Bumo Provider Profile Information Form

Facility Information

Please enter your facility information below.
Name of Your Facility
Facility Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Facility Main Phone Number

Area CodePhone Number
Facility Main Email
Assistant director email to also have access to licensing folder
example@example.com
Hours of Care
Example: 8am-5pm
Blurb/Description about Your Center
Name of Director

First NameLast Name
Director Email
Director Phone Number

Area CodePhone Number
Director Photo

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Director Bio
YesNo
What apps do you use for parent connection while you care for their children?
Sign-In/Sign-OutLive-updates in real-timeEnd-of-day updatesOther
VideoPhotosIncident ReportsDevelopmental NotesNapping Details (Start/End Time)Diaper Check UpdatesNone. We do not send any updates throughout or at end of day.
Youngest Age Accepted (In Months)
Oldest Age Accepted (in Months)
Do you provide meals?
Do you provide snacks?
We require children to wear masks indoors.We require children to wear masks outdoors.We do wellness checks for children.Staff are fully vaccinated for COVIDStaff are tested regularly for COVID.Other
Is your staff tested regularly for COVID?
What items do you require the families to bring each day they attend? (Please list and describe.)
Do you have an outdoor space?
Reggio EmiliaSoke EducationMontessoriPlay-basedBillingualTrilingualSTEMCognitive-BasedRIEWaldorfOther
Family HomeCenterLicense-Exempt/ Camps (Summer/Spring/Fall/Winter)Other
What time is nap time? For what ages?
(If applicable) Is potty training required? If so, for what age groups and do you help with potty training?
InfantToddlerPreschoolSchool-Age
Infant Licensing Number
Youngest Infant Age Accepted (In Months)
Oldest Infant Age Accepted (In Months)
Infant Total Capacity
Infant Target Ratio (number of students per teacher)
Example: If it's 1:4, type "4"
Toddler Licensing Number
Youngest Toddler Age Accepted (In Months)
Oldeest Toddler Age Accepted (In Months)
Toddler Total Capacity
Toddler Target Ratio (number of students per teacher)
Example: If it's 1:4, type "4"
Preschool Licensing Number
Youngest Preschool Age Accepted (In Months)
Oldest Preschool Age Accepted (In Months)
Preschool Total Capacity
Preschool Target Ratio (number of students per teacher)
Example: If it's 1:4, type "4"
School-Age Licensing Number
Youngest School-Age Accepted (In Months)
Oldest School-Age Accepted (In Months)
School-Age Total Capacity
School-Age Target Ratio (number of students per teacher)
Family Home Licensing Number
[For Family Home or Exempt Locations] Youngest Age Accepted (In Months)
[For Family Home or Exempt Locations] Oldest Age Accepted (In Months)
[For Family Home or Exempt Locations] Total Capacity
[For Family Home or Exempt Locations] Target Ratio (number of students per teacher)
Owner Information

A description of the section goes here.
Name of Owner

First NameLast Name
Owner Email
Owner Phone Number

Area CodePhone Number
Owner Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Booking Slot Info
Start Date
Days Open
Mon-Fri?
Times
Early Drop-Off:
Morning:
Afternoon:
Late Pick-Up:
Evening:

Full-Day Only?
Number of Spots
Infant:
Toddler:
PreK:
School-Age:
Parent Night Out?
Camps?
Closures
Other Notes/Comments
Additional Documents (Parent Handbook, Photo Release, etc.)

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Should be Empty:

Facility Information

Owner Information

Booking Slot Info