wp content uploads 2023 02 OCCRS child daycare facility
DHS-DCL-200 GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES DEPARTMENT OF HUMAN SERVICES BUREAU OF LICENSING APPLICATION FOR A VIRGIN ISLANDS CERTIFICATE TO OPERATE A CHILD DAY CARE FACILITY FOR USE BY DHS ONLY Application Date__________ Date Approved___________ Date Denied _____________ I. 1. Name of Agency: _____________________________________________________ 2. Mailing Address: _____________________________________________________ 3. Telephone Director: ___________________________________________________ 4. Name of Agency Director: _________________ Title: ______________________ II. 1. Name of Facility: _____________________________________________________ 2. Type of Facility: _____________________________________________________________________________ 3. Specific Address: _____________________________________________________________________________ 4. Telephone Number: ___________________________________________________________________________ 5. …
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DHS-DCL-200 GOVERNMENT OF THE VIRGIN ISLANDS OF THE UNITED STATES DEPARTMENT OF HUMAN SERVICES BUREAU OF LICENSING APPLICATION FOR A VIRGIN ISLANDS CERTIFICATE TO OPERATE A CHILD DAY CARE FACILITY FOR USE BY DHS ONLY Application Date__________ Date Approved___________ Date Denied _____________ I. 1. Name of Agency: _____________________________________________________ 2. Mailing Address: _____________________________________________________ 3. Telephone Director: ___________________________________________________ 4. Name of Agency Director: _________________ Title: ______________________ II. 1. Name of Facility: _____________________________________________________ 2. Type of Facility: _____________________________________________________________________________ 3. Specific Address: _____________________________________________________________________________ 4. Telephone Number: ___________________________________________________________________________ 5. Directions to Facility: _________________________________________________________________________ ___________________________________________________________________________________________ III. 1. Type of care: Full Day Half Day Other: _________________ After School Night-Care _________________ Specify 2. Operation: Days PER WEEK M T W T F S S (Circle each day open) From_____AM/PM to ______AM/PM 3. Vacation Periods in Year______________________________________________________________________ 4. Proposed Capacity: Total Number of Children (Include children of operation and staff)______________ Minimum Age_________________ Maximum Age_________________ 5. Proposed number of staff (full-time) _______________ (Part Time) ________________ 6. Fees – Monthly Fee (Indicate any variations in established fee, for example, for more than one (1) child in same family. _________________________________________________________________________________________ _________________________________________________________________________________________ Registration Fee (if any) $____________ Insurance Fee (if any) $____________