ORDER:
This licence is awarded to —————————————————————————————————————————— ————————————————————————————————————————————, of Tamil Nadu as an hostel or lodging house or home for women and children vide S.No._____ /Collectorate/ ______________ under section 5(2) /* 6 (2) / * 7(1)of the Tamil Nadu Hostels and Homes for Women and Children (Regulation) Act, 2014. Thiru / Tmt. .................................... is the manager or* resident manager of the said institution. The said institution is a hostel or* lodging house or home for women or for children or for both women and children.
The Licence is valid for the period of three years commencing from ___________ and ending on —————-. This licence is meant for ......... number of inmates to be admitted by the institution. The institution shall comply with rules or regulations or instructions issued by the State Government from time to time regarding licence. The licence is granted subject to the following conditions, namely:—
1. The Management shall run the institution in accordance with the Tamil Nadu Hostels and Homes for Women and Children (Regulation) Act, 2014.
2. This licence shall be displayed prominently for the information of parents or general public in the office room.
3. The owner or the resident manager or the manager shall ensure an average space norms of 40 sq.ft. per child and 120 sq.ft. per woman.
4. Institution shall follow rules and regulations issued by State Government from time to time.
5. The institution is subject to inspection by the inspection authorities under the Act or Rules and by the persons or officers authorized by the State Government or District Collector.
6. The infra-structure facilities shall be maintained properly.
7. The institution shall ensure proper education, child rights and necessary safeguards from child abuses.
8. The institution shall ensure water and sanitation facility and also safe drinking water.
9. The institution shall maintain sufficient supervisory and sub - staff as per the Act.
10. The institution shall maintain the kitchen in a hygienic manner.
11. The personnel of the institution shall be trained in handling fire safety facilities.
12. Rain water harvesting facilities shall be done in the institutions.
13. The institution should not have any thatched structure or shall not construct any thatched structure in future. If the hostel or lodging house or home for women and children is found to violate any one of the above said conditions, the licence issued is liable for cancellation.
District Collector
* Strike out whichever is not applicable.
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12 TAMIL NADU GOVERNMENT GAZETTE EXTRAORDINARY
FORM-IV
[See rule 4(4) ]
Application Form for Registration
1. Name of the institution and address .. Phone number ..
Fax ..
E-mail ..
2. Place of the institution ..
(i) Registered place ..
(ii) Current place ..
3. Nature of the home .. [hostel or lodging house or home for women and children] ..
4. Name and address of the contact person ..
5. Details of the governing body .. (managing committee/executive committee) ..
6. Under which Act the registration is made ..
(i) number, date and place of registration ..
(ii) If renewed, the renewal details ..
7. Total number of girls or boys or women ..
(i) Girls ..
(ii) Boys ..
(iii) Women ..
8. Infrastructure available in the hostel or lodging house or home for women and children. ..
9. Details of the manager / resident manager/ care taker's or care giver's / warden (men or women) appointed in the institution. ..
(i) Name ..
(ii) Age ..
(iii) Educational qualification ..
(iv) Date of joining ..
(v) Appointed by whom ..
(vi) Salary ..
(vii) Medical certificate ..
(viii) Conduct certificate ..
10. Details of entry and exit points in the institution ..
11. Details of security person appointed in the institution. ..
(i) Name ..
(ii) Age ..
(iii) Educational qualification ..
(iv) Date of joining ..
(v) Salary ..
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TAMIL NADU GOVERNMENT GAZETTE EXTRAORDINARY 13
(vi) Medical certificate ..
(vii) Conduct certificate ..
12. (i) Specify locations where the CCTV cameras have been installed. ..
(ii) If not installed, action taken to install the same...
13. Details of rooms allocated for manager or resident manager or warden or care taker / care giver or security persons. ..
14. Details of registers maintained in the institution. ..
15. Details of the visitors room and visiting hours. ..
16. The details and phone number of the institution registered in district website. ..
17. The details of the inmates registered in track child website. ..
18. Audit statement details for the past three years done by the chartered accountant. ..
19. Foreign Contribution Regulation Act details. ..
20. Bank account number .. Bank name and branch .. I declare that the facts mentioned above is absolutely true to the best of my knowledge. Place : Signature of the Applicant
Date & Seal:
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14 TAMIL NADU GOVERNMENT GAZETTE EXTRAORDINARY
FORM - V
[ See rule 4(4) ]
Certificate of Registration
PROCEEDINGS OF THE DISTRICT COLLECTOR
PRESENT:
Proc.Roc.No . Date:
Sub: Collectorate __________________________________________—________________________________ hostel or lodging house or home for women and children - Registration issued under section 12(3) of the Tamil Nadu Hostels and Homes for Women and Children (Regulation) Act, 2014 - Order Issued. Ref: Application received from____________________, dated____________
*****
ORDER:
_________________________________________ hostel or lodging house or home for women and children
___________________________________District which has already been registered under__________________ _____________________________________ Act is now registered under section 12(3) of the Tamil Nadu Hostels and Homes for Women and Children (Regulation) Act, 2014 vide Sl.No. _______ / Collectorate / ________ .
District Collector
FORM -VI
[ See rule 4(5) ]
REGISTER FOR REGISTRATION
S.No Name and Contact Name of the Contact details Number and Remarks Address of the details of hostel or lodging of the Manager / Date of Institution the owner house or home Resident Registration for Women and Manager Certificate
Children issued
(1) (2) (3) (4) (5) (6) (7)
Place : Signature of the Officer Date :
Seal :
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TAMIL NADU GOVERNMENT GAZETTE EXTRAORDINARY 15
FORM - VII
[See rule 5 (1)]
Certificate of Fitness
Signature of the Applicant:__________________________ This is to certify that We / I ________________________________ the undersigned have examined Thiru / Tmt/ Selvi / __________________ whose signature is given above and who has applied to the post of _____________________________ at ___________________________ hostel or lodging house or home for women and children and come to the conclusion that he / she is physically fit to perform the duty of the above mentioned post with effect from ____________. Medical Officer
(not below the rank of Civil Surgeon)
Station:
Date:
FORM-VIII Certificate of Structural Stability and Sanitation
I/We further certify that to the best of my/ our knowledge and belief, the structural work including sanitation is carried out as per prescribed applicable standards and codes, rules, regulation and stipulations and that the materials used and the workmanship and methodology employed for construction work are of accepted standards and the work is fit for occupation for its intended use.
This certificate is issued on the clear understanding that my/ our overall responsibility for the structural stability of the building and its proper structural performance will cease the moment any additions or alterations to the structural frame by accident or due to tampering by the users/ occupants for any reasons whatsoever. My/ our responsibility will also cease in the event of overloading or lack of proper maintenance of structure or any such act, which is detrimental to the structure. Two sets of final structural drawings executed along with the design data are enclosed herewith.
Sincerely,
Signature of the Structural Design Consultant
Date:
Place:
Cc: The Architect … Name
P.M. BASHEER AHAMED,
Secretary to Government.
PRINTED AND PUBLISHED BY THE DIRECTOR OF STATIONERY AND PRINTING, CHENNAI
ON BEHALF OF THE GOVERNMENT OF TAMIL NADU
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