vepamk¨ etsn— kare®ciseriskaremileztamekµg sm/agqab ... · curØ¥® kd...

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DSHS 22-859(X) CA (Rev. 12/04) 1. rayeQµaHvtΩ¨TaMg/s'EdlsMxan'sMrab' /ñknigkUnrbs'/ñk . 2. ®bmUls®maMgykeQµaH/ñkp∂l'karemIlEz TaMekµgsMxan'@Ø¥◊ne®cIn . 3. TUrs‡BÊeTA/ñkp∂l'karbMerIØ¥◊ne®cInehIysYr/MBI: kEn¬gsMrab'emIlEzkUnrbs'/ñk . em"ageBleZ√Ikar karCMnYseBlman visßmkal . ´z¬QñÁlnigTTYl®◊k'BICMnYynana . TIkEn¬g kardwknaM . /ahar nwgkar®ss'®sUb . smtΩPaBkñ¨gkarCYbnwgesck∂I®tUvkar rbs'kUn/ñkmñak'Gg . vtΩ¨epßgeT\tEdlsMxan'sMrab'/ñk . 4. dak'karNat'CYbedIm∫IeTAemIlbIkEn¬g… elIsBIenH . KWCakarsMxan'Nas' EdleTAEqkemIlTIkEn¬gTaMg /s'enaH edaypÊal'x¬Án . 5. ®tUvØ¥®◊kd sYrnUvsMnYrrbs'/ñkTaMg/s' enAeBl eTABinit¥dl'kEn¬g ehIynige®bI bJÇI®tYtBinit¥ dUcmankñ¨gkare◊HBumıpßay rbs'®ksYg DSHS "kare®CIserIskar emIlEzTaMekµg: es\vePAmK¨eTÊsn— /ñke®bI®◊s'sMrab'matabita " DSHS 22-516(X) edIm∫I◊"n'®bmaNkEn¬g . 6. EqkemIl/ñksM/agrbs'/ñkp∂l'karbMerI eday: ®b®s‡yCamYyøBukm∂ayEdlman kUnenAkñ¨gkmµviZI . edIm∫IEqkemIlBIkart÷ËjEt÷r nig®bvt∂i karrMelaPbMBan´n /ñkp∂l'karbMerI cUrTUrs‡BÊtamelxedayminbg´z¬ 1-866-482-4325 (1-866-48CHECK) . 7. ykkUnrbs'/ñkeTAemIlkEn¬gEdl/ñke®CIscug e®kay(TaMg/s') . ebIsinCa/aceZ√I◊n cUr/nuJÔa tØ¥kUnrbs'/ñkCYyeZ√IkarsMerccug e®kaybg÷s' . 8. cUreC]Tukcit∂karjaMgØ¥dwg nigkarBinit¥emIl rbs'/ñk . Kµankarer\bcM/√ImYyEdll÷≤t exçaHenaHeT ehIy/ñk nwg®tUvedaH®sayza etIkar s®mbs®mYl NamYyEdl/ñkcg'eZ√I enaHeT . 9. cUr/annUvbTbJÇa´pÊkñ¨g nigkmµviZInanarbs'/ñk p∂l'karbMerIeday®bug ®by‡tñ . cUrØ¥®◊kd cuHhtΩelxakñ¨g®kdas kicçsn¥a…kar®Bme®B\g CamYy/ñkp∂l'karbMerI ehIybJÇak'k∂ IrMBwgeTAvij eTAmkrbs'/ñkØ¥c∫as' las' edayrYmTaMg T®mg'´n´z¬QñÁl´z©Qb' sMrak visßmkal nigsMNgmkvij . 10. eZ√IEpnkarrkCMnYysMrab' eBlman karbnÊan'/asnñ . CMhankñ¨g kare®CIserIskaremIlEzTaMekµg DSHS 22-859(X) CA (Rev. 12/04) kmµviZI®◊k'CMnYy emIlEzTaMekµg & Ce®mIs´nkar/b'rMekµg ¨gbfmv‡y . ¨grdƒva"suinetan es\vePAmK¨eTsn— sM/agqab'rh‡s Washington State Department of Social and Health Services Washington State Department of Social and Health Services Division of Child Care and Early Learning PO Box 45480 Olympia, WA 98504-5480 mkBIkUnes\vePA, kare®CIserIskaremIlEzTaMekµg, es\vePAmK¨eTÊsn—/ñke®bI®◊s'sMrab'matabita DSHS 22-516(X) TUrs‡BÊtamelx 1-800-446-1114 sMrab'suMsMeNAcm¬gmYyc∫ab' .

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DSH

S 22-859(X) C

A (R

ev. 12/04)

1. rayeQµaHvtΩ¨¨TaMg/s'EdlsMxan'sMrab'

/ñknigkUnrbs'/ñk .

2. ®bmUls®maMgykeQµaH/ñkp∂l'karemIlEz

TaMekµgsMxan'@Ø¥◊ne®cIn .

3. TUrs‡BÊeTA/ñkp∂l'karbMerIØ¥◊ne®cInehIysYr/MBI:

• kEn¬gsMrab'emIlEzkUnrbs'/ñk . • em"ageBleZ√Ikar karCMnYseBlman visßmkal . • ´z¬QñÁlnigTTYl®◊k'BICMnYynana . • TIkEn¬g kardwknaM . • /ahar nwgkar®ss'®sUb . • smtΩPaBkñ¨gkarCYbnwgesck∂I®tUvkar

rbs'kUn/ñkmñak'Gg . • vtΩ¨¨epßgeT\tEdlsMxan'sMrab'/ñk .

4. dak'karNat'CYbedIm∫IeTAemIlbIkEn¬g… elIsBIenH .

KWCakarsMxan'Nas' EdleTAEqkemIlTIkEn¬gTaMg

/s'enaH edaypÊal'x¬Án .

5. ®tUvØ¥®◊kd sYrnUvsMnYrrbs'/ñkTaMg/s' enAeBl

eTABinit¥dl'kEn¬g ehIynige®bI bJÇI®tYtBinit¥

dUcmankñ¨gkare◊HBumıpßay rbs'®ksYg DSHS "kare®CIserIskar emIlEzTaMekµg: es\vePAmK¨eTÊsn—

/ñke®bI®◊s'sMrab'matabita " DSHS 22-516(X) edIm∫I◊"n'®bmaNkEn¬g .

6. EqkemIl/ñksM/agrbs'/ñkp∂l'karbMerI eday:

• ®b®s‡yCamYyøBukm∂ayEdlman kUnenAkñ¨gkmµviZI .

• edIm∫IEqkemIlBIkart÷ËjEt÷r nig®bvt∂i karrMelaPbMBan´n

/ñkp∂l'karbMerI cUrTUrs‡BÊtamelxedayminbg´z¬

1-866-482-4325 (1-866-48CHECK) .

7. ykkUnrbs'/ñkeTAemIlkEn¬gEdl/ñke®CIscug

e®kay(TaMg/s') . ebIsinCa/aceZ√I◊n cUr/nuJÔa

tØ¥kUnrbs'/ñkCYyeZ√IkarsMerccug e®kaybg÷s' .

8. cUreC]Tukcit∂karjaMgØ¥dwg nigkarBinit¥emIl rbs'/ñk .

Kµankarer\bcM/√ImYyEdll÷≤t exçaHenaHeT ehIy/ñk

nwg®tUvedaH®sayza etIkar s®mbs®mYl

NamYyEdl/ñkcg'eZ√I

enaHeT .

9. cUr/annUvbTbJÇa´pÊkñ¨g

nigkmµviZInanarbs'/ñk

p∂l'karbMerIeday®bug

®by‡tñ . cUrØ¥®◊kd

cuHhtΩelxakñ¨g®kdas

kicçsn¥a…kar®Bme®B\g

CamYy/ñkp∂l'karbMerI

ehIybJÇak'k∂IrMBwgeTAvij

eTAmkrbs'/ñkØ¥c∫as'

las' edayrYmTaMg

T®mg'´n´z¬QñÁl´z©Qb'

sMrak visßmkal

nigsMNgmkvij .

10. eZ√IEpnkarrkCMnYysMrab'

eBlman karbnÊan'/asnñ .

CMhankñ¨gkare®CIserIskaremIlEzTaMekµg

DSHS 22-859(X) CA (Rev. 12/04)

kmµviZI®◊k'CMnYy

emIlEzTaMekµg &

Ce®mIs´nkar/b'rMekµg

kñ¨gbfmv‡y . kñ¨grdƒva"suinetan

es\vePAmK¨eTsn—sM/agqab'rh‡s

Washington State Department of Social and Health Services

Washington State Departm

ent of Social and Health ServicesDivision of Child Care and Early LearningPO Box 45480Olym

pia, WA 98504-5480

mkBIkUnes\vePA, kare®CIserIskaremIlEzTaMekµg, es\vePAmK¨eTÊsn—/ñke®bI®◊s'sMrab'matabita

DSHS 22-516(X)

TUrs‡BÊtamelx 1-800-446-1114 sMrab'suMsMeNAcm¬gmYyc∫ab' .

kmµviZI CnNamanlk≈Nsm∫t∂i kar/Zib∫ay/MBIkmµviZI dak'Bak¥suMenATINa

cUrTak'TgeTAkmµviZIenAkñ¨gtMbn'

…TUrs‡BÊtamelx (360) 725-4686 edIm∫IrkkmµviZIEdlenACit/ñkCageK .

kmµviZI®◊k'CMnYyemIlEzTaMekµg &

Ce®mIs´nkar/b'rMekµgkñ¨gbfmv‡y . kñ¨grdƒva"suinetan

es\vePAmKK¨eTsn—sM/agqab'rh‡s

Child Care Resource and Refer-ral (R&R) Agencies

CPS Child Protective ServicesCSO Community Service OfficeCWS Child Welfare Services DASA Division of Alcohol and Substance AbuseDCCEL Division of Child Care and Early Learning

DCFS Division of Children and Family ServicesDSHS Department of Social and Health ServicesDVR Department of Vocation Rehabilitation ECEAP Early Childhood Education Assistance ProgramEHS Early Head Start

FPL Federal Poverty LevelNICU Neonatal Intensive Care UnitOCD Office of Community DevelopmentR&R Resource and ReferralTANF Temporary Assistance for Needy Families Start

sMrab'ZnZannigkarbJÇËn EdlenACit/ñk

cUrTUrs‡BÊeTA bN∂aj®bB‡nÛZnZannigkar

bJÇËn´nrdƒva"siunetan tamelx

1-800-446-1114 …

http://www.childcarenet.org

CYyøBukm∂ayrkkEn¬gemIlekµgmanKuNsm∫t∂i, ezak /acecj®◊k'◊n

nigman/aC∆ab‡Nˆ, PÇab'øBukm∂ayCamYy Bt·mankmµviZI®◊k'CMnYyEdl

/acman, CYysMrYldMeNIr karecj/aC∆ab‡NˆCamYy/ñkp∂l'karemIl

EzTaMekµg, ehIynigbeg˚ItØ¥mankaryl'dwgsaZarN:´ner]g

emIlEzTaMekµg .

Kµanlk≈N:vinicœ‡yBIlk≈N sm∫t∂i; CnNa

EdlTUrs‡BÊmk elxenHnwg®tUveKp∂l'

esvaØ¥. (exanZIx¬Hnwg®tUveKTarQñÁl

smrm¥dl'®KYsarEdlman®◊k' cMNUl

elIskMritmYycMnYn .)

Working Connections Child Care

*EdleZ√Ikar, ®KYsarEdl man®◊k'cMNUltic .

*®KYsarEdlmanlk≈N sm∫t∂iTTYlkmµviZI

WorkFirst (TANF), Edl ◊ncuHeQµaHenAkñ¨g

bJÇI TTYlrkkargareZ√I, karhat' h√wkh√Wn,

…eZ√Ikar .

*øBukm∂ayEdlman/ayu e®kam 22 qñaM

minTTYlkmµviZI TANF, cuHeQµaHer\nenA

mZ¥msikßa …er\nkmµviZI GED .

®◊k'CMnYysMrab'emIlEzTaMekµgKW/acmansMrab'®KYsar manlk≈Nsm∫t∂i

Edl®tUvkaremIlEzTaMekµg edIm∫Irkßa kargareZ√I…cUlrYmenAkñ¨gEpnkarh√wk

h√WnEdl◊n/nuJÔat .

kariyal‡ybMerIshKmn— ®ksYg

DSHS kñ¨gtMbn',

http://www.dshs.wa.gov

Child Protective Services Child Care

Child Welfare Services Child Care

Employed Foster Parent Child Care

Division of Vocational Rehabilitation (DVR)

Crisis Nursery

Division of Alcohol & Substance Abuse (DASA) Child Care

First Steps Child Care

Early Childhood Education and Assistance Program (ECEAP)

Head Start

Seasonal Child Care for Agricultural Workers

◊neZ√Ikar, Caksikrman®◊k' cMNUltic .

y"ag ehacNas'®◊k' cMNUl®bcaM qñaM

50% ®tUvEtTTYlmkBI kargarTak'Tg

Epñkksikmµ ®bcaMrdUv .

Homeless Child Care ®KYsarNaEdlKµanpÊHsEm∫g ehIynwgmin

TTYl®◊k'CMnYyCMnYsd´TepßgeT\tkñ¨gkmµviZI

emIlEzTaMekµg .

®KYsarEdleBlbcç¨b∫nñTTYl esvaBI®ksYg

karBarekµg (CPS) .

®KYsarEdleBlbcç¨b∫nñTTYl esvaBIkmµviZI

suxumalPaBekµg (CWS) .

sMrab'øBukm∂ayciJçwmman /aC∆ab‡N

EdleZ√Ikar .

buKlmanBikarPaBEdl manlk≈Nsm∫t∂iT

TYlesva nitism∫TakmµEpñkviCÇaCIv:

ehIynigtMrUvØ¥mankaremIl EzTaMekµgedIm∫IcUl

rYmkñ¨gesvanitism∫TakmµEpñkviCÇaCIv: …eZ√Ikar

gar . lk≈x‡NÎx¬H®tUv/nuvt∂ .

®KYsarEdlmanvibt∂i ehIy®tUv karesvaemIl

EzekµgCabnÊan' /asnñ sMrab'ekµgman/ayu 6 qñaMnigticCag .

øBukm∂aycUlB¥a◊lkñ¨gmnÊIrEdlmankar

/nuJÔatØ¥B¥a◊lkmµviZI Epñke®K]g®svwg…sar

Catiej\n .

®s∂Iman´pÊeBaHEdlTTYlemDIexd enA

eBlcUlB¥a◊l Binit¥EpñkeBT¥Edl®tUvZana

edaykmµviZIemDIexd, /ñkp∂l' karbMerI◊nbJÇa

Ø¥sMrakenAE®KsMraknigeTABinit¥Epñk NICU .

®KYsarEdlmanekµg/ayubI…bYnqñaM ehIy

®KYsarrbs'eK man®◊k'cMNUlrhUtdl'

110%FPL …EdlBuMdUecñHeT /ac®tUvTTYl

pl/a®kk'BIkarer\nmin◊nl÷ .

®KYsarmankUnbeg˚It/ayu 5 qñaMEdlman

®◊k'cMNUlrhUt dl' 100%FPL . p∂l'esva

ekµgmanlk≈Nsm∫t∂i Edlman/ayu 3-5

qñaM . kmµviZIzñak'mtiy¥dƒandMbUg (EHS)

p∂l'esvadl'®s∂Iman´pÊeBaH, ekµgnigkumarman

/ayurhUteTAdl' 3 qñaM .

®◊k'CMnYysMrab'emIlEzTaMekµgKW/acmansMrab'/ñkeZ√Ikar Epñkksikmµta

mrdUvEdlmanlk≈Nsm∫t∂i . øBukm∂ay ®tUve®CIs/ñkp∂l'karemIlEzTaM

Edlman/aC∆ab‡Nˆ …viJÔa bnb‡®t .

®◊k'CMnYysMrab'emIlEzTaMekµgKW /acmansMrab' eBløBukm∂ay

rkemIlpÊHsMrab'rs'enACa/ci´®n∂y—, rkkargareZ√I, …Nat'CYbeZ√Ikar

edaH®say/aCIvkmµpÊal'x¬Án dUcCaEpñkc∫ab', EpñkeBT¥ …hirJÔvtΩ¨¨CaedIm .

®◊k'CMnYysMrab'emIlEzTaMekµg/ac ®tUv◊n/nuJÔatCacMENkmYy´n

EpnkarsMNuMer]gsMrab'®KYsar EdlTTYlesvatamry:kmµviZI CPS .

®◊k'CMnYysMrab'emIlEzTaMekµg/ac ®tUv◊n/nuJÔatCacMENkmYy´n

EpnkarsMNuMer]gsMrab'®KYsar EdlTTYlesvatamry:kmµviZI CWS .

®◊k'CMnYysMrab'emIlEzTaMekµg obtΩm∏øBukm∂ayciJçwmenAkñ¨gkar

garrbs'eK . ®bEhl/ac®tUv ◊n/nuJÔatCacMENk´nEpnkar

sMNuMer]g .

®◊k'CMnYysMrab'emIlEzTaMekµg /acCYyGbuKlEdlmanBikarPaB

edIm∫IØ¥TTYlnigrkßakargareZ√I rbs'eK . naykdƒan DVR

/acCYybg'´z¬emIlEzekµgenA e®kamlk≈N:x¬H edIm∫ICYybuKl

Edlmanlk≈Nsm∫t∂ier\bcMnig TTYlkargareZ√I .

karemIlEzTaMekµgKW/acmanCamUldƒan 24 em"ag . øBukm∂ay/ac

e®bIesvarhUtdl' 72 em"ag . eKalbMNg´nkmµviZIKWkarBar

karrMelaPbMBannigkareZ√s ®bEhsdl'ekµg .

karemIlEzTaMekµg®tUv◊n p∂l'CUn enAeBløBukm∂ay ◊neTAB¥a◊l

Epñke®K]g ®svwg …e®K]gej\nEdlecj ®◊k'edayrdƒ…exanZI .

®◊k'CMnYysMrab'emIlEzTaMekµg KW/acmanenAeBløBukm∂ay eTABinit¥

eraKCa/ñkCMgWe®kA; eBleTABinit¥eraKKWZmµta ticCagbYnem"ag .

kmµviZIenHCYyekµgenAkñ¨g®bB‡nÛsalaer\nsaZarN:tamry:

esvay"agTUlMTUlay man smarhNkmµ edayrYmTaMg kar/b'

rMrbs'kumarkñ¨gbfmv‡y, Binit¥suxPaBnigeZµj, karbMb"n/ahar,

karcUlrYm rbs'øBukm∂ay, nwgesva obtΩm∏®KYsar .

kmµviZI/PivDÏn—ekµgy"agTUlM TUlaymanp∂l'karobtΩm∏ suxPaB, kar/b'rM,

nig®KYsar . øBukm∂ayk°®tUvcUlrYm ehIynigTTYlk´®mBIkmµviZI enaH .

karcUlTTYlCMnYyKWtamry:/ñk em"Akar

emIlEzTaMekµgtamrdUv enAkñ¨gtMbn' .

edIm∫IBt·man cUrTUrs‡BÊ eTATIPñak'gar

ZnZan & karbJÇËnEpñkemIlEzTaMekµg .

karcUlTTYlCMnYyKWtamry:mnÊIr

/ñkem"Akarkñ¨gtMbn' . edIm∫I Bt·man

cUrTUrs‡BÊeTATIPñak'gar ZnZan & ka

rbJÇËnEpñkemIl EzTaMekµg .

karcUlTTYlkaremIlEzTaMekµgKWtamry:

/ñkeZ√Ikarsgmkicç´n CPS .

karcUlTTYlkaremIlEzTaMekµgKWtam

ry:/ñkeZ√Ikarsgmkicç´n CWS .

karcUlTTYlkaremIlEzTaMekµgKWtam

ry:/ñkeZ√IkarEpñksgmkicç .

kariyal‡ynaykdƒan DVR kñgtMbn' .

edIm∫ITTYlBt·man e®cInEzmeT\t

TUrs‡BÊtamelx 1-800-637-5627

ÚeTAemIl bN∂aj/iuneZIENtenA

http://www1.dshs.wa.gov/dvr

®Kb'øBukm∂ayTaMg/s'KW/ac

bJÇËnedayx¬ÁnGg . edIm∫ITTYlBt·man

e®cInEzmeT\t TUrs‡BÊtamelx 1-800-446-1114 .

karcUlTTYlkaremIlEzTaMekµg KWtam

ry:buKlikmnÊIrB¥a◊l .

sMrab'ZnZanenAkñ¨gtMbn' cUrTUrs‡BÊ

Healthy Mothers Healthy Babies tamelx 1-800-322-2588 .

/ñkem"AkarkmµviZI ECEAP Ca/ñkkMNt'

elIlk≈Nsm∫t∂i . edIm∫ITTYlBt·

mane®cInEzmeT\t TUrs‡BÊeTA OCD

tamelx (360) 725-2830 …/IuEmleTA

[email protected] .