Get Calworks Child Care Reimbursement Report County ...

This guide provides clear and detailed instructions for users on how to effectively complete the CalWORKs Child Care Reimbursement Report online. It aims to assist individuals in navigating the form to ensure accuracy and compliance.

Follow the steps to successfully complete the reimbursement report.

1. Click ‘Get Form’ button to access the report and open it for editing.
2. Begin by filling out the participant information. Enter the case name, case number, worker name and number, and the month/year of the request. Ensure that the name is entered in the format of first, middle, and last.
3. Provide your home and work phone numbers, as well as your complete address, ensuring that it includes the street, city, state, and ZIP code.
4. Move on to the child care provider information section. Enter the name of the provider or facility, along with the provider code and social security number or tax ID, if applicable.
5. Indicate whether the provider is licensed or license-exempt, and fill in the address where care is provided, including the phone number.
6. List the name(s) of the child(ren) receiving care, their birth dates, and specify how you were charged (hourly, daily, weekly, or monthly) along with the rate charged and total amount billed.
7. In the section for hours of care, denote the number of hours provided for each child for each day of the month.
8. Complete the certification section by ensuring both the participant and provider signs where indicated, and date the form.
9. Review the entire report for accuracy and completeness, ensuring compliance with any previously given instructions, particularly regarding payments and reporting requirements.
10. Finally, save your changes, download, print, or share the completed form as needed.

Complete your CalWORKs Child Care Reimbursement Report online today!