Family day care home sponsors

Forms & Resource Center

Family day care home sponsor application, management plan and agreement
Form Name/Description Format Date
NDE 01-012 Family Day Care Home Sponsoring Organization Management Plan


  Instructions for Uploading Files Adobe pdf 7/2010
NDE 01-017
Page 6
Certificate of Authority (responsible individuals and principals)

Adobe pdf

NDE 01-017
Page 7
Organization Representatives Signature Page

Adobe pdf


NDE 01-017 Family day care homes sponsors must enter this portion of the application in the online application system.
This includes Sponsor Application, Day Care Home Providers, Day Care Home Budget, Day Care Home County Approval, Staff Profile, Supporting Documents
online application system  

Attachment B Agency Revenue word 9/2000

Attachment C Board of Directors word 9/2000

NS-304-H Agreement, Parts II and III
All sponsors of family day care homes must agree to abide by this agreement.



Provider and household forms and letters
Number Name/Description Format Date
NS-300-H Home Provider Application to Claim Meals Served to Own Children and/or Tier I Determination



NS-301-H Application for Tier I Determination in Tier II Family Day Care Homes word 4/2010


Sample Letter to Providers
income guidelines not included

word 4/2010


Sample Letter to Tier II Households
income guidelines not included

word 4/2010


Current Income Eligibility Guidelines 

Adobe pdf 7/2014

  Sample Sponsor-Provider Agreement word 3/2003
Resources for Family Day Care Home Sponsors
  Management Standards for Nebraska Family Day Care Home Sponsors Adobe pdf 11/2006

  Nebraska Family Day Care Home Recruitment Policy – adopted by Nebraska sponsors March 1, 1999  html 3/1999

  Nebraska Staffing Factors Adobe pdf July 17, 2003

  Sample Time Certification worksheet – for use to document time spent in CACFP Adove pdf  

  Electronic Funds Transfer Dates  html  

  Attachment E – (from National School Lunch Program) – Computing Income for Self Employed Persons  Adobe pdf  
Hearing Officer Resouces
  Hearing Officer Orientation – adapted from USDA presentations PowerPoint November 2008
  Hearing Officer Orientation – slides with script Adobe pdf November 2008
USDA Resources – Financial Management
  State Agency Monitoring of Sponsors’ Use of Administrative Funds PowerPoint April 2010
  State Agency Monitoring of Sponsors’ Use of Administrative Funds – script Word April 2010
  Financial Management Brochures – USDA web site htm  
  USDA Financial Management Instruction 796-2 Adobe pdf  
  USDA Management Plan Evaluation Guide Adobe pdf  
  FNS 796-2 – Cost Items Requiring Prior Approval and Specific Prior Written Approval Adobe pdf