Start-Up Grant Application Cover Page

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General information Start-Up Grant Application Cover Page APPLICANT S INFORMATION: Please type or print legibly. Applicant s Name: First Mi Last Child Care Address: email Mailing Address if different: Phone ( ) Social Security number: KDHE license # Application Requirements All applications must use this completed form as the cover page. Complete the Smart Start of Saline County s application budget page and attach to your application. Please do not include any supplemental materials except those requested. Using no more than two, 8½ X 11 single-sided sheets of paper, please tell us about your proposal in narrative form. Be sure to include the following, and label the information by letter in your narrative: a) Objective or Reason for use of requested grant funds b) Reflect how the training/education you have received influenced your need for the equipment. c) Describe how the requested equipment will enhance children s learning and interactions. d) Explain process for selection of equipment and give examples. e) Your expected results f) Your timetable and process for achieving results Please see general information sheet for more specifics on items to be included with application. Total project cost Smart Start grant requested (not to exceed $300) Other Funding sources If total grant requests exceed the amount of available funding. Are you willing to accept a grant less than your requested amount? Yes No Submit: A complete application includes cover page, application form, budget page, narrative, training documentation, reference letters, policy handbook, business contract, KDHE license, SRS contract and be postmarked no later than June 8, 2011. Questions? You can call Smart Start at 825-4455

Start-Up Grant Application Form Total number of children currently enrolled in care: 1. Number of children enrolled age birth to 12 months 2. Number of children enrolled age 13 months to 35 months 3. Number of children enrolled age 36 months to 5 yrs (not in school) 4. Number of SRS children in your care 5. Number of children with an IFSP/IEP in your care? Are you a TEACH recipient? Yes No WAGE$ or PDI recipient? Yes No Are you participating in the Infant/Toddler project through the R & R? Yes No Are you participating in KQIRS? Yes No Do you receive special needs child subsidies from Smart Start? Yes No Are you a Heartland partner? Yes No TRAINING INFORMATION: 20 hours of training required (no more than 10 of these hours can be completed online) Number of clock hours of KDHE approved (in person) in-service training and/or Early Childhood Education college classes credit submitted: (Start-up grant applicants must have at least 10 hours of training completed by June 8, 2011 to apply. If you only submit 10 hrs and are awarded a start-up grant, you will receive 50% of your grant award. The remaining 10 hours of training must be completed by August 15, 2011 to receive the other 50% of the grant award.) Send copies of certificates of training or college credit you have attended. Online college credit from any Kansas 2 or 4 yr. college in early childhood will be accepted. One college credit hour is equal to 15 contact hours of inservice. For this grant, if you complete one college credit hour from any Kansas 2 or 4 yr. college, you are allowed to count this as 10 hours of the total 20 you are required to attend. This is the only option for completing online training. The remaining 10 hours would need to be in person KDHE approved inservice hours in the surrounding area. APPLICANT S STATEMENT: I AFFIRM THAT ALL INFORMATION ON THIS APPLICATION IS TRUE AND CORRECT. MY SIGNATURE BELOW MAKES THIS STATEMENT BINDING. Signature of Applicant: Date:

Start-Up Grant General Information In order to improve the quality of child care in Saline County, Smart Start of Saline County is offering quality improvement grants available to family child care providers who have been in business more than one year. Terms of the Quality Improvement Grant: Provider will be in business less than one year as of June 8, 2011 Maximum amount awarded is $300.00 Must be a licensed child care provider Provider must supply a business contract with application Provider must supply a sample of policies/procedures given to parents with application. Provider must supply 3 current references from parents and be in good KDHE/SRS compliance Provider must have an SRS contract and submit a copy of the SRS contract Provider must have completed at least 10 hours of KDHE approved training or equivalent online college credit in early childhood education from a 2 yr. or 4yr. Kansas college that occurred between Nov. 1, 2010 June 8, 2011 to apply. The other 10 hours must be completed by August 15, 2011. All 20 hours can be submitted with the application if they have been completed. Application must be postmarked by June 8, 2011. Provider must purchase allowable items, (see list) and supply receipt of items purchased Grantors have the right to visit and see purchased grant items Shipping and handling are not covered as part of the grant (many companies will give you free shipping but you have to ask) Funding will not be given for requests such as: Televisions, VCR S, DVD players, any electronic games Appliances, Copier, Computer, Digital Camera, or office equipment Trampolines, Toy Boxes with Lids, Infant Walkers, Pools or pool toys or equipment Home repairs, carpet, concrete, or sheds of any type Water filters, air purifiers or Child Assessment tools Infant swings Fences Consumables ie: Arts & Crafts supplies Requirements of provider if funded: Signed assurance stating that by accepting grant funds provider agrees to all terms and conditions of the grant. Receipts must be submitted for all grant expenses by the deadline given in the award information Must complete an evaluation of grant process Must allow an on-site visit to confirm purchases made with grant funds Provider must remain in good standing with KDHE/SRS compliance Things to remember The awards will be made, based upon the availability of funds Funding will be awarded to providers in Saline County. This is a competitive process; not all applications can be funded

Grant selection process Start-Up Grant General Information continued The enclosed rubric will be used to rate/rank each grant application. A grant committee will review applications to determine which applications will be funded. Grant applicants will receive notification by mail regarding funding. Any purchases made before grant is awarded will not be eligible for reimbursement. Allowable Expenditures Furniture/equipment: strollers, cribs, highchairs, child size table and chairs, booster seats, cubbies, low shelves and storage units Music/movement: tape or CD players, appropriate music, recorded stories, instruments, movement games, dancing ribbons/scarves Balls/sports equipment: tumble balls, clutch balls, all kinds of sports balls, balance boards, outdoor physical games, jump ropes, stompers, parachutes Books: infant board books or cloth books, picture, short story and chapter Construction materials: soft blocks, plastic blocks, wooden blocks, legos/duplos, tinker toys and Lincoln logs, nuts and bolts, children s tool sets Dolls: soft dolls, multi-cultural dolls, doll clothing & accessories, small figures, cloth dolls, paper dolls, puppets and puppet stage Games/puzzles: simple games, matching games, bingo, guessing games, word games, non-reading action games, skill building games all levels of puzzles Out door equipment: tunnel, toddler climbers, ground cover Push and pull toys: toy mower, shopping cart, vacuum cleaner, poppers Riding equipment: infant/toddler riding toy, tricycle rocking horse, scooters Role play equipment: telephone, cash register, cooking toys, play money, dress up clothes and hats, small kitchen set and furniture, mirror Sand & Water materials: sand & water table, funnels, floating toys, molds, digging tools, buckets, fishing toys, plastic smocks, sponges Health and safety items: lock box, fire extinguisher, baby gates, child proof items, First aid Kit, smoke alarms

Budget Page Applicant: Date Project Expenses: TOTAL $

2011 Family Child Care Grant Applicant Reference Form When this form is complete, return it to your family child care provider so it can be included with the Smart Start Grant Application. If you have any questions, you may call Smart Start at 825-4455. This information will be kept confidential. Applicant: Phone: Reference: Phone: What skills and experience does the applicant have in working with young children? Please comment on any knowledge of the applicant s work habits, personal and professional conduct as they relate to a career in early childhood education.

2011 Family Child Care Grant Applicant Reference Form When this form is complete, return it to your family child care provider so it can be included with the Smart Start Grant Application. If you have any questions, you may call Smart Start at 825-4455. This information will be kept confidential. Applicant: Phone: Reference: Phone: What skills and experience does the applicant have in working with young children? Please comment on any knowledge of the applicant s work habits, personal and professional conduct as they relate to a career in early childhood education.

2011 Family Child Care Grant Applicant Reference Form When this form is complete, return it to your family child care provider so it can be included with the Smart Start Grant Application. If you have any questions, you may call Smart Start at 825-4455. This information will be kept confidential. Applicant: Phone: Reference: Phone: What skills and experience does the applicant have in working with young children? Please comment on any knowledge of the applicant s work habits, personal and professional conduct as they relate to a career in early childhood education.

Smart Start of Saline County Family Child Care Provider Mini Grants Rubric Objectives/Reasons for use of grant funds Equipment durability/& use by number of children Use of Training/Education Knowledge Plans for use of equipment Paper work included Budget Neatness of Proposal Area of child development to be enhanced with grant funds are thoroughly documented. Proposal reflects excellent consideration into a wide variety of materials/equipment Proposal thoroughly reflects the providers knowledge of developmentally appropriate equipment 5 3 1 Area of child development to be enhanced with grant funds is stated and some evidence of need is provided. Proposal reflects some consideration into a wide variety of materials/equipment Proposal indicates a basic knowledge of providers knowledge of developmentally appropriate equipment Proposal includes at least one method/idea for use of equipment Area of child development to be enhanced with grant funds is unclear. Proposal reflects little consideration into a wide variety of materials/equipment Proposal fails to show evidence of providers knowledge of developmentally appropriate equipment Proposal does not include any method/ideas for use of equipment Proposal includes a variety of methods/ideas for use of equipment All of the required paperwork is included in packet paperwork is included but not complete paperwork is not complete Budget is complete and contains all required information. Budget is cost Budget is complete but is not cost efficient and/or effective and linked to the child related to the child development enhancement development enhancement goal. goal. the proposal is neat and easy to understand the proposal lacks neatness and is hard to understand budget lacks required information or includes unallowable expenditures the proposal is sloppy and hard to understand