Lorain County Job and Family Services

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Forms - Providers

Please click on the form number in blue to go to the specific form:

Rules	Additional County Rules 2010 for Type B Child Care Home Providers
CCU-200	No Smoking Sign
CCU-201	No Firearms Sign
CCU-202	Fire Drill Log
CCU-203	Withdrawal/Disenrollment Form
CCU-204	Daily Sign-In Sheet
CCU-205	Statement of Non-Transportation
DC-100	Daycare Monthly Attendance Sheet
JFS 01299	Incident/Injury Report
JFS 01911	Infant Daily Report
JFS 01329	Statement of Non-Conviction
JFS 01332	Certified Child Care Handbook for Caretakers
JFS 01332-I	Instructions for Completing JFS 01332, Certified Child Care Handbook for Caretakers
JFS 01634	Caretaker/Provider Agreement
JFS 01643	Application for Professional Type B Child Care
JFS 01923	Emergency/Substitute Caregiver Statement
W9	Request for Taxpayer Identification Number & Certification (Complete and print page1only)

Child Care Information Data System (CCIDS) / ECC (Electronic Child Care) Links and Information

Please click on the applicable link to be redirected:

Provider Portal	https://www.ccidsportal.ohio.gov/login.jsf
Ohio ECC Provider FAQ's	http://jfs.ohio.gov/cdc/docs/Ohio%20ECC%20Provider%20FAQs.pdf
CCIDS Resource Guide	http://jfs.ohio.gov/cdc/docs/CCIDSResourceGuide092011.pdf
Parent/Card Carrier information	http://jfs.ohio.gov/cdc/CaretakerCardCarrier.pdf
Parent/Card Carrier FAQ's	http://jfs.ohio.gov/cdc/OhioECCCaretakerFAQswithspanish.pdf
More information	http://jfs.ohio.gov/cdc/CCIDS.stm

Lorain County Job
& Family Services
42485 North Ridge Road
Elyria, OH 44035-1057
Main Phone: (440) 323-5726
Lorain: (440) 244-4150
Fax: (440) 323-3422
TTY/TDD: (440) 284-4125
Cash/Food/Medical Call Center:
(440) 284-4300
Child Support Call Center:
(440) 284-4401

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