Lorain County Job & Family Services

Forms - Providers

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

CCU-200 No Smoking Sign
CCU-201 No Firearm Sign
CCU-202 Fire Drill Log
CCU-204 Daily Sign-In Sheet
JFS 00598 Owner's Authorized Representative/Partnership Form for Child Care
JFS 1121 Early Childhood Education Eligibility Screening Tool
JFS 1122 Publicly Funded Child Care Supplemental Application (With Voter Registration)
JFS 01228 Infant Daily Report
JFS 01250 Plan of Operation for Child Care
JFS 01276 Health Training Documentation
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 01306 Employee Record Chart
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 forTaxpayer 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