Temporary Child Care Service Grant

Families

Applicant Information

You may operate a child care facility on your own or with a partner. To be eligible as a worker, you must be currently certified and have background checks on record with Manitoba Early Learning and Child Care. Note: Regular child care rates will apply to the provision of child care under this grant program.

Applicant 1 (required)

Full & complete legal name

Last Name:

First Name:

Middle Name:

Previous name(s)

Last Name:

First Name:

Middle Name:

Contact Information

Phone Number:

Fax Number:

Email:
e.g bryan@example.com

Do you reside in the location in which care is going to be provided? Yes No

What is your current child care classification? CCA ECEII ECEIII

Which facility are you currently employed with? (If None, please check the box below indicating 'None')

None

Location Information

You may operate temporary child care services in your home or in an appropriate community space. Please provide us with the details of where you plan to provide care.

Mailing address

PO/Box #, building name; civic or municipal address etc.

City/town/municipality

Province:

Postal Code

Location address

Same as Mailing Address

Unit/Suite # building/house # Street Name & Type

City/town/municipality

Province:

Postal Code

Child Care Spaces and Children Information

Child Care Spaces and Children Information As a temporary home facility, you can offer child care to a maximum of 8 children under 12, including your own. Within the 8 child maximum, there is a maximum of 5 children under 6 years, only 3 of which can be under 2 years old.

Expected # of Children in Care	Age of Child	Is this your own Child?	Vacant (will accept placements)	Essential Service Family?
Child # 1	hidden_Label	Yes	Yes No	Yes No
Child # 2	hidden_Label	Yes	Yes No	Yes No
Child # 3	hidden_Label	Yes	Yes No	Yes No
Child # 4	hidden_Label	Yes	Yes No	Yes No
Child # 5	hidden_Label	Yes	Yes No	Yes No
Child # 6	hidden_Label	Yes	Yes No	Yes No
Child # 7	hidden_Label	Yes	Yes No	Yes No
Child # 8	hidden_Label	Yes	Yes No	Yes No

Child Care Hours/Availability

Based on the type of availability, additional requirements may be required to be licenced.

Weekdays Evenings Weekends Overnight

Child Care will be provided daily
From	To

Minimum Hours Available Per Day: (minimum of 6 hours daily)

Minimum Hours Available Per Week: (minimum of 30 hours per week)

Funding

Approved applications will receive up to $3,000 for the purchase of essential equipment and supplies. Please keep receipts for purchases, which may be required by Manitoba Early Learning and Child Care at a later date.

Eligible expenditures to support health and safety requirements include: fire extinguisher, safety devices and carbon monoxide detectors.

Eligible expenditures to support quality learning and care include: outdoor play equipment such as climbing structures, swings and slides, child size tables, chairs, benches, indoor child size furnishings and equipment such as: tables and chairs, high chairs, diapering table, stroller or carriage, sled or toboggan, soft child-sized furnishings. Supplies for crafts and activities are also acceptable. Items must be appropriate for the age group.

Verification of Enrolment

Successful applicants will be required to provide the names and addresses of enrolled children and their parent(s)/guardian(s) to the Manitoba Early Learning and Child Care Program for validation in order to receive payment.

Applicant consent

I give my consent for Manitoba Early Learning and Child Care to use the information provided above for the purposes of giving the applicant temporary authorization to provide child care services. The information provided is accurate and true to the best of my knowledge.

Date:

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