This letter transmits the JFS 01155 "Request for Early Learning Initiative Services" which has been developed to help county staff keep track of case activity for Early Learning Initiative (ELI) services and for monitoring the requirements of OAC rule 5101:2-16-07.1 County department of job and family services administrative responsibilities for the early learning initiative (ELI). The use of the JFS 01155 is not required.

County staff must document the following data items through existing case management procedures or through the use of the JFS 01155.

• Date of caretaker's request for ELI services
• Caretaker's signature and date of request for ELI services
• Name of child care facility/ELI provider requested
• Date JFS 01138 "Application for Child Care Benefits" received for child(ren)
• Date JFS 01138 "Application for Child Care Benefits" verified as completed
• Date child(ren) determined eligible for ELI services
• Name of ELI contracted agency

Use of the JFS 01155 will assist the department in monitoring case activity in the ELI program and will be documentation in the county's files to verify that required timelines are being met. A completed JFS 01138 "Application for Child Care Benefits" must be on file for all new ELI applications for children who are not transitioning from other publicly funded child care.

Two additional forms are also included with this letter, the JFS 01153 "Request by Contracted ELI Agent to Adjust Attendance Data" and the JFS 01154 "CDJFS Request to Adjust 3299 Data" and its instructions, which have been developed for use in the ELI program. These forms are required of ELI providers or CDJFS staff when changes must be made to the ELI data that has been submitted to the department for a payment cycle.

These forms will be available online at: http://www.odjfs.state.oh.us/forms/inner.asp. They will not be available in hard copy from the ODJFS warehouse.

INSTRUCTIONS: The following chart identifies the material that needs to be inserted into the Child Care Manual (CCM).