Licensed and Registered Child Care Services (CCS) Provider Application

Licensed and Registered Child Care Services (CCS) Provider Application

Thank you for applying to be a Workforce Solutions CCS Provider. You may complete this application if you have received a Becoming a CCS Provider Letter

Texas Rising Star and Entry Level Requirements

Texas Government Code 2308.3155 requires that all CCS child care and early learning programs participate in the Texas Rising Star program, beginning at the Entry Level Designation. Effective 10/2022, all child care vendors must meet the Entry Level Designation requirements to sign a CCS vendor agreement.

To begin the process, you must first complete a TRS Interest Form at this link (Please copy and paste in a different browser): https://cliengage.atlassian.net/servicedesk/customer/portal/1/group/63/create/301

***Please do not submit this application and supporting documentation until you have received a Becoming a CCS Provider Letter.

If you have received the Becoming a CCS Provider Letter, please submit your application and documents promptly as you must sign and return the CCS Agreement within seven (7) business days. If you have not received a letter, please contact Texas Rising Star staff at texasrisingstar@wrksolutions.com

Request Date*

Type of Center*

Select from the dropdown

Select

Operation/License #*

Provider's Name*

As listed on your license from DFPS

Center Phone #*

Center's Email Address*

Center's Physical Address*

Is Mailing Address Different?

Select

Center's Mailing Address*

Owner Name*

Owner's Address*

Contract Requirement. Needed in case of center closure so important documents can be sent out.

Owner's Email Address*

Tax Classification*

Please select the tax classification for the owner/business (this will be reflected on the W9)

Select or enter value

Director's Name*

Have you been contracted with us before?*

Any provider that loses its Entry Level designation and returns as an Entry Level designated CCS provider, will have a modified timeline to achieve certification based on the difference of the 24-month time frame and the Entry Level designation time previously provided.

Select

Do you provide Transportation?*

If so, you must include this on your published rate sheet and indicate if the transportation is included in your rates or separate

Select

Pre-K Partnership

A pre-K partnership is defined as a collaboration between a public school pre-K program and one or more quality-rated child care providers to provide high-quality care and education to eligible three- and four-year-old children.

If you have a partnership with a public school, check the box below and attach a copy of the agreement/MOU in the "Upload Files" section below.

Required Documentation

Please review and provide the required documentation below

Operation License*

Provide a copy of your License issued by DFPS. Check the box to validate the file was uploaded.

Proof of EIN Number (Licensed Facilities)

Provide a letter from the IRS with your EIN number if you are operating a Licensed Child Care Facility or Licensed Home (not required for Registered Child Care Home Providers). Check the box to validate the file was uploaded.

Proof of Social Security Number (Home Care Providers)

Provide a copy of your Social Security card if you are a Registered Child Care Home Provider (not required for a Licensed Child Care Facility or Licensed Home). Check the box to validate the file was uploaded.

Vendor's Published Rates*

Provide a copy of your published rates. Check the box to validate the file was uploaded.

Drivers License or ID

Provide a copy of your Drivers License or ID if you are a Registered or Licensed Home Care Provider (not required for a Licensed Child Care Facility). Check the box to validate the file was uploaded.

Voided Check*

Provide a copy of a Voided Check. This is required to set up Direct Deposit. Check the box to validate the file was uploaded.

Upload Files*

Once the License, EIN or Social, Rate Sheet, Published Rates, Voided Check and Drivers License or ID (if applicable) are uploaded, check the box to validate the file was attached. Workforce Solutions cannot process your vendor application without these documents.

You will receive the CCS Agreement and additional documents for your review and signature. These forms must be signed and returned as soon as possible. If you fail to sign and return all forms within seven (7) days of receiving the Becoming a CCS Provider Letter, you will be directed to complete a TRS Interest Form to begin the process from the beginning.

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