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Program Name Name of Child Date of Absence Time Parent/Guardian Contact Reason for absence DCF / CBC Contact ELC - ADM023 C Documents and Settings hgodwin.FLCHILD Local Settings Temporary Internet Files OLK78 Rilya Wilson Form Ver2003 Effect. Early Learning Coalition of Northwest Florida Rilya Wilson Documentation of Absence Must be submitted with monthly Attendance Rosters When a child is under PROTECTIVE SUPERVISION or custody of Department of Children and Families At Risk BG1 are ABSENT- YOU MUST REPORT If a BG1 child has ONE unexcused absence you must NOTIFY DCF or Community Based Care by close of business on the same day. If the child has SEVEN 7 consecutive EXCUSED absences you must notify DCF/Community Based Care by close of business the same day. If you fax to DCF/CBC attach fax confirmation to this form and write in faxed under DCF/CBC Contract. Early Learning Coalition of Northwest Florida Rilya Wilson Documentation of Absence Must be submitted with monthly Attendance Rosters When a child is under PROTECTIVE SUPERVISION or custody of Department of Children and Families At Risk BG1 are ABSENT- YOU MUST REPORT If a BG1 child has ONE unexcused absence you must NOTIFY DCF or Community Based Care by close of business on the same day. If the child has SEVEN 7 consecutive EXCUSED absences you must notify DCF/Community Based Care by close of business the same day. If you fax to DCF/CBC attach fax confirmation to this form and write in faxed under DCF/CBC Contract. This form is used to document the child s absences and the Provider s communication with the parent/ guardian and DCF/CBC as required* One form per child must be submitted with attendance roster in order to receive payment for 3 unexcused absences for At Risk child. Early Learning Coalition of Northwest Florida Rilya Wilson Documentation of Absence Must be submitted with monthly Attendance Rosters When a child is under PROTECTIVE SUPERVISION or custody of Department of Children and Families At Risk BG1 are ABSENT- YOU MUST REPORT If a BG1 child has ONE unexcused absence you must NOTIFY DCF or Community Based Care by close of business on the same day. If the child has SEVEN 7 consecutive EXCUSED absences you must notify DCF/Community Based Care by close of business the same day. If the child has SEVEN 7 consecutive EXCUSED absences you must notify DCF/Community Based Care by close of business the same day. If you fax to DCF/CBC attach fax confirmation to this form and write in faxed under DCF/CBC Contract. If you fax to DCF/CBC attach fax confirmation to this form and write in faxed under DCF/CBC Contract. This form is used to document the child s absences and the Provider s communication with the parent/ guardian and DCF/CBC as required* One form per child must be submitted with attendance roster in order to receive payment for 3 unexcused absences for At Risk child. If the child has SEVEN 7 consecutive EXCUSED absences you must notify DCF/Community Based Care by close of business the same day. If you fax to DCF/CBC attach fax confirmation to this form and write in faxed under DCF/CBC Contract. This form is used to document the child s absences and the Provider s communication with the parent/ guardian and DCF/CBC as required* One form per child must be submitted with attendance roster in order to receive payment for 3 unexcused absences for At Risk child.

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