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This document is a template of a child attendance report for all licensed child care facilities that is a required part of financial reporting. The form describes fees paid at the facility according to space type and itemized information about attendance of each child, according to the reporting period noted.

Departments/Crowns:Education and Early Childhood Learning, Families

Category:Families

Fair Practices Office - Policy and Procedures

This policy document describes the standards, procedures and complaints resolution process used by the Fair Practices Office to improve overall service capacity of four designated programs - Employment and Income Assistance, Community Living disABILITY Services, Children's DisABILITY Services, and Early Learning and Child Care (subsidy only) - and work to promote the concept of Fair Practices.

Department/Crown:Families

Categories:Families, Financial Assistance

Fair Practices Office Complaint (Intake) Form

This form is used to record details of a complaint about fair treatment from a person applying for, or receiving services from four designated programs - Employment and Income Assistance, Community Living disABILITY Services, Children's DisABILITY Services, and Early Learning and Child Care (subsidy only). This document authorizes the Fair Practices Office (FPO) to access any personal information and personal health information needed to complete an investigation, including consent to discuss the case with an advocate.

Department/Crown:Families

Families Research Policy and Procedures

This document provides Department of Families Research Policy and Procedures to guide research agreements between the department and researchers/post-secondary institutions.

Department/Crown:Families

Category:Families

Family Support Service Agreement (CFS-5)

Under the Child and Family Services Act, Subsection 15(2) Financial information and maintenance agreement the agency shall request the parent or guardian to agrees to pay to the agency maintenance for the child in accordance with the regulations . This form must not be changed other than by an amendment to the regulation. This is an agency form and is filled out by a case worker.

Department/Crown:Families

Category:Families

Family Violence Prevention Program (FVPP) - Standards Manual for Shelters

The standards manual outlines minimum requirements for all women's shelters in receipt of public funds in the form of core grants provided by the Government of Manitoba.

Departments/Crowns:Environment and Climate, Families, Sport, Culture and Heritage

Family/Group Child Care Home Operating Grant Application

Form required for family or group child care providers to apply for operating grant funding.

Departments/Crowns:Education and Early Childhood Learning, Families

Categories:Families, Financial Assistance

FASD Evaluation Manual for Service Providers

This guide provides the programs involved in the evaluation of Manitoba's FASD Strategy with information on the purpose of the evaluation and how to fill out the required forms.

Department/Crown:Families

Fire Health Inspection Request Form

This document is the template for a Fire Inspection or Public Health Inspection Request Form that is required by all ELCC licensed child care centres, family and group child care providers.

Departments/Crowns:Education and Early Childhood Learning, Families

Categories:Families, Licence

FNIN Letter - Mass Notification FNIHB

Mass notification letter regarding insured health benefits.

Department/Crown:Families

Categories:Families, Financial Assistance

Focus on Employment Referral Form

This document is a referral form for an EIA participant with a disability or disability related barriers to employment to apply for employment supports provided by Focus on Employment Inc. (Swan River, Manitoba).

Department/Crown:Families

Categories:Employment, Families, Financial Assistance

Form CA-1 Notice of Opportunity to Provide Information

Not for Public Use. Form CA-1 Notice of Opportunity to Provide Information is a form in the Child Abuse Regulation Schedule, as provided in subsection 11(1), that the child abuse committee is to give a person who is suspected of having abused a child an opportunity to provide information to the committee by giving the person a copy of this form.

Department/Crown:Families

Category:Families

Form CA-2 Affidavit of Service of Notice of Opportunity to Provide Information

Not for Public Use. Form CA-2 Affidavit of Service of Notice of Opportunity to Provide Information must be completed when a Notice is given in accordance with subsection 11(5) of the Child Abuse Regulation.

Department/Crown:Families

Category:Families

Form CA-3 Notice of Intended Entry on Child Abuse Registry

Not for Public Use. Form CA-3 provides the person to whom it is addressed of Notice of Intended Entry on the Child Abuse Registry in accordance with subsection 19(3) of The Child and Family Services Act. CA-3 is a form (pages 19 to 20) in the Child Abuse Regulation Schedule.

Department/Crown:Families

Category:Families

Form CFS-17

This form is to notify a parent or guardian of when their next court date is.This is a statutory regulated form embedded in The Child and Family Services Regulation, This is a form used by the agency.

Department/Crown:Families

Category:Families

Forty Hour Course Options for Child Care Assistants and Home-Based Child Care Providers

In Manitoba, all Child Care Assistants and licensed home-based child care providers are required to complete a 40 hour course related to early childhood education within the first year of employment. This web page describes options for completing the required 40 hour course.

Departments/Crowns:Education and Early Childhood Learning, Families

Category:Education and Training

Foster Children Application Form

Application form to be completed by a Child and Family Services social worker to apply for child care subsidy for a foster child.

Departments/Crowns:Education and Early Childhood Learning, Families

Categories:Families, Financial Assistance, Youth

Foster Family Manual

The foster family manual contains information that you need to know in your role as a foster parent.

Department/Crown:Families

Category:Families

Foster Family Questionnaire

This is the second part of the foster family application that explores relationships with children, discipline, neighbour hood and requests additional information. This form is to be filled out with a casework on the agency letterhead.

Department/Crown:Families

Category:Families

Foster Family Release of Information Form

When a foster family changes agencies and/or Authorities, they fill out this form so that all the information in their foster family file can be forwarded to the new agency. This form is located on the CFSIS system and the caseworker will download on agency letterhead.

Department/Crown:Families

Category:Families

Foster Family Transfer Agreement Form

This form is an internal form used when a foster family moves from one agency to another. It gives permission to transfer the foster home license to another agency.

Department/Crown:Families

Category:Families

Foster Home Review/Relicensing Guidelines

Annually the foster home license must be renewed. Each agency has their own forms on their letterhead which the foster home worker will fill out with the foster parents.

Department/Crown:Families

Categories:Application, Families

Foster Parent Intentional Damage Compensation Plan and Form

The plan provides coverage for intentional damage occurring in foster homes. Coverage applies to the property of home operators or to the property of others in care, custody and control of the foster home.

Department/Crown:Families

Categories:Application, Families

Frequently Asked Questions (Accessibility Standard for Customer Service)

This document provides frequently asked questions and answers on the Accessibility Standard for Customer Service.

Department/Crown:Families

Category:Families

Funding Policies and Procedures :Family/Group Child Care

This document describes guidelines and the application form required for licensed family and group child centres to apply for an ELCC operating grant.

Departments/Crowns:Education and Early Childhood Learning, Families

Categories:Families, Financial Assistance

Funeral Invoice Schedule B

Invoice used by Funeral Directors for services covered by EIA.

Department/Crown:Families

Categories:Families, Financial Assistance

FVPP Statistical Report for the Couple's Counselling Project

This form is used by the Couples Counselling Project to report statistical data on a quarterly basis.

Departments/Crowns:Environment and Climate, Families

FVPP - Standards Manual for Access Exchange Programs

The standards manual outlines minimum requirements for access exchange programs in receipt of public funds in the form of core grants provided by the Government of Manitoba.

Departments/Crowns:Environment and Climate, Families

FVPP - Standards Manual for MaMaWi

The standards manual outlines minimum requirements for the Ma Mawi Wi Chi Itata Centre Spirit of Peace Program which receives public funds in the form of core grants provided by the Government of Manitoba.

Departments/Crowns:Environment and Climate, Families

FVPP - Standards Manual for MAPS (Men Are Part of the Solution)

The standards manual outlines minimum requirements for the MAPS (Men Are Part of the Solution) organization, which receives public funds in the form of core grants provided by the Government of Manitoba.

Departments/Crowns:Environment and Climate, Families

FVPP - Standards Manual for Nor'West Community Health Centre

The standards manual outlines minimum requirements for Nor'West Community Health Centre, which receives public funds in the form of core grants provided by the Government of Manitoba.

Departments/Crowns:Environment and Climate, Families

FVPP - Standards Manual for Residential Second Stage Programs

The standards manual outlines minimum requirements for all second stage facilities in receipt of public funds in the form of core grants provided by the Government of Manitoba.

Departments/Crowns:Environment and Climate, Families

FVPP - Standards Manual for TLC (The Laurel Centre)

The standards manual outlines minimum requirements for The Laurel Centre, which receives public funds in the form of core grants provided by the Government of Manitoba.

Departments/Crowns:Environment and Climate, Families

FVPP - Standards Manual for Wahbung Abinoonjiiag

The standards manual outlines minimum requirements for Wahbung Abinoonjiiag which receives public funds in the form of core grants provided by the Government of Manitoba.

Departments/Crowns:Environment and Climate, Families

FVPP - Standards Manual for Women's Resource Centres

The standards manual outlines minimum requirements for women's resource centres in receipt of public funds in the form of core grants provided by the Government of Manitoba.

Departments/Crowns:Environment and Climate, Families

FVPP - Standards Manual for Women's Resource Centres with Residential Services

The standards manual outlines minimum requirements for women's resource centres with residential services in receipt of public funds in the form of core grants provided by the Government of Manitoba.

Departments/Crowns:Environment and Climate, Families

FVPP - Supervised Access/Exchange Service Statistical Report

This form is used by Access Exchange Programs to report statistical data on a quarterly basis.

Departments/Crowns:Environment and Climate, Families

FVPP - Urban Support Program Statistical Report

This form is used by Urban Support Programs to report statistical data on a quarterly basis.

Departments/Crowns:Environment and Climate, Families

FVPP A Woman's Place Statistical Report

This form is used by A Woman's Place to report statistical data on a quarterly basis.

Departments/Crowns:Environment and Climate, Families

FVPP Client Statistics for Residential Second Stage Housing Providers

This form is used by Second Stage Service Providers to report statistical data on a quarterly basis.

Departments/Crowns:Environment and Climate, Families

FVPP Couple's Counselling Program Statistical Report YWCA of Brandon

This form is used by the YWCA Brandon to report statistical data on a quarterly basis.

Departments/Crowns:Environment and Climate, Families

FVPP Shelter to Shelter Transfer

This form is used by women's shelters when arranging a transfer of a client to another women's shelter.

Departments/Crowns:Environment and Climate, Families

Grab Bar & Transfer Pole Installation Fax Form

Grab bar and transfer pole installation form.

Department/Crown:Families

Categories:Families, Financial Assistance, Health

Guide (public facing) Rental Housing Construction Tax Credit program Guide

A guide to the rental housing construction tax credit program

Department/Crown:Families

Category:Housing and Property

Guide for Public Sector Organizations

This guide was created by the Disabilities Issues Office to help Manitoba public sector agencies develop an accessibility plan, in compliance with The Accessibility for Manitobans Act.

Department/Crown:Families

Guide to the Inclusion Support Program

This is a detailed guide informing parents and staff at child care centres, nursery schools, and family and group child care homes about all aspects of the Inclusion Support Program (ISP). The ISP program, guided by an Individual Program Plan reduces or eliminates barriers so that children with additional support needs are able to meaningfully participate in licensed child care programming.

Departments/Crowns:Education and Early Childhood Learning, Families

Category:Families

Guidelines for Completion of the Families First Home Visitor Log

An internal document for public health outlining the process to complete the Families First screen form.

Departments/Crowns:Families, Health

Guidelines for Completion of the Families First Screening Process

This is an internal document for public health that outlines the process to complete the Families First screen form.

Departments/Crowns:Families, Health

Guidelines for Extended Hour Child Care Services for Day Care Centres and Family Day Care Homes

This document informs licensed child care facilities how to request extended hour child care service for families, beyond the normal operating hours of a child care facility, including evening, overnight and weekend care.

Departments/Crowns:Education and Early Childhood Learning, Families

Category:Families

HCMO Cash flow & Expenditure Report #1

Projection of cash flow for the fiscal year for community agencies/individuals who have a Service Purchase Agreement with Healthy Child Manitoba Office. This form is due at the beginning of each fiscal period.

Department/Crown:Families

Category:Business

HCMO Cash flow & Expenditure Report #2

6 month reporting of actual expenditures with a projection to the year's end. This financial report is completed by community agencies/individuals who have a Service Purchase Agreement with Healthy Child Manitoba Office.

Department/Crown:Families

Category:Business

HCMO Cash flow & Expenditure Report #3

Year end final report of actual expenditures. This form is completed by community agencies/individuals who have a Service Purchase Agreement with Healthy Child Manitoba Office. It reflects the projection and actual expenditures for the entire fiscal year and is due at the end of each year.

Department/Crown:Families

Category:Business

HCMO Organizational Identifying Info

A form filled out by HCMO funded agencies to provide information on their organizational structure.

Department/Crown:Families

Category:Business

HCMO Program Progress Report

A report completed by funded agencies detailing the progress/activities completed under the terms of their Service Purchase Agreement.

Department/Crown:Families

Category:Business

HCMO Reporting Schedule - Healthy Baby/Funded Agencies

Form issued on a yearly basis to inform funded agencies of the timelines for completing Healthy Baby program and financial reporting (as outlined in the SPA).

Department/Crown:Families

HCMO Staffing Report

A form filled out by HCMO funded agencies to report the number of staff employed in their funded programs and their respective classifications.

Department/Crown:Families

Category:Business

Healthy Baby - Participant Contact Form

Form for Healthy Baby Community Support Program service providers to complete when contact has been made with Manitoba Prenatal Benefit applicants who've signed a consent to be contacted.

Department/Crown:Families

Healthy Baby Community Program Guide

Comprehensive document that directs and guides the administrative and service delivery priorities for funded agencies who provide HB programming in the province. Core program elements, standards and research/evidence based practice ensure consistent application meeting the needs of participants, service providers and government.

Department/Crown:Families

Healthy Baby Letter - Application reassessment

Letter to applicant confirming request for re-assessment based on change in current year income. This letter requests statements of current year earnings and explanation as to why income has dropped.

Department/Crown:Families

Healthy Baby Letter - Approval

Letter to applicant confirming approval of Prenatal Benefits.

Department/Crown:Families

Healthy Baby Letter - CYA Approval

Letter to applicant to advise of benefit approval upon receipt of current year income information.

Department/Crown:Families

Healthy Baby Letter - Had Baby

Letter to applicant to advise of file closure due to early birth.

Department/Crown:Families

Healthy Baby Letter - Rejection Current Year Income

Rejection notification letter to applicant explaining that current year income totalled more than $32,000.

Department/Crown:Families

Healthy Baby Letter: Notice of Assessment

Letter to applicant requesting Notice of Assessment to meet eligibly requirement.

Department/Crown:Families

Healthy Baby Postnatal Attendance & Infant Feeding

Data collection form Healthy Baby participants complete related to infant feeding and tracking their attendance at a Healthy Baby program (as outlined in the SPA).

Department/Crown:Families

Healthy Baby Prenatal Attendance

Data collection form Healthy Baby prenatal program participants complete to track their attendance at a Healthy Baby program (as outlined in the SPA).

Department/Crown:Families

Healthy Baby Program Budget Notes

This is a form that funded agencies who provide Healthy Baby complete on a yearly basis to inform Healthy Child Manitoba Office of projected costs related to program operations.

Department/Crown:Families

Category:Business

Healthy Baby Session Tracking Sheet

Data collection form Healthy Baby service providers complete after each Healthy Baby session to detail program participation and activities (topics, milk coupon program etc.).

Department/Crown:Families

Healthy Baby: Manitoba Prenatal Benefit Application

Application form for the Manitoba Prenatal Benefit

Department/Crown:Families

Healthy Baby: We're Glad You're Here Postnatal

Data collection form Healthy Baby postnatal program participants complete when they attend a Healthy Baby program (as outlined in the SPA)

Department/Crown:Families

Healthy Baby: We're Glad You're Here Prenatal

Data collection form Healthy Baby prenatal program participants complete when they attend a Healthy Baby program (as outlined in the SPA).

Department/Crown:Families

Hearing Aid Claim Form

Hearing aid pre-approval/claim form.

Department/Crown:Families

High Fidelity Wraparound Registration Letter

The letter gathers basic information from training registrants (name, address, dietary concerns, etc).

Department/Crown:Families

Housing Program Contribution Agreement with Appendices (Metis Housing)

An agreement between MHRC and the organization that stipulates the terms.

Department/Crown:Families

IDL1 Letter - Excess Income No Benefits Issued

Letter sent explaining no benefits will be issued as earnings exceed EIA budget.

Department/Crown:Families

Categories:Families, Financial Assistance

In-Home Respite - Guide for Parents

This document informs parents about in-home respite for a child receiving support through Children's disABILITY Services. The guide is accompanied by a form requesting descriptive information about a child's care, routines and activity interests, behavioural issues, to be completed by parents and the direct service provider.

Department/Crown:Families

Categories:Application, Families

Inclusion Support Program - Consent for Release of Personal Information and/or Personal Health Information

This document is a template of the Consent Form granted by a parent/guardian to release personal information and/or personal health information for a child participating in the ELCC Inclusion Support Program.

Departments/Crowns:Education and Early Childhood Learning, Families

Category:Families

Inclusion Support Program - Individual Program Plan

This form is a detailed Individual Program Plan for a child participating in the Early Learning and Child Care Inclusion Support Program. The document includes information about the medical needs of the child and records details of actions for short and long term planning.

Departments/Crowns:Education and Early Childhood Learning, Families

Category:Families

Inclusion Support Program - Staffing Grant Payment Form

The staffing Grant Payment Form reports the children's attendance and salary and benefits paid under the Inclusion Support Program. The child care facility completes this form every four week billing to claim approved grant funding under the program.

Departments/Crowns:Education and Early Childhood Learning, Families

Categories:Application, Families

Inclusion Support Program Eligibility Application

This policy outlines the eligibility criteria for the Inclusion Support Program (ISP) as it applies to children, families and facilities, as well as the related procedures.

Departments/Crowns:Education and Early Childhood Learning, Families

Category:Families

Inclusion Support Program Eligibility Application

This form is required by the ELCC Program to determine eligibility for supports under the Inclusion Support Program.

Departments/Crowns:Education and Early Childhood Learning, Families

Categories:Application, Families

Inclusion Support Program Guaranteed Space Payment Application

This document is a template of a Guaranteed Space Payment Application form required for a child participating in an Inclusion Support Program delivered by a licensed ELCC family child care provider.

Departments/Crowns:Education and Early Childhood Learning, Families

Categories:Families, Financial Assistance

Inclusion Support Program Letter to Centres

This letter to child care centres introduces the Inclusion Support Program policy for eligibility and application process.

Departments/Crowns:Education and Early Childhood Learning, Families

Categories:Families, Financial Assistance

Inclusion Support Program Service Planning Request for Child Care Facilities

This form must be submitted by child care facilities to access services under the Inclusion Support Program.

Departments/Crowns:Education and Early Childhood Learning, Families

Categories:Application, Families

Inclusion Support Program Staffing Grant Application

This document is a Staffing Grant Application form requesting Early Learning and Child Care funding for staff to support child(ren) participating in a Inclusion Support Program delivered by a licensed child care facility in Manitoba.

Departments/Crowns:Education and Early Childhood Learning, Families

Categories:Families, Financial Assistance

Income Assistance Review

Employment and Income Assistance requires a review of the circumstances of each income assistance client.

Department/Crown:Families

Categories:Families, Financial Assistance

Income Declaration

This form is a full declaration of employment income and expenses at each month end, prior to any calculations of EIA eligibility for the upcoming month, or payment of any assistance. EIA participants are asked to forward this form with original cheque stubs and payment receipts after receiving the last income for the month.

Department/Crown:Families

Individual Client Action Plan

This 2011 Employment and Income Assistance circular reminds staff to ensure that Client Action Plans are current, signed and given as a copy to the participant.

Department/Crown:Families

Categories:Families, Financial Assistance

individual Program Plan

This form is part of the child in care file, It describes the medical professionals that are engaged in the child life, any assessments that have been done and any changes in the child's life. It is filled out by the caseworker on agency letterhead.

Department/Crown:Families

Category:Families

Infant Less than 12 weeks of Age - Exemption Request Checklist

This form is required to request an age exemption for a child less than 12 weeks of age to attend a Manitoba licensed child care facility.

Departments/Crowns:Education and Early Childhood Learning, Families

Category:Families

Information and Application for a warrant to search for a child (CFS-23)

If there is reasonable grounds to believe a child might be in need of protection, a judge will grant this warrant to allow peace officers to search for the child.This is a statutory regulated form embedded in The Child and Family Services Regulation. This is an agency form and would not be filled out by the general public.

Department/Crown:Families

Category:Families

Information and Application to obtain a warrant to apprehend an absconded child (CFS-25)

This warrant entitles a peace officer to apprehend and return a child in care to their placement if they run away. This is a statutory regulated form embedded in The Child and Family Services Regulation. It I s a form that would only be filled out by a CFS agency and/or a peace officer.

Department/Crown:Families

Category:Families

Information Booklet Full Citizenship

An introduction to A Manitoba Provincial Strategy On Disability

Department/Crown:Families

Categories:Families, Financial Assistance, Health

Information Disclosure Statement (CLDS-SDM)

This form is completed by the substitute decision maker for a Community LIving disABILITY Services participant to provide their consent for a referral to Behaviour Psychology Services. This form also provides substitute decision maker information on Behaviour Psychology Services, their role in the service as well as information regarding confidentiality.

Department/Crown:Families

Information for Individuals Applying for a Self-Check Mail Adult Abuse Registry Check: Checklist

The Registrar of the Adult Abuse Registry, is obtaining personal information so that the Registrar can conduct an Adult Abuse Registry check. The Registrar will also use this information to update the Adult Abuse Registry.

Department/Crown:Families

Categories:Application, Families

Information for Internationally Educated Applicants

This document provides detailed information for an Early Childhood Educator (ECE) who was educated outside Canada (internationally-educated) on what is required to apply and become classified as a Child Care Assistant, ECE II or ECE III in Manitoba.

Departments/Crowns:Education and Early Childhood Learning, Families

Categories:Certification, Education and Training, Families

Information on the Classification of early Childhood Educators and Child Care Assistants

This document provides detailed information about classification (upgrades and re-issue) of early childhood educators (ECE) and child care assistants, including the application process, education requirements, and equivalency assessments. This policy also outlines the proportion of trained professionals (ECE's) required in licensed early learning and child care centres and nursery schools in Manitoba.

Departments/Crowns:Education and Early Childhood Learning, Families

Categories:Certification, Education and Training, Families

INL1 Letter - Information Requested

Letter sent when information is required from a client.

Department/Crown:Families

Categories:Families, Financial Assistance

INL2 Letter - Information Requested 2nd Letter

Letter sent when requesting information from a client.

Department/Crown:Families

Categories:Families, Financial Assistance

Insight Evaluation Guide

This guide outlines the way in which HCMO's evaluation forms are to be administered with InSight Mentor Program participants.

Department/Crown:Families

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