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Issue Alert - Child Day Care (CDC) Provider Verification PEM 702

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Jan 05, 2007

Program Area:

Child Development Care (CDC)

Issue Summary:

The begin date of care must now be verified with the DHS-4025, Child Development and Care (CDC) Provider Verifcation, before payments can be authorized.

Persons Affected:

Child care providers and recipients

For More Information:

Center for Civil Justice
320 S. Washington, 2nd Floor
Saginaw, MI 48607
Phone: (989) 755-3120, (800)724-7441
Fax: (989) 755-3558

Michigan Poverty Law Program
611 Church Street, Suite 4A
Ann Arbor, MI 48104-3000
Phone: (734) 998-6100
Fax: (734) 998-9125


In the past, use of the DHS 4025 was optional. The form verifies the date that care started, where the care is provided, reimbursements that the provider receives on behalf of the children in care and to document relative status. The form must be signed by both the provider and the parent to certify that the information is correct.

Clients are not eligible for CDC payments for care provided by any of the following persons:
• A member of the CDC program group (see PEM 205).
• The applicant/client.
• The applicant/client’s spouse who lives in the home.
• The parent of the child(ren) or a legal guardian who is not a member of the CDC program group.
• A provider who also provides adult home help to any CDC program group member, the CDC applicant or the CDC applicant’s spouse for the same period in which child care is provided.

A relative care provider is related to the child needing care by blood, marriage or adoption as a:
• Grandparent/step-grandparent,
• Great-grandparent/step-great-grandparent,
• Aunt/step-aunt,
• Uncle/step-uncle or
• Sibling/step-sibling,
provides care in the relative's home, and does not live in the same home as the child.

What's Happening?

When a client requests an application for CDC in person, the local office must give the client a DHS-4025 that same day. When a client requests an application for CDC by letter or telephone, the DHS-4025 must be mailed to the client by the end of the next workday. All provider types must fill out the form.

What Should Advocates Do?

The DHS 4025 form can be found at:

Finding Help

Most legal aid and legal services offices handle these types of cases, and they do not charge a fee.

You can locate various sources of legal and related services, including the free legal aid office that serves your county, at

You can also look in the yellow pages under "attorneys" or call the toll-free lawyer referral number, (800) 968-0738.