Fillable FINAL HRP Hard Copy Application (Child Care Aware)

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FINAL HRP Hard Copy Application (Child Care Aware)

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Grant Application for Child Care Programs
Directions: Fill out the Grant application, W-9, Direct Deposit Form and Grant Agreement. Mail all four forms to
Child Care Aware of Kansas
1508 East Iron
Salina, Kansas 67401
Grant Types (please check all that you are applying for)
☐ Supply Grant: This grant is to support your essential needs as a child care provider that has remained open
for business and to assist you in maintaining your regular healthy environment. These funds will provide financial
assistance for all open licensed child care providers for the purposes of cleaning and sanitation, and other activities
necessary to maintain a healthy and safe operation of their program. This grant recognizes the rapid change in
recommendations by the CDC and local health departments to include a more rigorous cleaning regimen and
assessing for wellness that has led to an increased need for supplies in the child care settings. Supplies that may
be purchased with this grant include the following: thermometers, gloves, soap, disinfectants, cleaning wipes,
paper towels, trash bags, paperware, disposable table coverings, cleaning tools (buckets, bins, rags, mops). Other
activities may include using funds to assist the program in meeting KDHE or CDC Child Care Guidance. For
recommendations for Preventing the Introduction of COVID-19 INTO the Facility, please review the CDC’s
Supplemental Guidance for Child Care Programs that Remain Open at:
https://www.cdc.gov/coronavirus/2019-
ncov/community/schools-childcare/index.html. A one-time financial payment will be provided to open child care
providers with the expectation that funding be expended within a 90-day period, with a 30-day extension provided
if needed to expend any remaining funds.
Provide a short description of the items that you will purchase with a Supply Grant:
Program Name
Applicant Name
KDHE License Number
Address
City
Zip Code
County
Phone Number
Email Address
Is your program temporarily closed?
Yes
No
Do you provide emergency child care?
Yes No
How many emergency care slots do you have available?
* Emergency child care is being willing to provide temporary care when a regular child care program has been closed
due to a KDHE qualifying emergency. KDHE will work with willing programs.
☐ Sustainability Grant: This grant will support your child care business through operational challenges
caused by the COVID-19 pandemic. The disruption of normal operations will vary from provider to provider. As
recommended in the CARES Act, it is an expectation of child care providers receiving these funds, that a portion of
the funds received be utilized to continue to pay the salaries/wages of staff employed through the licensed child
care facility. Other allowable expenses based upon the impact to your facility may include items from your
operating budget such as: enrollment, food, supplies, labor, benefits, rent/mortgage, maintenance, equipment,
utilities, licensing fees, mileage, advertising, office supplies, professional development, phone/internet, classroom
supplies, liability/accident insurance, and software.
Provide a short description of your child care business expenses that you will pay for with a
Sustainability Grant:
_____________________________________________________________________________________
Agreement to Terms and Conditions
Please ensure you adhere to the requirements as outlined in the signed Agreement to Terms and Conditions
section of the grant application listed below. If you have questions, contact Child Care Aware of Kansas to explain
the requirements in greater detail.
• Child care centers and family child care programs must be licensed by and in good standing with Kansas
Department of Health and Environment (KDHE).
• Child care centers and family and group child care programs must hold a current Kansas Child Care Center
License; Kansas Day Care Home License; or Kansas Group Day Care Home license providing full time, full
year child care slots.
• Child care centers and family child care programs must agree to remain in business for at least 8 months
from the date of the approval letter.
• Child care centers and family child care programs must purchase items agree upon in the grant
application.
• Receipts for all items/expenses paid with grant funds must be kept by the child care centers and family
child care programs for 5 years. These funds are subject to state, federal and Child Care Aware of Kansas
audits. Receipts may be requested anytime within a 5-year timeframe.
• Supply grant funds must be spent with 90 days from the award date. A 30-day extension will be provided
if needed to expend any remaining funds.
• Sustainability grant funds must be spent by October 31, 2020.
I certify that to the best of my knowledge all the information in the Hero Relief Project application is correct. I
further agree that if my grant application is accepted, I will comply with all grant guidelines listed on the Grant
Guideline page.
In addition to the terms and conditions listed above I agree the Supply Grant funds will be spent in accordance
with the award and intended purpose.
Supply Grant
Date
I certify that to the best of my knowledge all the information in the Hero Relief Project application is correct. I
further agree that if my grant application is accepted, I will comply with all grant guidelines listed on the Grant
Guideline page.
In addition to the terms and conditions listed above I agree the Sustainability Grant funds will be spent in
accordance with the award and intended purpose. It is an expectation of child care providers receiving these
funds, that a portion of the funds received be utilized to continue to pay the salaries/wages of staff employed
through the licensed child care facility.
Sustainability Grant
Date
Program Consent to Share Information Form
In accepting funds awarded through the Hero Relief Program, I am authorizing Child Care Aware of Kansas to
collect and share information on your program with the agencies listed below for the purpose of supporting child
care program needs as a result of the COVID-19 outbreak. It is further agreed that all identifying information
shared among agencies will be held as confidential, unless otherwise required by law.
•
Kansas Department for Children and Families (DCF)
• Kansas Department of Health and Environment (KDHE)
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FINAL HRP Hard Copy Application (Child Care Aware)

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Completed 18 July 2020

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