CDC Daily Time and Attendance Form CDC Provider Child Care TimeAttendance Record - michigan 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Provider Name at the top of the form, followed by your Provider ID Number, which is a 7-digit ID found on the DHS-198 document.
3. Fill in the Pay Period Number corresponding to the billing dates. Remember to use a separate page for each week if necessary.
4. List each child's full name in alphabetical order. For each child, record their Begin Time and End Time, ensuring you indicate AM or PM clearly.
5. Document any Absence Hours for each child as needed, making sure not to exceed 208 hours per fiscal year.
6. Have parents or authorized representatives initial next to each child's entry daily to confirm accuracy.
7. Finally, sign and date the form where indicated and enter the Confirmation Number from the DHS-105 document.

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