The Alabama Central Registry Clearance form is a document used to request a background check regarding child abuse or neglect in Alabama. This form is essential for individuals or organizations seeking to ensure the safety of children under their care by verifying that potential employees or volunteers do not have a history of abuse or neglect. To begin the process of filling out the form, please click the button below.
The Alabama Central Registry Clearance form plays a crucial role in ensuring the safety and well-being of children in the state. Designed for individuals or organizations that provide unsupervised care to children, this form requires specific information about the requestor and the person being cleared. It collects essential details such as names, dates of birth, and current addresses. Additionally, it asks for information about previous names and the names of family members, ensuring a thorough background check. Requestors can include child placing agencies, residential child care facilities, and family day care homes, among others. After submission, the Alabama Department of Human Resources conducts a search of the Central Registry to determine if the individual has any history of child abuse or neglect. The form also includes a waiver, allowing the department to release pertinent information while protecting the rights of the individual being cleared. By streamlining this process, the form helps maintain a safe environment for children and supports the efforts of those dedicated to their care.
ALABAMA DEPARTMENT OF HUMAN RESOURCES
CHILD ABUSE / NEGLECT (CA/N) CENTRAL REGISTRY CLEARANCE
PRINT OR TYPE in black or blue ink. Additional information regarding the CA/N Central Registry is on the back of this form.
** See instructions for the address to use when submitting this form. **
Requesting Person or Agency/Organization
Check All That Apply
Mailing Address
Child Placing Agency
Residential Child Care Facility
Child Day / Night Care Center
Telephone Number (
)
Email:
Family Day / Night Care Home
PRINT Requestor’s Name
Exempt Child Day Care Center
Requestor
Date
Medicaid Rehab. Provider
Signature
DHR Vendor
Witness
Other (Please Specify)
_________________________________
The person whose name and identifying information, printed or typed below, will provide unsupervised care and
supervision of children as an
employee
volunteer
other. This person’s specific job/role is or will be:
_________________________________________________________________________________________________
Name _____________________________________________ Sex
Last First Middle
Male
Race ___________ DOB ___/___/______
Female
Current Mailing Address
__________________________________________________________________________
Alias, Maiden & Prior Married Name(s)
______________________________________________________________
Name & DOB of Spouse & Former Spouse(s)
_________________________________________________________
Name & DOB of Children / Stepchildren
Alabama counties where person has lived and/or worked
_________________________________________________
Attach additional pages as needed to provide all information requested above.
To be completed by person being cleared
I authorize the Alabama Department of Human Resources to release information contained in the Child Abuse / Neglect Central Registry about me to the above named person/agency/organization. I hereby waive any right to any review or hearing to which I may otherwise be entitled. I further release the Department of Human Resources, its officers, and employees from any and all claims arising out of or in any way connected to the release or dissemination of any information concerning me.
________________
Signature of Witness
To be completed by DHR
A search of the Alabama Child Abuse / Neglect Central Registry has been completed with the information provided to determine if the person identified above has been named as being responsible for child abuse or neglect in Alabama. DHR releases only that information which is necessary to discover or prevent child abuse / neglect.
Substantiated report (i.e., indicated) located. See attached information.
Type Report:
Physical Abuse
Neglect
Sexual Abuse
Mental Abuse / Neglect
No report located.
Request Denied
______________________________________________________________________________
Other _________________________________________________________________________________________
______________________________________
Office of Child Protective Services
Date Completed
DHR-FCS-1598 (Revised December 2009)
Filling out the Alabama Central Registry Clearance form is an important step for individuals or agencies seeking to ensure the safety and well-being of children. After submitting the form, the Alabama Department of Human Resources will review the information provided and conduct a search of the Child Abuse/Neglect Central Registry. This process helps determine if the individual has any history related to child abuse or neglect.
Once completed, ensure that the form is submitted to the appropriate address as indicated in the instructions. This will initiate the review process by the Alabama Department of Human Resources.
What is the Alabama Central Registry Clearance form?
The Alabama Central Registry Clearance form is a document required by the Alabama Department of Human Resources (DHR) to check an individual’s history regarding child abuse or neglect. This form is essential for anyone who will provide unsupervised care to children, including employees and volunteers in child care settings.
Who needs to complete this form?
This form must be completed by individuals who will be responsible for the care and supervision of children. This includes employees, volunteers, and other individuals involved in child care services such as residential facilities, day care centers, and family day care homes.
How do I fill out the form?
To fill out the form, print or type your information in black or blue ink. Provide details such as your name, date of birth, current mailing address, and any aliases or prior names. Additionally, include the name and date of birth of your spouse and children, if applicable. Make sure to check all relevant boxes that pertain to your role and provide a detailed description of your job or volunteer position.
Where do I submit the completed form?
The completed form should be sent to the address specified in the instructions on the back of the form. Ensure that you check the instructions carefully for the correct mailing address to avoid any delays in processing your request.
What happens after I submit the form?
Once submitted, the DHR will conduct a search of the Child Abuse/Neglect Central Registry using the information provided. They will determine if any substantiated reports exist regarding the individual named in the form. You will receive notification of the results, which may include details about any findings or a confirmation that no reports were located.
What if I have a substantiated report on my record?
If a substantiated report is found, the DHR will provide the necessary information regarding the nature of the report. Depending on the circumstances, this may affect your ability to work or volunteer in child care settings. It is advisable to seek legal counsel if you find yourself in this situation to understand your rights and options.
Can I appeal the findings from the Central Registry?
By signing the form, you waive your right to a review or hearing regarding the information released. This means you cannot appeal the findings directly through the DHR. However, you may still seek legal advice on how to address any concerns or disputes related to the findings.
How long does the clearance process take?
The time it takes to process the clearance can vary based on several factors, including the volume of requests being handled by the DHR. Typically, you can expect a response within a few weeks, but it is wise to follow up if you do not receive any communication after a reasonable period.
What should I do if I have questions about the form?
If you have questions or need assistance while completing the form, you can contact the DHR directly. They can provide guidance and clarify any uncertainties you may have regarding the process or requirements.
Filling out the Alabama Central Registry Clearance form can be straightforward, but many people make common mistakes that can delay the process. One frequent error is failing to use black or blue ink. The instructions clearly state this requirement, but some individuals overlook it, resulting in their forms being rejected.
Another mistake is neglecting to provide complete information about the person being cleared. This includes their full name, date of birth, and current mailing address. Incomplete details can lead to confusion and may require additional time to correct.
Many applicants forget to check all applicable boxes when indicating their relationship to the child care agency or organization. This oversight can cause delays as the processing team may need to clarify the requestor's role, which could have been easily communicated in the initial submission.
Some individuals fail to sign the form or include the date next to their signature. A missing signature can halt the entire process, as the Department of Human Resources needs authorization to release information. Always double-check for signatures before submitting.
Providing inaccurate information about previous names or aliases is another common pitfall. If a person has changed their name, it is crucial to include all previous names to ensure a thorough background check. Omitting this information can lead to incomplete results.
Applicants often overlook the requirement to list all Alabama counties where they have lived or worked. This information is essential for the registry search. Failing to include this can result in an incomplete background check.
Some people attach additional pages but do not label them properly. It is important to clearly indicate that extra information is being provided. Otherwise, the reviewing party might miss critical details that could affect the outcome.
Another mistake is not providing a witness signature where required. A witness is necessary for the authorization to be valid. Without this signature, the form may be considered incomplete.
Lastly, individuals sometimes forget to keep a copy of the completed form for their records. Having a copy can be helpful for future reference or if any issues arise during the processing of the clearance.
By avoiding these common mistakes, applicants can help ensure a smoother and faster processing of their Alabama Central Registry Clearance form.
The Alabama Central Registry Clearance form is an essential document for individuals and organizations seeking to ensure the safety of children in their care. Alongside this form, several other documents may be necessary to complete the clearance process or to fulfill related requirements. Below is a list of commonly used forms and documents that may accompany the Central Registry Clearance form.
These documents collectively support the goal of maintaining a safe environment for children. It is important to ensure that all necessary forms are completed accurately and submitted as required to facilitate the clearance process effectively.
The Alabama Central Registry Clearance form serves a specific purpose in ensuring the safety of children by checking for any history of child abuse or neglect. Several other documents share similarities in their intent and function. Here’s a list of eight such documents:
When filling out the Alabama Central Registry Clearance form, it is crucial to follow specific guidelines to ensure a smooth process. Below are important do's and don'ts to keep in mind.
By adhering to these guidelines, you can help ensure that your application is processed efficiently. Take the time to review your form before submission to avoid delays.
Understanding the Alabama Central Registry Clearance form is crucial for those involved in child care services. However, several misconceptions often arise regarding this important document. Below is a list of common misunderstandings:
Being informed about these misconceptions can help ensure that the process is understood and navigated correctly. It is essential to approach the Alabama Central Registry Clearance form with accurate information and awareness.
The Alabama Central Registry Clearance form is an important document for individuals or organizations seeking to ensure the safety of children in their care. Below are key takeaways regarding its completion and use.
Following these guidelines will help ensure a smooth application process for the Alabama Central Registry Clearance form.