Record Check Evaluation Process for SING (Iowa) And National Fingerprint Results (updated July 1, 2016)

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1 Record Check Evaluation Process for SING (Iowa) And National Fingerprint Results (updated July 1, 2016) STEP 1: Conduct the SING (Iowa) check prior to hire and the FBI National Fingerprint Check within 30 days of start date. a) If there is no criminal record found and there is no further research required of the Child Abuse or Dependent Adult Abuse Registry, you may proceed with hiring based on record check results. b) If the transgression(s) found has/have already been evaluated, proceed to the section on the next page titled Previously Evaluated Transgressions.* c) If the results of the SING check include criminal history and/or further research is required of the Child Abuse Registry or if the results of the national fingerprint check show additional transgressions that have not been evaluated based on the SING results, proceed as follows from STEP 2.** ** If you receive a message that further research is required of the Dependent Adult Abuse Registry, submit Form to the Central Abuse Registry and you will be notified if an evaluation is required. For questions or clarification, please contact recordcheckevals@dhs.state.ia.us. STEP 2: The director will complete Section A of Form , Agency/Provider/Person Requesting Evaluation. STEP 3: The applicant will complete Part B in black ink with a written signature and date. The applicant will need to complete Part D explaining each transgression in detail. Note: If the person has multiple transgressions, she/he needs to complete a separate page 2 for each transgression including any possible founded child abuse. Please help them be thorough and complete. If they have evidence of how they ve changed their behavior, encourage them to include additional documents. STEP 4: The director must obtain the responses from the applicant and submit a complete record check evaluation packet in ONE PDF attachment by to recordcheckevals@dhs.state.ia.us or by fax to [If you must send by mail, the address is: DHS Record Check Evaluations, PO Box 4826, Des Moines, Iowa ] Evaluation packet checklist: The completed Record Check Evaluation Form ( ) Any additional letters of reference or correspondence that demonstrate rehabilitative efforts and/or stability Iowa DHS criminal History Record Check Form B ( ) SING Printout Form S Criminal Results with RAP sheet (DCI printout) National fingerprint check results with a record found If different than or in addition to SING results that were already evaluated (proof of SING check must also be included.) STEP 5: The centralized record check committee will evaluate and return the decision to you by fax. If you do not supply a fax number, the decision will be mailed to you. NOTE: If you are notified that additional documentation is required for the evaluation, you must resubmit the entire packet including the additional documentation requested.

2 Record Check Evaluation Process for SING (Iowa) And National Fingerprint Results (updated July 1, 2016) If you have questions, contact Record Check Evaluations by at or by phone at *Previously Evaluated Transgressions: If you have an employee who has been employed at your center since their last record check and there is no new transgression on a subsequent SING or national fingerprint check, keep all SING/fingerprint results in the file as evidence of you conducting the renewal record checks [SING every 2 years and fingerprints every 4 years). If you have an applicant who says they were evaluated while at a different child care related job and can provide you a copy of their previous record check evaluation, they may begin work immediately pending the new record check results. You still have to conduct your own background check and submit the new results for evaluation. If they are not able to produce their prior evaluation, the applicant may not begin work until the new record check evaluation is completed with a decision of approval (6)c. Iowa records checks. Checks and evaluations of Iowa child abuse and criminal records, including the sex offender registry, shall be completed before the person s involvement with child care at the center (6)d. National criminal history checks. If the results of the Iowa records checks do not warrant prohibition of the person s involvement with child care or otherwise present protective concerns, the person may be involved with child care on a provisional basis until the national criminal history check and evaluation have been completed.

3 Iowa Department of Human Services Record Check Evaluation A. Agency/Provider/Person Requesting Evaluation Entity Requesting Evaluation Requestor s Name Phone Fax Street City State Zip Code The agency/provider/person listed above is requesting a Record Check Evaluation (RCE) on the following person after a background check revealed a criminal conviction (or deferred judgment), founded abuse (child or dependent adult), or a combination thereof. In order to complete the evaluation, we need to have all information, including form , SING, and Rap Sheet. Please ensure that all forms are dated within the 30 day period. All evaluation materials must be sent in together. B. Person Being Evaluated Last Name, First Name, Middle Initial Maiden/Previous Names Role/Position Applying For The individual listed above requests an evaluation to determine whether they can be permitted to perform duties under the section Role/Position Applying For. I realize that the information I provide in Section D. may be verified with local law enforcement agencies, the district court, Iowa Department of Human Services, or other persons having knowledge of the incident. Signature of Person Being Evaluated Telephone Date Street Address City State Zip Code C. Evaluation Determination/Notice of Decision FOR DHS USE ONLY (Rev. 11/14)

4 D. Explain, in detail, each crime or abuse (completed by applicant). Include date, location, others involved, relationship of the victim to you, age of the victim, and your actions for each abuse or criminal history (additional sheets may be used). What changes have you made to make you safe to work around or care for others? Explain your accomplishments; work history; caretaker history; counseling, therapy, parenting classes; etc. Supporting documents such as treatment certificates, reference letters from previous/current employers or probation officers should be included. Has DHS evaluated you in the past? Explain when the previous evaluation occurred, what position you were applying for, and whether you received the job/position (Rev. 11/14)

5 Iowa Department of Human Services Authorization for Release of Child and Dependent Adult Abuse Information This form must be used to authorize release of child or dependent adult abuse information when the person requesting the information does not have independent access to it under Iowa law. Complete a separate form for each person for whom information is requested and to dhsabuseregistry@dhs.state.ia.us, or fax to (515) , or mail to the Iowa Department of Human Services, Central Abuse Registry, P.O. Box 4826, Des Moines, IA Please specify which abuse registry you are requesting by checking the appropriate box below: Child Abuse Registry Dependent Adult Abuse Registry Both Please specify your preferred method of response by checking a box and completing the information in Section 1. Address Fax Section 1: To be completed by the person or agency requesting the information. Requester: Last First Agency Name Telephone Number ( ) Address Fax Number ( ) City State Zip Code List the name and address of the person whose information is being requested: Name (last, first, middle) Birth Date Social Security Number Address City County State Zip Code List maiden name, previous married names, and any alias: What is the purpose of your request for child or dependent adult abuse information? I have read and understand the legal provisions for handling child and dependent adult abuse information which is printed on the second page of this form. Signature of Requestor Date Section 2: To be completed by the person authorizing the Department of Human Services to release their child or dependent adult abuse information. I understand that my signature authorizes the requester to receive information to verify whether I am named on the Child Abuse or Dependent Adult Abuse Registry as having abused a child (Iowa Code section 235A.15) or dependent adult (Iowa Code section 235B.6). To the best of my knowledge, the information contained in Section 1 of this form is correct. Signature of Person Authorizing Date Section 3: To be completed by the Central Abuse Registry or designee. The person whose information is being requested is listed on the Child Abuse Registry as having abused a child. The person whose information is being requested is not listed on the Child Abuse Registry as having abused a child. The person whose information is being requested is listed on the Dependent Adult Abuse Registry as having abused a dependent adult. The person whose information is being requested is not listed on the Dependent Adult Abuse Registry as having abused a dependent adult. This request for information is denied because the form is incomplete. Signature of Registry Staff or Designee Comments Date (Rev. 2/16) Copy 1: Central Registry Copy 2: Returned to Requester

6 Page 2 LEGAL PROVISIONS FOR HANDLING CHILD AND DEPENDENT ADULT ABUSE INFORMATION Redissemination of Child and Dependent Adult Abuse Information (Iowa Code sections 235A.17 and 235B.8) A person, agency, or other recipient of child or dependent adult abuse information shall not redisseminate (release) this information, except that redissemination is permitted when ALL of the following conditions apply: The redissemination is for official purposes in connection with prescribed duties or, in the case of a health practitioner, pursuant to professional responsibilities. The person to whom such information would be redisseminated would have independent access to the same information under Iowa Code sections 235A.15 or 235B.6. A written record is made of the redissemination, including the name of the recipient and the date and purpose of the redissemination. The written record is forwarded to the Central Abuse Registry within 30 days of the redissemination. Criminal Penalties (Iowa Code sections 235A.21 and 235B.12) A person is guilty of a criminal offense when the person: Willfully requests, obtains, or seeks to obtain child or dependent adult abuse information under false pretenses, or Willfully communicates or seeks to communicate child or dependent adult abuse information to any agency or person except in accordance with Iowa Code sections 235A.15, 235A.17, 235B.6, and 235B.8, or Is connected with any research authorized pursuant to Iowa Code sections 235A.15 and 235B.6 and willfully falsifies child or dependent adult abuse information or any records relating to child or dependent adult abuse. Upon conviction for each offense, the person is guilty of a serious misdemeanor punishable by a fine or imprisonment. Any person who knowingly, but without criminal purposes, communicates or seeks to communicate child or dependent adult abuse information except in accordance with Iowa Code sections 235A.15, 235A.17, 235B.6, and 235B.8 is guilty of a simple misdemeanor punishable, upon conviction for each offense, by a fine or imprisonment. Any reasonable grounds for belief that a person has violated any provision of Iowa Code Chapters 235A or 235B shall be grounds for the immediate withdrawal of any authorized access that person might otherwise have to child or dependent adult abuse information (Rev. 2/16)