Written Documentation Acknowledgement
    Michigan Department of Licensing and Regulatory Affairs
    Bureau of Community and Health Systems

  • A written information packet has been provided at the time of enrollment. The packet included all the following information:

    • Criteria for admission and withdrawal
    • Schedule of operation, denoting hours, days, and holidays during which the center is open and services are provided
    • Fee policy
    • Discipline policy
    • Food service program
    • Program philosophy
    • Typical daily routine
    • Parent notification plan for accidents, injuries, incidents, illnesses
    • Exclusion policy for child illnesses
    • Notice of the availability of the center’s licensing notebook
    • The licensing notebook contains all the licensing inspection and special investigation reports and related corrective action plans since May 28, 2010
    • The licensing notebook is available to parents during regular business hours
    • Licensing inspection and special investigation reports from at least the past two years are available on the child care licensing website at

    I certify that I received all of the above items.

  • Date Format: MM slash DD slash YYYY