WA DSHS 09-966 2003-2024 free printable template

The background check form DSHS (Department of Social and Health Services) is a document used by the DSHS in Washington State, USA, to conduct background checks on individuals applying for employment or volunteer positions that involve working with vulnerable populations, such as children, the elderly, or individuals with disabilities. The form gathers information about the applicant's personal and employment history, criminal record, and other relevant details that help assess their suitability for the position. The completed form is submitted to DSHS for review and approval.

The Background Check Form DSHS (Department of Social and Health Services) is typically required to be filed by individuals who are seeking employment or volunteering in certain positions or roles that involve working with vulnerable populations, such as children, elderly individuals, or individuals with disabilities. This requirement may vary depending on the specific laws and regulations of the jurisdiction.

To fill out a background check form for DSHS (Department of Social and Health Services), follow these steps: 1. Obtain the form: You can usually find the background check form on the DSHS website or request it from the relevant department or agency. 2. Read the instructions: Carefully review the instructions provided with the form to ensure you understand the requirements and any supporting documents or identification needed. 3. Provide personal information: Begin by entering your personal details, including your full name, current address, social security number, date of birth, and contact information. 4. List previous addresses: Provide a complete list of your previous addresses for the past several years. Include the dates you resided at each address. 5. Employment history: Provide information about your employment history, starting from your most recent job. Include the name and address of the employer, your position, the dates of employment, and any supervisory or administrative roles you held. 6. Education history: List your educational background, including the names and addresses of schools attended, degrees or certifications obtained, and dates of attendance. 7. Volunteer work: If applicable, provide details about any volunteer work or community service you have performed. Include the organization's name, address, the dates of your involvement, and a brief description of your responsibilities. 8. Criminal history: Answer the questions about your criminal background as truthfully and accurately as possible. If you have any convictions, misdemeanors, or pending charges, provide the necessary details. Some forms may ask for specific types of offenses to be disclosed. 9. References: Some background check forms require personal or professional references. Provide the names, contact information, and relationships of individuals who can vouch for your character and qualifications. 10. Sign and date: Review the completed form for accuracy, sign and date it, and provide any other necessary signatures, initials, or authorizations as instructed. 11. Submit the form: Follow the instructions on where and how to submit the form. Ensure you include all necessary supporting documents, identification, and any applicable fees. Consider making a copy of the completed form for your records. Remember to answer all questions truthfully and provide accurate information. Providing false or misleading information on a background check form can have serious consequences.

The purpose of the background check form DSHS (Department of Social and Health Services) is to conduct a comprehensive background check on individuals applying for positions that involve working with vulnerable populations, such as children, elderly, and individuals with disabilities. This form is used to gather information about an applicant's criminal history, employment history, references, and other relevant information to ensure the safety and well-being of the people they will be serving. It helps DSHS make informed decisions about the suitability of an individual for the position and mitigate potential risks.

When conducting a background check through the Washington State Department of Social and Health Services (DSHS), the following information may be required: 1. Personal Information: The individual's full name, date of birth, social security number, and current address. 2. Employment History: Previous employers' names, addresses, and dates of employment. This may include voluntary roles, internships, or self-employment. 3. Education History: The names and addresses of educational institutions attended, degrees earned, and dates of attendance. This typically includes high school, college, or vocational training. 4. Criminal History: Details of any criminal convictions, including the nature of the offense, dates of conviction, and any resulting sentences. This may also include pending charges or criminal cases that are still open. 5. References: Contact information for individuals who can verify the applicant's character, work ethic, and suitability for the position. 6. Professional Licenses or Certifications: Information about any professional licenses or certifications held, including the issuing authority, license/certification number, and expiration date. Note that the specific information required on the background check form may vary depending on the purpose of the check and the requirements set by DSHS.

The penalty for the late filing of a background check form with the Washington State Department of Social and Health Services (DSHS) will vary depending on the specific circumstances and relevant laws and regulations. It is recommended to consult the DSHS or an attorney for accurate and up-to-date information on penalties and consequences associated with late filing of background check forms with DSHS.

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