Backup Childcare Pilot Provider Application

Backup Childcare Pilot Provider Application
Program Information

Thank you for your interest in the Backup Childcare Pilot. Selected providers will hold a pre-paid childcare slot for employees of participating employers when their regular childcare is not available.

Applications will be reviewed in mid-September. Finalists will be contacted to schedule a site walk-through and a discussion with the selection team, which will include a representative from a participating employer. Contracts will be provided to selected childcare providers in October with a pilot start date of November 1, 2026 and conclude after June, 2027.

If you have any questions, contact Robin VanWinkle at 541-530-2125 or rvanwinkle@desd.k12.or.us.
Section 1: Provider Information
1. What is your childcare Business Name?
2. What is your EIN (Employer Identification Number)?
3. Provider Contact Name
4. Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
5. Email Address
example@example.com
6. Program Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
7. What type of program are you?
8. What communities do you serve?
If other, please list community:
Section 2: Minimum Requirements
1. Have you ever had any serious valid findings related to your site/business?
If yes, please explain:
2. Have you had any valid findings in the past 12 months?
If yes, please explain:
3. Do you carry liability insurance for your childcare business?
If yes, what is the coverage per occurence?
If yes, what is the total aggregate coverage?
4. If you do not currently have liability insurance for your childcare business, are you willing to provide proof of the minimum coverage necessary if selected for the pilot project?

Other
5. Does your program operate at least 9 hours per day Mon-Fri?
What are your operating days and hours?
6. What is your current Spark rating?
If you do not have a Spark rating, describe any other quality ratings your site has:
Section 3: Backup Childcare Capacity
1. Which age groups could you reserve a backup care slot for? (check all that apply). The highest priorities are infants, toddlers, and preschool ages.
2. If available, would you be able to reserve two paid slots, one for infant/toddler age and one for preschool/after school age at your site?
3. Can you maintain the reserved slot from November 2026 through June 2027?
If no, please explain:
4. Explain the minimum notice you would need before a child can use a backup care slot (assuming the family has completed all required paperwork)?
Explain the minimum notice in your own words:
Section 4: Family Enrollment & Communication
1. How can families complete required enrollment information?
2. Is a family handbook available?
If yes, can it be viewed online?
3. Do you offer tours or orientations?
4. Will your site require a tour before care can begin?
5. Briefly describe what forms and requirements participants would need to complete before using your site for backup/drop in care:
6. Briefly describe how you help families understand expectations such as meals, diapers, drop-off, and pick-up procedures:
7. Please describe any additional fees or charges you currently have, or anticipate charging, beyond monthly tuition for drop in care. This may include application fees, registration fees, supply fees, field trip fees, or other costs.
8. Would you be willing waive any additional fees beyond tuition for families during this pilot project?
Section 5: Staffing & Reliability
1. Do you have a staffing backup plan if staff are absent?
2. Do you have substitute staff available?
3. Can you bring in additional staff if needed to maintain ratios?
4. Describe how you maintain services when staffing challenges occur:
5. What planned closure dates does your program typically have each year? (Please include holidays, professional development, vacations, facility cleaning/maintenance, and any other days your program is routinely closed.)
Section 6: Final Questions
1. Why are you interested in participating in the Backup Childcare Pilot?
2. Is there anything else you would like us to know?
Should be Empty:

Backup Childcare Pilot Provider Application

Section 1: Provider Information

Section 2: Minimum Requirements

Section 3: Backup Childcare Capacity

Section 4: Family Enrollment & Communication

Section 5: Staffing & Reliability

Section 6: Final Questions