Get Mi Temporary Provisional License Application -­ Facility

The MI Temporary Provisional License Application - Facility is an essential document for individuals seeking a temporary provisional license in Michigan. This guide provides a clear, step-by-step approach to assist users in successfully completing the form online.

Follow the steps to complete your application accurately.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Begin with Section I, where you will enter the applicant and facility information. Fill in the applicant's name, birthdate, social security number or FED ID number, and phone number. If there is a co-applicant, provide their details as well.
3. Continue by entering the facility address, including street number and name, city, state, and zip code.
4. In the emergency assistance section, provide the name, telephone number, age, and address of the adult who will assist in emergencies.
5. For the assistant caregiver, if applicable, supply their age and select the water type from the options: well or public. Then choose the sewer type as either septic or public.
6. Indicate the types of heat sources used in the facility - gas, electric, or propane. Also, specify the water heater type by checking gas, electric, or wood.
7. Answer the questions about previous licenses for care services and indicate the year the center was built.
8. If applicable, provide details of any other license applied for, including the license number. State the number of children for whom you wish to be licensed and their ages.
9. Provide information on who will supply food to the children and describe their sleeping arrangements.
10. Detail directions to the center, including the nearest intersection, and specify the days and times of operation.
11. In Section II, describe the planned daily activities for the children, including outdoor play provisions and a list of toys/materials as needed.
12. Document any training completed, including the name of the training agency and date received. Ensure to check which training applies to you.
13. Once all sections are complete, review your information for accuracy. You can then save changes, download the completed form, print a copy, or share it with relevant parties.

Complete your MI Temporary Provisional License Application - Facility online today!