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(circle one): Parent-led/Teacher-led/Mixed Service Provider Contact Person: Under 2: Date of Visit: Over 2: Names of ministry licensing staff: Total licensed number: Licensing assessment relates to:  Complaint investigation  Application for new centre (probationary licence) [For practice-related requirements (that cannot be fully observed before the centre begins operating), an assessment about whether the centre is likely to comply is required. This assessment will be based on .

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