The department is required by the following licensing rules: Family and Group Child Care Homes R 400.1962(2) Child Care Centers R 400.8158(3) Children's and Adult Foster Care Camps R 400.11127(9) Was the incident phoned to licensing? Yes If yes, date and time? No If no, contact your licensing consultant within 24 hours of the incident. DISTRIBUTION Send original to your licensing consultant and retain a copy for your records. TYPE OF REPORT Incident Accident Illnes.
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How to fill out the MI BCAL-4605 online
The MI BCAL-4605 form is a crucial document used in the state of Michigan for reporting various incidents related to child care and camps. Completing this form accurately and promptly is essential for compliance with licensing rules.
Follow the steps to fill out the MI BCAL-4605 form online.
- Click ‘Get Form’ button to access the MI BCAL-4605 form and open it in your preferred online editor.
- Indicate whether the incident was reported to licensing by selecting 'Yes' or 'No.' If 'Yes,' provide the date and time of the report in the specified fields.
- Choose the type of report you are submitting by selecting one of the options: Incident, Accident, Illness, Death, or Fire.
- Fill in the facility information, including the registration/license number, facility phone number, facility type, name, address, county, city, state, and zip code.
- Under the section for children involved, enter each child’s name, birthdate, sex, home address, city, state, zip code, name of parent, and their contact numbers.
- Provide information on any caregivers, other individuals involved, or witnesses by entering their names, addresses, and phone numbers.
- Detail the incident by entering the time and location of the incident. Use the description fields to provide a comprehensive account of what occurred.
- If applicable, indicate whether first aid was given. If yes, specify when and by whom.
- Note any health problems, exceptions, or handicaps related to the child’s health records if relevant to the incident.
- List any persons notified about the incident, including their names, notification dates, and times.
- Finally, sign the form as the person completing it, including your title and the date. Obtain the necessary signatures from the registrant or licensee.
- Review all entries for accuracy, then save the completed form, download it, or print it for distribution. Ensure that the original is sent to the licensing consultant while keeping a copy for your records.
Complete your MI BCAL-4605 form online today to ensure compliance and proper reporting.
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