Department of Human Services > Find a Document > For Providers > Child Care Forms Central Region (717) 772-7078 or (800) 222-2117 Northeast Region (570-963-4371 or (800) 222-2108 Southeast North and Southeast South Region (215) 560-2541 or (800) 346-2929 Western Region (412) 565-5183 or (800) 222-2149 To help meet this need the Child Care Licensing Bureau is now accepting requests for exceptions to the rules, rule variances, identified by child care professionals as barriers to bringing on new staff members. 85UN#"&`Qr)jp+ZtsTewBUY^X_X<3yMtR5+ All you have to do is download it or send it via email. Use professional pre-built templates to fill in and sign documents online faster. n(@g#LiV]zP%Z:~Gq{6W Ps~[il,y.7Z2\Z]6%K\,dRAwghs\I[-FjVd6Q".4uxhE;#O=huj\Py!cRsi;T$(Lk=u9^TM7{zk.xZoF+~[`U-)XO&nTNgwaWj}|#;!iq4FYpE04FHRDTbel1^m>6h@z^P*hHe2]L?zqTzdnH9{Sah11:H
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Make these fast steps to edit the PDF Child care renewal application online free of charge: Sign up and log in to your account. Add the PDF you want to work with using your camera or cloud storage by clicking on the. View child care resources regarding COVID-19 and Monkeypox information from the Center for Disease Control and the Michigan Department of Health and Human Services. LARA is dedicated to bridging the gap between civilian and military employment and helping veterans gain and retain employment. /Filter /FlateDecode LARA provides licensing services for three types of child care operations: family child care homes, group child care homes, and child care centers. Due to the President's Day Holiday, payments that would normally be issued on Thursday, 2/23/2023, will have a one-day delay and will be issued on Friday, 2/24/2023 instead. Providers do not need to take any action at this time. !tp,3+X =-N;HY(!8h y:ApBeX&Ct.e'me-q%mw#&*'?SejsiyyKcc\Z[5?X2eYcp)sr. Only updated Internet Explorer, FireFox, or Google Chrome browsers are compatible with MiLogin. Homes for the Aged Exemption from Licensure. Due to the President's Day Holiday, payments that would normally be issued on Thursday, 2/23/2023, will have a one-day delay and will be issued on Friday, 2/24/2023 instead. signNow helps you fill in and sign documents in minutes, error-free. Staffing Plan: Child Care Center CCL-5001 Excel, Child Care License Designee CCL-5003 - PDF Self-Certification of Transportation Provisions for Centers CCL-5044 - Word, Volunteer Certification for Field Trip Transportation CCL-5046 - PDF Received Medical Treatment if applicable and known Phone Number of Treating Physician / Medical Facility / Hospital if applicable Any Handicaps Health Problems or Exceptions Listed on the Child s Health Records if applicable If Fire Describe Damage PERSON S NOTIFIED law enforcement fire marshal parent/legal guardian etc. Search for the document you need to eSign on your device and upload it. Please note, if you do not register and obtain a SIGMA Vendor ID, MDHHS will not be able to process your payment. Follow our step-by-step guide on how to do paperwork without the paper. 3;Vpf !fn'~Y1qU."c.@*vz 4b%"Jt}L ,`z'Up\[8UDz9^OeK6'r#{*%4pSA2A0v69k"0qq4~-#^:Z9fYuKOw35 1 Tax Questions: Please keep in mind that CDC staff are not tax experts and are unable to answer questions related to filing your taxes. stream
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All child care providers are required to have a licensing notebook on-site and available during regular business hours. Family and Group Home Increased Capacity and Ratio Request - Word Version, Family and Group Home Increased Capacity and Ratio Request PDF Version, Waiver for Decreasing Capacity Fillable Word Version, Waiver for Decreasing Capacity PDF Version, Request of Child Care Forms CCL-2021 PDF, Request of Child Care Forms CCL-2021 Word, Child Care Licensing Information Request - CCL 001 -PDF, Child Care Licensing Information Request - CCL 001 - Word, Medication Permission and Instructions for Child Care Homes/Child Care Centers - CCL-1243 PDF, Medication Permission and Instructions for Child Care Homes/Child Care Centers - CCL-1243 Word, Permiso e Instrucciones Para la Medicacin Para Casas de Cuidado/Guarderias - CCL-1243-SP - PDF, Permiso e Instrucciones Para la Medicacin Para Casas de Cuidado/Guarderias - CCL-1243-SP - Word, Background Check and Fingerprinting Information, Report of Actual or Suspected Child Abuse or Neglect - DHS-3200, Notification of Changes in Status-Family and Group Child Care Home - CCL-1485 - PDF, Notification of Changes in Status-Family and Group Child Care Home - CCL-1485 - Word, Medical Clearance Request - CCL-3704 - PDF, Medical Clearance Request - CCL-3704 - Word, Child Information Record - CCL-3731 - PDF, Child Information Record - CCL-3731 - Word, Child Information Record - CCL 3731-AR (Arabic), Documento de Informacin del Nio Estado de Michigan - CCL-3731-SP, Zoning Approval for Group Child Care Homes - CCL-3748 - PDF, Zoning Approval for Group Child Care Homes - CCL-3748 - Word, Declaracin/Recibo de Nios en Cuidado - CCL-3900-SP, Child in Care Statement/Receipt - CCL-3900 - PDF, Child in Care Statement/Receipt - CCL-3900 - Word, Training Record Family/Group Child Care Homes - CCL-4590 PDF, Training Record Family/Group Child Care Homes - CCL-4590 - Word, Assistant Caregiver Certifications - CCL-4595 - PDF, Assistant Caregiver Certifications - CCL-4595 - Word, Home Fire and Tornado Drill Record - CCL-4593 - PDF, Home Fire and Tornado Drill Record - CCL - 4593 - Word, Licensing Notebook Summary Sheet - CCL-5052 - PDF, Licensing Notebook Summary Sheet - CCL-5052 - Word, Request for Modification of the Terms of the License - CCL-5054 - PDF, Request for Modification of the Terms of the License - CCL-5054 - Word, Variance Request Early Childhood Program Director Fillable Word Version, Variance Request Early Childhood Program Director PDF Version, Variance Request School-Age Program Director Fillable Word Version, Variance Request School-Age Program Director PDF Version, Variance Request Lead Caregiver Fillable Word Version, Variance Request Lead Caregiver PDF Version, Child Care Licensing Information Request - BCHS-CCL 001 - PDF, Child Care Licensing Information Request - BCHS-CCL 001 - Word, Medication Permission and Instructions for Child Care Homes/Child Care Centers - CCL-1243 - PDF, Medication Permission and Instructions for Child Care Homes/Child Care Centers - CCL-1243 - Word, Permiso e Instrucciones Para la Medicacin Para Casas de Cuidado/Guarderias - CCL-1243-SP - Word. The best way to generate an eSignature for your PDF document online, The best way to generate an eSignature for your PDF document in Google Chrome, How to make an electronic signature for signing PDFs in Gmail, How to create an electronic signature right from your smart phone, How to create an electronic signature for a PDF document on iOS, How to create an electronic signature for a PDF on Android OS, If you believe that this page should be taken down, please follow our DMCA take down process, You have been successfully registeredinsignNow. If you are a provider/licensed child care providerthat will be expecting compensation for services performed for MDHHS/MDE clients, you need to register with the Statewide Integrated Governmental Management Applications (SIGMA) Vendor Self Service (VSS) atwww.michigan.gov/sigmavss. 4-10) Previous editions obsolete. Corporation Forms; Limited Liability Company Forms; Limited Liability Partnership Form; . Michigan Office of Administrative Hearings and Rules. The web Browser you are currently using is unsupported, and some features of this site may not work as intended. A Camp SITE and Camp PROGRAM are licensed separately. a. I am responsible for any child care charges for periods before my provider completes the Great Start to Quality Orientation. Whitmer Launches New Program to Help Entrepreneurs Open New Child Care Programs, Increase Availability of Affordable Care for Parents, LARA Hosts Child Care Provider Access Fair In Petoskey. The Dept. of Licensing and Regulatory Affairs (LARA), Child Care Licensing Bureau (CCLB), has summarily suspended the group child care home license of Connie Rookus, located at New Caring for Mi Future start-up grant helps entrepreneurs start a child care business in Michigan, expands access to quality, affordable care for more working families Required Camp Policies and Documents Guidance. After its signed its up to you on how to export your bcal 4605: download it to your mobile device, upload it to the cloud or send it to another party via email. Corporations, Securities & Commercial Licensing Bureau. Out Strong Start is a program focusing on recruiting new child care entrepreneurs and helping current child care entrepreneurs expand. (Ru>wr)K"Ef'77(@lk\C]nn*!\|C_I6[lo)s%>rI3buH:%rg#YNZ*rS]|(gR-S5[l+m8OK9|)?h;Tu?*iwl.ch"JC?P {s6>]h[24v J,n[D"GCgT^Q Jo%q7:QaIIw 8GOjT The sigNow extension was developed to help busy people like you to decrease the stress of putting your signature on papers. not subject to the Freedom of Information Act (1976 PA 422, as amended). The signNow application is equally as productive and powerful as the web tool is. All child care providers are required to have a licensing notebook on-site and available during regular business hours. Complete this form within 72 hours of calling in a suspicion of abuse or neglect. b. I understand that if I am a child care staff member, I shall report to the child care facility within 3 business days after I have been arraigned for or convicted of 1 or more of the crimes listed in MCL 722.115r. Choose the correct version of the editable PDF form from the list and get started filling it out. e {LJ ro0`IL,. All users have the responsibility to determine whether information obtained from this site is still accurate, current, and complete. Select the area where you want to insert your eSignature and then draw it in the popup window. Oq
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^PS5z`XIm=5 Michigan Office of Administrative Hearings and Rules. Additional questions may be directed to the appropriate Regional Office of Child Development: *FOR QUESTIONS REGARDING YOUR PENNSYLVANIA CHILD ABUSE HISTORY CLEARANCE APPLICATION, CONTACT CHILDLINE AT 1-877-371-5422. Install the signNow application on your iOS device. Click on the Register button. Records and reports of suspected child abuse or neglect are subject to the Child Protection Law, 1975 PA 238, as
Enter your 7-digitProvider ID and 6-character PIN, then press the Submit Button. Select our eSignature tool and say goodbye to the old times with efficiency, affordability and security. Child Care Licensing Rules and Statutes | Child Care Licensing Licensing Rules for Child Care Centers and Homes provide minimum standards for regulated child care providers. This message area was updated Tuesday, February 21, 2023. @B/7 +b|sN= !7]/;xrWY-e [3Q
E7z_;$h;~|9sHo>9dN'~_Nw{\J Ywe;]/W.*|hZ0=)>+e*_.rho~x-w+yq6/X)y^4X5b 9~d|3~3UnZ9F1>nA0ww?,pg)_}$:_;t1c2-@57d"|Al@$!Dz&=bA!DO4 g39ATe]h- Get access to thousands of forms. LARA is dedicated to bridging the gap between civilian and military employment and helping veterans gain and retain employment. Once youve finished putting your signature on your bcal 4605, decide what you want to do after that - save it or share the doc with other people. Application for Child Care Plan Review (BCHS-FS-13), Child Care Center Notice of Arraignment or Conviction CCL-1486 - PDF, Child Care Center Notice of Arraignment or Conviction CCL-1486 - Word, Child Information Record - CCL-3731 Web Proected, Child Information Record - BCAL 3731-AR (Arabic), Documento de Informacin del Nio Estado de Michigan - BCAL-3731-SP, Written Information Packet Documentation CCL-4340 - PDF, Written Information Packet Documentation CCL-4340 - Word, Change of Use Space Request for School-Age Programs Located in Schools CCL-4342 - PDF, Change of Use Space Request for School-Age Programs Located in Schools CCL-4342 - Word, Lead Hazard Risk Assessment Summary CCL-4344 - PDF, Lead Hazard Risk Assessment Summary CCL-4344 - Word, No Change in Building Construction Declaration CCL-2129 - PDF, No Change in Building Construction Declaration CCL-2129 - Word, Infant/Toddler Primary Caregiver Documentation CCL-4557 - PDF, Infant/Toddler Primary Caregiver Documentation CCL-4557 - Word, Center Fire and Tornado Drill Record - CCL-4593 - PDF, Center Fire and Tornado Drill Record - CCL-4593 - Word, Staffing Plan: Child Care Center CCL-5001 - PDF The whole procedure can last a few moments. Licensing Rules for Child Care Centers and Homes provide minimum standards for regulated child care providers. 4 0 obj
Create your eSignature, and apply it to the page. Reducing Barriers to Licensure for Military Families, Corporations, Securities & Commercial Licensing, Find / Verify a Licensed Professional or Business, Make a Complaint About a Licensed Professional or Business, Look Up Underground Storage Tank Information, Access the Online Liquor Ordering (OLO) System, Regulated Products, Professions, & Businesses Activities, Resources for Veterans & Military Families, https://dev.michigan.local/som/json?sc_device=json, Go to An Online Resource for Skilled Immigrants, Medical Marijuana Program (MMMP) Patients & Caregivers, Learn About CRA Rules, Laws & Regulations, Find / Verify a CRA Licensed Professional or Business, Make a Complaint About a CRA Licensed Professional or Business, Track Marijuana Inventory - Statewide Marijuana Monitoring System (Metrc), Find Panel, Public Hearing & Workgroup Information, Find a Disciplinary Action Report or Document, Learn About CCL Rules, Laws & Regulations, Find / Verify a CCL Licensed Professional or Business, Make a Complaint About a CCL Licensed Professional or Business, Apply for / Renew a BCC License or Permit, Find / Verify a BCC Licensed Professional or Business, Make a Complaint About a BCC Licensed Professional or Business, Learn About Examinations & Continuing Education, Find / Verify a BCHS Licensed Professional or Business, Make a Complaint About a BCHS Licensed Professional or Business, Go to Corporations, Securities & Commercial Licensing, Find / Verify a CSCL Licensed Professional or Business, Make a Complaint About a CSCL Licensed Professional or Business, Contact the Michigan Liquor Control Commission, Local Government & Law Enforcement Resources, Go to Michigan Office of Administrative Hearings and Rules, Administrative Hearings Frequently Asked Questions, Request to Attend a Hearing (for Media Professionals), Go to Michigan Indigent Defense Commission, Learn About Continuing Legal Education (CLE), Make a Complaint or Inquiry About a Utility Provider, Compare Natural Gas Utilities Options (MI Gas Choice), Submit an Underground Utilities Locate Request (MISS DIG 811), Learn About Natural Gas & Pipeline Providers, Learn About Rules of Practice and Procedure, Find / Verify a BPL Licensed Professional or Business, Make a Complaint About a BPL Licensed Professional or Business, Michigan Automated Prescription System (MAPS), Find / Verify a UCC Licensed Professional or Business, Make a Complaint About a UCC Licensed Professional or Business, Go to Apply for / Renew a License or Permit, Go to Find / Verify a Licensed Professional or Business, Go to Make a Complaint About a Licensed Professional or Business, Go to Look Up Underground Storage Tank Information, Go to Look Up a Controlled Substance (MAPS), Go to Access the Online Liquor Ordering (OLO) System, Go to Look Up a Disciplinary Action Report, Go to Submit a Request for Information (FOIA), Go to Regulated Products, Professions, & Businesses Activities, Go to Requesting Information from LARA (FOIA), Go to Resources for Veterans & Military Families, Statewide Search for Licensed Child Care Centers/Homes, Provider Map for Licensed Child Care Centers/Homes, Child Care Providers Closed/Suspended Due to Disciplinary Action, LARA Summarily Suspends a Group Child Care Home License in Kent County, Gov. Log in to the editor with your credentials or click on Create free account to test the tool's functionality. Incident Report CCL-4605 - Word, Parent Notification of the Licensing Notebook CCL-5053 PDF, Parent Notification of the Licensing Notebook CCL-5053 - Word, Multiple Occupancy Documentation for Child Care Centers CCL- 2118 PDF, Multiple Occupancy Documentation for Child Care Centers CCL- 2118 Word, Ownership Interest Disclosure CCL-2119 PDF, Ownership Interest Disclosure CCL-2119 Word. The web Browser you are currently using is unsupported, and some features of this site may not work as intended. My experience is hardly unique. LARA is proud to be recognized as a Veteran-Friendly Employer committed to military veteran recruitment, training and retention practices. 2023 airSlate Inc. All rights reserved. 5m. ?mN,]jseyV.z~ONYq rK<9qNkFNmsq`_jU.1.Yl^y||EV^e`w7yr__SY;|@67rO3R(r^jO?>\? Forms Child Care Licensing Bureau forms are available on the website as PDFs and Word Documents. There are three variants; a typed, drawn or uploaded signature. Environmental Health Provisions - BCAL-4668, Child Care Center Compliance Record, Part 3. Use signNow to electronically sign and share Lara bcal for eSigning. Forms for child foster care Minnesota Adoption and Child Foster Care Application DHS-4258A (9-17) (PDF) Minnesota Corporate Child Foster Care Application DHS-4258H (8-17) (PDF) Parental Consent for Swaddling an Infant DHS-7218 (7-13) (PDF) Physician Directive for Alternative Infant Sleep Position DHS-7216 (7-13) (PDF) Forms for family child care Whitmer Makes $23 Million Bipartisan Investment to Start and Expand Child Care Businesses, Application Open 11/7, Gov. Whitmer Makes $23 Million Bipartisan Investment to Start and Expand Child Care Businesses, Application Open 11/7 October 27, 2022 LARA is proud to be recognized as a Veteran-Friendly Employer committed to military veteran recruitment, training and retention practices. Reports may be obtained by making a Freedom of Information Act request. Connect to a smooth web connection and start completing forms with a fully legitimate electronic signature within minutes. You may copy this form if you need additional sheets. LARA is dedicated to bridging the gap between civilian and military employment and helping veterans gain and retain employment. Important Notice: Providers who anticipate receiving payments from the Michigan Department of Health and Human Services (MDHHS) or the Michigan Department of Education (MDE). The Michigan Department of Licensing and Regulatory Affairs ( LARA ), originally the Department of Commerce among other names, is a principal department in the Michigan executive branch that oversees employment, professional licensing, construction, and commerce . As a result, you can download the signed bcal 4605 to your device or share it with other parties involved with a link or by email. Corporations, Securities & Commercial Licensing Bureau. Providers submitting billing are timing out before the PDF invoice displays. c. A child care licensee, licensee designee, or program director shall report to the department within 3 business days