2024-2025 Program Partner Assurances

2024-2025 Program Partner Assurances

These assurances are to be submitted by all Program Partners. A complete submission will be used to issue Academic Approval to Type III early learning centers and to participating Family Child Care sites. Program Partners must fill in all blanks and initial where indicated. Incomplete assurances will not be accepted.
Check all that apply to your site:*

Type III Child Care CenterCCAP-certified Family Child CareNSECD/Nonpublic SchoolSchool SystemCharter SchoolEarly Head StartHead Start
Does your site have a type III license or are you a CCAP-certified Family Child Care site?*

Program Partner Information
Is this your initial application for Program Partner Assurances, or a renewal of Program Partner Assurances?*
Thank you for your application! In the site code entry box below, please type Initial and then click Auto Complete Fields, as your site does not yet have a site code.
Please enter your site code and click "Auto Complete Fields." If you are not sure of your site code, please visit LouisianaSchools.com. Site codes are case sensitive. School Systems should enter their network code.*
Community Network/Parish*
Program Partner Site Name*
License Number (if applicable)*
If not applicable, please enter "N/A". If you are not sure of your license or registration number, please contact your Licensing Consultant.
CCAP Provider Number (if applicable)*
If not applicable, please enter "N/A".
Site Contact Information
Program Partner Authorized Personnel Name*

First NameLast Name
Primary Contact Name*

First NameLast Name
Primary Contact Title*
Primary Contact Phone Number*
Please enter a valid phone number.
Primary Contact Email Address*
A copy of this submission will be shared with this email address.
Site Street Address*
Site City*
Site Zip Code*
Is the mailing address the same as the physical address?*

YesNo
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Full-Time or Part-Time Designation
Part-time care is defined as offering less than 30 hours of care per week, with up to a maximum of 129 hours per month, including care offered on holidays, and before and after school.

Full-time care is defined as offering care for 30 hours or more per week.
Do you offer full-time or part-time care based on the definitions provided above?*
Please select all types of care provided at your site:*

30 or more hours per weekLess than 30 hours per weekBefore school careAfter school careHoliday careSummer care only

Part-Time Program Partner Assurances
1. My organization has met the requirements for Academic Approval as a Type III center that provides one or more of the following ONLY (select all that apply):*

Part-Time CareBefore and After School CarePart-Time or Full-Time Summer Care
I acknowledge and certify that the above part-time/full-time designation is true and correct.*

Clear
2. I understand that I will be subject to regular monitoring of payment activity to ensure that my status as a Type III center providing part-time, before & after school, and summer care only has not changed.
I have read, acknowledge, and agree to regular monitoring.*

Clear
3. I understand that should my situation change and I begin serving children in full-time care during the academic year, I must notify the Louisiana Department of Education, Office of Early Childhood Care and Education of this change within ten (10) business days of that change.
I have read, acknowledge, and agree to the above stipulation regarding notifying the department of updates at my site.*

Clear
4. I understand that should my status as a provider of part-time, before & after school, and summer care change to full-time:
- My organization will be required to comply with all provisions of State Board of Elementary and Secondary Education (BESE) Bulletin 140 - Louisiana Early Childhood Care and Education Network,
- My organization will be required to meet the requirements for Academic Approval of a Type III center providing full-time care during the academic year, as outlined in the next page, and that
- Failure of my organization to meet the above requirements may result in termination of my Academic Approval and possible revocation of my Type III license.
I have read, acknowledge, and agree to the above stipulations regarding what will be required of my organization should my status as a part-time provider change.*

Clear

Part-Time Program Partner Assurances

Section Two
SHOULD MY CENTER BEGIN SERVING CHILDREN FOR FULL-TIME CARE, I CERTIFY THAT MY CENTER WILL:
1. MEMBERSHIP IN THE COMMUNITY NETWORK
- Participate fully in my community Early Childhood Care and Education Community Network as provided in Chapter 3 of Bulletin 140, including:
  - Designation of an individual to serve as the primary point of contact between this organization and the Community Network Lead Agency and
  - Responding to communication from the Louisiana Department of Education (“Department”) Office of Early Childhood Care and Education and the Community Network Lead Agency when requested.
I have read, acknowledge, and agree to the above membership in the community network.*

Clear
2. PARTICIPATION IN THE EARLY CHILDHOOD CARE AND EDUCATION ACCOUNTABILITY SYSTEM
- Participate fully in the Early Childhood Care and Education Accountability System as provided in Chapter 5 of Bulletin 140, including:
  - Support administrators, teachers, and other staff to comply with Bulletin 140 regarding the use of BESE Bulletin 136—The Louisiana Standards for Early Childhood Care and Education Programs Serving Children Birth‐Five Years, CLASS®, and GOLD® or an approved alternate assessment;
  - Ensure that all required information for classrooms containing children from birth to five years is entered in the GOLD® online system; Additionally, all child assessment results for publicly-funded infants, toddlers, and pre-K children must be entered and checkpoints finalized by October 31, February 28, and May 31;
  - Cooperate with the Lead Agency in my Community Network to identify all sites/classrooms to be observed with the CLASS® Infant, Toddler and Pre‐K tools;
  - Participate in CLASS® observations, specifically allowing two CLASS® observations for each Infant, Toddler and Pre‐K classroom, unless my site was not open prior to October 1, 2024;
  - Allow third party observations to occur, unless my site was not open prior to October 1, 2024;
  - Meet with each teacher to provide written results and feedback from local observations within five business days of receiving the information;
  - Provide teachers with support to improve their interactions and instruction, including use of curriculum and assessment, in order to help prepare more children for Kindergarten;
  - Verify through the Department’s verification process the site‐level data that has been reported to the Department for the Performance Profile;
    Participate in any required improvement planning process approved by BESE and implemented by the Department;
  - Ensure that the Lead Agency is informed of any changes to staffing or classroom configuration within the observation period as defined by the Lead Agency; and
  - I understand that, pursuant to Bulletin 140, beginning with the 2016‐2017 school year, publicly funded sites rated as “Unsatisfactory,” as defined in LAC 28:XCI.509, for two school years in any consecutive three school year period, shall lose their public funding and have their Academic Approval terminated.
I have read, acknowledge, and agree to the above participation in the early childhood accountability system.*

Clear
3. PARTICIPATION IN THE COORDINATED ENROLLMENT PROCESS
- Count all publicly-funded birth to age five children currently being served in this program as of October 1 and February 1 of each academic year and submit to the Lead Agency as required by the State.
- Participate fully in the Community Network’s Coordinated Enrollment Process as provided in Chapter 7 of Bulletin 140 including:
  - A coordinated information campaign through which the Community Network informs families about the availability of publicly‐funded programs serving children ages birth to five years;
  - A coordinated eligibility determination through which the Community Network coordinates enrollment, eligibility criteria, and waiting lists to ensure that families are referred to other available publicly‐funded early childhood programs should they be ineligible for or unable to access their primary choice;
  - A coordinated application process through which the Community Network conducts a unified application process so families can easily indicate their enrollment choices for publicly‐funded programs; and
  - A process for matching based on family preference through which the Community Network enrolls at‐risk children, using available public funds and based upon stated family preferences.
- Inform parents and caregivers that they may request that the Department review the placement of their child resulting from the coordinated enrollment process as indicated in Bulletin 140.
I have read, acknowledge, and agree to the above participation in the coordinated enrollment process.*

Clear

Full-Time Program Partner Assurances
MY ORGANIZATION WILL COMPLY WITH ALL PROVISIONS OF STATE BOARD OF ELEMENTARY AND SECONDARY EDUCATION (BESE) BULLETIN 140 – LOUISIANA EARLY CHILDHOOD CARE AND EDUCATION NETWORK AND MY ORGANIZATION WILL MEET THE FOLLOWING REQUIREMENTS:
1. MEMBERSHIP IN THE COMMUNITY NETWORK
- Participate fully in the Early Childhood Care and Education Community Network as provided in Chapter 3 of Bulletin 140, including:
  - Designation of an individual to serve as the primary point of contact between this organization and the Community Network Lead Agency and
  - Responding to communication from the Louisiana Department of Education (“Department”) Office of Early Childhood Care and Education and the Community Network Lead Agency when requested.
I have read, acknowledge, and agree to the above membership in the community network.*

Clear
2. PARTICIPATION IN THE EARLY CHILDHOOD CARE AND EDUCATION ACCOUNTABILITY SYSTEM
- Participate fully in the Early Childhood Care and Education Accountability System as provided in Chapter 5 of Bulletin 140, including:
  - Support administrators, teachers and other staff to comply with Bulletin 140 regarding the use of BESE Bulletin 136—The Louisiana Standards for Early Childhood Care and Education Programs Serving Children Birth‐Five Years, CLASS®, and GOLD® or an approved alternate assessment;
  - Ensure that all required information for classrooms containing children from birth to five years is entered in the GOLD® online system. Additionally, all child assessment results for publicly-funded infants, toddlers and pre-K children must be entered and checkpoints finalized by October 31, February 28, and May 31.
  - Cooperate with the Lead Agency in my Community Network to identify all sites/classrooms to be observed with the CLASS® Infant, Toddler and Pre‐K tools;
  - Participate in CLASS® observations, specifically allowing two CLASS® observations for each Infant, Toddler and Pre‐K classroom, unless my site was not open prior to October 1, 2024;
  - Allow third party observations to occur, unless my site was not open prior to October 1, 2024;
  - Meet with each teacher to provide written results and feedback from local observations within five business days of receiving the information;
  - Provide teachers with support to improve their interactions and instruction, including use of curriculum and assessment, in order to help prepare more children for Kindergarten;
  - Verify through the Department’s verification process the site‐level data that has been reported to the Department for the Performance Profile;
  - Participate in any required improvement planning process approved by BESE and implemented by the Department;
  - Ensure that the Lead Agency is informed of any changes to staffing or classroom configuration within the observation period as defined by the Lead Agency; and
  - I understand that, pursuant to Bulletin 140, beginning with the 2016‐2017 school year, publicly funded sites rated as “Unsatisfactory,” as defined in LAC 28:XCI.509, for two school years in any consecutive three school year period, shall lose their public funding and have their academic approval terminated.
I have read, acknowledge, and agree to the above participation in the early childhood accountability system.*

Clear
3. PARTICIPATION IN THE COORDINATED ENROLLMENT PROCESS
- Count all publicly funded birth to age five children currently being served in this program as of October 1 and February 1 of each school year and submit to the Lead Agency as required by the State.
- Participate fully in the Community Network’s Coordinated Enrollment Process as provided in Chapter 7 of Bulletin 140 including:
  - A coordinated information campaign through which the Community Network informs families about the availability of publicly‐funded programs serving children ages birth to five years;
  - A coordinated eligibility determination through which the Community Network coordinates enrollment, eligibility criteria, and waiting lists to ensure that families are referred to other available publicly‐funded early childhood programs should they be ineligible for or unable to access their primary choice;
  - A coordinated application process through which the Community Network conducts a unified application process so families can easily indicate their enrollment choices for publicly‐funded programs; and
  - A process for matching based on family preference through which the Community Network enrolls at‐risk children, using available public funds and based upon stated family preferences.
- Inform parents and caregivers that they may request that the Department review the placement of their child resulting from the coordinated enrollment process as indicated in Bulletin 140.
I have read, acknowledge, and agree to the above participation in the coordinated enrollment process.*

Clear

THE FOLLOWING SECTIONS ARE FOR FULL-TIME TYPE III CHILD CARE CENTERS ONLY:
TYPE III CENTER SCHOOL READINESS TAX CREDIT ELECTION (YOU MUST SELECT ONE):*
School Readiness Tax Credits provide an incentive for families to enroll their children in quality-rated centers, support child care providers to provide a high-quality learning experience for children, and make a professional commitment to the field.
ANCILLARY CERTIFICATE REQUIREMENTS FOR TYPE III CENTERS:

I understand the following:
- A Lead Teacher is defined as the early childhood care and education classroom teacher that is primarily responsible for the classroom for a minimum 20 hours per week for every classroom providing full‐day care in a publicly‐funded site;
- Pursuant to Bulletin 140, all lead teachers in full-day Type III early learning centers hired into their role prior to July 1, 2018 must obtain their Early Childhood Ancillary Certificate by July 1, 2020 and all lead teachers in full-day Type III early learning centers hired into their role on or after July 1, 2018 must obtain their Early Childhood Ancillary Certificate within 24 months from their date of hire.
PLEASE NOTE: The Early Childhood Ancillary Certificate does not fulfill the requirements of a valid and current Louisiana teaching certificate for lead teachers in publicly-funded pre-K (LA 4 and NSECD) classrooms, and it will not qualify an individual to work as a lead teacher in public schools. The Bachelor’s degree and teaching certificate requirement for pre-K teachers in public and non-public schools will remain the same. Head Start and Early Head Start teacher requirements will continue to follow the national credential and qualification guidelines.
I have read, acknowledge, and agree to the above ancillary certification requirements for Type III centers.*

Clear
As of July 1, 2024, all of the lead teachers who have been working in my center for 24 months or more will have met the requirements set forth in Bulletin 140:*
I acknowledge and certify that all lead teachers in my center will be in compliance with Bulletin 140 as stipulated in the above.*

Clear

Program Partner Information
Is this your initial application for Program Partner Assurances, or a renewal or Program Partner Assurances?*
Please enter your CCAP Provider Number and click "auto complete fields." Ex: 20XXXXXXX*
Community Network/Parish*
Registration Number*
If you are not sure of your registration number, please contact Provider Certification at ProviderCertification@la.gov.
Site Contact Information
Full Name*
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Site Street Address*
Site City*
Site Zip Code*
Is the mailing address the same as the physical address?*

YesNo
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Family Child Care Program Partner Assurances
MY ORGANIZATION WILL COMPLY WITH ALL PROVISIONS OF STATE BOARD OF ELEMENTARY AND SECONDARY EDUCATION (BESE) BULLETIN 140 – LOUISIANA EARLY CHILDHOOD CARE AND EDUCATION NETWORK. I HEREBY CERTIFY I WILL COMPLETE ALL RESPONSIBILITIES LISTED BELOW.
1. MEMBERSHIP IN THE COMMUNITY NETWORK
- Participate fully in the Early Childhood Care and Education Community Network as provided in Chapter 3 of Bulletin 140, including:
  - Designation of an individual to serve as the primary point of contact between this organization and the Community Network Lead Agency and
  - Responding to communication from the Louisiana Department of Education (“Department”) Office of Early Childhood Care and Education and the Community Network Lead Agency when requested.
I have read, acknowledge, and agree to the above membership in the community network.*

Clear
2. PARTICIPATION IN THE EARLY CHILDHOOD CARE AND EDUCATION ACCOUNTABILITY SYSTEM

Participate fully in the Early Childhood Care and Education Accountability System as provided in Chapter 5 of Bulletin 140, including:
- Comply with Bulletin 140 regarding the use of BESE Bulletin 136—The Louisiana Standards for Early Childhood Care and Education Programs Serving Children Birth‐Five Years, CLASS®, and GOLD® or an approved alternate assessment;
- Ensure that all required information for children from birth to five years is entered in the GOLD® online system. Additionally, all child assessment results for publicly-funded infants, toddlers and pre-K children must be entered and checkpoints finalized by October 31, February 28, and May 31.
- Cooperate with the Lead Agency in my Community Network to identify all sites/classrooms to be observed with the CLASS® Infant, Toddler and Pre‐K tools;
- Participate in CLASS® observations, specifically allowing two CLASS® observations for each Infant, Toddler and Pre‐K classroom, unless my site was not open prior to October 1, 2024;
- Allow third party observations to occur, unless my site was not open prior to October 1, 2024;
- Meet with Community Network Lead Agency staff to receive written results and feedback from local observations within five business days of receiving the information;
- Continue to improve interactions and instruction, including use of curriculum and assessment, in order to help prepare more children for Kindergarten, by attending professional development opportunities and training sessions offered;
- Verify through the Department’s verification process the site‐level data that has been reported to the Department for the Performance Profile;
- Participate in any required improvement planning process approved by BESE and implemented by the Department;
- Ensure that the Community Network Lead Agency is immediately informed of any changes in status, configuration, and/or closures within the observation period as defined by the lead agency; and
- I understand that, pursuant to Bulletin 140, beginning with the 2016‐2017 school year, publicly-funded sites rated as “Unsatisfactory,” as defined in LAC 28:XCI.509, for two school years in any consecutive three school year period, shall lose their public funding and have their Academic Approval terminated.
I have read, acknowledge, and agree to the above participation in the early childhood accountability system.*

Clear
3. PARTICIPATION IN THE COORDINATED ENROLLMENT PROCESS
- Count all publicly-funded birth to age five children currently being served in this program as of October 1 and February 1 of each academic year and submit to the Community Network Lead Agency as required by the State.
  Participate fully in the Community Network’s Coordinated Enrollment Process as provided in Chapter 7 of Bulletin 140 including:
  - A coordinated information campaign through which the Community Network informs families about the availability of publicly‐funded programs serving children ages birth to five years;
  - A coordinated eligibility determination through which the Community Network coordinates enrollment, eligibility criteria, and waiting lists to ensure that families are referred to other available publicly‐funded early childhood programs should they be ineligible for or unable to access their primary choice;
  - A coordinated application process through which the Community Network conducts a unified application process so families can easily indicate their enrollment choices for publicly‐funded programs; and
  - A process for matching based on family preference through which the Community Network enrolls at‐risk children, using available public funds and based upon stated family preferences.
- Inform parents and caregivers that they may request that the Department review the placement of their child resulting from the coordinated enrollment process as indicated in Bulletin 140.
I have read, acknowledge, and agree to the above participation in the coordinated enrollment process.*

Clear

Once you click submit, your submission will be finalized and shared with the Louisiana Department of Education. Completed submissions will be used to issue Academic Approval to your site and ensure compliance with Bulletin 140 at all sites. If you would like to review any pages, you may click "Back" to view and make any necessary edits.

A copy of your submission will be sent to the email entered in the "Primary Contact Email Address" box on the first page of these assurances.

Thank you for your work to serve children and families in our state.
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2024-2025 Program Partner Assurances

Program Partner Information

Site Contact Information

Full-Time or Part-Time Designation

Part-Time Program Partner Assurances

Part-Time Program Partner Assurances

Full-Time Program Partner Assurances

THE FOLLOWING SECTIONS ARE FOR FULL-TIME TYPE III CHILD CARE CENTERS ONLY:

Program Partner Information

Site Contact Information

Family Child Care Program Partner Assurances