MDE is an equal opportunity employer/program.
Part 5 – Consent to Conduct Background and Criminal Record Check (applicant consent)
To be considered for enrollment in the CDC program:
a. I consent to and give permission to MDE through the Department of Licensing and Regulatory Affairs
(LARA), to conduct a background check that includes: 1) a review of the licensing database of people
with previous disciplinary action in a child care center, group child care home, family child care home, or
an adult foster care facility; 2) a search through the national and state sex offender registries; 3) a search
through all state criminal registries for any states where I've lived in the past five years; 4) a request that
the Michigan State Police (MSP) perform a criminal history check; and 5) a search of the child abuse and
neglect registry for Michigan and any states where I've lived for the past five years.
b. I understand that refusing the background check or knowingly providing false information in
connection with a background check will result in my being found not eligible.
c. I understand that MDE will make the final decision as to whether I am enrolled in the CDC program. I
also understand that MDE may end the background check or decide to not allow me to enroll in the CDC
program at any stage in the process.
d. I agree to provide all the information necessary to conduct a background check.
Privacy Act Statement:
Authority: Acquisition, preservation, and exchange of fingerprints and associated information by the Federal
Bureau of Investigation (FBI) is generally authorized under 28 U.S.C. 534. Depending on the nature of your
application, supplemental authorities include Federal statutes, State statues pursuant to Pub. L. 92-544,
Presidential Executive Orders, and federal regulations. Providing your fingerprints and associated information
is voluntary; however, failure to do so may affect completion or approval of your application.
Principal Purpose: Certain determinations, such as employment, licensing, and security clearances, may be
predicated on fingerprint-based background checks. Your fingerprints and associated information/biometrics
may be provided to the employing, investigating, or otherwise responsible agency, and/or the FBI for the
purpose of comparing your fingerprints to other fingerprints in the FBI’s Next Generation Identification (NGI)
system or its successor systems (including civil, criminal, and latent fingerprint repositories) or other available
records of the employing, investigating, or otherwise responsible agency. The FBI may retain your fingerprints
and associated information/biometrics in NGI after the completion of this application and, while retained, your
fingerprints may continue to be compared against other fingerprints submitted to or retained by NGI.
Routine Uses: During the processing of this application and for as long thereafter as your fingerprints and
associated information /biometrics are retained in NGI, your information may be disclosed pursuant to your
consent, and may be disclosed without your consent as permitted by the Privacy Act of 1974 and all
applicable Routine Uses as may be published at any time in the Federal Register, including the Routine Uses
for the NGI system and the FBI’s Blanket Routine Uses. Routine Uses include, but are not limited to,
disclosures to: employing, governmental or authorized non-governmental agencies responsible for
employment, contracting, licensing, security clearances, and other suitability determinations; local, state tribal,
or federal law enforcement agencies; criminal justice agencies; and agencies responsible for national security
or public safety.
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Part 4 – Reporting Requirement
I understand that if I am enrolled in the program, I am required to report to CDC within 3 business days
after I have been charged or convicted of a crime that is on the crime code list, located at
www.michigan.gov/childcare in the Providers section.