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Complaint Intake Form, the Designee Staff and their supervisor meet to discuss any concerns or questions the supervisor may have regarding the Complaint Intake Form and confirm the priority level of the complaint. The supervisor will thoroughly review the intake for content, formatting, and grammar.

The Complaint Intake Form is returned to the Designee Staff for any corrections or revisions as applicable until it is deemed ready by the supervisor. The Designee will forward the Complaint Intake Form to the MOA or CCPO Licensing Supervisor. Upon confirmation all documents were received and legible the documents are shredded.

2. Enter a Case Note The same day the Complaint Intake Form is deemed complete a case note is entered by the individual who completed the complaint intake form in the provider’s ICCIS case using subject heading: Complaint Received (Date MM-DD-YYYY) and the bodyof the case note is to include: Complaint Received – forwarded to CCPO or MOA Licensing. No other information regarding the complaint is documented in ICCIS at this time.

4340-1 B. RECEIVING A COMPLAINT REGARDING A CERTIFIED/ACCREDITED PROVIDER When a health and safety complaint is received by a Designee, CCPO, or the MOA Child Care Licensing office regarding a United States (US) Department of Defense or US Coast Guard Certified; Tribally Approved or Tribally Certified; or Nationally Accredited or Nationally Certified Day Camp or similar facility or program, the Designee, CCPO or MOA licensing office will attempt to connect the reporter with the provider’s certifying or approving authority. If unable to connect the reporter with an individual, the Designee, CCPO or MOA licensing office will complete the Complaint Intake Form, using the questions on the left side of the form as a guide in obtaining the most information possible. All original notes taken and received, during the intake process including information handwritten or received via email and then transferred on the Complaint Intake Form must be retained.

The complainant is to be advised the information will be documented and immediately forwarded to provider’s certifying or approving authority and the complainant may receive a follow up contact from that entity.