CCL-4590 (Rev. 7/27/2021) Previous edition obsolete.
TRAINING RECORD FOR FAMILY AND GROUP HOMES
Michigan Department of Licensing and Regulatory Affairs
Child Care Licensing Bureau
Facility/Licensee’s Name
License Number
Calendar Year
Individual’s Name
Role Licensee
Child Care Staff Member (18 years +)
Child Care Assistant (14-17 years)
Date of Hire
All licensees must complete a total of 10 clock hours of training annually. Child care staff members and child care assistants must complete a total of 5 clock
hours of training annually. CPR, first aid, and infectious disease trainings do not count towards the annual training requirements. The training must be related
to child development, program planning, and administrative management for a child care business. Verification of each training is to be kept on file by the
provider and available for the department’s review OR be on MiRegistry. [Rule 1905(1-2)] [Rule 1905(6)]
1 clock hour = 60 minutes. Training must be accrued annually during the calendar year.
ANNUAL TRAINING SUMMARY
Training Date
Title of Training
Number of
Hours
Trainer/Training Organization
Documentation of
Training
On File
On MiRegistry
On File
On MiRegistry
On File
On MiRegistry
On File
On MiRegistry
On File
On MiRegistry
On File
On MiRegistry
On File
On MiRegistry
On File
On MiRegistry
CPR & FIRST AID TRAINING SUMMARY
[Rules 1904a(2)(a-b), 1904b(3)(a-b), 1905(7)]
Infant, Child and Adult CPR
First Aid
Date Completed
Training Organization
Date Completed
Training Organization
HEALTH AND SAFETY TRAININGS
[Rules 1904a(2)(c), 1904b(3)(c), 1905(3-4) 1905(9)]
Date Completed
Training Topic
Date Completed
Training Topic
Prevention of infectious disease, including
immunizations.
Prevention of and responses to emergencies due to
food and allergic reactions.
Safe sleep practices to prevent sudden infant death
syndrome.
Handling and storage of hazardous materials and the
appropriate disposal of bio-contaminants.
Recognition of and the reporting of child abuse and
neglect.
Precautions in transporting children.
Prevention of shaken baby syndrome, abusive head
trauma, and child maltreatment.
Building and physical premises safety.
Child development.
All hazards emergency preparedness and response
planning.
Administration of medication.
Annual health and safety update.
SIGN AND DATE WHEN TRAINING IS COMPLETED. (KEEP ON FILE)
License’s Signature
Date
LARA is an equal opportunity employer/program.
