Division of Early Learning Services Early Care and EducationDaily SignIn/SignOut Record (DSSR) Provider/Payee: Provider ID No.: Parent(s): Address: Month/Year of Service: Child: Provider Phone: Child.

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How to fill out the Daily Sign-In/Sign-Out Record (DSSR) online

The Daily Sign-In/Sign-Out Record (DSSR) is an essential document for tracking attendance and invoicing in early care and education services. This guide will assist you in completing the form accurately and efficiently online, ensuring that you adhere to submission guidelines.

Follow the steps to complete the DSSR online successfully.

  1. Press the ‘Get Form’ button to access the Daily Sign-In/Sign-Out Record (DSSR) form and open it for editing.
  2. Begin by filling in the provider/payee name and provider ID number in the appropriate fields. This information identifies who is providing the care.
  3. Enter the parent(s) name along with their address and the month and year of service. This ensures that the records are correctly linked to the family.
  4. Provide the child's name and child ID number to associate the attendance record specifically with the child receiving care.
  5. For each date listed on the form, record the time in and time out for each session. Specify whether the time is in a.m. or p.m. This section captures the actual hours of care provided.
  6. If there was any absence on a given day, note the reason in the designated area next to the corresponding date.
  7. Complete the section for provider invoicing and family fee receipt to ensure proper reimbursement processing.
  8. Calculate the provider requested rates or any other fees, entering those amounts as needed.
  9. If applicable, record any state family fees received along with the date paid to ensure that all financial transactions are documented.
  10. Finally, add the total provider invoice amount and double-check all entries for accuracy. This prevents any issues with reimbursement.
  11. Sign and date the form both as the provider and as the parent, confirming that the information is true and accurate.
  12. Once all fields are complete, save your changes. You may also choose to download, print, or share the completed form as required.

Complete your Daily Sign-In/Sign-Out Record (DSSR) online today for streamlined processing.

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