Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 25 - Division of Provider Services and Quality Assurance › Rule 016.25.19-002 - Rules and Regulations for Conducting Criminal Record Checks for Employees of Long Term Care Facilities

Current through Register Vol. 49, No. 6, June, 2024
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If the facility cannot verify that the
				applicant has lived continuously in the state for the past five (5) years, the
				facility shall also perform a national criminal history records check on the
				applicant. The facility shall provide the applicant with the following:
* A form DMS-736;
* A pre-printed Fingerprint Card provided by the Office of Long
				Term Care;
* A form FBI-1 DHS Verification; and
* An envelope addressed as provided in DMS-736.
The facility may assist the applicant with the completion of
				the documents.
The applicant shall take the documents to law enforcement and
				request that law enforcement complete the fingerprint process, the Fingerprint
				Card, and the FBI-1 DHS Verification Form.
Law enforcement shall then place those items, along with the
				DMS-736, into the envelope, addressed as provided in DMS-736, and seal the
				envelope. The applicant shall return the sealed envelope to the
				facility.
The facility shall place the sealed envelope from the applicant
				into a second envelope, addressed as provided in DMS-736, along with any
				checks/payments/fees. The facility shall seal the second envelope and return it
				to the Office of Long Term Care.
NOTE:
A national criminal
				history records check shall not be performed on any individual whom the
				facility can verify has lived continuously in the state for the past five (5)
				years or who provides care to residents of a service provider subject to a
				professional license. See Section 502 for the complete list of excluded
				professions.
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PRIVACY ACT STATEMENT
Authority:
The FBI's acquisition, preservation,
				and exchange of fingerprints and associated information is generally authorized
				under 28 U.S.C. § 534. Depending on the nature of your application,
				supplemental authorities include Federal statutes, State statutes pursuant to
				Pub. L. 92-544, Presidential Executive Orders, and federal regulations.
				Providing your fingerprints and associated information is voluntary; however,
				failure to do so may affect completion or approval of your application.
Principal Purpose:
Certain determinations, such as
				employment, licensing, and security clearances, may be predicated on
				fingerprint-based background checks. Your fingerprints and associated
				information/biometrics may be provided to the employing, investigating, or
				otherwise responsible agency, and/or the FBI for the purpose of comparing your
				fingerprints to other fingerprints in the FBI's Next Generation Identification
				(NGI) system or its successor systems (including civil, criminal, and latent
				fingerprint repositories) or other available records of the employing,
				investigating, or otherwise responsible agency. The FBI may retain your
				fingerprints and associated information/biometrics in NGI after the completion
				of this application and, while retained, your fingerprints may continue to be
				compared against other fingerprints submitted to or retained by NGI.
Routine Uses:
During the processing of this
				application and for as long thereafter as your fingerprints and associated
				information/biometrics are retained in NGI, your information may be disclosed
				pursuant to your consent, and may be disclosed without your consent as
				permitted by the Privacy Act of 1974 and all applicable Routine Uses as may be
				published at any time in the Federal Register, including the Routine Uses for
				the NGI system and the FBI's Blanket Routine Uses. Routine uses include, but
				are not limited to, disclosures to: employing, governmental or authorized
				non-governmental agencies responsible for employment, contracting, licensing,
				security clearances, and other suitability determinations; local, state,
				tribal, or federal law enforcement agencies; criminal justice agencies; and
				agencies responsible for national security or public safety.