Home Based Child Care Providers Emergency Fund Application

Home Based Child Care Grant Application Hawaii Community Foundation has established the Home Based Child Care Providers Emergency Fund and the Hawaii Resilience Fund, to provide child care programs with one-time, flexible funding to ensure the continuity of program operations during the COVID-19 pandemic. The Fund will award emergency funds to licensed child care programs that are open, currently serving families, and meet the additional criteria identified below. The goal is to recognize the essential role child care plays in helping communities weather this crisis, get back to business, and ease the burden so that programs can focus on caring for children and families.

Emergency Fund Eligibility & Criteria: Applicant must be located in Hawaii Applicant is a licensed family child care program that is in good standing with DHS. Licensed center-based providers will be considered through Hawaii Resilience Fund and will use the same criteria.

Applicant's program is open and currently serving families and agrees to stay open for a minimum of one month after receipt of the funding. OR applicant’s program is currently closed, but plans to re-open as soon as the stay-at-home order is lifted and previously served families with subsidies.

Applicant agrees to prioritize children of essential and emergency workers as spots become available.

Applicant will serve, continue to serve, or agree to serve, children on child care subsidy.

Applicant will update PATCH (via survey) of operating status and available space information Applicant will use health and safety practices that prevent the spread of COVID-19 by following Center for Disease Control (CDC) and Hawaii Department of Health guidelines as much as possible.

Applicant will reply to HCF's request for a completed W9 form within 48 hours.

Applicant agrees to complete a survey report on how funds were used. Center-based providers agree to provide bi-weekly updates on # of children of essential workers receiving tuition assistance enrolled.

Funds will be awarded in the amount of $1,000-$3,000 (with average award size of ~$2,500) per applicant based on availability.

Applicants will be notified of the grant award via email with instructions on submitting information to complete the release of the grant award.

1. Contact Information * Name (as it appears on your child care license)

Title

* First Name

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Middle Name

* Last Name

Suffix

** Address Address 2 City State Zip Code Email Address Phone Number

* 2. Select business type Non-profit For-profit (small business: LLC, sole proprietor, or other) Other (please specify)

* 3. You are a:

* 4. Enter your child care license number as printed on license.

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* 5. Select geographic location you are located in (select one answer only).

East Hawaii Island West Hawaii Island Hawaii Island Maui Molokai Lanai Oahu West Oahu Central Oahu Kauai

* 6. What is your current licensed capacity according to your facility DHS license?

* 7. How many children are currently enrolled (select one answer only)?

0 1 2 3 4 5 6 7+

* 8. Do children enrolled in your program, or recently enrolled in your program receive (select one answer only): Child Care Connections subsidy Pauahi Keiki Scholars Both N/A

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* 9. If you are open, do you currently serve a child with an unemployed primary caregiver, a child with special needs, a child in a housing unstable situation, or a child age 2 or under?

Yes No

9a. If yes, please select which populations you serve.

A child with an unemployed primary caregiver A child with special needs A child in a housing unstable situation A child age 2 or under

* 10. Briefly describe the impact of COVID-19 on your program (i.e. loss of revenue, declining enrollment, increased expenses, etc.).

* 11. What do you anticipate using the emergency funds for (please select all that apply): Food (including formula) to provide required child care meals Cleaning supplies/hand soap/sanitizer to maintain safe environment Disposable/consumable materials needed to manage daily child care (paper products, wipes, diapers, etc.)

Rent/Mortgage Utilities/Insurance payments Payroll expenses Other (please specify)

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* 12. Have you applied for any loans or grant programs?

Small Business Administration Economic Injury Disaster Loan Paycheck Protection Program Aloha United Way COVID-19 Rent & Utility Assistance Program Private Loan I have NOT applied for any loans or grant programs Other (please specify)

13. If you have applied for any loans or grant programs, have you received notification of funding?

Yes No If yes, specify which funds

* Declaration: I understand that by checking the boxes below I agree to the following eligibility and criteria requirements should Emergency Funds be awarded to my program (must agree and check all the boxes to have a complete application): I am a licensed family or center-based program that is in good standing.

My program is open and currently serving families and I agree to stay open for a minimum of one month after receipt of the Emergency Funds. If my program should be required to close at the direction of the state health department or other authorized officials, I will not be required to return the funds.

I agree to prioritize children of essential and emergency workers as spots become available.

I will serve, continue to serve, or agree to serve upon request, children on child care subsidy.

I will update operating status and available space information with PATCH. I will use health and safety practices that prevent the spread of COVID-19 in a child care environment based on guidance from state health departments.

I understand my application will not be considered complete until I submit my completed W9 form.

* Certification I certify that all the information provided in this application is accurate to the best of my knowledge.

We understand this is a difficult time for all child care providers. We hope this funding may provide some immediate relief for you, the keiki, and ‘ohana you serve while federal and state resources are being mobilized.

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