Enhanced Support Funding - Staff Application

This application is to be completed by the child care programme based on the needs of an individual child who is enrolled in their programme for enhanced support staff due to a special need and/or disability.

Email

Date of Application

Enhanced support staff are employed/contracted by a licensed child care centre operator or home child care provider who feels they need additional staff to support the programme’s ability to ensure that children with special needs and/or disabilities can experience equitable participation in their programme. Enhanced Support Staff funding can be requested for the duration of the child’s placement (ongoing) or for a period of time (temporary).

Child's First Name and Last Name

What Classroom is this for?

Child's Date of Birth

The parent(s)/guardian(s) have been informed of the challenges detailed in this application and have provided their informed consent for its submission.

The programme has an ISP in place or is currently in the process of creating an ISP for this child

Please choose the most appropriate option for your needs (check all that apply)

The following are situations that relate to a more chronic and/or complex situations:

The child has a chronic and/or complex physical condition which can result in a dependency on specialized care that is required daily. Example: Tube fed, life threatening illness, regular seizures, or any other medical concerns while in the programme.

The child has an intellectual or physical condition that affects their ability to self-care and to participate in the programme. Example: Stamina, dexterity, respiratory disorders, hearing, and/or vision impairment.

The following are situations that can usually be mitigated by building staff capacity and making environmental changes. Please ensure that your programme reaches out for appropriate additional supports

Leaving the Programme

The child attempts to leave supervised areas several times daily resulting in jeopardizing their safety.

Harmful to Self

Deliberate infliction of harm on self – head banging, scratching self until bleeding, biting self, etc.

Harmful to Others

Beyond what is typical for the child’s age. When the child needs to have someone very close to them at all times for the protection of other children from hitting, biting, pushing, etc.

General Information

Days of week	Time Child Attends (e.g. 8:30am-4:30pm)	Hours for which Funding is Requested	Number of Staff members in the Classroom	Number of Children in the Classroom
Days of week	Time Child Attends (e.g. 8:30am-4:30pm)	Hours for which Funding is Requested	Number of Staff members in the Classroom	Number of Children in the Classroom
Days of week	Time Child Attends (e.g. 8:30am-4:30pm)	Hours for which Funding is Requested	Number of Staff members in the Classroom	Number of Children in the Classroom
Days of week	Time Child Attends (e.g. 8:30am-4:30pm)	Hours for which Funding is Requested	Number of Staff members in the Classroom	Number of Children in the Classroom
Days of week	Time Child Attends (e.g. 8:30am-4:30pm)	Hours for which Funding is Requested	Number of Staff members in the Classroom	Number of Children in the Classroom
Days of week	Time Child Attends (e.g. 8:30am-4:30pm)	Hours for which Funding is Requested	Number of Staff members in the Classroom	Number of Children in the Classroom
Days of week	Time Child Attends (e.g. 8:30am-4:30pm)	Hours for which Funding is Requested	Number of Staff members in the Classroom	Number of Children in the Classroom
Days of week	Time Child Attends (e.g. 8:30am-4:30pm)	Hours for which Funding is Requested	Number of Staff members in the Classroom	Number of Children in the Classroom

Goals

Describe how you will utilize the enhanced funding hours and how having enhanced staff in your programme will support you in meeting the child's needs and enhance your overall programme.

Fiscal Need

Please describe why the programme needs financial assistance for the Enhanced Support Staff

Consents and Signatures

I/We hereby apply for Enhanced Support Funding for additional staffing, and declare that the enclosed statements are true to the best of my/our knowledge.

I/We understand that the needs of the child and the child care programme, and the plans of the child care programme, must meet specific criteria to receive funding.

I/We understand that this application and consequent contract for funding is between the child care programme and the County of Wellington.

By signing this form electronically, you agree your electronic signature is the legal equivalent of your manual signature on this form.

Date

Privacy Notice

Personal information (PI) is collected under the authority of the Municipal Act, 2001. All personal information created, held or collected by the County of Wellington is protected in accordance with Municipal Freedom of Information and Protection of Privacy Act, 1990 (MFIPPA). For questions related to this collection of personal information, contact the Manager of Privacy and Information, County of Wellington, Office of the CAO, T 519.837.2600 x2528.