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This form is primarily required for individuals applying for direct service positions in child care facilities licensed by the Arizona Department of Health Services (ADHS). It is essential for professionals such as teachers, childcare workers, social workers, and healthcare providers who interact with children or vulnerable adults. For instance, a childcare worker must complete this affidavit to confirm their background regarding any allegations of abuse or neglect before being hired.
To file the ADCS Central Registry Affidavit, applicants must submit it prior to commencing employment in a direct service role. The form must be filled out completely and accurately, including personal information and any relevant history regarding investigations into abuse or neglect. Employers are responsible for maintaining confidentiality and ensuring that the form is submitted to the appropriate authorities.
Submitting the ADCS Central Registry Affidavit involves several steps: First, obtain the official template from your employer or directly from the Arizona Department of Health Services website. Next, fill out all required fields with accurate information. After completing the form, review it for any errors before signing it. Finally, submit either an online version through your employer's designated platform or print and deliver a hard copy to your employer's human resources department.
It is vital to note that providing false information on this affidavit can lead to severe legal consequences, including penalties for perjury. Additionally, if there are past allegations that resulted in substantiated findings, applicants are encouraged to provide context through supplementary documentation without disclosing any identifying details about involved parties.