Annual Survey of Local Residential Child Care Institutions Fall 2018 Section IV Child Count – Institution School System Date Completed Completed by: Name and Title (1) (2) (3) (4) (5) (6) (7) (8) Dates Consecutively Enrolled* Dates of the 30 Day Child Name and/or (N) Date of Date Date Counting Period Identification Number Neglected Birth Age Entered Terminated From To (One day must be in (D) October)** Delinquent (ex: 10/1/18 - 10/30/18) *Column 7 refers to the dates student was enrolled. **Column 8 refers to the 30 day counting period (One day must be in October). **Please note with regard to Column 8, all children should have the same 30 day counting period.
Annual Survey of Local Residential Child Care Institutions Fall 2018 Section IV – Child Count Institution School System Date Completed Completed by: Name and Title (1) (2) (3) (4) (5) (6) (7) (8) Child Name and/or Identification Number (N) Neglected (D) Delinquent Date of Birth Age Date Entered Date Terminated Dates Consecutively Enrolled* Dates of the 30 Day Counting Period (One day must be in October)** (ex: 10/1/18 - 10/30/18) From To *Column 7 refers to the dates student was enrolled. **Column 8 refers to the 30 day counting period (One day must be in October). **Please note with regard to Column 8, all children should have the same 30 day counting period.
Facility%20Form%20-%20Fall%202018%20LEA%20ND%20Survey.docx