The CS-274W form, titled the Child Care Provider Enrollment Supplement, is a legal document required by New York City's Administration for Children's Services (ACS) for enrolling unregulated child care providers in the city's subsidized child care program. Unregulated providers are individuals who deliver child care services in a home setting without a license or certification, as opposed to regulated providers such as licensed group day care centers or family day care programs. The CS-274W form works in tandem with the LDSS-4699 or LDSS-4700 enrollment forms to establish the formal terms of the child care arrangement and ensure providers are properly compensated through the program.
The CS-274W enrollment supplement is required for the following situations in New York City:
The enrollment supplement form requests detailed information from both the provider and the parent or caretaker. Documents and details required include:
The form includes two certification sections that both parties must sign. The provider certification confirms that the care provider is not a city employee and is not related to the child being cared for, as required by ACS program rules to prevent conflicts of interest. The parent or guardian certification confirms that the information provided is accurate and that they understand the terms of the child care arrangement established under the program.
Providers must retain supporting documents for all expenses and care services provided in order to support their request for reimbursement from ACS. The form also notes that regulated and licensed providers must meet additional documentation requirements set by ACS. Child care arrangements documented on the CS-274W form are reviewed by the relevant New York City Human Resources Administration (HRA) office to prevent duplication of services, ensure program integrity, and confirm that care rates are consistent with the current market rate guidelines for New York City unregulated child care providers.
Providers who fail to maintain complete records or who submit inaccurate information on the CS-274W form may be subject to a denial of reimbursement or removal from the child care subsidy program. Parents and caretakers are also responsible for notifying the ACS or HRA office of any changes to their child care arrangement, including changes in provider, schedule, or rates.
The CS-274W is one of several forms involved in the New York City unregulated child care enrollment process. Depending on your situation, you may also need the following related forms:
| Question | Answer |
|---|---|
| Form Name | Cs 274W Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | cs 274w face rev 4 08, nyc hra child care forms, cs 274w face, hra child care forms nyc |
