FLORIDA DEPARTMENT OF LAW ENFORCEMENTÃ‚Â NOTICE FOR APPLICANTS SUBMITTING FINGERPRINTS WHERE CRIMINAL RECORD RESULTSÃ‚Â WILL BECOME PART OF THE CARE PROVIDER BACKGROUND SCREENING CLEARINGHOUSEÃ‚Â
- SHARING OF CRIMINAL HISTORY RECORD INFORMATION WITH SPECIFIED AGENCIES,
- RETENTION OF FINGERPRINTS,
- RIGHT TO CHALLENGE AN INCORRECT CRIMINAL HISTORY RECORD
This notice is to inform you that when you submit a set of fingerprints to the Florida Department of LawÃ‚Â Enforcement (FDLE) for the purpose of conducting a search for any Florida and national criminal historyÃ‚Â records that may pertain to you, the results of that search will be returned to the Care ProviderÃ‚Â Background Screening Clearinghouse. By submitting fingerprints, you are authorizing the disseminationÃ‚Â of any state and national criminal history record that may pertain to you to the Specified Agency orÃ‚Â Agencies from which you are seeking approval to be employed, licensed, work under contract, or toÃ‚Â serve as a volunteer, pursuant to the National Child Protection Act of 1993, as amended, and SectionÃ‚Â 943.0542, Florida Statutes. “Specified agency” means the Department of Health, the Department ofÃ‚Â Children and Family Services, the Division of Vocational Rehabilitation within the Department ofÃ‚Â Education, the Agency for Health Care Administration, the Department of Elder Affairs, the DepartmentÃ‚Â of Juvenile Justice, and the Agency for Persons with Disabilities when these agencies are conductingÃ‚Â state and national criminal history background screening on persons who provide care for children orÃ‚Â persons who are elderly or disabled. The fingerprints submitted will be retained by FDLE and theÃ‚Â Clearinghouse will be notified if FDLE receives Florida arrest information on you.
Your Social Security Number (SSN) is needed to keep records accurate because other peopleÃ‚Â may have the same name and birth date. Disclosure of your SSN is imperative for theÃ‚Â performance of the Clearinghouse agenciesÃ¢â‚¬â„¢ duties in distinguishing your identity from that of other persons whose identification information may be the same as or similar to yours.Ã‚Â
Licensing and employing agencies are allowed to release a copy of the state and national criminalÃ‚Â record information to a person who requests a copy of his or her own record if the identification of theÃ‚Â record was based on submission of the personÃ¢â‚¬â„¢s fingerprints. Therefore, if you wish to review yourÃ‚Â record, you may request that the agency that is screening the record provide you with a copy. After youÃ‚Â have reviewed the criminal history record, if you believe it is incomplete or inaccurate, you may conductÃ‚Â a personal review as provided in s. 943.056, F.S., and Rule 11C8.001, F.A.C. If national information isÃ‚Â believed to be in error, the FBI should be contacted at 304-625-2000. You can receive any national
criminal history record that may pertain to you directly from the FBI, pursuant to 28 CFR Sections 16.30-16.34. You have the right to obtain a prompt determination as to the validity of your challenge before aÃ‚Â final decision is made about your status as an employee, volunteer, contractor, or subcontractor.
Until the criminal history background check is completed, you may be denied unsupervised access toÃ‚Â children, the elderly, or persons with disabilities.
The FBIÃ¢â‚¬â„¢s Privacy Statement follows on a separate page and contains additional information.
US Department of Justice,
Federal Bureau of Investigation,
Criminal Justice Information Services Division
Authority: The FBIÃ¢â‚¬â„¢s acquisition, preservation and exchange of information requested by this form isÃ‚Â generally authorized under 28 U.S.C. 534. Depending on the nature of your application, supplementalÃ‚Â authorities include numerous Federal statutes, hundreds of State statutes pursuant to Pub.L.92-544,Presidential executive orders, regulations and/or orders of the Attorney General of the United States, orÃ‚Â other authorized authorities. Examples include, but are not limited to: 5 U.S.C. 9101; Pub.L.94-29;Ã‚Â Pub.L.101-604; and Executive Orders 10450 and 12968. Providing the requested information isÃ‚Â voluntary; however, failure to furnish the information may affect timely completion of approval of your
Social Security Account Number (SSAN): Your SSAN is needed to keep records accurate because otherÃ‚Â people may have the same name and birth date. Pursuant to the Federal Privacy Act of 1974 (5 USCÃ‚Â 552a), the requesting agency is responsible for informing you whether disclosure is mandatory orÃ‚Â voluntary, by what statutory or other authority your SSAN is solicited, and what uses will be made of it.Ã‚Â Executive Order 9397 also asks Federal Agencies to use this number to help identify individuals inÃ‚Â agency records.
Principal Purpose: Certain determinations, such as employment, security, licensing and adoption, mayÃ‚Â be predicated on fingerprint based checks. Your fingerprints and other information contained on (andÃ‚Â along with) this form may be submitted to the requesting agency, the agency conducting the applicationÃ‚Â investigation, and/or FBI for the purpose of comparing the submitted information to available records inÃ‚Â order to identify other information that may be pertinent to the application. During the processing of thisÃ‚Â application, and for as long hereafter as may be relevant to the activity for which this application is beingÃ‚Â submitted, the FBI( may disclose any potentially pertinent information to the requesting agency and/or toÃ‚Â the agency conducting the investigation. The FBI may also retain the submitted information in the FBIÃ¢â‚¬â„¢sÃ‚Â permanent collection of fingerprints and related information, where it will be subject to comparisonsÃ‚Â against other submissions received by the FBI. Depending on the nature of your application, theÃ‚Â requesting agency and/or the agency conducting the application investigation may also retain theÃ‚Â fingerprints and other submitted information for other authorized purposes of such agency(ies).
Routine Uses: The fingerprints and information reported on this form may be disclosed pursuant to yourÃ‚Â consent, and may also be disclosed by the FBI without your consent as permitted by the Federal PrivacyÃ‚Â Act of 1974 (5 USC 552a(b)) and all applicable routine uses as may be published at any time in theÃ‚Â Federal Register, including the routine uses for the FBI Fingerprint Identification Records SystemÃ‚Â (Justice, FBI-009) and the FBIÃ¢â‚¬â„¢s Blanket Routine Uses (Justice/FBI-BRU). Routine uses include, but areÃ‚Â not limited to, disclosures to: appropriate governmental authorities responsible for civil or criminal law
enforcement counterintelligence, national security or public safety matters to which the information mayÃ‚Â be relevant; to State and local governmental agencies and nongovernmental entities for applicationÃ‚Â processing as authorized by Federal and State legislation, executive order, or regulation, includingÃ‚Â employment, security, licensing, and adoption checks; and as otherwise authorized by law , treaty,Ã‚Â executive order, regulation, or other lawful authority. If other agencies are involved in processing theÃ‚Â application, they may have additional routine uses.
Additional Information: The requesting agency and/or the agency conducting the applicationÃ‚Â investigation will provide you additional information pertinent to the specific circumstances of thisÃ‚Â application, which may include identification of other authorities, purposes, uses, and consequences ofÃ‚Â not providing requested information. In addition, any such agency in the Federal Executive Branch hasÃ‚Â also published notice.