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Update Your Provider Profile

This form allows you to send updated information about your program to the Child Care Resource and Referral Program in your county.

General Information
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Type of Care
Family Child Care Child Care Center Exempt Preschool Only
School Age Care Summer Camp Exempt
Address
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Mailing Address (if different)
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Service Information

(if applicable):

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(Maximum number of children in facility at one time)

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:  years months weeks

:    years months weeks

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Infant    Toddler    Preschool    School Age

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DSHS/State   Sliding Scale   Multi-child Discount

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Infant:    Toddler:    Preschool:   
School Age:    Part Days During School Years:

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Monthly    Weekly    Daily    Hourly

(optional):

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 Monday    Tuesday    Wednesday    Thursday    Friday     Saturday    Sunday

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Opening Time Closing Time Occasional Saturday
Occasional Sunday Occasional Evening Occasional Overnight
School-Age with Younger Sib only
Special Needs

The Special Needs field is used to track provider experience and training in caring for children with special needs. "Special needs" is loosely defined to include needs that go beyond a typical child's needs for that child's age. The philosophy behind the field is that information about the accommodations providers can offer is what is needed most by parents. This is in contrast to collecting information about diagnoses.

At best, this information is simply an indicator of a provider's training or experience in these areas. This list was intentionally kept short. It is not possible to gather the specific level of information that a parent would want, so parents should always be made aware that it is their responsibility to determine which program is the best fit for their child. On the provider's side, it is each provider's responsibility under the ADA to consider their ability to reasonably accommodate a specific child's needs in their program.

Check each category that applies to you. Underneath each category are some examples of the types of accommodations that fit into the category.

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  • Provides a level of structure beyond that needed by typical children
  • Reinforces positive behavior effectively
  • Has training or experience with structured reward systems to prevent negative behavior
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  • Understands/speaks sign language
  • Can use/accommodate assistive technologies for communication, such as hearing aids or computers
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  • Diapering an older child (especially school-age)
  • Assistance in managing toileting for an older child
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  • Feeding an older child
  • Altering the food for a specific child so that the texture is not a barrier to eating
  • Providing modified utensils
  • Tube feeding
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  • Caring for a child with a chronic condition that may require adult intervention (asthma, diabetes)
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  • Ensuring a child receives required medications on an ongoing basis, usually for a chronic condition
  • Complying with additional documentation requirements
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  • Assisting children with getting around in a child care setting
  • Modifying the environment to accommodate wheelchairs or crutches
  • Lifting a child or assisting a child to stand or walk
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  • Has a nursing credential
  • Provides access to a nurse for a child whose condition requires medical monitoring or intervention while the child is in child care
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  • Has a physical therapy credential, such as physical therapist or occupational therapist
  • Uses activities intentionally to support a child's PT goals
  • Provides access to PT while the child is in child care
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  • Provides specialized equipment for children with special needs
  • Accommodates specialized equipment provided by a parent

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