| Dakota County Family Child Care Association P.O. Box 22065 Eagan, MN 55122 952-985-3495 Provider of the Year – 2009 Nomination |
| “Provider of the Year” recipients must meet the following requirements: 1) Actively licensed for a minimum of three (3) years. 2) Has not previously received this award within the past ten (10) years. 3) Exhibits high standards as a child care provider. 4) Has made a positive impact in the lives of young children. 5) Continues to further his/her knowledge/skills as a child care provider. 6) Does not have any pending negative licensing actions and has not had any substantiated complaints within the last three years. Thank you for supporting licensed family child care by nominating your provider for this year’s “Provider of the Year” award. All applications will be reviewed by a committee made up of previous recipients, parents, and county licensing staff. All nominated providers and the finalists will be recognized at the 2009 DCFCCA Conference. Name of Nominee_________________________________________________________ Address_________________________________________________________________ City_____________________________________ Zip Code_______________________ Telephone Number________________________________________________________ Your Name______________________________________________________________ Address_________________________________________________________________ City_____________________________________ Zip Code_______________________ Telephone Number________________________________________________________ How long have you known this child care provider? _____________________________ 1) MEMBERSHIP Please check all that apply to the best of your knowledge…or ask your provider. Is your provider a member of any of the following organizations? ___Dakota County Family Child Care Association (DCFCCA) ___Minnesota Licensed Family Child Care Association (MLFCCA) ___National Association of Family Child Care (NAFCC) ___Other (please specify)__________________________________________________ 2) EDUCATION Please check all that apply to the best of your knowledge…or ask your provider. Does your provider have any of the following? ___Child Development Associate (CDA) ___NAFCC Accreditation ___Certificate in Child Development ___Diploma in Child Development ___Degree in Child Development. If so, what degree___________________________ ___Other related degree___________________________________________ ______ 3) How does your provider communicate with you? (Check all that apply) ___Email ___Daily Notes ___Conferencing ___Phone ___Bulletin Board ___Journals ___Photos ___Monthly Calendar ___Newsletter ___Daily/Verbal ___Other 4) Does your child care provider EXCEED the 8 hours of required training each year? YES_____ NO_____ For the last two questions, please type or PRINT clearly only in the space that is provided. No attachments will be accepted. Please be SPECIFIC in explaining the ways in which your provider is outstanding. For judging purposes, please do NOT refer to your provider by his/her name when answering the questions. 5) How has your child care provider gone “above and beyond” for your family? Please give specific examples or tell us a story about your provider. ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ 6) Why do you feel your provider should be recognized as one of the “Outstanding Provider’s of the Year?” Please give specific examples or tell us a story. ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ Your provider will receive a copy of this nomination form. Please complete and return this form to: DCFCCA – Attention: POY Committee P.O. Box 22065 Eagan, MN 55122 All forms must be received by January 10th, 2009 to be considered for the "Outstanding Provider of the Year” award. Announcements will be made at the 2009 DCFCCA Spring Conference. If you have questions or need more information please call the DCFCCA voice mail at 952-985-3495 or email us at MLFCCArep@dcfcca.org. |
