Form ACF-118-A CCDF Tribal Plan Preprint

CHILD CARE AND DEVELOPMENT FUND
For
Tribe:
FFY 2014-2015

This Plan describes the CCDF program to be administered by the Tribes for the period 10/1/2013 –
9/30/2015. As provided for in the applicable statutes and regulations, the Tribal Lead Agency has the flexibility
to modify this program at any time, including amending the options selected or described herein.
For purposes of simplicity and clarity, the specific provisions printed herein of applicable laws and regulations
are sometimes paraphrases of, or excerpts and incomplete quotations from, the full text. The Tribal Lead
Agency acknowledges its responsibility to adhere to them regardless of these modifications.
Public reporting burden for this collection of information is estimated to average 120 hours per response,
including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the
collection of information. An agency may not conduct or sponsor, and a person is not required to respond to,
a collection of information unless it displays a currently valid OMB control number.

(Form ACF 118-A; OMB Approval Number: 0970-0198, expires XX/XX/XXXX)

TABLE OF CONTENTS
Part 1 – Administration
Section 1.1 – Tribal Applicant and Designated Tribal Lead Agency
Section 1.2 – Administration through Contracts or Agreements
Section 1.3 – Estimated Funding
Section 1.4 – Indian Child and Indian Reservation or Service Area
Section 1.5 – Consortium
Section 1.6 – Program Integrity and Accountability
Part 2 – Developing the Child Care Program
Section 2.1 – Consultation in the Development of the CCDF Plan
Section 2.2 – Coordinating the Delivery of CCDF Services
Section 2.3 – Public Hearing Process
Section 2.4 – Public-Private Partnerships
Part 3 – Child Care Services Offered
Section 3.1 – Non-Exempt or Exempt Rule
Section 3.2 – Description of Direct Child Care Services
Section 3.3 – Payment System
Section 3.4 – Limitations of In-Home Care
Section 3.5 – Eligibility Criteria for Child Care
Section 3.6 – Priority Rules for Children
Section 3.7 – Payment Rates for Child Care Services
Section 3.8 – Sliding Fee Scale(s)
Part 4 – Procedures for Parents
Section 4.1 – How Families Apply for CCDF
Section 4.2 – Description of Procedures for Unlimited Parental Access
Section 4.3 – Record of Substantiated Parental Complaints
Part 5 – Activities and Services to Improve the Quality of Child Care
Section 5.1 – Needs
Section 5.2 – Goals
Section 5.3 – Activities
Section 5.4 – Relative Caregivers or other Small Home-based Providers
Section 5.5 – School-Age Care and Resource and Referral Activities
Section 5.6 – Child and Adult Food Program (CACPF)
Part 6 – Health and Safety Requirements for Providers
Section 6.1 – Centers
Section 6.2 – Group Home Child Care
Section 6.3 – Family Child Care Homes
Section 6.4 – In Home
Section 6.5 – Exemptions for Relative Providers
Section 6.6 – Monitoring and Enforcement of Health and Safety Requirements
Section 6.7 – Tribal Licensing Requirements

PLAN FOR: DRAFT 02-20-13
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Appendix 1
Appendix 2
Appendix 3
Appendix 4

CCDF Program Assurances and Certifications
Child Count Declarations
Amendments Log
List of Certifications

Required Attachments

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

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Part 1 – Administration
This section provides information on how the CCDF program is administered, including the
designated Tribal Lead Agency, funding information, the administrative structure, program integrity
and accountability policies and strategies, coordination efforts, and procedures.
Section 1.1. Tribal Applicant and Designated Tribal Lead Agency
1.1.1. Applicant - Official Name of Tribe as listed in the Federal Register or Tribal Consortium
a)
b)
c)
d)
e)
f)
g)
h)

Name of the Tribe:
Name of Tribal Chair/President/Leader:
Title:
Address:
City, State, Zip Code:
Telephone Number:
Fax Number:
Email Address:

1.1.2. What is the Lead Agency designated by the Tribe or Tribal consortium to administer
the CCDF program?
The agency shown below has been designated by the Tribe or Tribal consortium to represent
the Tribe or Tribal organization as the Tribal Lead Agency. The Tribal Lead Agency agrees
to administer the program in accordance with applicable Federal laws, regulations and in
accordance with provisions of this Plan, including assurances and certifications appended
hereto. (658D, 658E) See CCDF Assurances and Certifications
(Appendix 1)
a)
b)
c)
d)
e)
f)

Name of Lead Agency:
Address of Lead Agency:
City, State, Zip Code:
Phone Number:
Fax Number:
Web Address for Lead Agency:

1.1.3. Who is the CCDF administrator?
Identify the CCDF Administrator, the day-to-day contact with responsibility for administering
the CCDF program. This person(s) will serve as the primary contact for ACF. ACF will send
programmatic communications such as program announcements, program instructions, and
data collection instructions to the designated contact identified here. If there is more than one
designated contact with equal or shared responsibility for administering the CCDF program,
please identify the co-administrator or entity with administrative responsibilities and include
contact information. (98.16(a) and (c)(1))
CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

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a) Contact Information for CCDF Administrator:
1)
2)
3)
4)
5)
6)
7)
8)

Name of Tribal CCDF Administrator:
Title of Tribal CCDF Administrator:
Mailing Address of Tribal CCDF Administrator:
Physical Address (if different from mailing address:
Phone Number:
Public Phone Number (if different than above):
Fax Number:
Email Address:

b) Contact Information for CCDF Co-Administrator (if applicable):
1)
2)
3)
4)
5)
6)
7)

Name of Tribal CCDF Co-Administrator:
Title of Tribal CCDF Co-Administrator:
Address of Tribal CCDF Co-Administrator:
Phone Number:
Fax Number:
Email Address:
Description of the role of the CCDF Co-Administrator:

Section 1.2. Administration through Contracts or Agreements
The Tribal Lead Agency has broad authority to administer the program through other governmental,
non-governmental, or other public or private local agencies. Under the statute, the Tribal Lead
Agency remains the single point of contact and retains overall responsibility for the administration of
the CCDF program. (658D(b)(1)(A), 658E(c)(3)(C), 98.11, 98.16(c)(1))
Reminder: A consortium is considered an entity of the Tribe, not a non-governmental entity, for
purposes of this section.
1.2.1. Will the Tribal Lead Agency directly administer and implement all programs funded under the
Child Care and Development Fund? (98.16(c)(1)
Yes, the Tribal Lead Agency will administer and implement all of the programs funded
with CCDF funds. (If Yes, go to Section 1.3.1)
No, the Lead Agency will not directly administer and implement ALL programs funded
under the CCDF allocations. List the names of those agencies below.
a) Agency(ies) Name and Contact Information for Provision of Child Care
Services, including the payment to child care providers.
1) Name of Administrative Entity(ies):
2) Address of Administrative Entity(ies):
3) Name and Title of the Administrator:
4) Telephone: (
)
Ext:
5) Fax Number: (
)
CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

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6) Email Address:
b) Agency(ies) Name and Contact Information for Quality Child Care Activities
described in Part 5 of this Plan, if applicable.
1) Name of Administrative Entity(ies):
2) Address of Administrative Entity(ies):
3) Name and Title of the Administrator:
4) Telephone: (
)
Ext:
5) Fax Number: (
)
6) Email Address:
1.2.2. How will the Tribal Lead Agency maintain overall control of the CCDF-funded program
administered and implemented by the entities other than the Tribal Lead Agency?
Describe:
Reminder: Descriptions should be 1-2 paragraphs or less and should provide sufficient detail
to enable a reader to understand how this process works or will work.
Section 1.3. Estimated Funding
These are preliminary ESTIMATES for information and planning purposes and may increase or
decrease once the final grant awards are issued. Note: The current CCDF Tribal grantees should
use their funding amount from the FY 2013 as an estimate pending the availability of the Final FY
2014 CCDF allocation. A new CCDF applicant should use the base amount plus approximately $50
per child to estimate its allotment for Discretionary funding, and should use approximately $90 per
child to estimate its allotment for Tribal Mandatory funding. Put in the estimated amounts of the total
FY 2014 CCDF allocations (mandatory and discretionary) for the one-year period (10/1/2013 thru
9/30/2014) that will be available on all child care and related services including funds for direct
services, non-direct services, administration, and quality. Do not include any unobligated and/or
unliquidated CCDF balances from previous years.
1.3.1. Estimated FY 2014 CCDF Funding Allocation
What is your expected level of funding for the first year of the FY 2014 – FY 2015 plan
period? The Lead Agency estimates that the following amounts will be available for child
care services and related activities during the 1-year period from October 1, 2013 through
September 30, 2014. (98.13(a))
$

Estimated Federal Child Care and Development Fund

$

Other available funding

Reminder: Total administrative expenditures over the entire three-year liquidation period
may not exceed 15% of total expenditures, not including the base amount.

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

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1.3.2. Estimated Amount of Funds to be used for Construction or Renovation
This Application does not give approval to spend funds on construction or renovation. Funds
for this purpose cannot be spent until a Tribe has applied for and received approval, through
a separate application process, from the Administration for Children and Families.
As a part of the separate construction/renovation application process, a Tribe must show that
adequate facilities are not otherwise available to carry out child care programs, and that the
lack of facilities will inhibit future program operations. Furthermore, a Tribe cannot reduce the
level of child care services, as compared to the preceding fiscal year, in order to spend funds
on construction or renovation. Procedures regarding the separate construction/renovation
application process are contained in CCDF-ACF-PI-2010-03, dated April 7, 2010 and
regulations at 45 CFR 98.2 and 98.84.
Will the Tribal Lead Agency use 2014 funds for construction?
Yes. The Tribal Lead Agency estimates that the following amount of CCDF funds
awarded in FY 2013 will be used for construction or renovation purposes:
$

(Insert the amount you will set aside for construction from FY 2014 allocation).
No.

Section 1.4. Indian Child and Indian Reservation or Service Area
1.4.1. Indian Child
Identify which Indian child(ren) will be counted in your child count. (658O(c)(2)(B), 98.80(e),
98.81(b)(2)(i) and (ii), 98.81(b)(3)(ii), 98.81(b)(4))
Reminder: While Tribes have some flexibility in defining ―Indian Child,‖ the definition
must be limited to children from federally recognized Indian Tribes, consistent with the
Child Care and Development Block Grant Act’s definition of Indian Tribe.
The Tribal Lead Agency defines Indian child as:
1.4.2. Indian Child Count
The Tribal Lead Agency determines the number of Indian children, under age 13, who reside
on or near the reservation, or service area. The Tribal Lead Agency may not count any
children who are included in the Child Count of another CCDF Tribal Lead Agency. The
Tribal Lead Agency is required to confer with all other CCDF Tribal Lead Agencies that
have overlapping or neighboring service areas. (98.81(a)(4), 98.81 (b)(4))
Complete and attach the ―Child Count Declaration‖ at Appendix #2.
1.4.3. Indian Reservation or Service Area
Programs and activities are to be carried out for the benefit of Indian children living on or near
the Indian reservation. The service area must be within a reasonably close geographic
proximity to the borders of a Tribe’s reservation (with the exception of Tribes in Alaska,
CCDF Plan Effective Date: October 1, 2013
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California, and Oklahoma). Tribes that do not have reservations must establish service areas
within reasonably close geographic proximity to the area where the Tribe’s population
resides. ACF will not approve an entire state as a Tribe’s service area. (658O(c)(2)(B),
98.80(e), 98.81(b)(2)(i) and (ii), 98.81(b)(3)(ii), 98.83(b))
Reminder: Tribes can limit services within the reservation boundaries or can go beyond
the reservation boundaries (Example: "permanent residence is within the reservation
boundaries, however the participant is attending school outside of the reservation area",
or "resides within 20 miles of the reservation boundaries", etc.).
The Tribal Lead Agency defines the Reservation/Service Area as:
Section 1.5. Consortium
A consortium representing more than one Indian Tribe may be eligible to receive CCDF funds on
behalf of a particular Tribe. The Consortium Lead Agency must list all participating Tribes and
include an attachment with separate demonstrations (e.g. resolutions) from each Tribal consortium
member indicating that the consortium has the authority to seek funding on behalf of its constituent
Tribes. If there is any change in the consortium membership, the Tribal Lead Agency must
notify ACF through an amendment to the Plan.
1.5.1. Are you a Tribal Consortium?
Yes. If Yes, a Tribal consortium must provide a list of its participating member Tribes and
include demonstrations; for example, Tribal Resolutions from the participating members
indicating that the consortium has the authority to seek funding on their behalf.
(98.80(c)(1), 98.81(b)(8)(i))
These demonstrations are provided as Attachment:

(Enter Attachment #s)

Reminder: For Alaska Native Regional Nonprofit Corporations, the list and
demonstrations are for purposes of Discretionary Funds only.
No. If No, skip to section 1.6.
1.5.2. A Tribal consortium must describe how it coordinates services on behalf of its participating
member Tribes. Include a brief summary of how the consortium is coordinating services
(including direct services) on behalf of its participating members (or ―constituent‖ members in
the case of Alaskan entities). (98.81(b)(8)(ii),98.83(c)(1))
Describe:
Section 1.6. Program Integrity and Accountability ∆
The Tribal Lead Agency, as the single point of contact for the administration of the program, is
responsible for ensuring that policies and procedures are in place to monitor programs and services,
ensure compliance with rules of the programs, and provide oversight in the expenditure of all funds,
including misspent funds and fraud prevention and recovery. (98.11(b)) (98.60(i)).

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

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1.6.1. What policies and procedures does the Tribal Lead Agency have in place to ensure that
CCDF is in compliance with all Federal and Tribal rules and regulations?
Check and summarize all that apply:
Eligibility determination and redetermination - Summarize:
Parent co-payments - Summarize:
Child care payments - Summarize:
Oversight of sub-grantees and contractors - Summarize:
Other, Describe:

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

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Part 2 – Developing the Child Care Program
Section 2.1. Consultation in the Development of the CCDF Plan
Tribal Lead Agencies are required to consult with representatives of general purpose local
governments in the development of the CCDF Plan. (658D(b), 98.12(b), 98.14(b), 98.16(d))
Definition: For the purposes of developing this Plan, consultation involves meeting with, or obtaining
input from appropriate representatives of the Tribal community.
2.1.1. Describe how the Tribal Lead Agency consulted with representatives of the Tribal
community on the development of the Plan.
Describe:
Section 2.2. Coordinating the Delivery of CCDF Services
Tribal Lead Agencies are required to coordinate with other Tribal, Federal, State, and local child care
and, early childhood development programs, including such programs for the benefit of Indian
children. (658D(b)(1)(D), 658O(c)(2)(A), 98.14 (a)(1), 98.16(d), 98.82(b))
2.2.1. Describe how the Tribal Lead Agency coordinates the delivery of CCDF-funded child care
services with other Tribal, Federal, State, and local child care, early childhood development
programs, and before and after-school care services.
Describe:
2.2.2. Describe the results of the Tribal Lead Agency’s required coordination activities with the
following agencies, if applicable:
a) Public Health (including the agency responsible for immunizations)
Describe:
b) Employment services or workforce development
Describe:
c) Public Education
Describe:
d) State Temporary Assistance for Needy Families (TANF) agency and/or Tribal TANF
agency
Describe:
Section 2.3. Public Hearing Process
The Tribal Lead Agencies are required to conduct a public hearing no earlier than January 1, 2013.
The purpose of the public hearing is to provide the public an opportunity to comment on the provision
CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

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of the child care services of the plan. Before holding the hearing, Tribal Lead Agency must provide a
20-day notice of the hearing throughout the Tribal Lead Agency’s Service Area.
Reminder: Tribal Lead Agencies must make the contents of the plan available to the
public in advance of the hearing. (98.14(a)(c)(3)) must hold at least one public
hearing and the notice must be at least 20-days prior to the established hearing
date(s).
2.3.1. Describe the Tribe’s public hearing process to provide the general public an opportunity to
comment on the provision of child care services under this plan. (658D(b)(1)(C), 98.14(c)(13), 98.16(e))
a) Date of Public Hearing Notice: List date of notice(s):
(Must be a least 20-days prior to the date of the public hearing)
b) Date(s) of Public Hearing: List date of hearing(s):
(Must be no earlier than January 1, 2013)
c) Location(s) of the Public Hearing(s):
d) How was the public notified of the public hearing? Check all that apply:
Parent Newsletter
Tribal/local Media
Posting on community bulletin board, etc.
Other (Specify):
e) How was the content of the Plan made available throughout the service area prior to the
public hearing?
CCDF Program Sites
Tribal Office
Tribal Website
Tribal Email
Other (Specify):
f)

Describe how the input from the Public Hearing(s) was taken into consideration in the in
the provision of child care services under this Plan?

Section 2.4. Public-Private Partnerships
2.4.1. Does the Tribal Lead Agency conduct or plan to conduct activities to encourage publicprivate partnerships that promote business involvement in meeting child care needs?
(98.16(d))

Reminder: Provide examples of partnerships or planned activities with the business
community or other private organizations such as foundations. If there are no
businesses, foundations, and/or charitable organizations within the Tribal Lead Agencies
service area, please indicate.
CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

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Yes. If Yes, describe these activities or planned activities, including the results
expected from the public-private partnership.
Describe:
No. If No, state reason below.
Describe:

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

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Part 3 – Child Care Services Offered
This section focuses on the child care assistance program. Tribal Lead Agencies need to describe
their efforts to inform parents about the subsidy program and application policies and procedures,
eligibility criteria, how Tribal Lead Agencies ensure continuity of care and parental choice of high
quality settings for families, and sliding fee scale and payment rate policies and procedures.
Section 3.1. Non-Exempt or Exempt Rule
Non-Exempt Tribes (CCDF allocations equal to or greater than $500,000) are required to operate a
certificate program. Certificates must permit parents to choose from a variety of child care categories
including center-based care, group home care, family child care and in-home care. (98.30(e))
Exempt Tribes (CCDF allocations less than $500,000) are not required to operate a certificate
program unless the Tribe chooses to include such services and the associated requirements in its
program (98.81(b)(5)).
3.1.1

Based on the Tribe’s anticipated CCDF allocation check which rule applies to the Tribal Lead
Agency (Check only one):
Non-Exempt (CCDF allocations equal to or greater than $500,000 for a fiscal year)
Exempt (CCDF allocations less than $500,000 for a fiscal year)

Section 3.2. Description of Direct Child Care Services
3.2.1. Check all appropriate boxes below to describe the direct child care services offered by the
Tribal Lead Agency: (658A(b)(1), 658E(c)(3)(A)&(B), 658P(5)&(6), 98.16(g)(1), 98.30, 98.50)
a) A Certificate Program
Yes, as a Non-exempt Tribe, we operate a Certificate Program as required (skip
to 3.2.1c).
Yes, as an Exempt Tribe we are not required but have chosen to operate a
Certificate Program. Exempt Tribes may choose to select ―Yes‖ if you provide the
full categories of child care.
Reminder: The terms ―certificate‖ and ―voucher‖ are often used
interchangeably but for the purposes of the Tribal Plan Preprint, we have
chosen to make a distinction between the two terms. The term "certificate"
is used to designate the program that allows parents a provider choice
from all four categories of care (i.e., center-based care, group home care,
family child care and in-home care). The term "voucher" is used for
Exempt Tribes who operate like a certificate program, but offer parents
fewer choices than the full four categories of care.
b) A Voucher Program (for Exempt Tribes Only)
The Lead Agency has the option to limit the categories of care offered to parents. The
Lead Agency has chosen to offer the following categories of care:
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Center-based

Group-home

Family-home

In-home

c) Grants or Contracts for Child Care Slots
Yes. Describe and identify any limitations:
d) Tribally-operated Center(s)
Yes, we operate tribal centers. If Yes, complete the table below.
No, the Tribal Lead Agency does not operate tribal centers.

School Age

Preschool

Age Groups Served
(Check all that apply)

Infant and Toddler

Other Services
(Describe)

Before/After School

Part-Time

Full-Time

Table 3.2.1.d. Tribal-Operated Center
Identify Tribal Centers
Types of Services
(Check
all that apply)
Center Name, City & State

Note: If the Tribal Lead Agency operates more than 8 tribal centers, please identify
additional tribal centers as an attachment.
3.2.2. Are all of the child care services identified in 3.2.1 available throughout the entire service
area? (658E(a), 98.16(g)(3))
Yes.
No. If No, describe:
CCDF Plan Effective Date: October 1, 2013
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Section 3.3. Payment System
3.3.1. Describe the child care certificate or voucher payment process using the questions below.
(658E(c)(2)(A)(iii)), 658P(2), 98.2, 98.16(k) 98.30, 98.30(e)(1)(2))
a) A description of the child care certificate or voucher. Enter Attachment #:

)

Describe:
b) When is the child care certificate (also referred to as the authorization) issued to parents?
Before parent has selected a provider
After parent has selected a provider
Other. Describe:
Non-Exempt Tribes must also answer the following questions:
c) How does the Tribal Lead Agency inform parents that the child care certificate permits
them to choose from a variety of child care categories, including child care centers, child
care group homes, family child care homes, and in-home providers? (98.30(e)(2))
Check all options that the Tribe has chosen to implement.
Certificate form provides information about choice of providers.
Consumer education is provided at the time of application.
Parent Handbook provides information on parental choice.
Agency Web site:
Other. Describe:
d) If the Tribal Lead Agency is also providing child care services through grants and
contracts, explain how it ensures that parents offered child care services are given the
option of receiving a child care certificate.
Describe:
Section 3.4. Limitations of In-Home Care (i.e., Care in Child’s Home)
3.4.1. Does the Tribal Lead Agency allow for In-home care? (98.16(g)(2), 98.30(e)(1)(iv))
Reminder: Non-Exempt Tribal Lead Agencies must allow for in-home care (i.e., care provided
in the child’s own home) but may limit its use.
No. (Use this response only if an Exempt Tribe. Otherwise, skip to 3.5.)
Yes. If Yes, check what limits, if any, the Tribal Lead Agency will choose to establish.
Restricted based on minimum number of children in the care of the provider to
meet minimum wage law or Fair Labor Standards Act.
Restricted based on provider meeting a minimum age requirement.

CCDF Plan Effective Date: October 1, 2013
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Restricted based on hours of care (certain number of hours, nontraditional work
hours.)
Restricted to care by relatives.
Restricted to care for children with special needs or medical condition.
Restricted to in-home providers that meet some basic health and safety
requirements.
Other. Describe:
Section 3.5. Eligibility Criteria for Child Care
To be eligible for services, children must: (1) be under the age of 13, or under the age of 19 if the
child is physically or mentally disabled or under court supervision; (2) reside with a family whose
income does not exceed 85 percent of the Tribe’s or State’s median income for a family of the same
size; and (3) reside with a parent(s) or someone acting in loco parentis who is working or attending
job training or an educational program or receiving or needs to receive protective services.
(658E(c)(3)(B), 658P(3), 98.20(a)(b), 98.80(f), 98.81(b)(1))
3.5.1. How does the Tribal Lead Agency define the following eligibility terms?
a) Residing with:
b) In loco parentis (refers to an individual who assumes parental status and responsibilities
for another child):
3.5.2. Eligibility Criteria Based Upon Age
a) The Tribal Lead Agency serves children from
years (maximum age is through age 12).

(indicate weeks/months/years) to

b) Does the Tribal Lead Agency allow CCDF-funded child care for children age 13 and
above but below age 19 who are physically and/or mentally incapable of self-care?
(658E(c)(3)(B), 658P(3), 98.20(a)(1)(ii))
Yes. The upper age is:
Provide a definition of physical and mental incapacity:
No.
c) Does the Tribal Lead Agency allow CCDF-funded child care for children age 13 and
above but below age 19 who are under court supervision? (658P(3), 658E(c)(3)(B),
98.20(a)(1)(ii))
Yes. The upper age is:
No.

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3.5.3. Eligibility Criteria Based Upon Work, Job Training, or Educational Program
(98.16(g)(5), 98.20(a)(3)(i)
a) Does the Tribal Lead Agency provide CCDF child care assistance to parents who are
―working‖?
Reminder: Lead Agencies have the flexibility to include any work-related activities
in the definition of working, including periods of job search.
Yes. If Yes, how does the Tribal Lead Agency define ―working‖ for the purposes of
eligibility?
Definition of Working:
No.
b) Does the Tribal Lead Agency provide CCDF child care assistance to parents who are
attending job training?
Reminder: Lead Agencies have the flexibility to include any training related
activities in the definition of job training.
Yes. If Yes, how does the Tribal Lead Agency define ―attending job training‖ for the
purposes of eligibility?
Definition job training (include attendance requirements if applicable):
No.
c) Does the Tribal Lead Agency provide CCDF child care assistance to parents who are
attending an educational program?
Reminder: Lead Agencies have the flexibility to include any education-related
activities in the definition of education, including study time.
Yes. If Yes, how does the Tribal Lead Agency define ―educational program‖ for the
purposes of eligibility?
Definition of educational program, to include attendance requirements if applicable:

No.
3.5.4. Eligibility Criteria Based Upon Receiving or Needing to Receive Protective Services
a) Does the Lead Agency provide child care to children in protective services? (98.16(f)(7),
98.20(a)(3)(ii)(A) & (B))

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Reminder: Lead Agencies have the flexibility to define protective services beyond
formal child welfare or foster care cases, including but not limited to, homeless
children. If the Lead Agency provides CCDF-funded child care to children in foster
care whose foster care parents are not working, or who are not in education /training
activities for CCDF purposes, these children are considered to be in protective
services and must be included in this definition.
Yes. If Yes, how does the Lead Agency define ―protective services‖ for the
purposes of eligibility?
Definition of protective services:
No.
b) Does the Tribal Lead Agency waive, on a case-by-case basis, the co-payment and
income eligibility requirements for cases in which children receive, or need to receive,
protective services? (658E(c)(3)(B), 658P(3)(C)(ii), 98.20(a)(3)(ii)(A))
Yes.
No.
c) Does the Tribal Lead Agency provide CCDF-funded child care to children in foster care
whose foster care parent(s) are not working, or who is not in education/training activities?
(98.20(a)(3)(ii), 98.16(f)(7))
Yes. (This means that for CCDF purposes, the Tribal Lead Agency considers
these children to be served under the protective services eligibility category.)
No.
d) Does the Tribal Lead Agency provide respite child care to children in protective services?
(98.16(f)(7))
Reminder: If Yes, you must include respite care under your definition of protective
services in 3.5.4a.
Yes, and respite care is included under the Tribe’s definition of protective
services.
No.
3.5.5. Income Eligibility
All eligible children must be under the age of 13 and reside with a family whose income does
not exceed 85% of the Grantee Median Income (GMI) for a family of the same size. The
Tribal Lead Agency may use the State Median Income (SMI) or income established by the
Tribe as the grantee’s median income. (658E(c)(3)(B), 658P(4), 98.20, 98.80(f), 98.81(b)(1))
a) How does the Lead Agency define ―income‖ for purposes of eligibility determination?
(98.16(g)(5), 98.20(b))
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Reminder: The Tribe has flexibility in developing its definition of income. This flexibility
allows for the excluding or deducting of certain types of income, as defined by the Tribe,
from calculations of total family incomes for purposes of eligibility determination.
Definition of Income:
b) The law states that Tribes may establish income eligibility for child care under CCDF not
to exceed 85% of the Grantees Median Income (GMI). The Tribal Lead Agency has
selected to use (Check the appropriate box below):
State Median Income (SMI) for a family of the same size.
State:

Effective date of SMI:

Grantee Median Income (GMI) for a family of the same size residing in the area
served by the Tribal Lead Agency.
Effective date of GMI:
c) Provide the CCDF income eligibility limits.
Income limits must be provided in terms of Grantee Median Income, even if Federal
poverty level is used in implementing the program. (98.20(a)(2))
Complete column (a) and (b) of the matrix below based on the definition of GMI in 3.5.5a.
Indicate Income Eligibility not to exceed 85% of the Grantee Median Income (GMI) in
column (b) for a family of the same size. Complete column (c) ONLY IF the Tribal Lead
Agency is using income eligibility limits lower than 85% of the GMI – identify
percentage used in calculation.
3.4.5. Grantee Median Income (GMI)

Family
Size

(a)
100% of GMI
(For calculation
purpose only)
($/month)

(b)
(c)
85% of
Income eligibility, less than 85% GMI,
GMI
if used to limit eligibility
($/month)
($/month)

1
2
3
4
5
6
7
8

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3.5.6. Additional CCDF Eligibility Criteria or Definition
Does the Tribal Lead Agency establish additional eligibility criteria, for example, higher
income limits in one part of the tribal service area? (658E(a), 98.16(g)(5), 98.20(b))
Yes. If Yes, describe the additional eligibility criteria
No.
Section 3.6. Priority Rules for Children
At a minimum, CCDF requires Lead Agencies to give priority for child care services to children with
special needs. Prioritization of CCDF-services is not limited to eligibility determination (i.e.,
establishment of a waiting list or ranking of eligible families in priority order to be served). Lead
Agencies may fulfill priority requirements in other ways, such as higher payment rates for providers
caring for children with special needs. (658E(c)(3)(B), 98.44(b)), 98.83(d))
3.6.1. Priority Rules for Children with Special Needs
Tribal Lead Agencies have the flexibility in how they define ―special needs‖. Tribal Lead Agencies
are not limited in defining children with special needs to only those children with physical or mental
disabilities (e.g., with formal Individual Education Plan (IEP) required under the Individuals with
Disabilities Education Act (IDEA). Lead Agencies could consider children in the child welfare
system, children of teen parents, or homeless children in their definition of children with special
needs.
a) How does the Tribal Lead Agency define ―children with special needs?‖
Definition of ―children with special needs‖:
b) Describe how the Tribal Lead Agency will give priority for child care services to children
with special needs (658E(c)(3)(B), 98.44(b)
Describe:
3.6.2. Additional Priority Rules
a) Does the Tribal Lead Agency have additional priority rules or categories? (658E(c)(3)(B),
98.16(g)(5), 98.20(b))
Yes If Yes, include the additional priority rules or categories to include a description
and definition:
Definition and Description:
No.

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PLAN FOR: DRAFT 02-20-13
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Section 3.7. Payment Rates for Child Care Services
Lead Agencies are required to establish payment rates for child care services that ensure eligible
families equal access to child care services comparable to those services provided to families not
eligible to receive CCDF services. (658E(c)(4), 98.16(l), 98.43(a), 98.43(b), 98.43 (b)(1) and
98.43(b)(2)).
3.7.1. Attach a copy of your payment rates as Attachment. (Enter Attachment #:
attached payment rates be used in all parts of the Tribal service area?

) Will the

Reminder: The attached payment rates should reflect all the rates that cover the variety
of care offered in your program. Tribal Lead Agencies are reminded that payment rates
cannot be based on a family’s eligibility or circumstances. This means that the Lead
Agency may not establish payments for TANF families that differ from the payments for
child care for the working poor, or for families in education or training.
Yes. Effective Date:
No. Attach other payment rates as Attachment (Enter Attachment #:
). Indicate
their effective dates and describe or list the geographic areas where they are used:
3.7.2. Does the Tribal Lead Agency provide child care services only through a tribally-operated
center(s) or grants and contracts?
Reminder for Tribally Operated Centers: For Lead Agencies that only offer direct
services through a tribally-operated center, the Tribe could provide information about its
CCDF budget, including the average cost of providing care per child, or information about
what the center would charge a non-subsidized child for care in lieu of a payment rate
schedule.
Yes, if Yes attach information on cost of care per child, budget information or other
documentation regarding the cost of child care services. (Enter Attachment #:
)
No.
3.7.3. Market Rate Survey Requirements
Tribal Lead Agencies are required to establish payment rates for child care services that
ensure eligible families equal access to child care services comparable to those services
provided to families not eligible to receive CCDF services. At a minimum, Tribal Lead Agencies
are required to show how payment rates are adequate based on a local Market Rate Survey
conducted no earlier than two years prior to the effective date of the currently approved Plan
(i.e., between 10/1/11 and 6/30/13).
ACF recognizes that market rate surveys might not be feasible for some Tribal Lead Agencies
and provides Lead Agencies with three options for fulfilling the local Market Rate Survey
requirements: 1) conducting its own local Market Rate Survey, 2) using the State’s local
Market Rate Survey, or 3) providing alternative documentation in lieu of a local Market Rate
Survey if selected criteria are met.

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PLAN FOR: DRAFT 02-20-13
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Plan Period 10/1/13 – 9/30/15
Which option does the Tribal Lead Agency use in fulfilling the local Market Rate Survey
requirements? Please select only ONE option. (98.16(l), 98.43)
Option 1 – the Tribal Lead Agency conducts its own MRS.
a) Provide the date the MRS was conducted:

/

/

b) Describe how the payment rates are adequate to ensure equal access based on the
results of the market rate survey. At a minimum, indicate the relationship between the
attached payment rates and the market rate observed in the survey. (i.e., the
relationship between the attached payment rates and the market rates observed in
the survey). What additional facts (if any) were considered, in addition to the market
rate survey, to set the attached payment rates?
Describe:
Option 2 – the Tribal Lead Agency uses the State’s MRS
a) Identify the State(s) MRS:
b) Provide the date the MRS was conducted:

/

/

c) Describe how the payment rates are adequate to ensure equal access based on the
results of the market rate survey. At a minimum, indicate the relationship between the
attached payment rates and the market rate observed in the survey. (i.e., the
relationship between the attached payment rates and the market rates observed in
the survey). What additional facts (if any) were considered, in addition to the market
rate survey, to set the attached payment rates?
Describe:
Option 3 – the Tribal Lead Agency provides alternative documentation in lieu of a local
MRS. The Tribal Lead Agency must identify and meet at least one of the following two
criteria listed below and provide a description to support its choice.
Please select only one criteria.
Criteria 1 – check if the Tribal Lead Agency:
a) Provides CCDF direct services solely in Tribally operated facility(ies) and does not
provide services through certificates/vouchers, grants, or contracts; and/or
b) Funds CCDF direct services solely in unregulated home-based settings such as
in-home care (i.e., care in the child’s own home) or unregulated family child care
homes, and does not fund any CCDF services in centers, regulated family child
care homes or regulated group homes.
Describe how the Tribal Lead Agency funds CCDF services solely in Tribally operated
facility(ies) and does not provide services through certificates, vouchers, grants, or
contracts; or provides direct services solely in unregulated home-based settings and
does not provide any services through centers or regulated homes.
Describe:
Criteria 2 – check if the Tribal Lead Agency:
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a) Documents that all child care providers in the service area that would potentially
be included in a market rate survey (a) serve only children receiving CCDF
subsidies, and
b) serve no private-pay children.
Describe how the Tribal Lead Agency determined that all providers serve only
children receiving CCDF subsidies and serve no private-pay children, including a
description of all relevant providers’ types (i.e., centers, family child care, etc.) that
were examined.
Describe:
3.7.4. For Non-Exempt Tribes Only – If the payment rates do not reflect for the full range of
providers – center-based, group home, family child care home, and in-home care—explain
how the choice of the full range of providers is made available to parents.
Describe:
3.7.5. Tiered Reimbursement - Will the Tribal Lead Agency provide any type of tiered
reimbursement or differential rates on top of its base reimbursement rates for providing care
for subsidized children?
No.
Yes. Check all types of tiered reimbursement or differential rates the Tribal Lead
Agency has chosen to provide.
Nontraditional hours. Describe:
Children with special needs as defined by the Tribe: Describe:
Infants and toddlers. Describe:
School-age programs. Describe:
Higher quality as defined by the Tribe. Describe:
Other Rate. Describe:
Section 3.8. Sliding Fee Scale(s)
CCDF requires families to share in the cost of subsidized child care (658(E)(5), 98.42). The Tribal
Lead Agency must establish a sliding fee scale that details each family’s contribution(s) (i.e., ―copayment‖). The sliding fee scale must vary based on income and the size of the family.
3.8.1. Attach a copy of the sliding fee scale (Enter Attachment #

)

Will the attached sliding fee scale be used in all parts of the service area?
Yes. Effective date:
No. If No, attach other sliding fee scales and their effective date(s). Enter Attachment #

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3.8.2. Does the Tribal Lead Agency use other factors in addition to income and family size to
determine each family’s contribution to the cost of child care? (658E(c)(3)(B), 98.42(b))
Yes. Describe those additional factors:
No.
3.8.3. The Tribal Lead Agency may waive co-payments for families whose incomes are at or below
the poverty level for a family of the same size. (98.42(c). The poverty level used by a Tribal
Lead Agency for a family of 3 is $
Check which option the Tribal Lead Agency has
chosen to use:
Reminder: Tribal Lead Agencies are reminded that the co-payments may be waived
for only two circumstances – for families at or below the poverty level or on a case-bycase basis for children falling under the definition of ―protective services‖ (as defined in
3.5.4).
ALL families, including those with incomes at or below the poverty level ARE required to
pay a fee.
NO families with income at or below the poverty level for a family of the same size are
required to pay a fee.
SOME families with income at or below the poverty ARE NOT required to pay a fee. The
Lead Agency waives the fee for the following families:
3.8.4. The following is a description of how the co-payments required by the Tribal Lead Agency’s
sliding fee scale(s) are affordable. (98.43(b)(3))
Describe:

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PLAN FOR: DRAFT 02-20-13
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Part 4 – Procedures for Parents
In this section, the Tribal Lead Agency should provide a complete description of the application
process for families, the procedures for providing parents with unlimited access to their children
while they are in the care of a CCDF provider. Including how the Tribal Lead Agency maintains
substantiated parental complaints and how such information is made available to the public upon
request. (658E(c)(2)(D), 658D(b)(1)(A), 658E (c)(2)(C), 658E(c)(3)(B), 98.16(h), 98.30, 98.32).
Section 4.1. How Families Apply for CCDF
4.1.1. How are parents informed of the availability of child care assistance services under CCDF?
(658E(c)(2)(A), 98.30(a))
Tribal Lead Agency
Public schools
Early Head Start/Head Start
Health Clinics
TANF offices
Other tribal offices
Other governmental offices
Community outreach meetings workshops or other in-person meetings
Radio and/or television
Internet (provide website):
Other: Describe:
4.1.2

How can parents apply for CCDF services? Check all application methods used by the
Tribal Lead Agency.
In Person interview or orientation
By Mail
By Phone/Fax
Through the Internet, (provide website):
By Email
Other: Describe:

4.1.2. Describe how the Tribal Lead Agency documents and verifies the applicant information.
(658K(a)(1), 98.70(a), 98.71(a))
Describe:
4.1.3. TANF Agency’s Criteria/Definitions Regarding Inability to Obtain Care
The regulations at 98.33(b) require the Tribal Lead Agency to inform parents who receive
TANF benefits about the exception to the individual penalties associated with the work
requirement for any single custodial parent who has a demonstrated inability to obtain
needed child care for a child under 6 years of age. Lead Agencies must coordinate with

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TANF programs to ensure, that TANF families with young children will be informed of their
right not to be sanctioned if they meet the criteria set forth in the TANF statute and Plan.
In fulfilling this requirement, the following criteria or definitions are applied by the TANF
agency—which include both the Tribal TANF agency and the State TANF agency-- to
determine whether the parent has a demonstrated inability to obtain needed child care:
Reminder: The TANF agency, not the Child Care Tribal Lead Agency, is responsible
for establishing the following criteria or definitions. These criteria or definitions are
offered in this Plan as a matter of public record. This question is for informational
purposes.
a) Identify the TANF agency(ies) that established these criteria or definitions:
State(s) TANF Agency:
Tribal TANF Agency:
b) Provide the following definitions established by the TANF agency.
―Appropriate child care‖:
―Reasonable distance‖:
―Unsuitability of informal child care‖:
―Affordable child care arrangements‖:
c) How are parents who receive TANF benefits informed about the exception to individual
penalties associated with the TANF work requirements?
In writing
Verbally
Other:
4.1.4. Is the application process for child care under CCDF different for families receiving TANF?
98.16(g)(4)
Yes. If Yes, describe:
No.
Section 4.2. Description of Procedures for Unlimited Parental Access
The Lead Agency shall have procedures to ensure that providers receiving CCDF funds afford
parents unlimited access to their children, and access to the providers caring for their children,
during normal hours of provider operation and whenever the children are in the care of the provider.
(658E(c)(2)(B), 98.31, 98.16(n))
Describe how the Lead Agency ensures that parents have unlimited access:
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Section 4.3. Record of Substantiated Parental Complaints
a) Describe in detail how the Tribe maintains a record of substantiated parental complaints
about a child care provider. (658E(c)(2)(C), 98.32, 98.16(m))
Describe:
b) Describe in detail how the substantiated parental complaints are available to the public on
request, including who should be contacted to receive them. (658E(c)(2)(C), 98.32, 98.16(m))
Describe:

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PLAN FOR: DRAFT 02-20-13
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Plan Period 10/1/13 – 9/30/15

Part 5 – Activities and Services to Improve the Quality of Child Care
In this section, Tribal Lead Agencies are asked to describe their needs, goals and activities for the
implementation of child care quality improvement activities. Core elements of CCDF include quality
investments and support systems for programs and staff. Tribes are encouraged, regardless of size,
to take an intentional approach to quality improvement – assessing the current quality of care
available and the training and technical assistance needs of providers; investing their quality funds
and efforts in accordance with the needs; and reviewing the success of their activities to improve
quality and making adjustments as necessary.
The Tribal Lead Agency should consider its goals for a child care quality improvement system for all
families, not just those receiving assistance under CCDF. (658G, 658E(c)(3)(B), 98.16(h), 98.51,
98.83(f))
Reminder: CCDF regulations require non-exempt Lead Agencies (those receiving $500,000 or
more) to spend at least 4 percent on quality activities. These activities may include, but are not
limited to; activities designed to provide comprehensive consumer education, increased
parental choice, and to improve the availability and quality of child care services.
Exempt Lead Agencies (those receiving less than $500,000) are strongly encouraged to spend
CCDF funds on quality activities but are not required to meet the 4 percent provision.
Section 5.1. Quality Improvement Needs
5.1.1. How does the Tribal Lead Agency learn about the quality of care currently offered and the
training needs of providers?
Note: Tribes make their own decisions about how to determine their needs and make
investments. For technical assistance purposes, ACF would like to learn how Tribes
perform these functions – from the use of formal tools to determine the quality of
programs to more informal methods to learn about the needs of caregivers.
Describe:
Section 5.2. Quality Improvement Goals
In the upcoming Biennium, describe the Tribal Lead Agency’s goals for improving the quality of care
in your program. (Responses will be used to guide future training and technical assistance provided
by OCC.)
Describe:
Section 5.3. Quality Improvement Activities
Identify the quality improvement activities the Tribal Lead Agency intends to implement during this
plan period. As this list is not exclusive, Tribal Lead Agencies can use the ―Other‖ box for additional
activities. Tribal Lead Agencies can also choose to include a description of each activity checked
using the Other box.

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PLAN FOR: DRAFT 02-20-13
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a) Quality Training Activities
Training Topics ∆
Child development
Infant and toddler child care
Physical activity and nutrition
Language and literacy
Inclusive child care for special needs children
Health and safety
Social-emotional development
Fiscal management
Administration and program management
Curriculum development and instruction
Child Care as a business
Other topic(s):
Optional: Describe any of the activities checked above:
Strategies for Making Training Accessible ∆
Grants or stipends for attending training events
Time off to attend training
Make substitute providers available
Other: Describe:
Optional: Describe any of the activities checked above:
Training Outcomes
Certificate
Credential
Degree
Credit towards required training hours
Other: Describe:
Optional: Describe any of the activities checked above:
b) Assisting Providers in meeting Licensing and Health and Safety Standards ∆
Provide health and safety materials/equipment
Grants/mini-grants for health and safety equipment/materials
Classroom materials and resources
Financial assistance in meeting licensing requirements
Other: Describe:

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Optional: Describe any of the activities checked above:
c) Consumer Education
Resource and referral services
Resource library for parents and providers
Newsletters for providers and parents
Parent handbooks
Toy lending library
Internet-based consumer education on quality child care
Other: Describe:
Optional: Describe any of the activities checked above:
d) Staff Compensation & Financial Incentives for Programs
Supplement wages of staff
Bonuses to recruit providers caring for infants/toddlers or other areas of provider
shortages
Increase staff compensation in blended Child Care/Head Start programs
Bonuses to higher quality programs
Implement cash and non-cash career-ladder incentives
Other: Describe:
Optional: Describe any of the activities checked above:
e) School-Age Child Care Activities ∆
Cultural activities with elders (e.g., regalia making)
Culturally-based summer youth programs
Mentoring program
Drug prevention program
Teen pregnancy prevention programs
Other: Describe:
Optional: Describe any of the activities checked above:
f) Culturally Relevant Activities ∆
Tribal language immersion programs
Integration of storytellers in child care programs
Cultural training opportunities for parents and providers
Cultural training to non-Native providers
Other: Describe:

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PLAN FOR: DRAFT 02-20-13
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Optional: Describe any of the activities checked above:
g) Quality Support for Programs ∆
Grants to programs to expand quality activities
Health Consultation or other related activities
Assessment of classroom practice
Integrating children with special needs (creating inclusive child care settings)
Higher rates for programs caring for infants and toddlers
Other: Describe:
Optional: Describe any of the activities checked above:
5.4.

Quality Improvement Initiatives for Relative Caregivers or other Small Home-based
Providers
Does Tribal Lead Agency have quality improvement initiatives specifically for relative
caregivers or other small home-based providers that are not described in your answers
above?
Yes. If Yes, describe:
No.

5.5.

School-Age Care and Resource and Referral Activities
Tribal Lead Agencies are required to spend a specific amount on developing and improving
School-Age Care activities and/or Resource and Referral services.
How does the Tribal Lead Agency intend to use these funds?
Describe:

5.6.

Child and Adult Care Food Program (CACFP)
The US Department of Agriculture’s Child and Adult Care Food Program (CACFP) plays a
vital role in improving the quality of care for children by providing financial support for meals
served in child care settings.
a) Does the Tribal Lead Agency participate in the Child and Adult Care Food Program
(CACFP)?
Yes. Identify which programs participate, for example Centers,
Family Child Care, etc.
No
Tribe participates in CACFP but CCDF is not included

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b) If the answer to 5.6.(a) is no, please indicate reasons why the Tribal Lead Agency does
not participate in CACFP.
No CACFP sponsoring agency locally
Difficult to complete initial CACFP application
Difficult to maintain required CACFP documentation
Not eligible to participate for the following reason(s):
Do not have enough information about CACFP
Not Interested
Other, describe:

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PLAN FOR: DRAFT 02-20-13
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Part 6 – Health and Safety Requirements for Providers
Activities to Ensure the Health and Safety of Children in Child Care
This section is intended to collect information on how Tribal Lead Agencies meet the statutory and
regulatory provisions related to health and safety and how these requirements are effectively
enforced. In the following pages, provide the appropriate responses for each category of care offered
addressing the CCDF health and safety requirements.
The CCDF health and safety requirements at 98.41 require Lead Agencies to have health and safety
requirements in the following areas:
Prevention and Control of Infectious Disease (including immunizations)
Building and Physical Premises Safety; and
Health and Safety training.
CCDF identifies and defines four categories of care: child care centers, family child care homes,
group child care homes and in-home child care providers (§98.2). The CCDF definition for each
category is listed below.
Center-Based Child Care: Center-based child care providers are defined as a provider
licensed or otherwise authorized to provide child care services for fewer than 24 hours per
day per child in a non-residential setting, unless care in excess of 24 hours is due to the
nature of the parent(s)’ work.
Group Home Child Care: Group home child care provider is defined as two or more
individuals who provide child care services for fewer than 24 hours per day per child, in a
private residence other than the child’s residence, unless care in excess of 24 hours is due to
the nature of the parent(s)’ work.
Family Child Care: Family child care provider is defined as one individual who provides child
care services for fewer than 24 hours per day per child, as the sole caregiver, in a private
residence other than the child’s residence, unless care in excess of 24 hours is due to the
nature of the parent(s)’s work.
In-Home Care: In-home child care provider is defined as an individual who provides child
care services in the child’s own home.
6.1. Health and Safety Requirements - Centers
6.1.1 Check the health and safety requirements for prevention and control of infectious disease.
(658E(c)(2)(F)(i), 98.41(a)(1)).
Prevention and Control of Infectious
Disease topics
Physical exam or health statement
Tuberculosis check
Immunizations
Hand-washing policy
Diapering policy and procedures
CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

Check if required
for providers
For providers
For providers
For providers
For providers

Check if required
for children
For children
For children
For children
For children

32

PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
Prevention and Control of Infectious
Check if required
Check if required
Disease topics
for providers
for children
Providers required to submit a self-certification or complete health and safety checklist
Other. Describe
6.1.2 Check the health and safety requirements for building and physical premises safety.
(658E(c)(2)(F)(ii), 98.41(a)(2))
Building inspection
Fire inspection, safety and evacuation policy
Accessibility for people with disabilities
Health inspection
Toxic substances policy
Lead paint policy
Transportation policy
Safety policy for bodies of water, including swimming pools
Safe sleep policy, including SIDS prevention
Providers to submit a self-certification or complete health and safety checklist
Tobacco exposure reduction
Group size limits based on age of children
Staff child ratio based on ages of children
Other: Describe
6.1.3

Health and Safety Training – Centers

6.1.3.a.

Check the health and safety requirements for health and safety training.
(658E(c)(2)(F)(iii), 98.41(a)(3))

Table 6.1.1.a. Health and Safety Training - Centers
Tribal Lead Agencies have the flexibility to define these terms, for this question, ―pre-service‖
refers to any training that happens prior to a person starting or shortly thereafter (e.g., first week,
etc). ―On-going‖ would be some type of routine occurrence.
Health and safety training requirements
Cardiopulmonary resuscitation (CPR)
First Aid
Training on Infectious Diseases
SIDS Prevention (i.e., Safe Sleep)
Medication Administration
Mandatory Reporting of Suspected Abuse or Neglect
Child Development
Supervision of Children
Behavior Management
Nutrition
Breastfeeding
Tobacco Exposure Reduction
Physical Activity
Working with Children with Special Needs or Disabilities
Emergency Preparedness and Response
Other. Describe
CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

Pre-Service

On-Going

33

PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
6.1.3.b Does the Tribal Lead Agency require child care center directors and providers to complete a
specific number of training hours per year?
Yes. If ―Yes‖, indicate the requirements for directors and providers below.
Indicate requirements for directors:
At least 30 training hours required in first year
At least 24 training hours per year after first year
Other:
Indicate requirements for providers:
At least 30 training hours required in first year
At least 24 training hours per year after first year
Other:
No.
6.2. Health and Safety Requirements - Group Home Child Care
6.2.1

Check the health and safety requirements for prevention and control of infectious
disease. (658E(c)(2)(F)(i), 98.41(a)(1)).

Prevention and Control of Infectious Disease topics

Check if required Check if required
for providers
for children
For providers
For children
For providers
For children
For providers
For children
For providers
For children

Physical exam or health statement
Tuberculosis check
Immunizations
Hand-washing policy
Diapering policy and procedures
Providers required to submit a self-certification or complete health and safety checklist
Other. Describe
6.2.2

Building and Premises Safety – Group Home Child Care

Check the health and safety requirements for building and physical premises safety.
(658E(c)(2)(F)(ii), 98.41(a)(2))
Building inspection
Fire inspection, safety and evacuation policy
Accessibility for people with disabilities
Health inspection
Toxic substances policy
Lead paint policy
Transportation policy
Safety policy for bodies of water, including swimming pools
Safe sleep policy, including SIDS prevention
Providers to submit a self-certification or complete health and safety checklist
Tobacco exposure reduction
Group size limits based on age of children
Staff child ratio based on ages of children
Other: Describe

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

34

PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
6.2.3

Health and Safety Training – Group Home Child Care

6.2.3.a Check the health and safety requirements for health and safety training. (658E(c)(2)(F)(iii),
98.41(a)(3))
Table 6.2.3.a. – Health and Safety Training – Group Home Child Care
Tribal Lead Agencies have the flexibility to define these terms, for this question, ―preservice‖ refers to any training that happens prior to a person starting or shortly thereafter
(e.g., first week, etc). ―On-going‖ would be some type of routine occurrence.
Health and safety training requirements
Cardiopulmonary resuscitation (CPR)
First Aid
Training on Infectious Diseases
SIDS Prevention (i.e., Safe Sleep)
Medication Administration
Mandatory Reporting of Suspected Abuse or Neglect
Child Development
Supervision of Children
Behavior Management
Nutrition
Breastfeeding
Tobacco Exposure Reduction
Physical Activity
Working with Children with Special Needs or Disabilities
Emergency Preparedness and Response
Other. Describe

Pre-Service On-Going

6.2.3.b Does the Tribal Lead Agency require group home child care providers to complete a specific
number of training hours per year
Yes. If ―Yes‖, indicate the requirements for group child care home providers below.
Indicate requirements for directors:
At least 30 training hours required in first year
At least 24 training hours per year after first year
Other:
Indicate requirements for providers:
At least 30 training hours required in first year
At least 24 training hours per year after first year
Other:
No.
6.3 Health and Safety Requirements – Family Child Care Homes (Care in the provider’s home)
6.3.1

Check the health and safety requirements for prevention and control of infectious
disease. (658E(c)(2)(F)(i), 98.41(a)(1)).

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

35

PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
Prevention and Control of Infectious Disease topics

Check if required Check if required
for providers
for children
For providers
For children
For providers
For children
For providers
For children
For providers
For children

Physical exam or health statement
Tuberculosis check
Immunizations
Hand-washing policy
Diapering policy and procedures
Providers required to submit a self-certification or complete health and safety checklist
Other. Describe

6.3.2 Check the health and safety requirements for building and physical premises safety.
(658E(c)(2)(F)(ii), 98.41(a)(2))
Building inspection
Fire inspection, safety and evacuation policy
Accessibility for people with disabilities
Health inspection
Toxic substances policy
Lead paint policy
Transportation policy
Safety policy for bodies of water, including swimming pools
Safe sleep policy, including SIDS prevention
Providers to submit a self-certification or complete health and safety checklist
Tobacco exposure reduction
Group size limits based on age of children
Staff child ratio based on ages of children
Other: Describe
6.3.3 Health and Safety Training – Family Child Care Homes (Care in the provider’s home)
6.3.3.a Check the health and safety requirements for health and safety training. (658E(c)(2)(F)(iii),
98.41(a)(3))
Table 6.3.3.a Health and Safety Training – Family Child Care Homes
Tribal Lead Agencies have the flexibility to define these terms, for this question, ―pre-service‖
refers to any training that happens prior to a person starting or shortly thereafter (e.g., first week,
etc). ―On-going‖ would be some type of routine occurrence.
Health and safety training requirements
Cardiopulmonary resuscitation (CPR)
First Aid
Training on Infectious Diseases
SIDS Prevention (i.e., Safe Sleep)
Medication Administration
Mandatory Reporting of Suspected Abuse or Neglect
Child Development
Supervision of Children
Behavior Management
Nutrition
CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

Pre-Service

On-Going

36

PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
Table 6.3.3.a Health and Safety Training – Family Child Care Homes
Tribal Lead Agencies have the flexibility to define these terms, for this question, ―pre-service‖
refers to any training that happens prior to a person starting or shortly thereafter (e.g., first week,
etc). ―On-going‖ would be some type of routine occurrence.
Health and safety training requirements
Breastfeeding
Tobacco Exposure Reduction
Physical Activity
Working with Children with Special Needs or Disabilities
Emergency Preparedness and Response
Other: Describe

Pre-Service

On-Going

6.3.3.b Does the Tribal Lead Agency require family child care home providers to complete a specific
number of training hours per year?
Yes. If ―Yes‖, indicate the requirements for family child care home providers below.
Indicate requirements for providers:
At least 30 training hours required in first year
At least 24 training hours per year after first year
Other:
No.
6.4. Health and Safety Requirements – In-Home Child Care (Care in the child’s home)
6.4.1 Check the health and safety requirements for prevention and control of infectious disease.
(658E(c)(2)(F)(i), 98.41(a)(1)).
Prevention and Control of Infectious Disease topics

Check if required Check if required
for providers
for children
For providers
For children
For providers
For children
For providers
For children
For providers
For children

Physical exam or health statement
Tuberculosis check
Immunizations
Hand-washing policy
Diapering policy and procedures
Providers required to submit a self-certification or complete health and safety checklist
Other. Describe
6.4.2 Building and Premises Safety – In-Home Child Care
Check the health and safety requirements for building and physical premises safety.
(658E(c)(2)(F)(ii), 98.41(a)(2))
Building inspection
Fire inspection, safety and evacuation policy
Accessibility for people with disabilities
Health inspection
Toxic substances policy
CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

37

PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
Lead paint policy
Transportation policy
Safety policy for bodies of water, including swimming pools
Safe sleep policy, including SIDS prevention
Providers to submit a self-certification or complete health and safety checklist
Tobacco exposure reduction
Group size limits based on age of children
Staff child ratio based on ages of children
Other: Describe
6.4.3 Health and Safety Training – In-Home Child Care
6.4.3.a Check the health and safety requirements for health and safety training. (658E(c)(2)(F)(iii),
98.41(a)(3))
6.4.3.a. Health and Safety Requirements – In-Home Care
Tribal Lead Agencies have the flexibility to define these terms, for this question, ―pre-service‖
refers to any training that happens prior to a person starting or shortly thereafter (e.g., first week,
etc). ―On-going‖ would be some type of routine occurrence.
Health and safety training requirements
Cardiopulmonary resuscitation (CPR)
First Aid
Training on Infectious Diseases
SIDS Prevention (i.e., Safe Sleep)
Medication Administration
Mandatory Reporting of Suspected Abuse or Neglect
Child Development
Supervision of Children
Behavior Management
Nutrition
Breastfeeding
Tobacco Exposure Reduction
Physical Activity
Working with Children with Special Needs or Disabilities
Emergency Preparedness and Response
Other. Describe

Pre-Service

On-Going

6.4.3.b Does the Tribal Lead Agency require in-home child care providers to complete a specific
number of training hours per year?
Yes. If ―Yes‖, indicate the requirements for family child care home providers below.
Indicate requirements for providers:
At least 30 training hours required in first year
At least 24 training hours per year after first year
Other:
No.
CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

38

PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
6.5.

Exemptions for Relative Providers

A Tribal Lead Agency has the option to exempt the following relatives from some or all of its health
and safety requirements: grandparents, great-grandparents, siblings (if living in a separate
residence), aunts, and uncles.
Does the Tribal Lead Agency exempt relative providers from the health and safety requirements
described in 6.4? (658)(4)(B), 98.41(e)).
Yes, all relative providers are exempt from all health and safety requirements
Some or all relative providers are subject to different health and safety requirements from
those described in Section 6.4 and the following describes those different requirement and
which relatives they apply to;
Describe
No, all relative providers are subject to the same requirements as described in Section 6.4 as
appropriate; there are no exemptions for relatives or different requirements for them.
Section 6.6. Monitoring and Enforcement of Health and Safety Requirements
The Tribal Lead Agency is required to certify that procedures are in effect to ensure that child care
providers caring for children receiving CCDF services comply with the applicable health and safety
requirements. (658E(c)(2)(E), 658E(c)(2)(G), 98.40(a)(2), 98.41(d))
In this section, use the series of questions below to describe how the Tribal Lead Agency effectively
enforces the applicable health and safety requirements. Check the appropriate box below that best
describes monitoring visits (announced and unannounced), background checks and any other
enforcement policies and practices that govern Tribal child care programs.
6.6.1. Monitoring Visits – Announced and Unannounced
Does the Tribal Lead Agency include announced and/or unannounced monitoring visits in its
policies as a way to effectively enforce the applicable child care requirements?
Yes. If ―Yes‖ please refer to the chart 6.6.1 below and check all that apply.
No.
Table 6.6.1 Information on Monitoring and Inspections carried out by the Tribal Lead
Agency or other tribal entity.
Provider
Frequency of Routine
Frequency of Routine
Categories
Announced Visits
Unannounced Visits
Center-Based
Once a Year
Once a Year
More than Once a Year
More than Once a Year
Once Every Two Years
Once Every Two Years
Other: Describe:
Other: Describe:
Family Child Care
Once a Year
Once a Year
Home
More than Once a Year
More than Once a Year
Once Every Two Years
Once Every Two Years
Other: Describe:
Other: Describe:
CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

39

PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
Table 6.6.1 Information on Monitoring and Inspections carried out by the Tribal Lead
Agency or other tribal entity.
Provider
Frequency of Routine
Frequency of Routine
Categories
Announced Visits
Unannounced Visits
Group Home
Once a Year
Once a Year
More than Once a Year
More than Once a Year
Once Every Two Years
Once Every Two Years
Other: Describe:
Other: Describe:
In-Home Care
Once a Year
Once a Year
More than Once a Year
More than Once a Year
Once Every Two Years
Once Every Two Years
Other: Describe:
Other: Describe:
6.6.2 Background Checks
Tribal Lead Agencies may have agreements with Federal, State, or Tribal entities that conduct
background checks of providers and employees. Some Tribal Lead Agencies have entered into
agreements with Tribal law enforcement to conduct background checks.
Does the Tribal Lead Agency use background checks as a way to effectively enforce health and
safety requirements?
Yes. If Yes, please refer to the chart below and check all that apply.
No.
Table 6.6.2 Background Checks (Check all that apply) ∆

Check all requirements that the Lead
Agency has chosen to implement:

For each requirement checked, identify which
providers must meet the requirement.
Centerbased

Group Family
Child Care home

Family Child
Care home

Inhome

Child Abuse Registry
Tribal Criminal Background
Check here if the Tribal
background checks include
fingerprints.
State Criminal Background
Check here if the State
background checks include
fingerprints.
FBI Criminal Background
Sex Offender Registry
Other: Describe:

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

40

PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
6.6.3

Enforcement of Health and Safety Standards

What methods does the Tribal Lead Agency use to effectively enforce CCDF health and safety
requirements?
Conduct regular training on the Health and Safety requirements
Develop corrective action plan to address issues
Conduct follow up to monitor corrective action progress
Fines
Injunctions through court
Emergency or immediate closure not through court action
License or certificate revocation, probation, or non-renewal
Other: Describe:
6.6.4 Does the Tribal Lead Agency disseminate information to parents and the public, about child
care program compliance records?
Yes. If Yes, describe:
No.
6.7

Tribal Licensing Requirements ∆

Many Tribes have adopted policies and licensing standards from a variety of sources. In some
cases, these policies may serve as the Tribe’s licensing standards. In other cases, the Tribe may
use only portions of the policies. Indicate below whether the Tribe uses policies or licensing
standards from the sources listed below and whether the policies serve as the tribal licensing
standards or have been adapted by the Tribe in some way.
Source

Serves as Tribal Licensing
Standards

Tribe Adapted Portions from
the Source

Minimum Tribal Child Care
Standards
Caring for Our Children or Stepping
Stones
State licensing standards. If so, list
state(s):
Other. Describe

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

41

PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
APPENDIX 1
CCDF PROGRAM ASSURANCES AND CERTIFICATIONS
The Tribal Lead Agency is designated by the Tribe (or Tribal consortium) to represent the Tribe (or
Tribal organization).
The Tribal Lead Agency agrees to follow the Federal laws and regulations that apply to the CCDF
program and to follow this Plan, when approved, including the following assurances and
certifications.
The Tribal Lead Agency assures that:
(1) Upon approval, it will have in effect a program that complies with the provisions of the Plan
printed herein, and is administered in accordance with the Child Care and Development Block
Grant Act of 1990 as amended, Section 418 of the Social Security Act, and all other applicable
Federal laws and regulations. (658D(b), 658E(a), 98.15(a)(1))
(2) The parent(s) of each eligible child within the Tribe or Tribal service area who receives or is
offered child care services for which financial assistance is provided is given the option either to
enroll such child with a child care provider that has a grant or contract for the provision of the
service or to receive a child care certificate. (658E(c)(2)(A)(i), 98.2, 98.30, 98.15(a)(2)) [Exempt
Tribal Lead Agencies are not required to operate certificate programs.]
(3) In cases in which the parent(s) elect(s) to enroll the child with a provider that has a grant or
contract with the Tribal Lead Agency, the child will be enrolled with the eligible provider selected
by the parent to the maximum extent practicable. (658E(c)(2)(A)(ii), 98.15(a)(3), 98.30)
(4) The child care certificate offered to parents shall be of a value commensurate with the subsidy
value of child care services provided under a grant or contract. (658E(c)(2)(A)(iii), 98.15(a)(4),
98.30) [Exempt Tribal Lead Agencies are not required to operate certificate programs.]
(5) The Tribe, or Tribal consortium, will coordinate, to the maximum extent feasible, with the Tribal
Lead Agency(ies) in the State(s) in which the child care programs or activities will be carried out.
(98.12, 98.14(a)&(b), 98.81(b)(3)(i), 98.82)
(6) Tribal Child Care and Development Fund (CCDF) programs and activities will be carried out for
the benefit of Indian children on an Indian reservation (except for Programs located in Alaska,
California, or Oklahoma). (98.81(b)(3)(ii), 98.83(b))
(7) With respect to State and local regulatory requirements (or Tribal regulatory requirements),
health and safety requirements, payment rates, and registration requirements, State or local (or
Tribal) rules, procedures or other requirements promulgated for the purpose of the CCDF will not
significantly restrict parental choice from among categories of care or types of providers.
(658E(c)(2)(A), 98.15(a)(5), 98.15(p), 98.30(e)&(f), 98.40(b)(2), 98.41(b), 98.43(d), 98.45(d))

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

42

PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
The Tribal Lead Agency certifies that:
(1) It has procedures in place to ensure that providers of child care services for which assistance is
provided under the Child Care and Development Fund (CCDF) afford parents unlimited access
to their children and to the providers caring for their children during the normal hours of
operations and whenever such children are in the care of such providers. (658E(c)(2)(B),
98.15(b)(1), 98.31)
(2) It maintains a record of substantiated parental complaints and makes information regarding such
complaints available to the public on request. (658E(c)(2)(C), 98.15(b)(2), 98.32)
(3) It will collect and disseminate to parents of eligible children and the general public, consumer
education information that will promote informed child care choices. (658E(c)(2)(D), 98.15(b)(3),
98.33)
(4) There are licensing requirements in effect that are applicable to child care services provided
within the area served by the Tribal Lead Agency pursuant to 98.40. (98.15(b)(4), 98.40)
(5) There are—under Tribal, local, or State law—requirements in effect designed to protect the
health and safety of children; these requirements are applicable to child care providers that
provide services for which assistance is made available under the CCDF. (658E(c)(2)(F),
98.15(b)(5), 98.41)
(6) Procedures are in effect to ensure that child care providers that provide services for which
assistance is provided under the CCDF comply with all applicable health and safety
requirements. (658E(c)(2)(G), 98.15(b)(6), 98.41)
(7) Payment rates under the CCDF for the provision of child care services will be sufficient to ensure
equal access for eligible children to comparable child care services in the Tribe or Tribal service
area that are provided to children whose parents are not eligible to receive assistance under this
program or under any other Federal or State child care assistance programs. (658E(c)(4)(A),
98.15(b)(7), 98.43)
(8) By the end of each three-year funding period (expenditure period for each Federal fiscal year’s
grant funding), the Tribe must have expenditures that are equal to grant funds received for that
fiscal year. (98.67(c))

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

43

PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
APPENDIX 2
CHILD COUNT DECLARATION
Federal Fiscal Year:

Name of Tribe/Tribal Lead Agency:
This certifies that the number of Indian children under age 13 who reside on or near the reservation
or service area is:
(number)
The Tribe/Tribal Lead Agency may not count any children who are included in the Child Count of
another CCDF Tribe/Tribal Lead Agency. To ensure unduplicated child counts, a Tribe/Tribal Lead
Agency is required to confer with all other CCDF Tribe/Tribal Lead Agencies that have overlapping
or neighboring service areas.
This count shows the number of Indian children under age 13 as of (date)

Date:

/

/

Official Signature of Individual Authorized to Act for the Tribe

Type or Write Name and Title

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

44

PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
CHILD COUNT DECLARATION
(P.L. 102-477 Tribe)
Federal Fiscal Year:
Name of Tribe/Tribal Lead Agency:
This certifies that the number of Indian children under age 13 (as defined in the CCDF section of the
102-477 plan) who reside on or near the reservation or service area (as defined in the CCDF section
of the 102-477 plan) is:
(number)
The Tribe/Tribal Lead Agency may not count any children who are included in the Child Count of
another CCDF Tribe/Tribal Lead Agency. To ensure unduplicated child counts, a Tribe/Tribal Lead
Agency is required to confer with all other CCDF Tribe/Tribal Lead Agencies that have overlapping
or neighboring service areas.
This count shows the number of Indian children under age 13 as of date:

Date:

/

/

/

/

Official Signature of Individual Authorized to Act for the Tribe

Type or Write Name and Title

REQUEST FOR REALLOTTED TRIBAL DISCRETIONARY FUNDS
The Tribe named above requests Discretionary Funds that may be available through the
reallotment process.
Yes
No

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

45

PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
APPENDIX 3
AMENDMENTS LOG
Child Care and Development Fund Plan
For the period: 10/1/2013 –9/30/2015

Tribal Lead Agencies are required to request approval from Administration for Children and Families
(ACF) whenever a ―substantial‖ change in the Tribal Lead Agency’s approved CCDF plan occurs.
Please refer to the ACF Program Instruction regarding CCDF Plan amendments for more information
http://www.acf.hhs.gov/programs/occ/resource/pi-2009-01
Plan amendments must be submitted to ACF within 60 days of the effective date of the change.
Under the regulation, the plan amendment must be approved no later than the 90th day following the
date on which the amendment is received by ACF unless the Lead Agency and ACF mutually agree
in writing to extend the period. (§98.18 (b)).
ACF encourages Tribal Lead Agencies to contact the Child Care program staff in the appropriate
ACF Regional Office to discuss any proposed amendment as early as possible.
Instructions:
(1) Tribal Lead Agency completes the first 3 columns and sends a photocopy of this log (showing
the latest amendment sent to ACF) and the amended section(s) to the ACF Regional contact. A
copy of the log, showing the latest amendment pending in ACF, is retained in the Tribal Lead
Agency’s Plan.
(2) ACF completes column 4 and returns a photocopy of the log to the Tribal Lead Agency.
(3) The Tribal Lead Agency replaces this page in the Plan with the copy of the log received from
ACF showing the approval date.
(4) Program Instruction CCDF-ACF-PI-2009-01 provides specific details and timelines specific to the
plan amendment process.
Reminder: This process depends on repeated subsequent use of the same log page over the life
of the Plan. At any time the log should reflect all amendments, both approved and pending in
ACF. The Tribal Lead Agency is advised to retain those ―old‖ plan pages that are superseded by
amendments in a separate appendix to its Plan.

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

46

PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
Table: Appendix 3 – Amendment Log
Tribal Lead Agency:

Section Amended

Proposed Effective
Date

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

Grantee Signature and
Date Submitted to ACF

ACF Approving Official’s
Signature and Date

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PLAN FOR: DRAFT 02-20-13
CHILD CARE & DEVELOPMENT FUND
Plan Period 10/1/13 – 9/30/15
APPENDIX 4
LIST OF CERTIFICATIONS

New Tribal CCDF applicants must complete and submit the following certifications as Appendix 4 of
their Tribal plan preprint:
Assurance of compliance with Title VI of the Civil Rights Act of 1964
Certification regarding debarment (includes definitions for use with the certification of
debarment)
HHS certification regarding drug-free workplace requirements
Certification of compliance with the Pro-Child Act of 1994
New applicants should contact their ACF Regional Office to obtain copies of the required
certifications.
Current Tribal Lead Agencies were previously required to submit these certifications with their 2-year
plan preprint. Therefore, the certifications do not need to be submitted again. Tribes are reminded
that even if they have changed their Tribal Lead Agency, the certifications apply to the successor
agency.

CCDF Plan Effective Date: October 1, 2013
Amended Effective: [Insert Date as Amended]

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