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\,%s-&F"K?^j?qfAnL.YT.G$By\\9aOX 'A*SHIY]j~BuQb:|T2O7|?NWW{G@u/V\>>Vt+[7,F?)5}lyrO+qDJeGn9gqM#tt+mhN}T(!S Also see Important Notice below regarding reimbursement from MDHHS. Important Notice: Providers who anticipate receiving payments from the Michigan Department of Health and Human Services (MDHHS) or the Michigan Department of Education (MDE). 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 85UN#"&`Qr)jp+ZtsTewBUY^X_X<3yMtR5+ e1~BcU_+add;*^9,>a^9!:TNeS%{8*]Keq`&Ji7uSr{'shrZ~) Go digital and save time with signNow, the best solution for electronic signatures. Enter your 7-digitProvider ID and 6-character PIN, then press the Submit Button. Search for the document you need to eSign on your device and upload it. Get access to thousands of forms. Certification of School Building Fire Safety Provisions CCL-5043 - Word, Self-Certification of Transportation Provisions for Centers CCL-5044 - PDF 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 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. +z7?A}W LARA is proud to be recognized as a Veteran-Friendly Employer committed to military veteran recruitment, training and retention practices. endobj LARA is proud to be recognized as a Veteran-Friendly Employer committed to military veteran recruitment, training and retention practices. Records and reports of suspected child abuse or neglect are subject to the Child Protection Law, 1975 PA 238, as The signNow application is equally as productive and powerful as the web tool is. 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. 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. Also, if using the "back" button, the Date Submitted may not appear and hours entered are not stored on the billing screens. The Dept. N?PQ$xhrjK@1DnpF7"9"VL? of Licensing and Regulatory Affairs (LARA), Child Care Licensing Bureau (CCLB) will host a Child Care Access Fair at North Central Michigan College in Petoskey on Apri LARA is proud to be recognized as a Veteran-Friendly Employer committed to military veteran recruitment, training and retention practices. Use professional pre-built templates to fill in and sign documents online faster. An Online Resource for Skilled Immigrants. c. A child care licensee, licensee designee, or program director shall report to the department within 3 business days 2023 airSlate Inc. All rights reserved. Playground Inspection Certification Summary CCL-5047 Word, Incident Report CCL-4605 - PDF The statutes listed are referenced in the licensing rules. To apply for aChild Care Home or Center licensesee the instructions below and apply online at MiLogin. The Word documents are fillable and are intended for electronic completion. endobj Select our eSignature tool and say goodbye to the old times with efficiency, affordability and security. a. I am responsible for any child care charges for periods before my provider completes the Great Start to Quality Orientation. I will inform you before each occurrence. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer. You may copy this form if you need additional sheets. lara child care forms michigan child care payment schedule 2021 Create this form in 5 minutes! Reports may be obtained by making a Freedom of Information Act request. All users have the responsibility to determine whether information obtained from this site is still accurate, current, and complete. 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. Caring for Mi Future is a $100 million strategy to open 1,000 new child care programs by the end of 2024. ?mN,]jseyV.z~ONYq rK<9qNkFNmsq`_jU.1.Yl^y||EV^e`w7yr__SY;|@67rO3R(r^jO?>\? Reminder: Please see the Guidance for Temporary Billing Based on Enrollment and not Attendance memo. Due to the President's Day Holiday, payments that would normally be issued on Thursday, 2/23/2023, will have a one-day delay and will be issued on Friday, 2/24/2023 instead. The web Browser you are currently using is unsupported, and some features of this site may not work as intended. /Filter /FlateDecode 1 0 obj Licensing Rules After that, your bcal 4605 is ready. "# +bc5iA F WXJT3H>.Le|e0}etGyJFx{ln(oTm=uYwQhW#Cf~53a4~I &!p"fy}L Eo$% Start completing the fillable fields and carefully type in required information. Providers submitting billing are timing out before the PDF invoice displays. Click on the Register button. Child Care Homes Child Care Centers Checklists - Homes and Centers Renewal Applications % Open the doc and select the page that needs to be signed. 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. Michigan Office of Administrative Hearings and Rules. Please enable scripts and reload this page. <> An Online Resource for Skilled Immigrants. Fire Safety Provisions - BCAL-0722, Child Care Center Compliance Record, Part 4. LARA is dedicated to bridging the gap between civilian and military employment and helping veterans gain and retain employment. The recent changes to PA 116 allows family and group homes to request an increase in capacity if the licensee meets certain conditions. The notebook must include all licensing study and special investigation reports issued and related corrective actions developed after 5/27/10. 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.

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