FIRST UNITED METHODIST CHURCH RATE AGREEMENT.PDF

FOR DES USE ONLY: Month and year entered to this section indicate the actual month and year DES made the
provider’s rate revision effective: 11/27/2023
CC-214 (9-21)
ARIZONA DEPARTMENT OF ECONOMIC SECURITY
Child Care Administration
CHILD CARE PROVIDER RATE AGREEMENT
Please read the reverse for additional information.
Provider/Facility’s Name  Maricopa County Human Services - First United Methodist Church Head Start
Provider Number   P0028668207
√ Initial Rate Notification
1.
Complete and submit original and canary copy of this agreement (faxed copies are unacceptable).
2.
Rate revision only: (ALL RATE REVISIONS SHALL BE EFFECTIVE ON THE FIRST DAY OF THE MONTH.) 
Provider shall submit the Child Care Provider Rate Agreement a minimum of 30 days prior to the proposed effective 
date of any changes to the Child Care Provider’s rates.
Enter the month and year your proposed rate revision will begin 9/21/2023 (Month and year entered
may not be the same month and year DES makes rates effective.)
3.
Rates entered in the “PROVIDER’S RATE” column below must be your normal and customary charges. 
Information Regarding the DES Reimbursement Rates:
1.
The DES will pay the rates indicated in the shaded area entitled RATES AUTHORIZED BY DES minus any DES 
required customer co-payment. (Co-payment: An amount established by DES requiring families to pay to the 
provider.)
2.
The DES shall review its provider’s rates, complete the shaded areas, sign the Agreement, and return the canary
copy to the provider. DES shall maintain the original in the provider’s file.
3.
Reimbursement rates authorized by DES under this Agreement may be revised through a fully executed Child Care 
Provider Rate Agreement or upon thirty (30) days written notice to the provider of the revised reimbursement rates 
established by DES.
DO NOT LIST HOURLY, WEEKLY, OR MONTHLY RATES.
RATES ENTERED BELOW SHOULD BE A FULL DAY DAILY RATE AND/OR A PART DAY DAILY RATE.
 
DO NOT ENTER INFORMATION TO SHADED AREAS. DES USE ONLY
AGE GROUPS
PROVIDER’S 
RATES
*RATES AUTHORIZED BY DES
Do not change age 
groups below.
Full Day
(6 hrs or more)
Part Day
(Less than 6 
hrs)
Full Day
(6 hrs or more)
Part Day 
(Less than 6 
hrs)
BP Eligibility      
(P Kind)
Toddlers: One (1) and 
Two (2) years-old
$78.12
 
$46.15
  
$46.15 
Preschool: Three (3), 
Four (4), Five (5) years-
old
$64.68
 
$40.80
  
$40.80 
National 
Accreditation
No
Star Rating 
 
*Incentive rates are subject to change.
DES Authorized Representative’s Signature: 
Michelle Genaro, Deputy Assistant Director, Division of Child Care
Date:11/28/2023