PHMC Health and Safety Support for early education providers

Public Health Management Corporation (PHMC), through generous funding from the William Penn Foundation is able to support Philadelphia child care providers in operationalizing Centers for Disease Control and Prevention (CDC) guidance. Please complete the information below to request assistance for your program.

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* 1. What is your contact information? If a multi-site organization, please enter the address of one of your Philadelphia programs. Please provide the BEST phone number, preferably cell, and email address to reach you during this time when your business may be closed.

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* 2. What is your program type?

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* 3. What is your business type?

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* 4. Are you a single-site, multi-site, and/or multi-service organization? Please check all that apply.

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* 5. Are you currently open and operating?

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* 6. What is the licensed capacity of your program?

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* 7. How many children were on your roster as of 3/16/20?

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* 8. How many staff were employed in February 2020?

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* 9. What is the approximate percentage of children enrolled under each funding source?

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* 10. In what area(s) are you seeking help? Please check all that apply.

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* 11. Have you participated in/are a recipient of the following programs:

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