STATE OF CALIFORNIAHEALTH AND HUMAN SERVICES AGENCY DEPARTMENT OF SOCIAL SERVICES CHILD CARE AND SUPERVISION COMPONENT PROGRAM WORKSHEET (SR 2A) PROVIDER NAME: PROGRAM NUMBER: Column C Column A Paid.
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How to fill out the CA SR 2A online
This guide provides a comprehensive overview of how to complete the CA SR 2A form online. By following these detailed steps, you will efficiently fill out the necessary sections and ensure accurate submission.
Follow the steps to successfully fill out the CA SR 2A form.
- Click ‘Get Form’ button to retrieve the CA SR 2A and open it in your editor.
- Enter the provider name as shown on the Group Home Program Rate Application (SR1) in the 'Provider Name' field.
- In the 'Month/Year' field, indicate the relevant month and year for the hours worked.
- List the names of all staff members performing child care and first-line supervision activities in the 'CCS/First-Line Supervisor' field.
- For 'Paid Awake Hours' (Column A), input the total number of paid-awake hours for each individual, factoring in hours for paid vacation or sick leave.
- Leave 'Verified Hours' (Column B) blank; this is for FCARB use only, and providers do not complete this section.
- Fill in the 'Experience' column (Column C) by entering the appropriate value based on the residential child care experience of staff: 0 for 0-23 months, .15 for 24-47 months, and .25 for 48+ months.
- In the 'Education' field (Column D), enter values based on the educational background of staff: 0 for 0-59 units, .05 for 60+ units, .10 for a BA in a major other than behavioral science, .25 for a BA in behavioral science, and .40 for an MA in behavioral science.
- For 'Training' (Column E), if formal training of 40 or more hours per year is provided per child care staff, enter .10.
- Calculate the 'Weighting' (Column F) by entering 1.0 plus the sum of the values from Columns C, D, and E, ensuring the maximum does not exceed 1.75.
- In 'Total Weighted Hours' (Column G), multiply the value in Column A by the value in Column F.
- Input the grand total of paid awake hours in the 'Total' field (Column A) and transfer this to SR 2, Column (2).
- Enter the grand total weighted hours in Column G and transfer this to SR 2, Column (3).
- Upon completion, save your changes, then download, print, or share the CA SR 2A as necessary.
Complete your CA SR 2A form online now to ensure a smooth submission process.
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Caltrans proposes to restore and reopen a segment of State Route (SR) 39 that has been closed to public traffic since 1978 due to massive mud and rockslides caused by heavy rains and floods. CALIFORNIA STATE ROUTE 39 (SAN GABRIEL CANYON ROAD ... ca.gov https://dot.ca.gov › district-7 › documents › env-docs › s... ca.gov https://dot.ca.gov › district-7 › documents › env-docs › s...
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Is California 39 open?
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