%PDF-1.7 The signNow application is equally as productive and powerful as the web tool is. Fire Safety Provisions - BCAL-0722, Child Care Center Compliance Record, Part 4. Corporations, Securities & Commercial Licensing Bureau. Once registered in SIGMA VSS, you will receive a SIGMA Vendor ID that will allow you to get paid for services performed. Use a lara incident report 2019 template to make your document workflow more streamlined. You will find a camp licensing overview, camp rules and statutes, forms, and resources to assist you at http://www.Michigan.gov/laracamps. 3 0 obj An Online Resource for Skilled Immigrants. Reports may be obtained by making a Freedom of Information Act request. Required Camp Policies and Documents Guidance. To date, the governor has expanded access to free or low cost child care for 150,000 more kids and their families, awarded nearly $1 billion in grants to nearly 6,000 child care businesses, and provided bonuses up to $1,000 for 38,000 child care professionals. L [H 3f&Yh!00\SLN32TDNf0m#|RQI,}g6T]a#hsxd B~/ The sigNow extension was developed to help busy people like you to decrease the stress of putting your signature on papers. An Online Resource for Skilled Immigrants. Oq ]DX~s%Scr&=N>&Q%r'@8 ^PS5z`XIm=5 The web Browser you are currently using is unsupported, and some features of this site may not work as intended. An Online Resource for Skilled Immigrants. 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. Click on the Register button. Reminder Regarding Temporary Rate Increases and End Dates: For additional information, please see the Child Care Provider Rates and Payments section of the CDC Handbook. Business Entity Forms. Decide on what kind of eSignature to create. Log in to the editor with your credentials or click on Create free account to test the tool's functionality. With over 9,000 vacancies, shortages of staff are impacting the industrys ability to serve children and families. This policy will be in effect through September 30, 2023. Select our eSignature tool and say goodbye to the old times with efficiency, affordability and security. Sec. [R 400. You may be required to add "Michigan.gov" to your compatibility view settings for the application to be submitted successfully. Gov. Print and read the Licensing Rules for Home for the Aged,and 1978 PA 368(emphasis Part 201 and 213) prior to submitting your application. Self-Certification of Transportation Provisions for Centers CCL-5044 - Word, Volunteer Certification for Field Trip Transportation CCL-5046 - PDF c. I am responsible for reporting child care payments to the IRS and issuing my provider a Form W-2 or Form 1099 MISC, if appropriate. convenience of interested persons. Please enable scripts and reload this page. c. A child care licensee, licensee designee, or program director shall report to the department within 3 business days Corporations, Securities & Commercial Licensing Bureau. Get access to thousands of forms. You may copy this form if you need additional sheets. stream 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. CDC Provider Login Enter your 7-digitProvider ID and 6-character PIN, then press the Submit Button This message area was updated Tuesday, February 21, 2023. Add the PDF you want to work with using your camera or cloud storage by clicking on the. Guidance for Temporary Billing Based on Enrollment and not Attendance memo. Use signNow to electronically sign and share Lara bcal for eSigning. Enter your 7-digitProvider ID and 6-character PIN, then press the Submit Button. LARA assumes no responsibility for any errors or omissions, or for the use of information obtained from this site. With signNow, it is possible to eSign as many documents in a day as you need at a reasonable price. n# 6H=f,=`S0p~gAs,o(W #1KIUHaF|mI5Ddf)u If you have any problems and/or need assistance during the registration process, please contact SIGMA Vendor Payment Support at 1-855-443-6424. An Online Resource for Skilled Immigrants. Child Care Licensing . 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, applicable Licensing Rules for your Adult Foster Care Home. Only updated Internet Explorer, FireFox, or Google Chrome browsers are compatible with MiLogin. Our Strong Start supports child care professionals with a team of trained navigators who connect them with grant opportunities, help troubleshoot any barriers in the licensing process, and address any concerns about starting or expanding their business. 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. The statutes listed are referenced in the licensing rules. 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. 3;Vpf !fn'~Y1qU."c.@*vz 4b%"Jt}L ,`z'Up\[8UDz9^OeK6'r#{*%4pSA2A0v69k"0qq4~-#^:Z9fYuKOw35 1 Speed up your businesss document workflow by creating the professional online forms and legally-binding electronic signatures. N?PQ$xhrjK@1DnpF7"9"VL? PFaD,;5UVrf$@`{&0,TrG,@(vb(v6Fr}Y[*ALewgALuchj%]FLz8U). 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, Rules and Statutes | Child Care Licensing. We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our 3rd party partners) and for other business use. Licensing Rules Get Form How to create an eSignature for the fillable online michigan family home daycare licensing Use professional pre-built templates to fill in and sign documents online faster. (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 Swimming Provisions - BCAL-1890, Child Care Home Record Requirements - BCAL-5040, Child Care Center Record Requirements - BCAL-5041. The following table gives a summary of each of these child care license types, its definition under Michigan law, and where to find the associated rules and regulations. Important Notice: Providers who anticipate receiving payments from the Michigan Department of Health and Human Services (MDHHS) or the Michigan Department of Education (MDE). For answers to questions about the CDC program, visit our website at www.michigan.gov/childcare. /Filter /FlateDecode Volunteer Certification for Field Trip Transportation CCL-5046 - Word, Playground Inspection Certification Summary CCL-5047 - PDF Homes for the Aged Exemption from Licensure. 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. We apologize for this inconvenience. n(@g#LiV]zP%Z:~Gq{6W Ps~[il,y.7Z2\Z]6%K\,dRAwghs\I[-FjVd6Q".4uxhE;#O=huj\Py!cRsi;T$(Lk=u9^TM7{zk.xZoF+~[`U-)XO&nTNgwaWj}|#;!iq4FYpE04FHRDTbel1^m>6h@z^P*hHe2]L?zqTzdnH9{Sah11:H +%93R?y '{1|u6)u&,Aehnv8C:%zYiJ|"-Z%V9C(RupDJ\glaR<8jwI.D 7,Prv,c5]E6hm2MFv5ag &Fmv$u14w](BlQ"x_gZ6\Pr5%e1n-ni!7NjX 8kZ )ZvCpC-1=4.]lr[eYcfkB Staffing Plan: Child Care Center CCL-5001 - Word Click on the name of the facility for more detailed information including online inspection reports completed on or after July 1, 2002. LARA is proud to be recognized as a Veteran-Friendly Employer committed to military veteran recruitment, training and retention practices. These child care forms include printable curriculum forms and child care lesson plans. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. % This is one piece of a historic $1.4 billion investment to expand access to quality, affordable child care for families. endobj 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 Requesting Increases to Capacity and Ratio for Homes. BCAL-5001 Part 2 (Rev. Corporations, Securities & Commercial Licensing Bureau. You may find the MiLogin RegistrationInstructionshelpful to navigate the website. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. lara child care forms michigan child care payment schedule 2021 Create this form in 5 minutes! LARA is dedicated to bridging the gap between civilian and military employment and helping veterans gain and retain employment. Download your copy, save it to the cloud, print it, or share it right from the editor. ?mN,]jseyV.z~ONYq rK<9qNkFNmsq`_jU.1.Yl^y||EV^e`w7yr__SY;|@67rO3R(r^jO?>\? A full-time day care spot can take months or even years to secure, especially for the youngest children; 80% of day care spots are reserved for children age 3 or older. Open the email you received with the documents that need signing. LARA is proud to be recognized as a Veteran-Friendly Employer committed to military veteran recruitment, training and retention practices. Incorrect Star Ratings: A system issue has caused some licensed and registered providers to be paid at a rate that is incorrect for their star levels. Tax Questions: Please keep in mind that CDC staff are not tax experts and are unable to answer questions related to filing your taxes. 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 . We recommend providers use the Save & Continue feature to save their hours while we correct these issues. Child Care License Designee CCL-5003 - Word, Certification of School Building Fire Safety Provisions CCL-5043 - PDF The web Browser you are currently using is unsupported, and some features of this site may not work as intended. We know how stressing completing documents can be. Make these fast steps to edit the PDF Child care renewal application online free of charge: Sign up and log in to your account. This message area was updated Tuesday, February 21, 2023. History [ edit] Install the signNow application on your iOS device. Print and read the applicable Licensing Rules for your Adult Foster Care Home,and 1979 PA 218prior to submitting your application. endobj Create an account using your email or sign in via Google or Facebook. Whitmer Makes $23 Million Bipartisan Investment to Start and Expand Child Care Businesses, Application Open 11/7, Gov. The notebook must include all licensing study and special investigation reports issued and related corrective actions developed after 5/27/10. A Camp SITE and Camp PROGRAM are licensed separately. 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. Corporations, Securities & Commercial Licensing Bureau. Michigan Office of Administrative Hearings and Rules. Michigan Office of Administrative Hearings and Rules. LARA provides licensing services for three types of child care operations: family child care homes, group child care homes, and child care centers. 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, Vehicle Protection Product Warrantor Forms. To apply for either license, please follow the instructions specific to each category. General Provisions - BCAL-1888, Child Care Center Compliance Record, Part 2. Z49u0w~eC>?'reS@`v5qupy&V&k>!iLA)fILMa5pV\TAkIn2=]=J dYTewz]Ttk} XEnfG2k]O5A]03XD^O&dQKR//' =nTk6.d`| />LvXQ{$=mya+bP_$aJt> )26hkK+AHEYb&xz?XEgu``5+`q.wBLc#XC$*E9QK \+1iv58mQk:5A/0GcYG%}0K'cw"e,x_Dkps{S6B}(7C6i>rW "1=rW +N9! <> Nh6>a5Pf=@x9HOf6UYf Certification of School Building Fire Safety Provisions CCL-5043 - Word, Self-Certification of Transportation Provisions for Centers CCL-5044 - PDF The Dept. Please note, if you do not register and obtain a SIGMA Vendor ID, MDHHS will not be able to process your payment. Go digital and save time with signNow, the best solution for electronic signatures. The whole procedure can last a few moments. The PDF versions are not fillable and are intended for printing. 2023 airSlate Inc. All rights reserved. Child care staffing shortages throughout the state have made it difficult to find caregivers for our youngest Michiganders. Use its powerful functionality with a simple-to-use intuitive interface to fill out Lara daycare forms online, eSign them, and quickly share them without jumping tabs. The Child Care Organizations Act (1973 PA 116) provides authority to establish these rules. As new information becomes available, we will update this message area. I will inform you before each occurrence. Corporations, Securities & Commercial Licensing Bureau. The signNow extension gives you a variety of features (merging PDFs, including multiple signers, and many others) to guarantee a better signing experience. Proudly founded in 1681 as a place of tolerance and freedom. The web Browser you are currently using is unsupported, and some features of this site may not work as intended. Playground Inspection Certification Summary CCL-5047 Word, Incident Report CCL-4605 - PDF Child Care Licensing Bureau forms are available on the website as PDFs and Word Documents. 5m. Click, Fillable Online Michigan Family Home Daycare Licensing, Rate able Online Michigan Family Home as 5 stars, Rate able Online Michigan Family Home as 4 stars, Rate able Online Michigan Family Home as 3 stars, Rate able Online Michigan Family Home as 2 stars, Rate able Online Michigan Family Home as 1 stars, how to become a licensed childcare provider in michigan, unlicensed child care provider michigan payment, michigan child care licensing application, michigan child care payment schedule 2021, Nm affordable housing credit claim form help 2011, Can I Sign South Dakota Standstill Agreement, Sign South Dakota Standstill Agreement Mobile, Sign South Dakota Standstill Agreement Now, Sign South Dakota Standstill Agreement Later, Sign South Dakota Standstill Agreement Myself, Sign South Dakota Standstill Agreement Free. Connect to a smooth web connection and start completing forms with a fully legitimate electronic signature within minutes. Staffing Plan: Child Care Center CCL-5001 Excel, Child Care License Designee CCL-5003 - PDF }{a,O,o7MYeUyYfAO~;gO}$+m^j1g(/5BdB ql8Z,yW~8vngeid L Transportation Provisions - BCAL-1891, Child Care Center Compliance Record, Part 5. Out Strong Start is a program focusing on recruiting new child care entrepreneurs and helping current child care entrepreneurs expand. Complete this form within 72 hours of calling in a suspicion of abuse or neglect. Forms Child Care Licensing Bureau forms are available on the website as PDFs and Word Documents. LARA is dedicated to bridging the gap between civilian and military . Get access to thousands of forms. 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. Summer 2022 Child Care Stabilization Grants:To go directly to information about the Summer 2022 grants, click the following link: Summer 2022 Child Care Stabilization Grants. And due to its multi-platform nature, signNow can be used on any gadget, desktop computer or smartphone, irrespective of the operating system. ?tfmV:gH3e4C+ \-lSXnD\fMC"o.2nDZBzfvwk o;3/ It is the practice of LARA to obtain and verify information from the Printing and scanning is no longer the best way to manage documents. Michigan Office of Administrative Hearings and Rules. To apply for a new license or renew a license, use the applicable applications below. << Disclaimer: Licensing and registration records are made available on this website by LARA to provide immediate access to information for the 85UN#"&`Qr)jp+ZtsTewBUY^X_X<3yMtR5+ 4 0 obj Child Care Homes Child Care Centers Checklists - Homes and Centers Renewal Applications Today, Gov. If you have questions concerning filing your taxes, see page 5 of the CDC Handbook or contact your tax preparer. Whitmer Makes $23 Million Bipartisan Investment to Start and Expand Child Care Businesses, Application Open 11/7 October 27, 2022 The Child Care Licensing Bureau (CCLB) performs state licensing regulatory duties as required by state laws and federal requirements. ?n&/Q2[Gk2Ax2$ - ?)*por~$g*O #|}}r51yq!k]Iz Obtain access to a GDPR and HIPAA compliant platform for optimum simpleness. Search for the document you need to eSign on your device and upload it. Select the document you want to sign and click. Go to the Chrome Web Store and add the signNow extension to your browser. c. A child care licensee, licensee designee, or program director shall report to the department within 3 business days 4 0 obj % Start putting your signature on bcal 4605 by means of tool and become one of the numerous satisfied customers whove previously experienced the advantages of in-mail signing. _gg+e8U4unu/!%}]Jiui2m(DX j!8qEWzx7Bv0>XzBU:z.s5E5MIs_RpU8&Y wrQ [Ns]=XQh[#R24)!RmG|1J|3= Wy Find the extension in the Web Store and push, Click on the link to the document you want to eSign and select. 1 0 obj *4UQuJ^'ILrlE~bPF8/'K'OeV'#o@=G6A.Bay`H Hlr&Ee/c{m .UB|Fl:S'`D"C@ Thq8H=0;<4>SLW{8V:Z$H4FK&\)C> K L@ GaL\x><. 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. a. I am responsible for any child care charges for periods before my provider completes the Great Start to Quality Orientation. 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. You can now submit your Pennsylvania Child Abuse History Clearance Request, Application for Certificate of Compliance for Center Group and Family, CD 51 (formerly CY 51) Child Health Assessment, CD 357 Documentation of Emergency Plan Delivery, CD 357 Request For Waiver of Child Care Facility Regulation, CY 863 Verbal Request for Release of Child, CY 867 Emergency Contact/Parental Consent Form, CY 113 Pennsylvania Child Abuse History Clearance, CY999 Consent/Release of Information Authorization Form, SP 4-164 Request for Criminal Record Check, PW 29A Day Care Services Enrollment/Attendance Record.
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