Governor's Child Care Stabilization Grant Program

Governor’s

Child Care Stabilization Grant

Program

Maryland State Department of Education

200 West Baltimore Street

Baltimore, Maryland 21201

Deadline

August 29, 2022

No later than 11:59 p.m. EST

GRANT INFORMATION GUIDE

Governor’s Child Care Stabilization Grant Program August 3– August 29, 2022

Maryland State Department of Education | 1

MARYLAND STATE DEPARTMENT OF EDUCATION

Mohammed Choudhury

State Superintendent of Schools

Secretary-Treasurer, Maryland State Board of

Education

Deann M. Collins, Ed D.

Deputy Superintendent, Teaching and

Learning

Steven Hicks

Assistant State Superintendent, Division of

Early Childhood Education

Larry Hogan

Governor

Clarence C. Crawford

President, Maryland State Board of

Education

Susan J. Getty (Vice President)

Shawn D. Bartley, Esq.

Gail Bates

Chuen-Chin Bianca Chang

Charles R. Dashiell Jr., Esq.

Jean C. Halle

Vermelle Greene, Ph.D.

Dr. Joan Mele-McCarthy

Rachel L. McCusker

Lori Morrow

Brigadier General Warner I. Sumpter (Ret.)

Holly C. Wilcox, Ph.D.

Merin Thomas (Student Member)

MARYLAND STATE BOARD OF EDUCATION

Governor’s Child Care Stabilization Grant Program August 3– August 29, 2022

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Table of Contents

Program Description .......................................................................................................................................................... 4

Name of Grant Program ............................................................................................................................................... 4

Purpose ............................................................................................................................................................................ 4

Authorization .................................................................................................................................................................. 4

Dissemination ................................................................................................................................................................. 4

Deadline ........................................................................................................................................................................... 4

Grant Period .................................................................................................................................................................... 4

Funding Amount Available ........................................................................................................................................... 4

Estimated Number of Grants ....................................................................................................................................... 4

Grant Amount ................................................................................................................................................................. 4

Submission Instructions ................................................................................................................................................ 5

State Responsibilities .................................................................................................................................................... 5

Program Contact ............................................................................................................................................................ 5

Eligibility ............................................................................................................................................................................... 5

Funding Priorities ............................................................................................................................................................... 6

Child Care Gap ................................................................................................................................................................ 7

Social Vulnerability Index ............................................................................................................................................. 9

Sample Scenarios ........................................................................................................................................................ 10

Use of Funds .................................................................................................................................................................... 10

Application ........................................................................................................................................................................ 11

Application Review ......................................................................................................................................................... 11

Payment Process ............................................................................................................................................................. 12

Reporting Requirements ................................................................................................................................................ 13

Non-Discrimination Statement ..................................................................................................................................... 13

Governor’s Child Care Stabilization Grant Program August 3– August 29, 2022

Maryland State Department of Education | 3

The General Education Provisions Act (GEPA), Section 427 ................................................................................. 13

Customer Service Support Sessions ............................................................................................................................ 13

Questions .......................................................................................................................................................................... 14

Grant Application Timeline ............................................................................................................................................ 14

Appendix ........................................................................................................................................................................... 14

Sample Online Application ........................................................................................................................................ 14

Direct Deposit Form ................................................................................................................................................... 14

W-9 Form ..................................................................................................................................................................... 14

Governor’s Child Care Stabilization Grant Program August 3– August 29, 2022

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Program Description

On January 17, 2022, Governor Larry Hogan announced that the State of Maryland would provide an

additional $50 million in grant funding to support child care providers during the COVID-19 pandemic.

The Maryland State Department of Education has administered two rounds of stabilization grants totaling

$285 million of federal funding. With federal funds exhausted, the governor is taking action in his Fiscal

Year 2023 budget to extend the program and provide additional relief to licensed child care providers.

Licensed child care providers can apply for a grant payment to cover expenses associated with providing

or preparing to provide child care during the COVID-19 pandemic. These expenses may be personnel

costs, rent or mortgage payments, Personal Protective Equipment (PPE), mental health support for

children and employees, as well as prior expenses.

NAME OF GRANT PROGRAM

Governor’s Child Care Stabilization Grant Program

PURPOSE

To address the hardships faced by child care providers and to address the instability of the child care

market as a whole.

AUTHORIZATION

House Bill 89

, “Child Care Stabilization Grants”

Senate Bill 480, “Child Care Stabilization Grants” fiscal and policy note

DISSEMINATION

This Grant Information Guide (GIG) was released on August 3, 2022.

DEADLINE

Applications are due no later than 11:59 p.m. on August 29, 2022.

GRANT PERIOD

August 3, 2022 – December 31, 2022

FUNDING AMOUNT AVAILABLE

$50 million

ESTIMATED NUMBER OF GRANTS

7,099

GRANT AMOUNT

Grant amounts are determined on a formula-basis and are weighted according to priority area from

HB89/SB480.

Governor’s Child Care Stabilization Grant Program August 3– August 29, 2022

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SUBMISSION INSTRUCTIONS

Grant applications must be submitted by 11:59 p.m. August 29, 2022 through the online application

STATE RESPONSIBILITIES

The MSDE is responsible for providing required information, data, documentation, and technical assistance

to facilitate the grantee’s performance of the work and will provide such additional assistance when

requested.

PROGRAM CONTACT

Andre Murray

Program Manager

(410) 767-0583

childcaregrants.msde@maryland.gov

Eligibility

This funding opportunity is designed for all Maryland licensed child care providers. Applicants may be a

family home child care provider, a large family home child care provider, a child care center, or an

education program under a Letter of Compliance. It is not the intention of this program to fund the start-

up of new child care programs that are not yet operating.

To be eligible for a grant payment under this funding, applicants must meet both criteria listed below.

License / Regulation

Status

My program was licensed or registered by the

Maryland State Department of Education on or

before May 1, 2022.

My program is open and available to provide

child care services as of the date of the

application.

Notes:

Applicants who received funding in previous rounds are still eligible to receive funding again in this round.

Applicants who own or operate more than one child care location must submit a separate application for

each site.

Additional information can be found on the Child Care Stabilization webpage

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Funding Priorities

Funding amounts for all eligible providers will be determined based on the following criteria:

Priority Funding Amount Per Licensed Child Care Slot and

Data Criteria

1. Stabilization Award for all Licensed Slots

$75 – Every licensed slot, by provider, from a

snapshot count of May 2, 2022

2. Providers that have not received a stabilization

grant in a prior application cycle (HB89/SB480

(b)(2))

$150 - W

hether or not a provider, by license

number and provider ID, had not received a

stabilization grant payment from the federal

childcare stabilization rounds one and two (in

Fiscal Year 2022)

3. Providers that participate in the Child Care

Scholarship Program (HB89/SB480 (b)(3))

$25

- Whether or not a provider had received

child care scholarship payments in FY 22 through

at any time before May 2, 2022

4. Providers located in areas designated by the

State Department of Education as lacking child

care slots (HB89/SB480 (b)(4))

$75 -

Whether or not a provider is located in a

county with an above-median gap in supply and

need for licensed childcare slots, as measured by

the bipartisan policy center childcare gap

assessment

5. Providers that have a demonstrated financial

hardship that poses significant risk of the

provider’s business closing within the next 12

months (HB89/SB480 (b)(1)) AND providers

that serve primarily low–income populations in

areas of high poverty (HB89/SB480 (b)(5))

$100 - Whether or not a provider's location has a

Social Vulnerability Index (SVI) value of greater

than 0.6. SVI is a proxy for both measures as the

CDC index represents "potential negative effects

on communities caused by external stresses on

human health" (e.g., disasters and global

pandemics). 13 measures comprise the index,

including community poverty, language spoken in a

home, local educational attainment, etc.)

6. Providers that serve children with special

needs (HB89/SB480 (b)(6))

$50 -

Whether or not a provider was eligible to

enroll children with an IEP or IFSP as of the

snapshot count of May 2, 2022

7. Providers that serve children 2 years old and

under (HB89/SB480 (b)(7))

$30 - Wh

ether or not a provider enrolled children

age two or under, as measured by whether or not

the provider was licensed for infants, as of the

May 2, 2022 data snapshot

Notes:

For priority areas in #5, the MSDE will be using the Social Vulnerability Index score using the address of

the licensed child care site.

For the purpose of the grant award, MSDE determines eligibility in priority area #3 based on whether or

not a program has invoiced the MSDE for payment between January 1, 2022 and April 24, 2022.

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See the Child Care Gap section below for more detailed information about the calculation method for the

child care gap priority (priority area #4).

The grant amount will differ for each provider depending on whether the provider meets one or more of

the priorities above.

The balance of any unutilized funds made available from providers not seeking a grant award will be

distributed to all grant-awarded providers evenly, per licensed slot.

The MSDE will use the number of licensed child care slots on record at the Division of Early Childhood

Education as of May 2, 2022 to calculate program funding amounts.

The Child Care Scholarship Program (formerly known as Child Care Subsidy) provides financial assistance

with child care costs to eligible working families in Maryland. For more information, visit the

Child Care

Scholarship program webpage.

CHILD CARE GAP

For the purposes of the Governor’s Childcare Stabilization Grant, the MSDE designated an area as lacking

child care slots if it is below the median percentage of available slots to potential, eligible-aged students, as

identified in the Bipartisan Policy Institute’s Child Care Gaps Assessment of Maryland data, by county.

According to the Bipartisan Policy Institute, the childcare gap refers to:

The number of children who potentially need care but whose families cannot reasonably

access formal care by driving. Each census block group—the census’s best available

household location estimate—was assigned a service area of a specific driving radius. It

was assumed that families with children five and under in a given block group could

reasonably access the child care facilities within their service area. Thus, potential child

care need within each block group was proportionally allocated to the child care providers

within each service area until all provider capacity was filled. Urban block groups were

assigned service areas with a 3.5-mile driving radius, while rural block groups were

assigned service areas with a 10-mile radius to reflect the distances parents in those

communities are willing to drive. This methodology enabled BPC to quantify the number

of children without access to child care by location. See the report for a detailed

explanation of the methodological decisions made in this analysis by visiting

the Child

Care Gaps Assessment webpage.

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The table below details the child care gap data, by Maryland county, the median gap for the state, and the

counties the MSDE designates as an area as lacking child care slots.

Jurisdiction Child Care Gap Gap

Percentage

Median Gap Designated as an Area

Lacking Child Care Slots

1. Allegany

650 0.247 0.1455 Yes

2. Anne Arundel

5910 0.200 0.1455 Yes

3. Baltimore County

7660 0.185 0.1455 Yes

4. Calvert

140 0.033 0.1455 No

5. Caroline

0 0.000 0.1455 No

6. Carroll

1230 0.155 0.1455 Yes

7. Cecil

650 0.147 0.1455 Yes

8. Charles

920 0.121 0.1455 No

9. Dorchester

310 0.182 0.1455 Yes

10. Frederick

1320 0.109 0.1455 No

11. Garrett

330 0.342 0.1455 Yes

12. Harford

1920 0.150 0.1455 Yes

13. Howard

2490 0.155 0.1455 Yes

14. Kent

0 0.000 0.1455 No

15. Montgomery

8200 0.144 0.1455 No

16. Prince George's

7440 0.142 0.1455 No

17. Queen Anne's

1 0.000 0.1455 No

18. St. Mary's

73 0.013 0.1455 No

19. Somerset

110 0.139 0.1455 No

20. Talbot

0 0.000 0.1455 No

21. Washington

0 0.111 0.1455 No

22. Wicomico

950 0.171 0.1455 Yes

23. Worcester

660 0.329 0.1455 Yes

30. Baltimore City

6250 0.193 0.1455 Yes

Data obtained July 2022 through the Bipartisan Policy Center's Child Care Gaps Assessment

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SOCIAL VULNERABILITY INDEX

For the purposes of the Governor’s Childcare Stabilization Grant, the MSDE designated an area According

to the Centers for Disease Control (CDC), “social vulnerability refers to the potential negative effects on

communities caused by external stresses on human health.” The Social Vulnerability Index (SVI) tracks

data by census tract and rates vulnerability on 15 key social and demographic indicators. “Census tracks”

are subdivisions of counties and are ranked on 15 social factors including poverty, lack of vehicle access,

and crowded housing. Specifically, this measure uses (See Figure I below):

Providers can also visit Social Vulnerability Index webpage for more information and documentation about

the Social Vulnerability Index.

Source (obtained 05/12/2022) through the Agency for Toxic Substances and Disease Registry's Social Vulnerability

Index

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SAMPLE SCENARIOS

SCENARIO 1

A child care provider with 50 licensed slots who is in an area that lacks child care slots (Baltimore County),

serves a primarily low-income community AND was more likely to be severely and disproportionately

affected by the Pandemic, including related economic uncertainty and risk of closure (as measured via an

SVI score of .721) would receive:

• 50 slots X Base Award ($75) = $3,750

• 50 slots X child care desert ($75) = $3,750

• 50 slots X financial hardship/low-income community ($100) = $5,000

• Total = $12,500

SCENARIO 2

A child care family provider with 8 licensed slots is eligible to enroll students with IEPs or IFSPs, is licensed

for infants, and did not apply for or receive a federal stabilization grant award (stabilization round one

/two) would receive:

• 8 slots X Base Award ($75) = $600

• 8 slots X ability to enroll students with IEPs or IFSPs ($50) = $400

• 8 slots X first time stabilization grantee ($150) = $1,200

• Total = $2,200

Use of Funds

Funds may be used for the following:

Category

Description

Personnel Costs Includes wages and benefits for child care program personnel; increases

in compensation for any staff in a child care center or family child care

providers and their employees; health, dental, and vision insurance;

scholarships; paid sick or family leave; retirement contributions; ongoing

professional development or training; premium or hazard pay; staff

bonuses; employee transportation costs to or from work; resources to

support staff in accessing COVID-19 vaccines, including paid time off for

vaccine appointments and to manage side effects, and transportation

costs to vaccine appointments

Rent/Mortgage, utilities,

facilities, maintenance, and

insurance

Late fees or charges related to late payment; facility improvements

including, but not limited to, building or upgrading playgrounds,

renovating bathrooms, installing railing, ramps, or automatic doors to

make the facility more accessible, removing non-load bearing walls to

create additional space for social distancing; maintenance and minor

renovations to address COVID19 concerns; improvements that make

child care programs inclusive and accessible to children with disabilities

and family members with disabilities are encouraged; refer to licensing

regulations to ensure compliance

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Personal protective

equipment, cleaning, and

other health and safety

practices

Costs specifically in response to the COVID-19 public health emergency

and may include equipment, supplies, services, and training that support

meeting state and local health and safety guidelines, including those

related to the prevention and control of infection diseases, prevention of

sudden infant death syndrome and use of safe sleep practices,

administration of medication (consistent with standards for parental

consent), prevention and response to emergencies due to food and

allergic reactions, building and physical premises safety, prevention of

shaken baby syndrome and abusive head trauma and child maltreatment,

response planning for emergencies from a natural disaster or a man-

caused event, handling and storage of hazardous materials and the

appropriate disposal of bio contaminants, appropriate precautions in

transporting children, pediatric first-aid and CPR, and recognition and

reporting of child abuse and neglect

Equipment and supplies Purchase of or updates to equipment and supplies to respond to the

COVID-19 public health emergency. So long as the equipment and

supplies are in response to the COVID-19 public health emergency, they

may include indoor and outdoor equipment and supplies that facilitate

business practices consistent with safety protocols and developmentally

appropriate practice, as well as business items needed to respond to new

challenges, such as business software and upgrades

Goods and services Includes any material good or service necessary for the operation of a

child care program; examples of goods are food and equipment and

materials to facilitate play, learning, eating, diapering and toileting, or safe

sleep; examples of services are business automation training and support

services, shared services, child care management services, food services,

and transportation; also includes fees associated with licensing and costs

associated with meeting licensing requirements

Mental health services To support the mental health of children and employees; for example,

infant and early childhood mental health consultation (IECMHC), an

evidence-based, prevention-based strategy that teams mental health

professionals with people who work with young children and their

families to improve their social, emotional, and behavioral health and

development in the settings where children learn and grow; the

wellbeing of caregivers is also important to stabilizing the child care

sector because the mental health and wellbeing of staff impacts training,

recruitment, and retention as well as the level of care provided to

children; mental health consultations for staff and other types of mental

health supports to staff are also allowable

Application

Providers who wish to apply for a grant payment must do so through the Child Care Stabilization online

application. A sample application is provided in the appendix.

Application Review

The MSDE will begin processing grant applications on a rolling basis. Once an application is submitted, the

MSDE will review the application to confirm eligibility and match the provider to their respective award

amount (award amounts determined as per the formula described in this resource and in the grant

application).

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If the application is complete and a provider is eligible, the MSDE will notify the provider of the award and

the award amount. If the application is incomplete or the MSDE records a provider as ineligible, the MSDE

will notify the provider and give the provider one week (7 calendar days) to resolve any identified issues.

Given the rolling basis of grant application review, the MSDE anticipates that it will complete the

processing of grants as early as the beginning of October 2022. The MSDE will complete all award

processing by October 28, 2022. This means: the MSDE will have submitted all awards to the Comptroller

for payment issuance on or by this date. After the MSDE sends payment information to the Comptroller

for processing, providers can expect to receive funds from the state 3-4 business days for ACH (direct

deposit) payment or within 30 days for checks sent via regular mail. Please note that post office delays can

result in further time between payment processing and check receipt.

Scenario 1

A provider submits their application on August 29, the final day of the application window, but it is

incomplete – the provider accidentally attached the incorrect file when attempting to load a digital copy of

their license. The MSDE reviews application and documentation and responds on August 29, requesting

that the corrected information be provided within 7 calendar days. On September 2, the provider sends in

the updated file. The additional information is reviewed by the MSDE by September 7. The MSDE then

begins its internal accounting processes and completes its accounting on September 19. The MSDE sends

the payment information to the Comptroller to be processed on September 26. The provider chose to

receive funds as a direct deposit, which is processed, and funds arrive in the provider’s bank account

around 3-4 business days after September 26.

Scenario 2

A provider submits their application on August 11 – the application is complete and all documents are

correct. The MSDE reviews the application and notifies the provider of award on August 20. The MSDE

then begins its internal accounting processes and completes its accounting in early September. The MSDE

sends the payment information to the Comptroller who issues a check to the provider and mails the check

via USPS few weeks later (depending upon USPS delivery times).

Payment Process

Grant funds will be disbursed in one payment on a rolling basis. Providers can indicate how they wish to

receive payments (direct deposit or check via USPS) at the end of the grant application.

Direct Deposit

If you were awarded a grant payment during the first round, you are still at the same address, you are

operating under the same license, and you received your payment through direct deposit, then the MSDE

already has your direct deposit information.

If not, and you would like to receive your grant payment through direct deposit, then you must complete a

Direct Deposit form and send it via mail or fax to the Comptroller’s Office, which triggers a identity-

identification process. Please allow 14 days from the date of verification for the Comptroller’s Office to

process your request.

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Check via USPS

If you elect to have payment sent as a check via USPS, the check will be mailed to the physical address

provided in the application. Checks sent via USPS will arrive later than payments sent by direct deposit.

MSDE is unable to provide tracking and delivery information for payments sent through USPS.

Reporting Requirements

Use of the grant funds is subject to audit. If grant funds are not spent on Allowable Expenses, or are

otherwise misused, you may be required to pay those funds back. Be sure to keep accurate and complete

accounting records.

Non-Discrimination Statement

The Maryland State Department of Education does not discriminate on the basis of age, ancestry/national

origin, color, disability, gender identity/expression, marital status, race, religion, sex, or sexual orientation

in matters affecting employment or in providing access to programs and activities and provides equal

access to the Boy Scouts and other designated youth groups. For inquiries related to Department policy,

please contact:

Equity Assurance and Compliance Office

Office of the Deputy State Superintendent for Operations

Maryland State Department of Education

200 W. Baltimore Street - 2nd Floor Baltimore, Maryland 21201-2595 410-767-0123 - voice

410-767-0431 - fax

410-333-6442 - TTY/TDD

The General Education Provisions Act (GEPA), Section 427

Each application must develop and describe the steps the applicant proposes to take to ensure equitable

access to, and equitable participation in, the project or activity to be conducted with such assistance, by

addressing the special needs of students, teachers, and other program beneficiaries in order to overcome

barriers to equitable participation.

Customer Service Support Sessions

The MSDE will hold several customer service support sessions for interested applicants. During these

sessions, MSDE personnel will review what applicants need to get started and walk through the online

application, as well as answer any questions participants may have. To register for a session, click on a date

below:

● Tuesday, August 9 from 1:00 -2:00 p.m.

● Thursday, August 11 from 6:00 -7:00 p.m.

● Saturday, August 13 10:00 -11:00 a.m.

● Monday, August 15 from 1:00 -2:00 p.m.

● Tuesday, August 16 from 6:00 -7:00 p.m.

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Questions

If you have questions about the application or the program, you can contact MSDE staff via:

EMAIL: childcaregrants.msde@maryland.gov

FORM: Complete this online inquiry form

PHONE: 1-855-476-5010

A customer service specialist will respond to all inquiries within 24 hours or the next business day and a

list of frequently asked questions (FAQ) and answers will be posted to the

Child Care Stabilization

webpage following customer service support sessions.

Grant Application Timeline

This funding opportunity, including all attachments and updates, are found on the Child Care Stabilization

webpage.

Date

Program Milestone

August 3, 2022 The Grant Information Guide and the application are released

August 9 from 1-2pm

August 11 from 6-7pm

August 13 from 10-11am

August 15 from 1-2pm

August 16 from 6-7pm

The MSDE will hold virtual customer service support sessions for

interested providers

August 29, 2022 The grant application period closes

Appendix

SAMPLE ONLINE APPLICATION

DIRECT DEPOSIT FORM

W-9 FORM

8/2/22, 8:21 AM

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English

Intro

Welcome to the Governor's Child Care Stabilization Program round 3

application!

The State of Maryland is providing additional funding to support child

care providers during the pandemic. Grant funds can be used to cover

expenses associated with providing, or preparing to provide, child care

during the COVID-19 pandemic, such as personnel costs, rent or

mortgage payments, Personal Protective Equipment (PPE), mental

health support for children and employees, as well as prior expenses.

We hope that this streamlined application process will make it easier for

providers to apply for funding. Please note that applicants who operate

more than one child care location must submit separate applications for

each site. All applications are due by Monday, August 29, 2022 at 11:59

p.m.

Center Info

Please provide the name, license number, address, and phone number

of your child care program.

Note: For programs with multiple locations, a separate online application

must be completed for each location.

Child Care Program

SAMPLE

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Name (as printed on

your license or

registration)

Child Care License

Number (Example

Provided Below)

Provider Identification

Number (Example

Provided Below)

Address Line 1

Address Line 2 (for

apartment or suite

number. If this does not

apply, write n/a)

City

State

Zip Code

Phone Number

(##########)

SAMPLE

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SAMPLE

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Please provide the name and contact information for your child care

program.

Block 7

Upload an updated W-9 form from the provided link.

Complete, sign, and upload the documents. Grant recipients must have

a W-9 on file to receive a grant. Applicants will not be able to move

forward with their application without uploading an updated W-9 form.

Eligibility

To be eligible for funding through this round of Child Care Stabilization

Grants, child care programs must meet two criteria. Please affirm that

the two requirements below are true.

First Name

Last Name

Phone Number

(##########)

SAMPLE

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My child care program was licensed or registered by the Maryland State

Department of Education on or before May 2, 2022.

My program is available to provide child care services on the date of this

application.

CriteriaFail

Based upon the information you have provided, you are not eligible for

this round of Child Care Stabilization Grants. We thank you for your

time. If you believe that you are eligible and have reached this screen in

error, you may resubmit your application with corrected information.

Additionally, please review the Child Care Stabilization Grants

information guide for clarifications on eligibility and you may

contact the

MSDE with any questions or concerns.

SupportDocs

ELL

Does your child care program serve children who come from homes

where English is not the primary spoken language?

Note: This question is for information purposes and will not affect

Yes

SAMPLE

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eligibility for Child Care Stabilization Grants nor the quantity of funds

received. This information is purely for data collection purposes in order

to enable the MSDE to better serve this population with future programs

and initiatives.

Cert

I agree to the terms and conditions associated with opening and

operating safety amidst the COVID-19 pandemic:

Yes

Prefer not to answer

agree

disagree

I understand that I must have a current child care center license, letter of compliance, family

child care certificate of registration or large family certification of registration.

I agree to notify a licensing specialist and the local health department (LHD) if there are any

children, family members, or staff with symptoms of COVID-19 and/or they receive a positive

test result. I also agree to follow all guidance given by the LHD and the regional licensing office.

I agree to follow all guidance on the MSDE website as it relates to this grant.

I agree to report all suspected cases and/or positive cases of COVID-19 to the local health

department and the licensing specialist and I will follow all closing guidance given.

I understand that not reporting suspected cases and/or positive cases of COVID-19 to the local

health department and the OCC licensing office could result in an action taken against my

program that may include sanctions, emergency suspension, and revocation.

SAMPLE