Licensing Record Clearance Request form (BCAL 1326A - FP) and Livescan Fingerprint Background Check Request (RI-030).

Livescan Fingerprints are required for an applicant licensee, licensee designee, and authorized representative (HFA Only).

The Adult Foster Care/Homes for the Aged Licensing Record Clearance Request (BCAL 1326A-FP) and the Livescan Fingerprint Background Check Request (RI-030) forms must be submitted to licensing unit together. To obtain a copy of the BCAL 1326A - FP and the RI-030 please contact the licensing unit at 1-866-685-0006.

Note: If you are fingerprinted prior to the filing of an application or prior to notifying your licensing consultant of a change in Licensee Designee, you may have to be re-fingerprinted at your additional expense.

Fingerprint Approved Vendor's Contact Information

For AFC & HFA settings: direct care staff, employees, administrators or responsible persons fingerprinting must be completed through the Workforce Background Check (WBC) program. Please continue the criminal history background check process established for these individuals. 

Background Check Information

Licensing Information Request form (BCHS-AFC 100)

Adult household members, administrators and responsible persons must complete the Adult Foster Care Licensing Information Request (BCHS-AFC 100) form and submit the form to licensing unit.  Adult household members are not fingerprinted.  A background check for Administrators and responsible persons on the Workforce Background Check (WBC) program is required to ensure compliance with Public Act 218.

Adult Foster Care Licensing Information Request, BCHS-AFC 100

Related Documents:

Background Checks for Adult Foster Care (AFC) MCL 400.734b
Background Checks for Home for the Aged (HFA) MCL 333.20173a