Free Missouri Dc 20 PDF Template Modify Form Online

Free Missouri Dc 20 PDF Template

The Missouri DC 20 form is a program evaluation questionnaire used by the Missouri Department of Health and Senior Services to assess the regulatory status of children's programs. Completing this form is essential for ensuring compliance and maintaining the quality of care provided to children. Ready to get started? Fill out the form by clicking the button below.

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Table of Contents

How to Use Missouri Dc 20

Completing the Missouri DC 20 form is essential for ensuring compliance with regulations for children's programs. After filling out the form, you will need to gather and submit additional documents that support the information provided. This includes program descriptions, parent policies, and any relevant tax exemption letters if applicable.

  1. Identify the Program: Write the name of the program at the top of the form.
  2. Provide Location Details: Fill in the street address, city, state, and zip code of the program's location. If the mailing address is different, include that as well.
  3. County Information: Indicate the county where the program operates.
  4. Contact Information: Enter the program's telephone number.
  5. Administration Details: Specify the organization or individual responsible for managing the program, along with their address and telephone number.
  6. Contact Person: Provide the name and title of the contact person, along with their telephone number and email address.
  7. Program Status: Indicate whether the program is currently in operation. If not, provide the target opening date.
  8. Child Enrollment Information: Specify the number of children and their age range.
  9. Months of Operation: Check all applicable months during which the program operates.
  10. Hours of Operation: Fill in the operating hours for each program.
  11. Attendance Limits: State the maximum number of hours a child may attend each day.
  12. Employee Enrollment: Indicate the number of employees’ children enrolled in the program.
  13. Compensation Explanation: Describe how the program is funded or compensated for its services.
  14. Other Programs: If applicable, provide the name and address of any other child care programs operated by the owner or organization.
  15. Funding Sources: Indicate whether the program receives any direct state or federal funds, and list any agencies providing such funds.
  16. Program Activities: Explain the types of activities offered by the program, such as educational or recreational services.
  17. Signatures: The director and administrator must print their names and titles, sign, and date the form to affirm that the information is accurate.

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Document Features

Fact Name Details
Purpose The Missouri DC-20 form is used to evaluate the regulatory status of children's programs.
Governing Law This form is governed by Missouri state laws concerning child care regulations.
Submission Requirements Along with the form, applicants must submit program descriptions, parent policies, and other documentation.
Religious Organizations Religious organizations must provide a federal tax exemption letter or proof of tax-exempt status for their facilities.
Contact Information Applicants must provide contact details for the program's administration and management.
Program Operation Status The form asks if the program is currently operating or if there is a target opening date.
Age Range Applicants must specify the age range of children served by the program.
Hours of Operation The form requires details on the hours of operation for each program offered.
Funding Sources Applicants need to explain how they are compensated and if they receive state or federal funds.
Signature Requirement The form must be signed by both the director and the administrator to affirm the accuracy of the information provided.

Key takeaways

Filling out and utilizing the Missouri DC 20 form is an essential step for those operating children's programs in Missouri. Here are some key takeaways to consider:

  • The form is used to determine the regulatory status of children's programs.
  • It requires submission of various documents, including a description of the program and parent policies.
  • If affiliated with a national or regional organization, provide documentation of good standing.
  • Religious organizations must submit a federal tax exemption letter or relevant documentation regarding tax-exempt status.
  • An organizational chart must be included, showing the management structure of the program.
  • Identifying information for the program, such as location and contact details, is necessary.
  • Indicate whether the program is currently operational and provide a target opening date if not.
  • Detail the age range of children served and the maximum hours of attendance allowed each day.
  • Clarify how services are compensated, including any funding sources.
  • Ensure that the form is signed by both the director and the administrator for accuracy and accountability.

By following these guidelines, individuals can effectively complete the Missouri DC 20 form and facilitate compliance with state regulations.