CHILD CARE STABILIZATION GRANT (CCSG) WORKFORCE AMOUNT.PDF

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Child Care Stabilization Grant (CCSG) Workforce Amount
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Provider Name
Provider ID Number
Provider Type
County
Is the information above correct? *
Provider Information
Please note you must be a current CCSG recipient to apply for this grant.  If you do not see your name and you ARE a CCSG Grantee,
please email us at childcaregrants@azdes.gov for assistance. 
Contact Name *
 Contact Email *
 Contact Phone Number *
Contact Information
Please provide the contact information that we can use if we have any questions or notifications regarding the grant.
Please select the center director's or family child
care owner's gender. *
Please select the center director's or family child
care owner's race. *
Federal Reporting
Child Care Stabilization Grant (CCSG) Workforce Amount
The Child Care Stabilization Grant (CCSG) Workforce Amount must be used for increasing wages (increases in payroll),
employee benefits, or other recruitment and retention activities (ex: sign on bonus, retention incentive, etc.). A DHS Certified
Group home with no other employees, may use the Workforce Amount on the approved CCSG expense categories found on
the CCSG website, which may include maintaining or increasing wages and benefits. 
 
Each provider will be audited.  You will need to ensure that you keep thorough records of how the funding is spent and keep
receipts of all purchases or payments. 
NOTE: If you are a provider with multiple sites, each site will need to apply separately.
Yes
No
First
Last
Male
American Indian or Alaskan Native
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Child Care Stabilization Grant (CCSG) Workforce Amount
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Please select the center director's or family child
care owner's ethnicity.
  *
Grant Requirements
Female
Non-Binary
No Response
Asian
Black or African American
Native Hawaiian or Pacific Islander
White
Other/No Response
Hispanic
Non-Hispanic
No Response
 
The Child Care Stabilization Grant (CCSG) Workforce Amount must be used for increasing wages (increases in
payroll), employee benefits, or other recruitment and retention activities (ex: sign on bonus, retention incentive, etc.).
A DHS Certified Group home with no other employees, may use the Workforce Amount on the approved CCSG
expense categories found on the CCSG website, which may include maintaining or increasing wages and benefits. 
Should the provider receive funding under this grant application, the provider (hereinafter referred to as ‘grantee’) shall, and
affirmatively promises to, comply with all of the provisions set forth below.
To receive the Workforce Amount, the grantee must certify that:
The grantee will use the CCSG Workforce Amount for spending related to hiring and employing all child care staff.
Approved CCSG Workforce Amount categories can be found in the FAQs on the CCSG website.
The grantee will increase employee’s salary or wages, which may include benefits or bonuses, with the Workforce Amount
of my grant award. This must go above and beyond current compensation, benefits, or other incentives. If I am a DHS
Certified Group home with no other employees, I will use my Workforce Amount on the approved CCSG expense
categories found in the FAQs on the CCSG website, which may include maintaining or increasing my own wages and
benefits.
The grantee will provide payroll documentation to prove the base pay and the increase for all child care staff employed at
the program as outlined in the FAQs on the CCSG website.
The grantee will continue to meet CCSG requirements as attested in my CCSG application.
 
I, , certify that I have read and agree to the Child Care Stabilization Grant (CCSG) Workforce Amount terms set forth and I
understand all of its provisions.  I further agree that all information submitted is true and accurate. (Please review your
answers and ensure they are correct before you sign and submit)
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Child Care Stabilization Grant (CCSG) Workforce Amount
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