Stage 1 Child Care Provider (White Provider Payment Request)

Stage 1 Payment Timelines & Document Guidelines

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The CalWORKs Child Care Provider Payment Request form is known as the PPR. All the information on this form is pre-printed.  Please do not alter any of the pre-printed information on the form. If any of this information is incorrect, please contact CCRC.  

A PPR for each child will be mailed to you after child care has been authorized. From then on, CCRC will send you a PPR by the 1st of the month. If you do not receive one by the 1st week of the month, call Provider Payments at extension 4717 and request a reprint.


Payment Timelines
Your payment will be electronically transferred to you within ten (10) business days after CCRC receives a properly completed PPR. Payment should appear within 24 hours.  Please check your provider pay card or bank account for availability of funds.


Document Guidelines
In order for the Provider Payment Request (PPR) form to be processed in a timely manner, the following information must be properly completed:

  • The PPR must be completed in blue or black ink; correction fluid/tape will not be accepted.
  • You must indicate the total number of hours and day’s child care was provided each week.
  • You must claim the amount you wish to be reimbursed.  For hourly, daily or weekly rates complete the “Amount Provider is Billing” each week, total up all weeks in the “Total” box.  Please make sure the weekly totals add up to the total in the “Total” box.
  • For monthly rates fill in the “Total” box at the bottom.
  • At the bottom of the form, the parent and child care provider must sign and date the form declaring, under penalty of perjury, that the information reported is accurate.
  • For children on a variable schedule, you must include the parent’s ST1-21 (Monthly Variable Schedule Calendar) along with the PPR in order for payment to be processed (the ST1-06 will indicate if the schedule is varied).
  • Incomplete or inaccurately completed PPR’s will be returned to the provider and payment will be delayed.

Click here for more information on “How To Complete A CalWORKS PPR" in English Click here for more information on "How To Complete A CalWORKS PPR" in Spanish.

Submitting a PPR

Original PPRs must be submitted to a CCRC office after the authorized period, otherwise payment may be delayed.

There are four methods for submitting a PPR:

  • U.S. Mail
  • External Drop Box located outside the Antelope Valley or Chatsworth Office
  • Lobby Drop Box located inside the Antelope Valley or Chatsworth Office
  • Front Desk Representative

If you have any questions, please call CCRC's Provider Payments at (818) 717-1000.