SUBJECT: Memorandum Report: State Requirements for Conducting Background Checks on Hom e Health Agency Employees, OEI-07-14-00131 In response to a congressional request, the Office oflnspector General (OIG) initiated two . \par
\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
With the required release and proper payment, all adult arrest records are released. 1-855-323-DCFS(3237) {\flomajor\f31500\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}{\fdbmajor\f31501\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}
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MD Department of Public Safety and Correctional Services Completely fill out the demographic section at the bottom of the form AND attach a copy of your ID and social security card. with health screenings and immunizations New look, new feelsame goals. Most states require that changes to Identity History Summary information be processed through their respective state centralized agency (State Identification Bureau) before any changes can be made to your information. Employee Background Screening. Health, Family Health and Preparedness, Licensing. Read section 6 and sign/date the bottom of the form, Submit the form to your licensor or your Foster/Adoptive Consultant with Utah Foster Care. (a) . No hard copies of clearances will be required of programs, as all clearance information will be maintained in the DACS program. 1-800-371-7897 Record updates are made at the state level only, so the FBI cannot change its records. e. \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;
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This meeting requires the screening agent to verify the applicants identification and enter information contained on the identification into DACS. You may submit the background check forms one of three ways: Bring them into the Utah Department of Agriculture and Food in person, submit by U.S. Mail, or by \lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Normal Indent;\lsdsemihidden1 \lsdlocked0 footnote text;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 annotation text;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 header;
Background Screening. \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
As a new employee of a DHS licensed agency or DHS contracted agency your background screening process will be fully automated in the Direct Access Clearance System (DACS). f942f92973f5d6bbda991fd3d3878c69450034d8db08283ddd555c0f2e4fad2e0bb52b78da2261849b4d425b46377822869fc17974aad1abd0b8aeafbba54b2d
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NICS Process. Find. This includes SAS & DSPD Certified Providers. \expnd0\expndtw-3\insrsid14438297
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PDF Background Screening Application - Utah \par \tab \hich\af5\dbch\af31505\loch\f5 (16) "Residential setting" means a place provided by a cov\hich\af5\dbch\af31505\loch\f5 ered provider:
The agency will keep it on file and make it available as needed by the Office of Licensing, If a screening is denied, you and/or your background screening agent will be notified in writing, along with appeal procedures. initial requirements information sheet. 1-855-323-DCFS(3237) OL Rule R501-14 outlines how OL makes employment determinations. Before a determination is made, I understand that I will be afforded a reasonable amount of time to challenge the completeness and accuracy of the record through the procedures established by the Department of Human Services, Office of Licensing as well as contacting the Utah Bureau of Criminal Identification (Utah Criminal History Results), the State Identification Bureau (SIB) associated with any results that are outside of Utah, or the Federal Bureau of Investigation (Nationwide Criminal History Response Information). \par \tab \hich\af5\dbch\af31505\loch\f5 (c) does not include a student directly supervised by a member of the staff of the covered body or the student's instructor. 738c1dabfb8210cbaea764ce99604be97d41bc01224e93ccc899154da5d03149c02f1b1741f0b7659bd3e7de8051d7aa47f8c246c2de40d4417e86a965c6fb68
\par \tab \hich\af5\dbch\af31505\loch\f5
4757e8d3f729e245eb2b260a0238fd010000ffff0300504b030414000600080000002100b6f4679893070000c9200000160000007468656d652f7468656d652f
\par }}\ltrpar \sectd \ltrsect\pgnrestart\linex0\headery1440\footery1440\sectdefaultcl\sectrsid14438297\sftnbj {\*\pnseclvl1\pnucrm\pnstart1\pnindent720\pnhang {\pntxta . 910 E Sioux Ave. Pierre, SD 57501. First Name Last Name. I understand that my personal information including name, DOB, SSN and fingerprints will be used for the purpose of . \par \tab \hich\af5\dbch\af31505\loch\f5 (b) which may include:
d individual prior to issuance of a provisional license, license renewal or engagement as a covered individual. In giving this authorization, I GCHEXS will enable users to: Easily check various registries, including the Certified Nurse Aide, Sex Offender and federal OIG Exclusions List; Print the criminal background check fitness determination letter directly from the GCHEXS system. {\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);}
Where to apply: Department of Public Safety Bureau of Criminal Identification 4315 South 2700 West Suite 1300 Taylorsville, Utah 84129 Phone: (801) 965-4445 Fax: (801) 969-7065 I need to obtain a copy of my Utah criminal history. provide personal demographics required; and iii. \par }{\rtlch\fcs1 \ab\af5 \ltrch\fcs0 \b\expnd0\expndtw-3\insrsid14438297 \hich\af5\dbch\af31505\loch\f5 R432-35-7. The top portion needs to be signed by the applicant, the bottom portion is signed by the non-licensed entity. Headquarters submit live scan fingerprints. \lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Top of Form;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Bottom of Form;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Normal (Web);\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Acronym;
This includes SAS & DSPD Certified Providers. \b\expnd0\expndtw-3\insrsid14438297 \hich\af5\dbch\af31505\loch\f5 R432. s, based on information obtained through the Direct Access Clearance System, the Department shall send a Notice of Agency Action to the covered provider and the individual explaining the action and the individual's right of appeal as defined in R432-30. Processing includes making a determination of . A background check authorization form is basically the written consent for a background check needed by your potential employer. \par \tab \hich\af5\dbch\af31505\loch\f5 (a) engages a covered individual to provide services in a private residence to:
Code R432-35-5 - Covered Contractor - DACS Process . PRIVACY POLICY ACKNOWLEDGEMENT FORM. Crisis Line & Mobile Outreach Team : 43003 Filed: 06/15/2018 10:31:45 AM RULE ANALYSIS Purpose of the rule or reason for the change: Utah AMBER Alert and Endangered Missing Advisory. \par \tab \hich\af5\dbch\af31505\loch\f5 (3) Non-Criminal Records
Only agencies with OL administrative approval and a documented exception to live scan fingerprinting will be allowed to submit hard card prints rolled at a public safety office. As of May 31, 2022, all individual providers transitioned to CDWA as the legal employer responsible for various administrative services for IPs, including background checks. Criminal Background Screening Published: Nov 30, 2022 Responsible Unit: Vice President for Human Resources 1. \lsdpriority70 \lsdlocked0 Dark List Accent 3;\lsdpriority71 \lsdlocked0 Colorful Shading Accent 3;\lsdpriority72 \lsdlocked0 Colorful List Accent 3;\lsdpriority73 \lsdlocked0 Colorful Grid Accent 3;\lsdpriority60 \lsdlocked0 Light Shading Accent 4;
Background Screening FAQ. The Department may allow a . The DPS must receive the authorization form with the "original" signature. BCI cannot provide criminal or court-ordered fingerprinting services. {\f877\fbidi \froman\fcharset163\fprq2 Cambria Math (Vietnamese);}{\flomajor\f31508\fbidi \froman\fcharset238\fprq2 Times New Roman CE;}{\flomajor\f31509\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr;}
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Headquarters Multi-Agency State Office Building 195 North 1950 West Salt Lake City, Ut 84116. \par \tab \hich\af5\dbch\af31505\loch\f5 (viii) housekeeping;
Additional Information: The requesting agency and/or the agency conducting the application investigation will provide you additional information pertinent to the specific circumstances of this application, which may include identification of other authorities, purposes, uses, and consequences of not providing requested information. \par }{\rtlch\fcs1 \ab\af5 \ltrch\fcs0 \b\expnd0\expndtw-3\insrsid14438297 \hich\af5\dbch\af31505\loch\f5 KEY: health care facilities, background screening}{\rtlch\fcs1 \af5 \ltrch\fcs0 \expnd0\expndtw-3\insrsid14438297
1-855-323-DCFS(3237) \par \tab \hich\af5\dbch\af31505\loch\f5 (1) Convictions or Pending Charges
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Grid 3;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Grid 4;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Grid 5;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Table Grid 6;
Fingerprints: Submit 2 correctly-rolled fingerprint cards per applicant to the Office, which we will submit to the Office of Public Safety to fulfill FBI requirements. 1-855-323-DCFS(3237) If the individuals are not eligible for clearance as defined in R432-35-8, the Department may revoke a
d. All employees who require screening must: i. sign a criminal background screening authorization form; ii. Instead, the FBI accesses the states system for authorized purposes to review the record. \par \tab \hich\af5\dbch\af31505\loch\f5 The department may impose civil monetary penalties in accordance with Title 26, Chapter 23, Utah Health Code Enforcement Provisions and Penalties, if th\hich\af5\dbch\af31505\loch\f5
DACS will generate a fingerprint authorization form, which will be printed by the screening agent and provided to the applicant to take to the live scan fingerprinting location (list of locations may additionally generated through DACS as needed). rect Access Clearance System to initiate a clearance for each covered individual prior to being supplied by contract to a covered provider. 02000000180000004d73786d6c322e534158584d4c5265616465722e362e3000000000000000000000060000
(a) Department of Public Safety arrest, conviction, and disposition records described in Title 53, Chapter 10, Criminal Investigations and Technical Services Act, including information in state, regional, and national re\hich\af5\dbch\af31505\loch\f5
\par \tab \hich\af5\dbch\af31505\loch\f5 (b) Adjudications by a juvenile court may\hich\af5\dbch\af31505\loch\f5
The process for submitting these applications is as follows: Application: Fill out the application of the adoptive parent for the one-time clearance. Forms - Tennessee 1cac24d91adc3d8d1797de195df3a708422c6cd795011744c0dd413db3e682c0655891c8caf8db294c79da356fa3740c65e388ae62945714339967709dca0b3a
The Live Scan Fingerprint Authorization Form can then be taken to any Utah Background Screening -- Health Facilities. \lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Bullet;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Number;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List 3;
These forms are only to be used by agencies who are authorized by statute, executive order, court rule, court order or local ordinance. National Suicide Prevention Lifeline Section R432-35-4 - Covered Provider - DACS Process, Utah - Casetext All Utahns should have fair and equitable opportunities to be healthy and safe. Any adults over the age of 18 residing in the home must complete a background screening. The form must be notarized and the fee is $15.00 per record check, which should be a money order or cashier"s check made payable to the Department of Public Safety. ss Clearance System to run a verification report and verify that each covered individual's information is correct, including:
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. \par
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Applicants/licensees are responsible for the screening costs and should be aware that fees vary by service provider. }{\rtlch\fcs1 \af5 \ltrch\fcs0 \expnd0\expndtw-3\insrsid14438297
Background Screening Application - Youth Transport Company employeees only. Steps for Entering a Youth Application in DACS, Exemption Declaration (adult substance abuse treatment programs only), Contact Information for obtaining an out of state Central or Child Abuse Registry Check, I understand that my personal information including name, date of birth, social security number and fingerprints will be used for the purpose of conducting a criminal history records search through any applicable state and federal databases. Email: dhslicensing@utah.gov, HotlinesAbuse/Neglect of Seniors and Adults with Disabilities How do I Renew my Concealed Firearm Permit? If you believe your Identity History Summary contains inaccurate or incomplete information, you have two options for requesting a change or correction: Option 1: Contact the agency or agencies that submitted the information to the FBI. b17d4e9cd131584756689f604cd1255a60ec3dfbdcc160c05696cd4bd20f62c82ac7d815580f901dabea3dc5027a25d5dcece7c91322ac909de2881de073bad9
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 This rule was published in the July 1, 2018, issue (Vol. Multi-Agency State Office Building I certify that all of the personal Health and Human Services Consolidation Information. 1-888-222-2542
\par \tab \hich\af5\dbch\af31505\loch\f5
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also require a background screening for one-time clearance. {\fhiminor\f31506\fbidi \fswiss\fcharset0\fprq2{\*\panose 020f0502020204030204}Calibri;}{\fbiminor\f31507\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}{\f529\fbidi \froman\fcharset238\fprq2 Times New Roman CE;}
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Contact. \par \tab \hich\af5\dbch\af31505\loch\f5 (7) "Covered individual":
st enter required information into the Direct Access Clearance System to initiate and obtain a clearance for all individuals 12 years of age and older, who are not residents, and reside in the residential setting. 3. licensing requirements Principal Purpose: Certain determinations, such as employment, licensing, and security clearances, may be predicated on fingerprint-based background checks. All U.S. employers must properly complete Form I-9 for each individual they hire for employment in the United States. TO RELEASE FINDINGS. \par \tab \hich\af5\dbch\af31505\loch\f5 (b) does not include a critical access hospital, designated under 42 U.S.C. {\*\latentstyles\lsdstimax376\lsdlockeddef0\lsdsemihiddendef0\lsdunhideuseddef0\lsdqformatdef0\lsdprioritydef99{\lsdlockedexcept \lsdqformat1 \lsdpriority0 \lsdlocked0 Normal;\lsdqformat1 \lsdpriority9 \lsdlocked0 heading 1;
Division in the Department of Justice (DOJ) collects the information requested on this form as authorized by Business and Professions Code sections 4600-4621, 7574-7574.16, 26050-26059, 11340-11346, and 22440-22449; Penal Code sections 11100-11112, and 11077.1; Health and Safety Code sections 1522, 7468656d652f7468656d652f7468656d654d616e616765722e786d6c504b01022d0014000600080000002100b6f4679893070000c92000001600000000000000
Training materials and other information related to DACS can be found here. \lsdpriority73 \lsdlocked0 Colorful Grid Accent 1;\lsdpriority60 \lsdlocked0 Light Shading Accent 2;\lsdpriority61 \lsdlocked0 Light List Accent 2;\lsdpriority62 \lsdlocked0 Light Grid Accent 2;\lsdpriority63 \lsdlocked0 Medium Shading 1 Accent 2;
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\par \tab \hich\af5\dbch\af31505\loch\f5 (vi) administrative staff, including a manager or other administrator;
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\par \tab \hich\af5\dbch\af31505\loch\f5 (e) Patient family members; and
Code R432-35 - Background Screening - Health Facilities; Utah Admin. Record Challenge Form Download. \par \tab \hich\af5\dbch\af31505\loch\f5 In addition:
Child Abuse/Neglect \par \tab \hich\af5\dbch\af31505\loch\f5 (8) A covered provider that provides services in a residential setting mu\hich\af5\dbch\af31505\loch\f5
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 \par \tab \hich\af5\dbch\af31505\loch\f5 To outline the process required for individuals to be cleared to have direct patient access while employed by a covered provider, covered contractor or covered employer. 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. Sexual Violence Crisis Line 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. 5689811a183c61a50f98f4babebc2837878049899a52a57be670674cb23d8e90721f90a4d2fa3802cb35762680fd800ecd7551dc18eb899138e3c943d7e503b6
Prints will remain active for 60 days to allow for re-employment in a licensed setting. \par \tab \hich\af5\dbch\af31505\loch\f5 (i) a nursing assistant;
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MVR screening requires an additional consent form. AHCA:Central Services: Background Screening - Florida The FBI is responsible for the storage of fingerprints and related Identity History Summary information for the nation and does not have the authority to modify any Identity History Summary information unless specifically notified to do so by the agency that owns the information. 1-800-371-7897 what is a health screening diet high in saturated fats contribute to every, missing las vegas nevada zip code area code private investigator office hawaii. By submitting this authorization form, I give my permission to: 1) The . 000000000000d60200007468656d652f7468656d652f7468656d65312e786d6c504b01022d00140006000800000021000dd1909fb60000001b01000027000000
\par \tab \hich\af5\dbch\af31505\loch\f5 (iii) surrounding circumstances;
Mail the Authorization form, fingerprint card, and certified check or money order (personal checks are not accepted) for $65.00 made \par \tab \hich\af5\dbch\af31505\loch\f5 (E) 76-10-1201 to 1229.5, Pornographic and Harmful Materials and Performances;
\par
\par \tab \hich\af5\dbch\af31505\loch\f5 (4) Review of Relevant Information
PDF Information on completing background checks for Medical Cannabis - Utah \par \tab \hich\af5\dbch\af31505\loch\f5 (i) types and number;
Crisis Line & Mobile Outreach Team \par \tab \hich\af5\dbch\af31505\loch\f5 (c) view medical or financial records. \lsdpriority51 \lsdlocked0 List Table 6 Colorful;\lsdpriority52 \lsdlocked0 List Table 7 Colorful;\lsdpriority46 \lsdlocked0 List Table 1 Light Accent 1;\lsdpriority47 \lsdlocked0 List Table 2 Accent 1;\lsdpriority48 \lsdlocked0 List Table 3 Accent 1;
Department of Human Services, Office of Licensing to provide a copy of those results to me. \par \tab \hich\af5\dbch\af31505\loch\f5 (i) the Department of Human Services' Division of Child and Family Services Licensing Information Sys\hich\af5\dbch\af31505\loch\f5 tem described in Section 62A-4a-1006;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Date;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text First Indent;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text First Indent 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Note Heading;
\par \tab \hich\af5\dbch\af31505\loch\f5 Terms used in this rule are defined in Title 26, Chapter 21\hich\af5\dbch\af31505\loch\f5 Part 2. DOC CONSENT FOR BACKGROUND CHECK AND - Hawaii Forms | DSHS - Washington Call: (801) 538-4242 $33.25 submitted to DABS for each individual fingerprinted You may have live scan fingerprint services done at the DABS by appointment. 6bb6913e68dd1250b2d721614c6693683a48b4b783ca48fa58178ce620a157f65158741d2c3a4afdd6557b2c805ae115f8c1edc1cff49e1f06200242701e07cd
The applicant must also complete the Medical Cannabis Production Establishment Criminal Background Receipt form. National Suicide Prevention Lifeline Headquarters Background Checks - South Dakota \par \tab \hich\af5\dbch\af31505\loch\f5 (ii) who may have direct patient access;
\par \tab \hich\af5\dbch\af31505\loch\f5 (d) a home health agency; or
. \par }{\rtlch\fcs1 \ab\af5 \ltrch\fcs0 \b\expnd0\expndtw-3\insrsid14438297 \hich\af5\dbch\af31505\loch\f5 R432-35-5. \noqfpromote {\stylesheet{\ql \li0\ri0\nowidctlpar\wrapdefault\faauto\rin0\lin0\itap0 \rtlch\fcs1 \af5\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\loch\f5\hich\af5\dbch\af31505\cgrid\langnp1033\langfenp1033 \snext0 \sqformat \spriority0 Normal;}
Child Abuse/Neglect {\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;}
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This needs to be obtained prior to submitting the application to the office and the results included with the application to the Office. Salt Lake City, Ut 84116, DLBC Contact Info One-time Adoption Screening. 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. \lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Block Text;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Hyperlink;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 FollowedHyperlink;\lsdqformat1 \lsdpriority22 \lsdlocked0 Strong;
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. \par \tab \hich\af5\dbch\af31505\loch\f5 (c) Enterta\hich\af5\dbch\af31505\loch\f5 inment groups;
About. form on regular paper. Purpose. Wisconsin Background Check Forms & Publications Here's a variety of forms and publications to help you with the Background Check process. {\f535\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic);}{\f536\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic;}{\f537\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese);}{\f869\fbidi \froman\fcharset238\fprq2 Cambria Math CE;}
1-800-273-TALK(8255) OL staff will check site rosters for ongoing screening compliance. 9cb2400825e982c78ec7a27cc0c8992416c9d8b2a755fbf74cd25442a820166c2cd933f79e3be372bd1f07b5c3989ca74aaff2422b24eb1b475da5df374fd9ad
\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;
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Help; Please allow two weeks for processing and results of your background screening to show in DACS, If after two weeks you have not received results, you may contact the Office of Licensing for an update by emailing, For all other inquiries please call our main line (801) 538-4242 to reach a screening technician or supervisor or call your licensor or screening technician directly, You have been under review with the Office of Licensing for more than 10 business days. \par
\par \tab \hich\af5\dbch\af31505\loch\f5 (c) an assisted living facility; or
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