CODES Service Code HS- Head Start or CC- Child Care Eligibility Code A- Preventive/Non-Mandated B- Preventive Mandated C- Placement D- Protective and identify what these needs are in the comments section. For reauthorization of Child Care services after the end of the service dates resubmit a CS-186D-2 referral form. 6. CS-186D-2 PAGE 1 OF 4 REV. 11/08 Referral for Child Care and Head Start Services CCHS THIS IS NOT A VOUCHER For Child Care Refer.

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How to fill out the Cs 186d 2 form online

The Cs 186d 2 form is essential for referring children to Child Care and Head Start services. This guide provides a clear, step-by-step approach to completing the form online, ensuring that users who may have limited legal experience can navigate the process with ease.

Follow the steps to successfully complete the Cs 186d 2 form online.

  1. Press the ‘Get Form’ button to obtain the form and open it in your online editor.
  2. Fill in the case identification section with the State Central Register (SCR) case number and case name.
  3. Indicate the type of referral by checking the appropriate box for new, reauthorized, or termination, and provide the date of referral if applicable.
  4. Complete the referral source information by inputting the name, agency, phone number, fax, and email of the referral source, as well as the case planner's contact details.
  5. Provide family and caretaker information including the caretaker's name, title, phone numbers, address, annual income, and employment status if applicable.
  6. List the children needing care by providing their names, sex, primary language, special needs status, birth dates, service codes, borough requirements, and service dates.
  7. If there are more than three children needing services, copy the relevant section and complete it for additional children.
  8. Obtain an authorizing signature from the relevant personnel in Family Permanency Services, Family Support Services, or Child Protective Services, and provide their contact information.
  9. Once all sections are completed, save changes and use the available functionalities to download, print, or share the form as necessary.

Complete the Cs 186d 2 form online today to ensure prompt access to child care and Head Start services.

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