child care by asking your county worker, at your On-line CalWORKs Appraisal Tool (OCAT) assessment, or by submitting this form or any request in writing. You should ask for child care as soon as you know you will need it. Child care will be approved when you get approved for cash aid.

HOW DO I FIND CHILD CARE?

The local Child Care Resource and Referral Agency (R&R) can help you find the best child care option for your family. You can visit or contact them using the information below, or you can call the California Resource and Referral Network at: 1-800-KIDS-793.

If you answered No to questions 1, 2, or 3 above:

Even if you don't need child care now, you can ask for child care at any time.

CHILD CARE RULES: TRUSTLINE

Your child care provider must be eligible before they can get paid. An eligible provider is a licensed child care provider, a provider who has cleared the TrustLine fingerprinting and background check process, or a provider who doesn't have to get TrustLine registered. If you choose a child care provider who is required to be TrustLine registered, the county will only pay your provider if they clear TrustLine. Once your child care provider is TrustLine registered, the county will pay for child care for up to 120 days from the date you asked for child care or when the child care began, whichever is later. A grandparent, aunt, or uncle of the child(ren) does not need to be TrustLine registered but must turn in a form called a Declaration of Exemption from TrustLine Registration and Health and Safety Self-Certification (CCP1).

TWO-PARENT FAMILIES

In two-parent families, if one parent is able and available to care for the child(ren), the county will not pay for child care. A parent is considered available to provide care unless they are working (or sleeping after working), doing a county-approved WTW activity, or have a condition verified by a doctor, that prevents them from caring for the child(ren

CERTIFICATIONS

I understand that if I choose a child care provider who is required to be TrustLine registered, the provider is not eligible for any reimbursement if they do not get TrustLine registered. I understand that I do not have to go to any Welfare-to-Work (WTW) appointment or activity unless I have found child care that will accept child care payment from the County. I understand that I must tell my worker as soon as I need child care. I understand that I need to ask for child care within 30 calendar days from the first day I received child care services for my provider to get fully paid.