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Effective Date: 




Updated: 5/2018



Child Care Licensing staff complete Section I. The provider completes Section II. Section III will be signed by both Licensing and the provider once everyone agrees with the plan.



Section I: Instructions for Licensing Staff:

  • Fill in the information about the operation.
  • Identify the deficiencies noted during the compliance history review.
  • Note the dates of the Compliance History Report.
  • Provide this form to the operation with a request that the form be completed and returned within 10 days of receipt.
  • Meet with the permit holder or designee and the administrator or director of the operation in person or by phone to review the answers provided and ensure the plan addresses identified risk.
  • The agreed upon plan requires the signature of the licensing staff, supervisor and the administrator or director of the operation.
  • Explain to the administrator or director how licensing staff will follow up on this plan.
  • Provide the operation and permit holder with a signed copy of this plan 15 days prior to the start date of the plan of action.

Section II: Instructions for Providers:

  • Answer all questions.
  • Describe your plan in full.
  • Include any additional documents or supporting information.
  • Return this form to your licensing inspector within 10 days of receipt.

Section III: The operation's administrator or director and licensing staff must sign and date this plan of action upon review.



Form 7277 is returned to the licensing inspector within 10 days of receipt.