Lorain County Job & Family Services

Forms - Providers

Please click on the form number in blue to go to the specific form:

CCU-202 Fire Drill Log
CCU-204 Daily Sign-In Sheet
CCU-205 Statement of Non-Transportation
JFS 1121 Early Childhood Education Eligibility Screening Tool
JFS 1122 Publicly Funded Child Care Supplemental Application (With Voter Registration)
JFS 1280 Medical Statement for Type B Home and In-Home Aide Child Care Providers
JFS 01299 Incident/Injury Report for Child Care Centers/Type A Homes/Type B Providers
JFS 1299-I Instructions for Completing JFS 1299
JFS 1302
Request for Child Care and Neglect Report Information
JFS 01329

Statement of Non-Conviction for Type B Homes and In-Home Aides

JFS 01332

Certified Child Care Handbook for Caretakers 
JFS 01332-I Instructions for Completing JFS 01332
JFS 1527 Notification of Criminal Records Check and Child Abuse and Neglect Check for Employees and Assistants
JFS 1528 Type B Home Provider Employee Record Chart
JFS 01634 Caretaker/Provider Agreement for Type B Homes and In-Home Aides
JFS 01643 Application for Professional Type B Child Care 
JFS 1911 Infant Daily Report -Type B Child Care Homes and In-Home Aides
JFS 1920 Emergency/Substitute Caregiver Acting as an Assistant in a Type B Child Care Home
JFS 1933 Liability Insurance Statement for Type A and Type B Child Care Homes
W9 Request for Taxpayer Identification Number & Certification 


Child Care Information Data System (CCIDS) / ECC (Electronic Child Care) Links and Information

Please click on the applicable link for more information.

Provider Portal https://www.ccidsportal.ohio.gov/login.jsf
Ohio ECC Provider FAQ's http://jfs.ohio.gov/cdc/docs/Ohio%20ECC%20Provider%20FAQs.pdf
CCIDS Resource Guide http://jfs.ohio.gov/cdc/docs/ChildCareinOhioResourceGuide.pdf
Parent/Card Carrier information http://jfs.ohio.gov/cdc/CaretakerCardCarrier.pdf
Parent/Card Carrier FAQ's http://jfs.ohio.gov/cdc/OhioECCCaretakerFAQswithspanish.pdf
ODJFS Providers Home Page http://jfs.ohio.gov/cdc/providers.stm
More information http://jfs.ohio.gov/cdc/CCIDS.stm