HCJFS 8011 (REV. 1-19)
Hamilton County Department of Job and Family Services
Child Care Intake Application Packet
The following forms are included in this packet. Please review and retain this page only for your reference.
1.
You must verify all current income for your family and all activities for which you need child care.
You must have a source of income or document how you meet your household expenses.
Gather any verifications that apply to your family. Without required verification your case will be denied.
Attach a readable copy of all current income &/or school verifications. Income verification must be 6 weeks old or less.
Caretakers must provide the appropriate documentation to verify the child is one of the following:
A U.S. born citizen. To verify U.S. Citizenship, the caretaker must provide a civilian birth, baptismal, or church certificate
showing a birthplace in the U.S.
A foreign born U.S. citizen. To verify U.S. Citizenship, the caretaker must provide a citizen certification, U.S. passport,
consular's certification of birth, or certificate of naturalization as verification.
A qualified alien. To verify the child is a qualified alien, the caretaker must provide forms issued through the immigration
and naturalization service, including the INS I-151, I-155 or I-94. Children must have lived in U.S for five years, unless
they were admitted as a refugee or granted asylum under the Immigration and Nationality Act.
2.
Fill out all pages completely.
Read Your Rights and Responsibilities carefully.
Sign and date the application.
3.
You need only have this form completed when your last four weeks of pay stubs are not available or you have had a change in your
schedule or income which is not reflected on your pay stubs, or you are returning from a leave of absence.
Employment verification must be no more than six weeks old.
If the form is needed, it must be completed by your employer.
4.
You need only have this form completed if you are without a documented source of regular monthly income.
Return all information by Fax, Mail or In Person:
Mail or In Person
Fax
Mail: Hamilton County JFS, Child Care
222 East Central Parkway
Cincinnati, OH 45202-1225
In Person: Scan at 1
st
Floor Kiosk
FAX: 513-946-1830
Phone Number: 513-946-1800
Note: You may fax documents for FREE from any Hamilton County Library
Child care is unable to update cases immediately! Cases are processed in the order received.
Applications may take up to 30 days to be approved or denied. You will receive a Notice of Approval or Notice of Denial once your
eligibility has been determined along with a Notice of State Hearing Rights.
Child Care Connections
Visit www.hcjfs.org to report your choice of child care providers. When choosing a child care center, view www.jfs.ohio.gov for licensing
information. To search providers who care for children in their own homes, visit http://childcaresearch.ohio.gov/
You must report your selected provider or change in providers on or before the 1
st
day of care.
Each child can only be authorized to one provider during a week unless an exemption is met. Call the county for
information.
It may take up to 5 business days to process:
Adding a new provider
Changing a provider
Adding an additional provider
Child Care Time, Attendance and Payment (TAP) Important – READ THIS!
Tracking attendance in the Ohio Child Care Time, Attendance and Payment (TAP) system is a requirement of Child Care eligibility. Upon
approval for publicly funded Child Care, the authorization is created for the provider identified on the application or through the Child Care
Connection. The provider will see the authorization the next business day in TAP and attendance tracking can begin.
Caretakers must tap in and out for care and must approve any corrected attendance before the provider can submit for
payment.
Use of TAP to track attendance for each child at each authorized provider ensures appropriate payment.
Failure to follow these requirements may result in the caretaker being required to pay out of pocket.
HCJFS 5166B: Child Care Verification Requirements. Read carefully for detailed verification requirements.
JFS 01138: Child Care Application
HCJFS 3050: Child Care Employment Verification (optional)
HCJFS 1902: Family Household Income Statement (optional)
