Make the following selections per the License(s) you currently hold from the Office of Regulatory Child Care License for CCI or CPA Services; selections must be congruent with your current License.
*A copy of the program License(s) must be submitted with this application as detailed under Required Supplemental
Detail Admission Criteria
List any Exclusionary Criteria:
DJJ will process provider applications in accordance with the following dates
***Document submissions are required for each service type. For example, if you are providing group home care and foster care, you must submit a separate application packet for each one. Please note that these documents serve as a significant part of the provider enrollment process, so please submit all required documents as requested.
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