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1-801-587-3000 submit live scan fingerprints. \par \tab \hich\af5\dbch\af31505\loch\f5 (e) an assisted living facility; \par \tab \hich\af5\dbch\af31505\loch\f5 (c) federal criminal background databases available to the state; \par \tab \hich\af5\dbch\af31505\loch\f5 (ii) a disabled individual, as defined by department rule; Email: dhslicensing@utah.gov, HotlinesAbuse/Neglect of Seniors and Adults with Disabilities About. Forms - Tennessee We have transtioned to DACS (Direct Access Clearance System), a completely online background screening system. \leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext\'03(\'04);}{\levelnumbers\'02;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 }{\listlevel\levelnfc4\levelnfcn4\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0 form on regular paper. \par \tab \hich\af5\dbch\af31505\loch\f5 (b) where an individual who is not a resident also lives. \par \tab \hich\af5\dbch\af31505\loch\f5 (iii) an individual licensed to engage in the practice of nursing under Title 58, Chapter 31b, Nurse Practice Act; Click here. 2d51e252394309350d7e8264ec2239ddf0b9891b0b099e8e3065de78818570c93ce6b05ec3e90f21cdb8dd7e4a37898de4929cbb749e20c64ce4889d0f6394ac determines there exists credible evidence that a covered individual has been arrested or charged with a felony or a misdemeanor that would be excluded under R432-35-8(1), the Department may act to protect the health and safety of patients or residents in used by Utah Department of Health (UDOH) to determine my eligibility for licensure as a medical cannabis product establishment owners or directors, or . {\f5\fbidi \fmodern\fcharset0\fprq1{\*\panose 02070409020205020404}Courier{\*\falt Courier New};}{\f34\fbidi \froman\fcharset0\fprq2{\*\panose 02040503050406030204}Cambria Math;} \'02\'01. \red255\green0\blue255;\red255\green0\blue0;\red255\green255\blue0;\red255\green255\blue255;\red0\green0\blue128;\red0\green128\blue128;\red0\green128\blue0;\red128\green0\blue128;\red128\green0\blue0;\red128\green128\blue0;\red128\green128\blue128; Utah Domestic Violence MD Department of Public Safety and Correctional Services \lsdsemihidden1 \lsdunhideused1 \lsdlocked0 line number;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 page number;\lsdsemihidden1 \lsdlocked0 endnote reference;\lsdsemihidden1 \lsdlocked0 endnote text; For example, if your disposition information is incorrect or missing, you may submit documentation obtained from the court having control over the arrest or the office prosecuting the offense. This screening requires a separate application (see below). \par \tab \hich\af5\dbch\af31505\loch\f5 (vi) the List of Excluded Individuals and Entities database maintained by the United States Department of Health and Human Services' Office of Inspector General. Human Services Program Forms. \lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority9 \lsdlocked0 heading 2;\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority9 \lsdlocked0 heading 3;\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority9 \lsdlocked0 heading 4; 2. \lsdpriority65 \lsdlocked0 Medium List 1;\lsdpriority66 \lsdlocked0 Medium List 2;\lsdpriority67 \lsdlocked0 Medium Grid 1;\lsdpriority68 \lsdlocked0 Medium Grid 2;\lsdpriority69 \lsdlocked0 Medium Grid 3;\lsdpriority70 \lsdlocked0 Dark List; 1-855-323-DCFS(3237) \lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Grid 7;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Grid 8;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table List 1;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table List 2; \par \tab \hich\af5\dbch\af31505\loch\f5 (7) The Department may allow a covered individual direct patient access\hich\af5\dbch\af31505\loch\f5 ere has been a failure to comply with the provisions of this chapter, or rules promulgated pursuant to this chapter, as follows: \par \tab \hich\af5\dbch\af31505\loch\f5 (ii) passage of time; ;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 }{\listlevel\levelnfc3\levelnfcn3\leveljc0\leveljcn0\levelfollow2\levelstartat1\levelspace0\levelindent0{\leveltext 493c1b9426881fd2fc08bc6eda7c0ca52e7105c0633a3f37818f08f480102f4ea33c16a0c308ee835a9fc4c82a60ea5db8e375c32dff5d658fc1be7c61d1b8c2 If you believe a background check has been triggered for some other than the reasons listed above, contact HR Records at hrsc-records@austin.utexas.edu or 512-471-4772. DACS | Division of Licensing and Background Checks - Utah In the interest of professionalism, public trust and safety for families and individuals, Utah code requires that all persons associated with a licensed facility (owner, director, governing body, employee, agent, provider, contractor or volunteer) who has or will have direct access to children and/or vulnerable adults must pass a criminal Follow the instructions on page 2 of the form for submitting the form and the payment information. However, if your application has been submitted for longer than three weeks, you can request a status update by emailing cbsunit@utah.gov. {\fbimajor\f31544\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic);}{\fbimajor\f31545\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic;}{\fbimajor\f31546\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese);} Help; . \par }{\rtlch\fcs1 \ab\af5 \ltrch\fcs0 \b\expnd0\expndtw-3\insrsid14438297 \hich\af5\dbch\af31505\loch\f5 R432-35-5. \par How to get a pre-employment background check. A student employee moves to a non-student position. Upon receipt of an official communication from the agency with control over the data, the FBI will make appropriate changes and notify you of the outcome. \par }{\rtlch\fcs1 \ab\af5 \ltrch\fcs0 \b\expnd0\expndtw-3\insrsid14438297 \hich\af5\dbch\af31505\loch\f5 R432-35-1. \par Health, Family Health and Preparedness, Licensing. (7) The Department may allow a covered individual direct patient access with conditions, during an appeal process, if the covered individual can demonstrate the work arrangement does not pose a threat to the safety and health of patients or residents. Notice of Proposed Rule (New Rule) DAR File No. Background checks will be repeated on a regular basis; every year for the NYS Sex Offenders' Registry, every 3 years for the Criminal History File check and MVR check. employee signs and dates section 5 of the application. Call: (801) 538-4242 Principal Purpose: Certain determinations, such as employment, licensing, and security clearances, may be predicated on fingerprint-based background checks. {\fdbmajor\f31525\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic;}{\fdbmajor\f31526\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese);}{\fhimajor\f31528\fbidi \fswiss\fcharset238\fprq2 Calibri Light CE;} \s24\ql \li720\ri720\sl240\slmult0\nowidctlpar\tqr\tldot\tx9360\wrapdefault\hyphpar0\faauto\rin720\lin720\itap0 \rtlch\fcs1 \af5\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\loch\f5\hich\af5\dbch\af31505\cgrid\langnp1033\langfenp1033 \par \tab \hich\af5\dbch\af31505\loch\f5 (ii) any felony, class A or B conviction under Utah Criminal Code 76-6-106(2)(b)(i)(A) Criminal Mischief - Human Life; overed provider must submit required information to the Department to initiate and obtain a clearance prior to the issuance of the provisional license. \par \tab \hich\af5\dbch\af31505\loch\f5 (1) Utah Code, Title 26, Chapter 21, Part 2 requires that a covered employer be allowed to enter required information into the Direct Access Clearance System to initiate and obtain a cl\hich\af5\dbch\af31505\loch\f5 \lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 3;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 4;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 5;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 6; \par \tab \hich\af5\dbch\af31505\loch\f5 (1) Convictions or Pending Charges 1cac24d91adc3d8d1797de195df3a708422c6cd795011744c0dd413db3e682c0655891c8caf8db294c79da356fa3740c65e388ae62945714339967709dca0b3a \lsdpriority48 \lsdlocked0 Grid Table 3 Accent 1;\lsdpriority49 \lsdlocked0 Grid Table 4 Accent 1;\lsdpriority50 \lsdlocked0 Grid Table 5 Dark Accent 1;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful Accent 1; 8f40d2f9b2d598749bdd41abd26df627956034e854bac3d6a0326a0ddba3c9681876ba9357be77a1c141bf390c5ae34ea5551f0e2b41aba6e877ba9576d068f4 \par }{\rtlch\fcs1 \ab\af5 \ltrch\fcs0 \b\expnd0\expndtw-3\insrsid14438297 \hich\af5\dbch\af31505\loch\f5 R432-35-3. \par \tab \hich\af5\dbch\af31505\loch\f5 (6) A covered contractor may not supply to a covered provider a covered individual who has been determined to be not eligible to have direct patient access. If the applicant is under 18, include the Criminal Background Screening Authorization with the guardian's signature. The needs of our communities continue to change as more and more people choose to make Utah their home. 6e22206267313d226c743122207478313d22646b3122206267323d226c743222207478323d22646b322220616363656e74313d22616363656e74312220616363 Sexual Violence Crisis Line Each screening agent has permissions to link a cleared application to as many sites under that licensed organization as will be applicable for that applicant. \lsdpriority50 \lsdlocked0 Grid Table 5 Dark;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful;\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful;\lsdpriority46 \lsdlocked0 Grid Table 1 Light Accent 1;\lsdpriority47 \lsdlocked0 Grid Table 2 Accent 1; Salt Lake City, Ut 84116, DLBC Contact Info Forms | DSHS - Washington Authority: The FBIs acquisition, preservation, and exchange of fingerprints and associated information is generally authorized under 28 U.S.C. In the event that a new fingerprint based criminal offense is detected, OL will be alerted and will change the employment status to supervised only until the disposition is achieved. Covered Contractor - Direct Access Clearance System Process. \par \tab \hich\af5\dbch\af31505\loch\f5 (a) employment status; Sec. 02000000180000004d73786d6c322e534158584d4c5265616465722e362e3000000000000000000000060000 \par \tab \hich\af5\dbch\af31505\loch\f5 (4) "Corporation" means a corporation that has business interest/connection to covered providers that employ individuals who provide consultative services which may result in direct patient access. f942f92973f5d6bbda991fd3d3878c69450034d8db08283ddd555c0f2e4fad2e0bb52b78da2261849b4d425b46377822869fc17974aad1abd0b8aeafbba54b2d Form I-9 Acceptable Documents | USCIS \par }{\rtlch\fcs1 \ab\af5 \ltrch\fcs0 \b\expnd0\expndtw-3\insrsid14438297 \hich\af5\dbch\af31505\loch\f5 R432-35-10. Completely fill out the demographic section at the bottom of the form AND attach a copy of your ID and social security card. Utah Domestic Violence 7ce8306e3b99fc70e5e3743265f3027d8d3af0c80e7af4b14f72f0d46749289dca0dc527421ffc08f83db398c0a092d3279eb838055cc5f0a8ca1c4c60e1228e {\revtim\yr2020\mo4\dy22\hr14\min21}{\version2}{\edmins0}{\nofpages1}{\nofwords2655}{\nofchars15139}{\nofcharsws17759}{\vern125}}{\*\xmlnstbl {\xmlns1 http://schemas.microsoft.com/office/word/2003/wordml}} Employment Background Checks Forms - DPS - Criminal Identification (BCI) \par \tab \hich\af5\dbch\af31505\loch\f5 (ii) over the age of 28 and has convictions or pending charges identified in R432-35-8(1)(a). Initiate your screening by submitting the appropriate application: Please direct inquiries about fingerprinting, Utah criminal records (including expungement or correction procedures) to: Utah Department of Public Safety, Bureau of Criminal Identification (BCI), 3888 West 5400 South \par \tab \hich\af5\dbch\af31505\loch\f5 (b) which may include: \hich\af5\dbch\af31505\loch\f5 n\hich\af5\dbch\af31505\loch\f5 existing license or deny licensure as a health care facility. \par \tab \hich\af5\dbch\af31505\loch\f5 The following groups or individuals are excluded as volunteers and are not required to complete the background clearance process as defined in R432-35: \par \tab \hich\af5\dbch\af31505\loch\f5 (ii) a personal care aide; \lsdpriority50 \lsdlocked0 Grid Table 5 Dark Accent 3;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful Accent 3;\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful Accent 3;\lsdpriority46 \lsdlocked0 Grid Table 1 Light Accent 4; \lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table 3D effects 3;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Contemporary;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Elegant;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Professional; \par \tab \hich\af5\dbch\af31505\loch\f5 (iii) potential risk to patients or residents. The Utah Department of Health and Human Services is now one agency. \par \tab \hich\af5\dbch\af31505\loch\f5 (i) under the age of 28; or If the background screening report reveals something that may cause you to decide not to hire the person, you must notify them of the results of the . }}{\*\pnseclvl4\pnlcltr\pnstart1\pnindent720\pnhang {\pntxta )}}{\*\pnseclvl5\pndec\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl6\pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}} Request a Conditional Approval You may be eligible to request a conditional clearance per R501-14-7-2 if: You do not reside in a foster home; and \par e Department determines an individual is not eligible for direct patient access based upon the criminal background screening and the individual disagrees with the information provided by the Criminal Investigations and Technical Services Division or court Multi-Agency State Office Building Definitions. (Amendment) DAR File No. \lsdpriority48 \lsdlocked0 Grid Table 3 Accent 5;\lsdpriority49 \lsdlocked0 Grid Table 4 Accent 5;\lsdpriority50 \lsdlocked0 Grid Table 5 Dark Accent 5;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful Accent 5; Application to Become a Qualified Entity for Background Checks on Employees or Volunteers Download Utah Consent to Background Check Form Download \par }}{\*\aftncn \ltrpar \pard\plain \ltrpar\ql \li0\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0\pararsid14438297 \rtlch\fcs1 \af5\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\loch\af5\hich\af5\dbch\af31505\cgrid\langnp1033\langfenp1033 { \par \tab \hich\af5\dbch\af31505\loch\f5 \par \tab \hich\af5\dbch\af31505\loch\f5 (i) any felony or class A convi\hich\af5\dbch\af31505\loch\f5 ction under Utah Code. d0cf11e0a1b11ae1000000000000000000000000000000003e000300feff090006000000000000000000000001000000010000000000000000100000feffffff00000000feffffff0000000000000000ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff {\fbiminor\f31582\fbidi \froman\fcharset162\fprq2 Times New Roman Tur;}{\fbiminor\f31583\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew);}{\fbiminor\f31584\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic);} Multi-Agency State Office Building \expnd0\expndtw-3\insrsid14438297 In accordance to UCA62A-2-120 and 78B-6-128, the Office is permitted to accept applications for the purpose of a one-time adoption from a non-licensed entity (adoption attorney, or other). \par \tab \hich\af5\dbch\af31505\loch\f5 (14) "Patient" means an individual who receives health care services from one of the following covered provid\hich\af5\dbch\af31505\loch\f5 ers: Criminal Background Screening Authorization Form. AUTHORIZATION FOR BACKGROUND CHECK AND. 534. PRIVACY POLICY ACKNOWLEDGEMENT FORM. 195 North 1950 West provide personal demographics required; and iii. \par 195 North 1950 West \par }{\*\themedata 504b030414000600080000002100e9de0fbfff0000001c020000130000005b436f6e74656e745f54797065735d2e786d6cac91cb4ec3301045f748fc83e52d4a Child Care Background Check Process | Missouri Department of Elementary \par \tab \hich\af5\dbch\af31505\loch\f5 (viii) housekeeping; Background Check Forms & Publications - Wisconsin 4b0d592c9c070d8a65cd2e88b7f07c2ca71ba8da481cc52c6ce1c715e6e97818c9b48d13df49c873517d23d59085adb5dd20d6b52bd521ef2cdd5eb9246a3d8b Call: (801) 538-4242 000000300100005f72656c732f2e72656c73504b01022d00140006000800000021006b799616830000008a0000001c0000000000000000000000000019020000 The screened professions listed below require background screening at initial licensure and/or renewal of licensure. Sexual Violence Crisis Line \lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority9 \lsdlocked0 heading 5;\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority9 \lsdlocked0 heading 6;\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority9 \lsdlocked0 heading 7; However, if your application has been submitted for longer than three weeks, you can request a status update by emailing cbsunit@utah.gov. As the applicant, you are responsible for providing this fee at the time of the live scan fingerprint appointment, The Rap Back system checks state, regional and national databases for criminal records, By submitting an application, you give consent for the Office of Licensing to monitor all relevant databases for as long as you remain licensed or associated with a licensee, The Office of Licensing will issue a screening clearance or denial, according to standards and procedures outlined in, If you receive clearance on your screening, your application will be returned to the background screening agent that submitted it. \expnd0\expndtw-3\insrsid14438297 \hich\af5\dbch\af31505\loch\f5 e\hich\af5\dbch\af31505\loch\f5 arance as defined in R432-35-8, the Department may revoke an existing license or deny licensure for healthcare services in the residential setting. \par \tab \hich\af5\dbch\af31505\loch\f5 (2) If th\hich\af5\dbch\af31505\loch\f5 Caregivers Criminal History Screening Program - nmhealth.org Payment for both the license application fee and the FBI/BCI fingerprint fee of $28.25 ($13.25 FBI/$15 BCI) must be made by credit card during the online license application process. PDF Background Screening Policy - Utah Department of Health \lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority39 \lsdlocked0 TOC Heading;\lsdpriority41 \lsdlocked0 Plain Table 1;\lsdpriority42 \lsdlocked0 Plain Table 2;\lsdpriority43 \lsdlocked0 Plain Table 3;\lsdpriority44 \lsdlocked0 Plain Table 4; \par \tab \hich\af5\dbch\af31505\loch\f5 (b) address; and Employee Background Screening. \lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Outline List 1;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Outline List 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Outline List 3;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Simple 1; \rtlch\fcs1 \af5\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\loch\f5\hich\af5\dbch\af31505\cgrid\langnp1033\langfenp1033 \sbasedon0 \snext0 toc 8;}{\s29\ql \fi-720\li720\ri0\sl240\slmult0\nowidctlpar 8376bf330efaaff23606569ea58fdc16605ecdebde7f010000ffff0300504b0304140006000800000021000dd1909fb60000001b010000270000007468656d65 \par \tab \hich\af5\dbch\af31505\loch\f5 (e) Patient family members; and The DPS must receive the authorization form with the "original" signature. \par }}{\*\aftnsep \ltrpar \pard\plain \ltrpar\ql \li0\ri0\sl-20\slmult0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 \rtlch\fcs1 \af5\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\loch\af5\hich\af5\dbch\af31505\cgrid\langnp1033\langfenp1033 { Once the application, forms and fees have been submitted to UDAF, UDAF will send the applicant a "Live Scan Fingerprint Authorization Form" to continue the process. Background Screening Application - Youth Transport Company employeees only. 1-800-273-TALK(8255) Learn more about the Utah Department of Health & Human Services transition. \par \tab \hich\af5\dbch\af31505\loch\f5 (ii) child abuse or neglect findings described in Section 78A-6-323;