CFS 452-7
6/2018
State of Illinois
Department of Children and Family Services
COMPLIANCE with the COMPASSIONATE USE OF MEDICAL CANNABIS PILOT
PROGRAM ACT – Child Care Facility
I am aware of the restrictions outlined in the COMPASSIONATE USE OF MEDICAL CANNABIS
PILOT PROGRAM ACT [410 ILCS 130], AS FOLLOWS:
• Cannabis cannot be used, carried or stored in, or on the premises of any licensed child
care facility
• No person using medical cannabis may transport by any means a child served by a
licensed child care facility
• No child being served by a licensed child care facility or it’s employees shall be in close
physical proximity to medical cannabis which means being able to witness or smell
medical cannabis
Plan of compliance with the COMPASSIONATE USE OF MEDICAL CANNABIS PILOT
PROGRAM ACT:
Medical cannabis shall be stored at the following location:
Medical cannabis shall be used at the following location:
Applicant/Licensee understands a change in this plan or any new prescriptions of medical cannabis
will require an updated CFS 452-7 to be submitted to the facility Licensing Representative. Proof of
physician authorization must accompany this form. Applicants and Licensees may refer to:
Compliance with the Compassionate Use of Medical Cannabis Pilot Program Act [410 ILCS 130]
Applicant/Licensee Signature and Printed Name
Date
Applicant/Licensee Signature and Printed Name
Date
CFS 452-7
6/2018
State of Illinois
Department of Children and Family Services
COMPLIANCE with the COMPASSIONATE USE OF MEDICAL CANNABIS PILOT
PROGRAM ACT – Child Care Facility
I am aware of the restrictions outlined in the COMPASSIONATE USE OF MEDICAL CANNABIS
PILOT PROGRAM ACT [410 ILCS 130], AS FOLLOWS:
• Cannabis cannot be used, carried or stored in, or on the premises of any licensed child
care facility
• No person using medical cannabis may transport by any means a child served by a
licensed child care facility
• No child being served by a licensed child care facility or it’s employees shall be in close
physical proximity to medical cannabis which means being able to witness or smell
medical cannabis
Plan of compliance with the COMPASSIONATE USE OF MEDICAL CANNABIS PILOT
PROGRAM ACT:
Medical cannabis shall be stored at the following location:
Medical cannabis shall be used at the following location:
Applicant/Licensee understands a change in this plan or any new prescriptions of medical cannabis
will require an updated CFS 452-7 to be submitted to the facility Licensing Representative. Proof of
physician authorization must accompany this form. Applicants and Licensees may refer to:
Compliance with the Compassionate Use of Medical Cannabis Pilot Program Act [410 ILCS 130]
Applicant/Licensee Signature and Printed Name
Date
Applicant/Licensee Signature and Printed Name
Date
ADVERTISEMENT