Child Care Services Parent Waitlist Application Form

Waitlist Information

Waitlist applications are processed in the order received. Being on the waitlist is not a guarantee of services. The wait to receive services can be lengthy. We encourage you to have a back-up plan for your child care needs.

Waitlist Criteria

  • The child must be born, to be on the waitlist.
  • The child(ren) needing services must be a US Citizen or Legal Immigrant/Qualified Alien.
  • The person applying for services must have primary custody of the child(ren) needing services. If applicant is not the parent of the child needing services, then applicant must provide the following with the application:
    • Reason the parent is not available, and
    • Paperwork verifying reason parent is not available, and
    • Paperwork verifying that applicant is the person responsible for the child.
    • Click here for information about acceptable documentation

See Loco Parentis chart below for acceptable documentation.
You will be able to attach the required documentation before submitting this application or you can send documentation to rcachildcareservices@ruralcapital.net, or fax it to 855-584-7332. Once documentation is received, we will contact you should we have any questions.

In Loco Parentis Matrix

Reason Parent is Unavailable Documentation Verifying Reason Parent is Unavailable Documentation Verifying Caretaker is Responsible for the Child
Medical Incapacitation

or

In Treatment

or

Rehabilitatione
A document from a licensed medical professional, e.g., physician, psychiatrist, or psychologist, stating the medical condition that makes the parent unable to care for his or her children.

OR

A document from a licensed professional such as a counselor or therapist is an acceptable alternative as long as the recommendation or diagnosis does not exceed the licensed professional’s authority

If the parent is in a treatment or rehabilitation center, a letter from the facility verifying admission must be signed by an authorized representative of the facility and include both the admission and anticipated release date. A copy of the order mandating the placement will suffice.
A caretaker must have a notarized power of attorney or a sworn affidavit of temporary custody/guardianship of the child.
Child Protective Services (CPS) Placement
  • A recent (within six months) CPS safety plan or CPS placement agreement;
  • A court order naming the individual as the caretaker; or
  • A letter from CPS that confirms the children’s placement with the caretaker is ongoing.
No other documentation is necessary.
Military Deployment
  • Military orders; or
  • A suitable alternative such as a confirmation by the base commander or other military official.
A military power of attorney appointing the caretaker as the guardian of the child.

OR

In lieu of a military power of attorney, a military family plan that gives the caretaker the authority to execute decisions on child care matters.
Incarcerated
  • A “commitment” order from the court;
  • Verification from the Texas Department of Criminal Justice (TDCJ) Offender Information Search database(http://www.tdcj.state.tx.us/offender_information.h tm) for offenders who are incarcerated in a TDCJ facility; or
  • A letter from the sheriff’s office confirming incarceration if the parent is in a local jail.
The document must include the date of incarceration and anticipated release date.
A caretaker must have a notarized power of attorney or a sworn affidavit of temporary custody/guardianship of the child.
Other Reasons Parent or Legal Guardian is Unavailable A sworn affidavit of facts attesting to:
  • the circumstances of how and why the caretaker assumed responsibility for the child;
  • the whereabouts of the natural parent(s);
  • the caretaker’s relationship to the child; and
  • the length of time the child has been with the caretaker.
A caretaker must have a notarized power of attorney or a sworn affidavit of temporary custody/guardianship of the child.

In addition, the caretaker must have documentation from a verifiable source that establishes his or her parental responsibility for the child. The documentation may be one of the following:
  1. the caretaker's most recent IRS tax return listing child as a dependent;
  2. a letter from a child care center or other independent, non-relative, verifiable source that can establish the individual’s parental and financial responsibility for the child;
  3. a letter from an independent school district; or
  4. documentation that the caretaker is receiving Temporary Assistance for Needy Families benefits on behalf of the child, or has received benefits within the past six months.
  • Each parent and step-parent living in the household, must be working, attending school, in training/other educational program, or combination of these, at least an average of 25 hours each week. Child care assistance is not provided for the pursuit of education beyond a bachelor’s degree.

    NOTE: Families who identify as homeless are exempt from this requirement to apply for services. You will be asked to provide additional information for this exemption.
  • Families must meet income guidelines based on gross household income (before taxes) and family size. Types of other household income includes but are not limited to: rental income for a house, homestead, store, or other property; income from boarders/lodgers; income from estate and trust funds, or royalties; pensions, annuities, life insurance, and retirement income, Social Security Disability Income (SSDI), workers’ compensation income, alimony, court settlements, or judgements.
    Family Size Household Gross Monthly Income Limit-before taxes
    2 $3,775
    3 $4,663
    4 $5,552
    5 $6,440
    6 $7,328
    7 $7,495
    8 $7,661
    9 $7,828
    10 $7,994
    11 $8,161
    12 $8,327
    13 $8,494
    14 $8,660
    14 $8,827
  • Families must live within one of these counties: Bastrop, Blanco, Burnet, Caldwell, Fayette, Hays, Lee, Llano, or Williamson.
  • Families who owe recoupment, anywhere in Texas, are not eligible to apply for services or enroll into services or continue services until the recoupment has been paid in full.
I have read the eligibility criteria listed above and would like to apply for services

Pre-Qualification
Select your parental household status
Household members include those that live in the household: parents, step-parents, adult dependents* and a child or other minor living in the household who is the responsibility of the parent. *Adult dependent is an adult that you claim as a dependent on your income taxes.



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