FINGERPRINT CLEARANCE CARD INSTRUCTIONS



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FINGERPRINT CLEARANCE CARD INSTRUCTIONS TO: Phoenix College Health Professions Students SUBJECT: Criminal Background Check & Fingerprint Clearance Card Requirement Nearly all healthcare programs at Phoenix College and the greater Maricopa County Community College District require a student and/or program applicant to pass a criminal background check by obtaining a Fingerprint Clearance Card through the Arizona Department of Public Safety (DPS). Many states including Arizona require clearance of a background check to work and care for children, the elderly and vulnerable adults. The various healthcare programs of the Maricopa County Community College District contract with clinical agencies and employers that require this background clearance. As a result, nearly all the healthcare programs require a student to obtain a Fingerprint Clearance Card. To apply for and obtain a Fingerprint Clearance Card, you must get your fingerprints taken on an FBI print collection card, complete the Arizona Department of Public Safety application, and then submit both items with payment to DPS. You must allow up to 8 weeks for processing your application and to receive your Fingerprint Clearance Card. If there is a positive criminal history, a clearance may be denied. If you are unable to receive or be granted the Fingerprint Clearance Card, you will not be able to enroll or continue in your health profession courses. This set of instructions will assist you in completing the Arizona DPS application and in locating an agency where you can complete the fingerprinting requirements on the FBI print collection card. The Fingerprint Clearance Card is valid for 6 years. The card must be valid for you to receive clinical/professional practice placement, and must be current the entire time that you are assigned to a health care site. It is important to note that the card required for the health programs around the Maricopa County Community College District and here at Phoenix College will not meet the requirements for certification or licensure through the Arizona State Board of Nursing and/or other credentialing agencies. Please understand that the addition of the Fingerprint Clearance Card requirement is important to protect patient safety and thus is a mandatory part of the health and safety requirements of the healthcare programs offered at Phoenix College. Further information about the Fingerprint Clearance Card is available on the DPS website at: http://www.azdps.gov/services/fingerprint/

Step by Step Guide for Obtaining your Fingerprint Clearance Card: 1. Obtain a Fingerprint Clearance Card application, FBI print collection card and envelope (see illustration below). These materials are available from the Arizona Department of Public Safety, and can be obtained by calling DPS at (602) 223-2279, or by faxing your request to (602) 223-2947. You may alternatively visit the Arizona Department of Public Safety Fingerprint Clearance Card Unit at 2320 N. 20 th Ave., Phoenix, AZ 85009. The building is located at the southwest corner of Lewis Ave. and 20 th Ave. Dial extension 5319 in the lobby. Hours are generally 8am to 5pm, excluding holidays. You are also welcome to inquire at the Advisement Center to see if application materials are available for distribution to students. The Advisement Center can sometimes stock the application materials for students convenience. However, it is not the responsibility of the Advisement Center to stock the application materials, and please know that supplies are limited. 2. Have your fingerprints taken at one of the participating agencies. Please see the list of recommended agencies that provide fingerprinting to the public. DO NOT BEND OR FOLD the FBI print collection card. DPS does not provide fingerprinting services. 3. Complete the application following the example within these instructions. 4. Submit your completed application, FBI print collection card and payment per the directions on the DPS application. Keep the yellow and pink copies of the 3-part application.

Agencies that Provide Fingerprinting Services: Listed below are some agencies that provide fingerprinting services. Costs for obtaining this service may vary depending on the agency. Please follow the respective agency's procedures for having your fingerprints properly taken. Phoenix College recommends calling ahead to verify hours, cost, and acceptable forms of payment for fingerprinting services. You will need to provide proper photo identification in order to be fingerprinted. Acceptable forms of identification include: driver s license, state issued ID card, passport, or resident alien card. (School ID is not acceptable). AccuSearch, Inc. Monday Friday 9:00AM 4:00PM 2338 W. Royal Palm Rd., Suite J $19 Cash, checks, major credit cards accepted Phoenix, AZ 85021 (602) 249-3466 Chandler Police Department Tuesdays 5:00PM 7:00PM 250 E. Chicago St. Thursdays 11:00AM 1:00PM Chandler, AZ 85225 $10 Cash, checks, debit, Visa or Mastercard accepted (480) 782-4000 Community Wellness & Safety of Arizona Phoenix Monday Friday 8:00AM 5:00PM 4730 E. Indian School Rd., Suite 124 $15 Cash, debit card, Visa or Mastercard accepted Phoenix, AZ 85018 Community Wellness & Safety of Arizona Tempe Monday, Wednesday & Friday 8:00AM 5:00PM 8400 S. Kyrene Rd., Suite 122 $15 Cash, debit card, Visa or Mastercard accepted Tempe, AZ 85284 Community Wellness & Safety of Arizona Gilbert Monday Friday 8:00AM 5:00PM 522 N. Gilbert Rd., Suite 104 $15 Cash, debit card, Visa or Mastercard accepted Gilbert, AZ 85234 Glendale Police Department Mondays 2:00PM 4:00PM 6835 N. 57th Dr. Wednesdays 8:00AM 10:00AM Glendale, AZ 85301 $10 Cash or money orders accepted (623) 930-3000 Maricopa County Sheriff s Office Monday Friday 8:00AM 5:00PM 201 W. Jefferson St. $8 Cash or money orders accepted Phoenix, AZ 85003 (602) 876-1070 Phoenix Police Department Monday Friday 8:00AM 4:00PM Dept. of Code Enforcement $6 Cash, checks, money orders, debit and 1717 E. Grant St., Suite 100 major credit cards accepted Phoenix, AZ 85034 (602) 534-1127

Frequently Asked Questions about the Fingerprint Clearance Card Process: The following information is from the Arizona Department of Public Safety website: http://www.azdps.gov/services/fingerprint/ Notes from Phoenix College are in italicized text. Q: How can I obtain an application packet for an initial or renewal Fingerprint Clearance Card? A: You may request a packet directly from DPS by either calling (602) 223-2279 or faxing your request to (602) 223-2947. Office hours are Monday through Friday from 8:00 a.m. to 5:00 p.m. Q: How long will it take to obtain my Fingerprint Clearance Card? A: The average processing time is five to eight weeks depending on whether or not the person has a criminal record. Please ensure you affix sufficient postage to the envelope and place your return address in the top left corner of the envelope. Q: Does the Department of Public Safety fingerprint applicants for a Fingerprint Clearance Card? A: No. An applicant may contact their local law enforcement agency to find out if they take applicant fingerprints or they may contact a private fingerprinting service. (Please refer to the list of participating agencies provided.) Q: What will my fingerprints be used for? A: Your fingerprints will be used to obtain both a state and federal criminal records check. Q: What is the fee to obtain a Fingerprint Clearance Card? A: The current fee as of January 1, 2009 for volunteers is $65.00 and the fee for all others is $69.00. Maricopa Community College students should submit their application as a volunteer. Q: What forms of payments are accepted? A: DPS accepts Cashier s Checks, Money Orders or a check drawn on a business account. All forms of payment should be made payable to the AZ Department of Public Safety. Cash and person checks are not accepted. Q: I lost my Fingerprint Clearance Card. How may I obtain a replacement? A: An application for a replacement card may be obtained by calling (602) 223-2279 or faxing your request to (602) 223-2947. A $5.00 fee will be charged per replacement card. Q: Where can I find out what would preclude me from obtaining a Fingerprint Clearance Card? A: Precluding offenses for a level one Fingerprint Clearance Card can be found in A.R.S. 41-1758.07, subsection B and C (website link below). Precluding offenses for the regular Fingerprint Clearance Card can be found in A.R.S. 41-1758.03 (website link below). A.R.S. 41-1758.07 http://www.azdps.gov/links/ars/?l=41/01758-07.htm A.R.S. 41-1758.03 http://www.azdps.gov/links/ars/?l=41/01758-03.htm For specific questions regarding Fingerprint Clearance Card eligibility, please contact the Arizona Department of Public Safety at (602) 223-2279 or visit their website at http://www.azdps.gov/services/fingerprint/. Q: Need Directions? A: The Fingerprint Clearance Card Unit is located at 2320 N. 20th Avenue in Phoenix. Access to the parking area can only be made from W. Lewis Ave., which is one block north of Encanto Blvd. and is accessible from either 19th Ave. or 21st Ave.

% & f l E R E 6 m C SAFm APPLICATION NUMBER APPLICATION FOR A FINGERPRINT CLEARANCE CARD B (602) 223-2279 P.O. Box 18390, Phoenix, AZ, 85005-8390 000 1881251 Instructions: Type or print all information in black ink. All fields marked with a* are required. Submit the orisinal white copv ONLY to DPS (reproductions will not be accepted). The yellow copy is for the employer or agency. The pink copy is for the applicant. Please do not P If you are aware the enclosed payment exc&ds the amount due, and the overpayment is less than $10.00, signing this application indicates your agreement to have the excess funds donated to the State General Fund. If this application is not signed your packet will be returned to you. Fees are subject to change and are not refundable per A.R.S. Q 41-1750 and 6 41-1758. Y Work in Child Day Care I Child Nutrition Programs,, De t. of Economic Securit - Work in JOBS / WIA **Dept. of Economic Security (ARS 41-1964 & 46-141) Programs (ARS 46-141) Dept. of Education (ARS 46-321) **Dept. of Health Services (ARS 36-897.01 & Arizona Department of Education - Exceptional Student 36-897.03) Services Program - Surrogate Parents (ARS 15-763.01) **Dept. of Health Services (ARS 36-883.02 & 36-882),, **De t. of Economic Securi Child Protective d I I 1 1 k **Dept. of Economic Securitv - Child Care Home Services - State Employee (ARS 8-802). Provider (ARS 41-1967.01) Dept. of Economic Securitv Employees (Non-CPS) Work in Child 1 Welfare & Adolescent Behavioral **State Employee, Non CPS (ARS 41-1 968) Health Treatment Proqrams **State Employee, IT Position (ARS 41-1 969) Supreme Court, Administrative Office of the Court (ARS 8-322) I / **Dept. of Economic Securitv Adoption (ARS 8-1 05) **Dept- of Economic (ARS 46-141) CW & ABH **Dept. of Economic Security Foster Home Licensure Dept. of Juvenile Corrections (ARS 41-2814) I I IARS 8-509) De~t. of Health Services IARS 36-425.03) I I Dept. of Economic Securitv - Work in Domestic Violence Wirk with Persons Who Have Developmental 1 1 / Homeless Shelters lars 36-3008 & 46-141) Disabilities **Dept. of Economic Security (ARS 36-594.01) **Dept. of Economic Security Developmental Home ~icensure (ARS 36-594.02) - 11 I3 Volunteer Foster Grandparent Proqram (ARS 46-141) 1 Nursinq Care Administrators & Assisted Living Facility Manaqers (ARS 36-446.04) Dept. of Health Services - Residential or Nursinq Care Institutions; Home Health Aqencies (ARS 36-41 1 ) DEMA Employee (ARS 26-103) - - - - - Health Science Student & Clinical Assistant <ARS 15-1 8. ) Public andlor Charter School Contractor, Subcontractor or Vendor OR; Employee of a Contractor, Subcontractor or Vendor of a Public andlor Charter School (ARS 15-51 2) **Arizona Board of Finqerprintinq Members and Staff (ARS 41-61 9.52) for more information. DPS 802-06857 Rev. 07-2009 I