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PDF personnel records r9-5-402 a , r9-5-403 - Arizona Department of 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the Employee Name, Date of Birth, Home Address, Position, and Telephone Number in the designated fields.
  3. Indicate whether the employee will be working alone or supervised by checking the appropriate box.
  4. Fill in the Start Date and End Date as applicable.
  5. Provide an Emergency Contact name and complete the Immunization Statement by signing and dating where indicated.
  6. Complete sections regarding Verification of Fingerprint Registration, ensuring all required documents are attached.
  7. List any required documents such as High School Diploma/GED Certificate and TB Test Results, including dates where necessary.
  8. Document training requirements under R9-5-403, including New Staff Training and Annual In-Service Training details.
  9. Ensure to fill out Current License or Certification details along with expiration dates for relevant certifications.
  10. Finally, include Good Faith Efforts to contact previous employers and retain the entire file for 12 months from termination date.

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Pursuant to A.R.S. section 39-121, the public has a right to inspect (i.e. view in person) public records. Pursuant to A.R.S. section 39-121.01, the public has a right to obtain copies of public records, subject to reasonable copy fees.
CDA Certification Once you have obtained your CDA Credential in Preschool, Infant/Toddler, or Family Child Care, you will be qualified as a teacher-caregiver in Arizona.
Subject to section 39-121.03: 1. Any person may request to examine or be furnished copies, printouts or photographs of any public record during regular office hours or may request that the custodian mail a copy of any public record not otherwise available on the public bodys website to the requesting person.
To review the record, the subject may begin the process by going to or by contacting the Central State Repository Section at (602) 223-2000, selecting Option #2 (Records and Reports), and then Option #3 (Statewide Criminal Records).
Public records requests are processed by the Executive Office Communications Department. For more information, please contact Public Records at PublicRecords@azag.gov or 602-542-4266.

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