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Kentucky Provider Update Form

Required fields are marked with an asterisk (*).

Contact Person:*
Program Name:*
Program Address:*
City:*
State:*
Looking for Ohio? Click here for the Ohio form.
ZIP:*
Primary Phone:*
Additional/Alternate Phone:
Email:*
Website:
Age care begins:  
Age care ends:  
Has this program closed or is it closing?

Location and Transportation
Is your program located near a public bus stop? (i.e. METRO, RTA, TANK)


What school district is your program in?


What school(s) do the children enrolled in your care attend?


Transportation available between your program and area schools:



Care Available
(check all that apply)










*Assuming openings are available and parents have completed necessary paperwork.


Program Type


Vacancies
Infant
Birth to 11 months
Young Toddler
12 to 23 months
Older Toddler
24 to 35 months
Young Preschool
3 years
Older Preschool
4-5 years
Kindergarten
First Grade and
Older

Rates per Age Group
Tuition information is used to calculate the average cost of child care in the area. It may also be shared with individual families seeking care. 4C does not publish individual programs' tuition information.
Full-Time FeesPart-Time Fees
0-11 months
12-23 months
24-35 months
3 years
4-5 years
Winter, Spring and Summer
Breaks
Before and/or After-School
Care
Kindergarten
First grade and older

Hours of Operation
Day Shift
(6 a.m.–7 p.m.)
Second Shift
(7:01 p.m.–12 a.m.)
Overnight
(12:01 a.m.–5:59 a.m.)
Time OpenTime Closed Time OpenTime Closed Time OpenTime Closed
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Quality Rating and Accreditation
STARS for Kids Now
Other Accrediting Bodies
(check all that apply)




Subsidy / Financial Assistance
(check all that apply)





Program Policies
(check all that apply)





Environment
(check all that apply)




Safety
(check all that apply)

Special Needs
Does your program have a willingness, training or experience to help children with special needs?
Would you like referral to your child care program if a child’s special need is (check all that apply):





Languages Spoken in Program
Do you have a staff member fluent in and able to discuss child care with parents in (check all that apply):






Meals Provided
(check all that apply)





Additional Fees
(check all that apply)


Philosophy
(check all that apply)



Child Care Setting



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