Form OCC1206 "Staffing Pattern for Child Care Facilities" - Maryland

What Is Form OCC1206?

This is a legal form that was released by the Maryland State Department of Education - a government authority operating within Maryland. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2017;
  • The latest edition provided by the Maryland State Department of Education;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form OCC1206 by clicking the link below or browse more documents and templates provided by the Maryland State Department of Education.

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MARYLAND STATE DEPARTMENT OF EDUCATION
Office of Child Care
STAFFING PATTERN FOR CHILD CARE FACIITIES
Name of Facility: _________________________________________________________ Facility #: ___________________________
Hours of Operation:__________________________ Total Hours Per Week: ____________ Days of Operation: _______________
Effective Date: _________________________________________________ Director: _____________________________________
DIRECTOR’S WORK SCHEDULE:
SUN:
MON:
TUES:
WED:
THURS:
FRI:
SAT:
Number of hours each day the Director is regularly scheduled with a group to directly supervise children:
SUN:
MON:
TUES:
WED:
THURS:
FRI:
SAT:
See directions on back for instructions on how to fill in the staffing pattern.
Room # / Group ID:
Room # / Group ID:
Total
# of
# of
# of
Total
# of
# of
# of
Time
Age:
Time
Age:
# of
2 yr.
Toddlers
Infants
# of
2 yr.
Toddlers
Infants
of Day
of Day
Capacity:
Capacity:
Children
Olds
18-24 mo.
0-18 mo.
Children
Olds
18-24 mo.
0-18 mo.
6:00
*
*
*
*
6:00
*
*
*
*
6:30
+
+
+
+
6:30
+
+
+
+
7:00
*
*
*
*
7:00
*
*
*
*
7:30
+
+
+
+
7:30
+
+
+
+
8:00
*
*
*
*
8:00
*
*
*
*
8:30
+
+
+
+
8:30
+
+
+
+
9:00
*
*
*
*
9:00
*
*
*
*
9:30
+
+
+
+
9:30
+
+
+
+
10:00
*
*
*
*
10:00
*
*
*
*
10:30
+
+
+
+
10:30
+
+
+
+
11:00
*
*
*
*
11:00
*
*
*
*
11:30
+
+
+
+
11:30
+
+
+
+
12:00
*
*
*
*
12:00
*
*
*
*
12:30
+
+
+
+
12:30
+
+
+
+
1:00
*
*
*
*
1:00
*
*
*
*
1:30
+
+
+
+
1:30
+
+
+
+
2:00
*
*
*
*
2:00
*
*
*
*
2:30
+
+
+
+
2:30
+
+
+
+
3:00
*
*
*
*
3:00
*
*
*
*
3:30
+
+
+
+
3:30
+
+
+
+
4:00
*
*
*
*
4:00
*
*
*
*
4:30
+
+
+
+
4:30
+
+
+
+
5:00
*
*
*
*
5:00
*
*
*
*
5:30
+
+
+
+
5:30
+
+
+
+
6:00
*
*
*
*
6:00
*
*
*
*
6:30
+
+
+
+
6:30
+
+
+
+
Day(s)
Day(s)
:_________________________________
Signature of Operator, Agent or Director
Date:_____________________
OCC 1206 - Revised 1/17 – (Title modified only. Previous editions may be
continue to be used.)
Page 1 of 2
MARYLAND STATE DEPARTMENT OF EDUCATION
Office of Child Care
STAFFING PATTERN FOR CHILD CARE FACIITIES
Name of Facility: _________________________________________________________ Facility #: ___________________________
Hours of Operation:__________________________ Total Hours Per Week: ____________ Days of Operation: _______________
Effective Date: _________________________________________________ Director: _____________________________________
DIRECTOR’S WORK SCHEDULE:
SUN:
MON:
TUES:
WED:
THURS:
FRI:
SAT:
Number of hours each day the Director is regularly scheduled with a group to directly supervise children:
SUN:
MON:
TUES:
WED:
THURS:
FRI:
SAT:
See directions on back for instructions on how to fill in the staffing pattern.
Room # / Group ID:
Room # / Group ID:
Total
# of
# of
# of
Total
# of
# of
# of
Time
Age:
Time
Age:
# of
2 yr.
Toddlers
Infants
# of
2 yr.
Toddlers
Infants
of Day
of Day
Capacity:
Capacity:
Children
Olds
18-24 mo.
0-18 mo.
Children
Olds
18-24 mo.
0-18 mo.
6:00
*
*
*
*
6:00
*
*
*
*
6:30
+
+
+
+
6:30
+
+
+
+
7:00
*
*
*
*
7:00
*
*
*
*
7:30
+
+
+
+
7:30
+
+
+
+
8:00
*
*
*
*
8:00
*
*
*
*
8:30
+
+
+
+
8:30
+
+
+
+
9:00
*
*
*
*
9:00
*
*
*
*
9:30
+
+
+
+
9:30
+
+
+
+
10:00
*
*
*
*
10:00
*
*
*
*
10:30
+
+
+
+
10:30
+
+
+
+
11:00
*
*
*
*
11:00
*
*
*
*
11:30
+
+
+
+
11:30
+
+
+
+
12:00
*
*
*
*
12:00
*
*
*
*
12:30
+
+
+
+
12:30
+
+
+
+
1:00
*
*
*
*
1:00
*
*
*
*
1:30
+
+
+
+
1:30
+
+
+
+
2:00
*
*
*
*
2:00
*
*
*
*
2:30
+
+
+
+
2:30
+
+
+
+
3:00
*
*
*
*
3:00
*
*
*
*
3:30
+
+
+
+
3:30
+
+
+
+
4:00
*
*
*
*
4:00
*
*
*
*
4:30
+
+
+
+
4:30
+
+
+
+
5:00
*
*
*
*
5:00
*
*
*
*
5:30
+
+
+
+
5:30
+
+
+
+
6:00
*
*
*
*
6:00
*
*
*
*
6:30
+
+
+
+
6:30
+
+
+
+
Day(s)
Day(s)
:_________________________________
Signature of Operator, Agent or Director
Date:_____________________
OCC 1206 - Revised 1/17 – (Title modified only. Previous editions may be
continue to be used.)
Page 1 of 2
DIRECTIONS
1.
Clearly identify each room/group, ages and list its capacity. Identify the days of the week covered by this pattern.
2.
Use vertical lines to indicate hours of the day each staff member is directly supervising children in the room/group identified for each
block. Some staff members may appear in more than one block at different times of the day or on different days of the week.
3.
Do not continue a line through times when a staff member is not directly supervising children, i.e., off duty or on a break. Add name
of person supervising children during this time.
4.
Write full name of each staff member and position.
D = Director
TI = Teacher with Infants/Toddlers
TP= Teacher with Preschool Age
TS = Teacher with School Age
ATS = Assistant Teacher with School Age
A = Aide
5.
List total number of children present in each group and number of two year olds, toddlers and infants included in each group for
specific hours of the day. The number of children present cannot exceed the room’s capacity.
SAMPLE
Rm#/Group ID:
Total
# of
# of
# of
Time
# of
2 yr. Olds
Toddlers
Infants
Age: 2’s and 3’s
of Day
Children
18-24 mo.
0-18 mo.
Capacity: 20
0
0
0
0
6:00
*
*
*
*
1
2
6:30
+
+
+
+
Identify each room/group
1
Indicate the total number
6
7:00
*
*
*
*
of children present
6
2
7:30
+
+
+
+
6
3
8:00
*
*
*
*
10
3
8:30
+
+
+
+
15
3
Use vertical lines to indicate
9:00
*
*
*
*
hours worked
20
6
Indicate the number of
9:30
+
+
+
+
2 year olds present
10:00
*
*
*
*
10:30
+
+
+
+
11:00
*
*
*
*
11:30
+
+
+
+
12:00
*
*
*
*
12:30
+
+
+
+
Indicate the number
of toddlers present
1:00
*
*
*
*
Write in staff using full
1:30
+
+
+
*
name and position
2:00
*
*
*
2:30
+
+
+
+
3:00
*
*
*
*
3:30
+
+
+
+
Indicate the number
4:00
*
*
*
*
of infants present
4:30
+
+
+
+
20
6
5:00
*
*
*
*
10
4
5:30
+
+
+
+
6
1
6:00
*
*
*
*
0
0
0
0
6:30
+
+
+
+
Day(s)
Monday, Wednesday, Friday
OCC 1206 - Revised 1/17 (Title modified only. Previous editions may continue to be used)
Page 2 of 2
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