CFC-Background Checks and Required Paperwork

Completion of required paperwork and instructions regarding background checks

Requestor Information

Children on Campus background check links (from University Human Resources or HireRight) will be sent to your umich email or the one you list here.
I am:
I am:
Job Title
Job Title

Request Information

With which institution is your class, research or project affilated?
With which institution is your class, research or project affilated?
For which course is your placement or observation?
For which course is your placement or observation?
My research will take place in the classroom in the presence of Children's Center staff.
My research will take place in the classroom in the presence of Children's Center staff.
At which center(s) do you (or will you) work or participate, click all that apply (if this is a request for a project, at which center(s) would you like to complete your project?:
At which center(s) do you (or will you) work or participate, click all that apply (if this is a request for a project, at which center(s) would you like to complete your project?: (required)

Oversight required by Licensing Rules

The U-M Children's Centers are licensed by the State of Michigan Lifelong Education, Advancement, and Potential. The policies, processes, and information requests included in this form are required to meet licensing rules and/or to comply with the University of Michigan's Children on Campus policy.

Child Care Licensing rules are availble at https://www.michigan.gov/mileap/-/media/Project...

U-M's Children on Campus policy is available at https://spg.umich.edu/policy/601.34

Licensing Rule: 400.8213 Staff; volunteer. (1) All staff and volunteers present at the center shall: (a) Provide appropriate care and supervision of children at all times. (b) Act in a manner this is conducive to the welfare of children.
Licensing Rule: 400.8213 Staff; volunteer. (1) All staff and volunteers present at the center shall: (a) Provide appropriate care and supervision of children at all times. (b) Act in a manner this is conducive to the welfare of children.

U-M Children’s Centers Child Abuse and Neglect Policy

All employees and participants at the U-M Children's Centers shall make an immediate verbal report to the Department of Health and Human Services, Children’s Protective Services, by telephone at 1-855-444-3911, on reasonable cause to suspect child abuse or child neglect. The verbal report must be followed by submission of a written report within 72 hours of the verbal report.

In accordance with the State of Michigan Lifelong Education, Advancement, and Potential (MiLEAP) licensing rules all staff and participants are informed that (i) child abuse and neglect is against the law (ii) are provided with this U-M Children’s Centers policy on child abuse and neglect and (iii) are aware they are mandated reporters.

Upon suspicion of the need to report an abuse and/or neglect situation to the Department of Health and Human Services (1-855-444-3911) it may be advisable, but not required, to inform the center director as to your concerns and action taken.

Employed staff and participants are required to be familiar with and understand their mandated responsibility regarding the reporting of child abuse or neglect.

Resources:
State of Michigan Child Protection Law
https://www.michigan.gov/mdhhs/-/media/Project/...
Mandated Reporter's Resource Guide
https://www.michigan.gov/en/mdhhs/adult-child-s...

Staff and volunteers who report suspicions of child abuse or neglect are immune from discharge, retaliation or other disciplinary action for that reason alone unless it is proven that the report is malicious.

I am aware abuse and neglect of children is against the law, have been informed of the center's policies above and I am aware I am a mandated reporter required by law to immediately report suspected abuse or neglect to children's protective services at 1-855-444-3911.
I am aware abuse and neglect of children is against the law, have been informed of the center's policies above and I am aware I am a mandated reporter required by law to immediately report suspected abuse or neglect to children's protective services at 1-855-444-3911.

U-M Children's Centers Blood Borne Pathogen Policy

Bloodborne pathogens, particularly Hepatitis B and HIV, pose a particular danger to those who work in a setting with children. To minimize this danger, all non-professional staff participants must be very careful not to come in contact with blood from a child. To minimize risk of blood contact, non-professional staff participants must:

Remove themselves from a blood incident and immediately report it to the professional staff/classroom teachers;

Use protective measures (gloves) to ameliorate the situation if the professional staff/classroom teachers are not available;

Ask the child to contain the wound with an absorbent compress (tissues, paper towels, clean diaper).

If in extreme circumstances a non-professional staff participant receives a blood contact, they must immediately report that contact to the professional staff/classroom teacher so appropriate measures can be taken. (All professional staff have the required training and will know procedures for responding.)

Blood Borne Pathogen Policy Acknowledgment
Blood Borne Pathogen Policy Acknowledgment
My observations/participation is for the sole purpose of a course-related or research project. Any data collected will be de-identified, confidential and destroyed upon completion of project. Photo, video or audio recording require express written permission of the research & training coordinator.
My observations/participation is for the sole purpose of a course-related or research project. Any data collected will be de-identified, confidential and destroyed upon completion of project. Photo, video or audio recording require express written permission of the research & training coordinator.
Michigan Child Care licensing rule R 400.8213 requires child care centers to check the public sex offender registry (PSOR) for volunteers prior to contact with children.
State of Michigan Child Care Licensing Rules do not have a designation for "observers" and so we use the rule for the closest match; supervised volunteer (i.e. an individual who is not employed by the center, is 16 years of age or older, and who is never with enrolled children without a staff person present).
Michigan Child Care licensing rule R 400.8213 requires child care centers to check the public sex offender registry (PSOR) for volunteers prior to contact with children.
Your full legal name will be used to order any necessary background checks. Each background check required for your particular role at the center will be listed in this form and you will be required to consent by checking the "I understand and consent" box.
A U-M background check is required prior to participation and every two years thereafter. You will receive an email from HireRight and you must provide the requested information within 5 business days.
A U-M background check is required prior to participation and every two years thereafter. You will receive an email from HireRight and you must provide the requested information within 5 business days.
A State of Michigan fingerprint background check is required prior to participation and every five years.
A State of Michigan fingerprint background check is required prior to participation and every five years.
File attachments associated with the ticket.
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