utah department of health criminal background screening authorization formmissouri esthetician scope of practice

Your SSAN is needed to keep records accurate because other people may have the same name and birth date. Criminal Background Screening Published: Nov 30, 2022 Responsible Unit: Vice President for Human Resources 1. \par \tab \hich\af5\dbch\af31505\loch\f5 (a) Signs a criminal background screening authorization form which\hich\af5\dbch\af31505\loch\f5 must be available for review by the department; and 0000000000000000000000000000000000000000000000000105000000000000}}. \par \tab \hich\af5\dbch\af31505\loch\f5 (b) a long-term care hospital; Receiving Results: Once the Office reviews this information a determination will be made per 62A-2-120 and emailed from the Office to the email address provided from the non-licensed entity on the Background Screening Application. For information on obtaining the Out of State Registry, visit this link on our website: https://dlbc.utah.gov/out-of-state-registries, Submit the fee of $37.25 per application in one of the following forms: Company check, cashiers check, or money order made payable to Department of Human Services. \par \tab \hich\af5\dbch\af31505\loch\f5 (1) Convictions or Pending Charges This screening requires a separate application (see below). \par }{\rtlch\fcs1 \ab\af5 \ltrch\fcs0 \b\expnd0\expndtw-3\insrsid14438297 \hich\af5\dbch\af31505\loch\f5 Notice of Continuation: January 29, 2018}{\rtlch\fcs1 \af5 \ltrch\fcs0 \expnd0\expndtw-3\insrsid14438297 {\flominor\f31504\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}{\fdbminor\f31505\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;} Department of Human Services Clarence H. Carter, Commissioner 505 Deaderick Street Nashville, TN 37243-1403 Contact Information. \tqr\tldot\tx9360\wrapdefault\hyphpar0\faauto\rin0\lin720\itap0 \rtlch\fcs1 \af5\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\loch\f5\hich\af5\dbch\af31505\cgrid\langnp1033\langfenp1033 \sbasedon0 \snext0 toc 9;}{ Human Services. Record Challenge Form Download. \par \tab \hich\af5\dbch\af31505\loch\f5 \par \tab \hich\af5\dbch\af31505\loch\f5 (a) by employmen\hich\af5\dbch\af31505\loch\f5 t; Screening Minors (under age of 18) Prior to conducting criminal background screening on a minor (under age of 18), hiring departments must obtained a signed copy of the " Background Screening Consent Form for Minors " from the minor and the minor's parent or legal guardian. \s21\ql \fi-720\li720\ri720\sb480\sl240\slmult0\nowidctlpar\tqr\tldot\tx9360\wrapdefault\hyphpar0\faauto\rin720\lin720\itap0 \rtlch\fcs1 \af5\afs24\alang1025 \ltrch\fcs0 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 background screening. }{\rtlch\fcs1 \af5 \ltrch\fcs0 \expnd0\expndtw-3\insrsid14438297 79fdf77c6eadca923b466964cafdf2dd1ffef3cd6fbd7ffff0ed2f5fff319b7a172f4cfcbbbffdeedd3ffef93ef5b0e2d2146ffff4fdbb1fbf7ffbe7dfffebaf 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 (15) "Resident" means an individual who receives health care services from one of the following\hich\af5\dbch\af31505\loch\f5 covered providers: be04197c6d1948eca6cc7b6d3343d49aa00c9819822ec3956e41c4727f29a28aab165b3be596f6a62ddd00dd91d5f42424fd6007b4d3fb84ffbbde073a8cb77f \par \tab \hich\af5\dbch\af31505\loch\f5 (3) The covered contractor must ensure the \hich\af5\dbch\af31505\loch\f5 Direct Access Clearance System reflects the current status of the covered individual within 5 working days of placement or termination. }{\rtlch\fcs1 \af5 \ltrch\fcs0 \expnd0\expndtw-3\insrsid14438297 The following form is for those individuals seeking to obtain a copy of their own Utah criminal history record. \par \tab \hich\af5\dbch\af31505\loch\f5 This rule is adopted pursuant to Title 26 Chapter 21 Part 2. By submitting this authorization form, I give my permission to: 1) The . Charges will be fairly assessed by the Office of Licensing as described in state law, A licensed program shall not be provided the details of any applicants screenings nor can they disclose screening results except as authorized by Utah or federal law. 1-800-371-7897 \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). Out-of-state applicants, or their employers, can call the Division of Criminal Investigation (DCI) to request a state only fingerprint kit to be mailed to them directly at 605. . If you choose not to use a DCFS Live Scan, you may submit two fingerprint cards. \par \tab \hich\af5\dbch\af31505\loch\f5 (e) child abuse or neglect findings described in Section 78A-6-323; \par \tab \hich\af5\dbch\af31505\loch\f5 (F) 76-10-1301 to 1314, Prostitution; and \lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Subtle 1;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Subtle 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Web 1;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Web 2; }{\rtlch\fcs1 \af5 \ltrch\fcs0 \expnd0\expndtw-3\insrsid14438297 \red192\green192\blue192;\red0\green0\blue0;\red0\green0\blue0;}{\*\defchp \fs22\loch\af31506\hich\af31506\dbch\af31505 }{\*\defpap \ql \li0\ri0\sa160\sl259\slmult1\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 } \par \tab \hich\af5\dbch\af31505\loch\f5 (10) "Disabled individual" means an individual\hich\af5\dbch\af31505\loch\f5 5689811a183c61a50f98f4babebc2837878049899a52a57be670674cb23d8e90721f90a4d2fa3802cb35762680fd800ecd7551dc18eb899138e3c943d7e503b6 \lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Smart Hyperlink;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Hashtag;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Unresolved Mention;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Smart Link;}}{\*\datastore 01050000 1-800-273-TALK(8255) These forms are only to be used by agencies who are authorized by statute, executive order, court rule, court order or local ordinance. \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 1-800-273-TALK(8255) \par \tab \hich\af5\dbch\af31505\loch\f5 (b) commit theft; or (a) Signs a criminal background screening authorization form which must be available for review by the department; and (b) Submits fingerprints within 15 working days of engagement. \lsdpriority52 \lsdlocked0 Grid Table 7 Colorful Accent 1;\lsdpriority46 \lsdlocked0 Grid Table 1 Light Accent 2;\lsdpriority47 \lsdlocked0 Grid Table 2 Accent 2;\lsdpriority48 \lsdlocked0 Grid Table 3 Accent 2; List of Certified Concealed Firearm Instructors, Information for Concealed Firearm Instructors, Concealed Firearm Permit Forms / Instructor Forms, Utah Missing Persons Clearinghouse Functions, Surety Bond and Liability Insurance Information, Documentation of Experience and Qualifications, Concealed Firearm Permit Instructor Applications, Employment/Volunteer Background Check Forms, Application to Become a Qualified Entity for Background Checks on Employees or Volunteers, Authorization to Transfer FBI Rapback Subscription NCPA/VCA, Authorization to Transfer FBI Rapback Subscription School Employees, Authorization to Transfer WIN Rapback Subscription Tow Truck Operators. {\flomajor\f31511\fbidi \froman\fcharset161\fprq2 Times New Roman Greek;}{\flomajor\f31512\fbidi \froman\fcharset162\fprq2 Times New Roman Tur;}{\flomajor\f31513\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew);} \lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List 4;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List 5;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Bullet 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Bullet 3; (3) The covered provider must ensure that DACS reflects the current status of the covered individual within 5 working days of the engagement or termination. each applicant and instructor signs a criminal background screening authorization form which must be available for review by the department; . The way will require some information, such as full name, date of birth, social security number, address, and driver's license number. Salt Lake City, UT 84114-8280. Title: Microsoft Word - Policies and Procedures for Conducting Criminal Background Checks.docx Health, Family Health and Preparedness, Licensing Rule R432-35 Background Screening -- Health Facilities Notice of Proposed Rule (Amendment) DAR File No. overed provider must submit required information to the Department to initiate and obtain a clearance prior to the issuance of the provisional license. This meeting requires the screening agent to verify the applicants identification and enter information contained on the identification into DACS. voluntary, by what statutory or other authority your SSAN is solicited, and what uses will be made of it. \par \tab \hich\af5\dbch\af31505\loch\f5 (a) As required by Utah Code Subsection \hich\af5\dbch\af31505\loch\f5 \lsdpriority60 \lsdlocked0 Light Shading Accent 3;\lsdpriority61 \lsdlocked0 Light List Accent 3;\lsdpriority62 \lsdlocked0 Light Grid Accent 3;\lsdpriority63 \lsdlocked0 Medium Shading 1 Accent 3;\lsdpriority64 \lsdlocked0 Medium Shading 2 Accent 3; Your Authorization for Release of Information form and the fingerprint card must be complete . the Background Screening Form, or the criminal background screening procedure, call the Background Clearance Unit at 866-320-0513. ss Clearance System to run a verification report and verify that each covered individual's information is correct, including: \par \par \tab \hich\af5\dbch\af31505\loch\f5 (b) As required by Utah Code Subsection 26-21-204, if an individual or covered individual has a warrant for arrest or an arrest for any of the identified offenses in R43\hich\af5\dbch\af31505\loch\f5 \lsdpriority71 \lsdlocked0 Colorful Shading Accent 4;\lsdpriority72 \lsdlocked0 Colorful List Accent 4;\lsdpriority73 \lsdlocked0 Colorful Grid Accent 4;\lsdpriority60 \lsdlocked0 Light Shading Accent 5;\lsdpriority61 \lsdlocked0 Light List Accent 5; ;}{\levelnumbers\'01;}\rtlch\fcs1 \af0 \ltrch\fcs0 \hres0\chhres0 }{\listlevel\levelnfc0\levelnfcn0\leveljc0 {\fhimajor\f31536\fbidi \fswiss\fcharset163\fprq2 Calibri Light (Vietnamese);}{\fbimajor\f31538\fbidi \froman\fcharset238\fprq2 Times New Roman CE;}{\fbimajor\f31539\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr;} \par \tab \hich\af5\dbch\af31505\loch\f5 (a) cause physical or mental harm; d individual prior to issuance of a provisional license, license renewal or engagement as a covered individual. Notice of Proposed Rule (New Rule) DAR File No. (5) If the Department determines an individual is not eligible for direct patient access, based on information obtained through the Direct Access Clearance System, the Department shall send a Notice of Agency Action to the covered contractor and the i \par \tab \hich\af5\dbch\af31505\loch\f5 (v) steps taken to correct or improve. \par \tab \hich\af5\dbch\af31505\loch\f5 (iv) a provider of medical, therapeutic, or social services, including a provider of laboratory and radiology\hich\af5\dbch\af31505\loch\f5 services; All U.S. employers must properly complete Form I-9 for each individual they hire for employment in the United States. 1-800-897-LINK(5465), Abuse/Neglect of Seniors and Adults with Disabilities. Resources 211Utah - United Way Safe UT. Contact. (1) The Department may conduct a background screening on current employees based on division's background screening guidelines determined by risk associated with the employees' work responsibilities. Salt Lake City, Ut 84116, DLBC Contact Info \par 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 (b) a long-term care hospital; 738c1dabfb8210cbaea764ce99604be97d41bc01224e93ccc899154da5d03149c02f1b1741f0b7659bd3e7de8051d7aa47f8c246c2de40d4417e86a965c6fb68 8f40d2f9b2d598749bdd41abd26df627956034e854bac3d6a0326a0ddba3c9681876ba9357be77a1c141bf390c5ae34ea5551f0e2b41aba6e877ba9576d068f4 0c895fcf6720192de6bf3b9e89ecdbd6596cbcdd8eb28e7c365ecc4ec1ff1460f53fe813d3cc7f5b7f020000ffff0300504b030414000600080000002100a5d6 \par \tab \hich\af5\dbch\af31505\loch\f5 (1) Utah Code, Title 26, Chapter 21, Part 2 requires that a covered contractor enter required information into the Di\hich\af5\dbch\af31505\loch\f5 \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 { Health and Human Services Consolidation Information. 2. \par \tab \hich\af5\dbch\af31505\loch\f5 (d) a small health care facility; Processing includes making a determination of . You may contact the respective State Identification Bureau for assistance, and, if applicable, request that they provide the FBI with updates to your Identity History Summary. \lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Grid 7;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Grid 8;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table List 1;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table List 2; (2) If the Department determines an individual is not eligible for direct patient access, based on information obtained through the Direct Access Clearance System, the Department shall send a Notice of Agency Action to t\hich\af5\dbch\af31505\loch\f5 OL staff will check site rosters for ongoing screening compliance. While it can be somewhat scary at first, it is actually a good thing. \par \tab \hich\af5\dbch\af31505\loch\f5 (vii) dietary and food service staff; (5) The department may allow a current employee to continue to work with conditions, during the reconsideration process as defined in each division's background screening guidelines if the employee can demonstrate the work arrangement does not pose a threat to the department and the safety and health of Utah citizens. \widowctrl\ftnbj\aenddoc\hyphhotz950\trackmoves0\trackformatting1\donotembedsysfont0\relyonvml0\donotembedlingdata1\grfdocevents0\validatexml0\showplaceholdtext0\ignoremixedcontent0\saveinvalidxml0\showxmlerrors0 {\*\cs10 \additive Default Paragraph Font;}{\*\ts11\tsrowd\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\trcbpat1\trcfpat1\tblind0\tblindtype3\tsvertalt\tsbrdrt\tsbrdrl\tsbrdrb\tsbrdrr\tsbrdrdgl\tsbrdrdgr\tsbrdrh\tsbrdrv 0528a2c6cce0239baa4c04ca5bbabac4df000000ffff0300504b01022d0014000600080000002100e9de0fbfff0000001c020000130000000000000000000000 {\fbimajor\f31541\fbidi \froman\fcharset161\fprq2 Times New Roman Greek;}{\fbimajor\f31542\fbidi \froman\fcharset162\fprq2 Times New Roman Tur;}{\fbimajor\f31543\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew);} I certify that all of the personal Social Security Account Number (SSAN). endnote reference;}{\s18\ql \li0\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 \rtlch\fcs1 \af31507\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\loch\f5\hich\af5\dbch\af31505\cgrid\langnp1033\langfenp1033 \sbasedon0 \snext18 \slink19 Missing or Incorrect State (Non-Federal) Information. \par \tab \hich\af5\dbch\af31505\loch\f5 (vi) intervening circumstances; and \par \tab \hich\af5\dbch\af31505\loch\f5 (b) does not include a critical access hospital, designated under 42 U.S.C. {\*\pnseclvl7\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl8\pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl9\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}\pard\plain \ltrpar Crisis Line & Mobile Outreach Team 3198720e274a939cd08a54f980ae38a38f56e422a3a641c8bbd048f7757da0f19b017cc524bd62107bd5001996509affb3fd381a89672f1f165dfe514173d985 footnote text;}{\*\cs19 \additive \rtlch\fcs1 \af5\afs20 \ltrch\fcs0 \f5\fs20 \sbasedon10 \slink18 \slocked \ssemihidden \styrsid14438297 Footnote Text Char;}{\*\cs20 \additive \rtlch\fcs1 \af0 \ltrch\fcs0 \super \sbasedon10 footnote reference;}{ You can find more information on background screenings in, DACS tutorials and training materials for screening agents, Abuse/Neglect of Seniors and Adults with Disabilities. If the email address is not legible or comes back invalid, it will be sent via USPS to the address listed for the non-licensed entity. \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; Us department of justice criminal background check. cords files; . \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. There is no charge for the fingerprinting services but the $33.25 Background fee will still apply. Email: dhslicensing@utah.gov, HotlinesAbuse/Neglect of Seniors and Adults with Disabilities The following factors may be \fs24\lang1033\langfe1033\loch\f5\hich\af5\dbch\af31505\cgrid\langnp1033\langfenp1033 \sbasedon0 \snext0 \sqformat caption;}{\*\cs34 \additive _Equation Caption;}}{\*\listtable{\list\listtemplateid100{\listlevel\levelnfc1\levelnfcn1\leveljc0\leveljcn0 Utah AMBER Alert and Endangered Missing Advisory. 000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000ffffffffffffffffffffffff000000000000000000000000000000000000000000000000 \par \tab \hich\af5\dbch\af31505\loch\f5 (f) Individuals volunteering services for 20 hours per month or less. \lsdpriority72 \lsdlocked0 Colorful List Accent 6;\lsdpriority73 \lsdlocked0 Colorful Grid Accent 6;\lsdqformat1 \lsdpriority19 \lsdlocked0 Subtle Emphasis;\lsdqformat1 \lsdpriority21 \lsdlocked0 Intense Emphasis; \par \tab \hich\af5\dbch\af31505\loch\f5 (viii) housekeeping; This payment authorizes a subscription to the FBIs Rap Back System which continually monitors all fingerprint based criminal records in real time. 1cac24d91adc3d8d1797de195df3a708422c6cd795011744c0dd413db3e682c0655891c8caf8db294c79da356fa3740c65e388ae62945714339967709dca0b3a Headquarters The needs of our communities continue to change as more and more people choose to make Utah their home. . \lsdpriority67 \lsdlocked0 Medium Grid 1 Accent 6;\lsdpriority68 \lsdlocked0 Medium Grid 2 Accent 6;\lsdpriority69 \lsdlocked0 Medium Grid 3 Accent 6;\lsdpriority70 \lsdlocked0 Dark List Accent 6;\lsdpriority71 \lsdlocked0 Colorful Shading Accent 6; \lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Outline List 1;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Outline List 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Outline List 3;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Simple 1; \par \tab \hich\af5\dbch\af31505\loch\f5 (5) "Cove\hich\af5\dbch\af31505\loch\f5 red contractor" means a person or corporation that supplies covered individuals, by contract, to: 1-888-222-2542 {\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);} Applications for Utah Criminal History and Expungements do not require appointment) Fingerprinting services are by appointment only. {\fhimajor\f31502\fbidi \fswiss\fcharset0\fprq2{\*\panose 020f0302020204030204}Calibri Light;}{\fbimajor\f31503\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;} \lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Signature;\lsdsemihidden1 \lsdlocked0 Default Paragraph Font;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text Indent;

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