What is the purpose of the Texas Criminal History Check Form?
The Texas Criminal History Check Form is designed to ensure that individuals involved in home and community support services meet the licensure eligibility criteria set by the Texas Health and Safety Code. This form collects personal information from owners, administrators, and chief financial officers of agencies, allowing the Texas Department of Aging and Disability Services to conduct necessary background checks.
Who needs to complete this form?
This form must be completed by the owner, administrator, and chief financial officer of a home and community support services agency. If there are any alternate administrators or additional individuals involved in the agency's management, their information should also be included. Accurate and complete information is essential for the licensure process.
What information is required on the form?
The form requires personal details such as names (including any aliases), dates of birth, race/ethnicity, sex, and social security numbers. Additionally, it asks for the current license number and contact information. It's important to provide all applicable information accurately to avoid delays in processing.
How should the completed form be submitted?
Once the form is completed, it should be submitted either by mail or fax to the Texas Department of Aging and Disability Services. The mailing address is Regulatory Services - Agency Licensing, Mail Code E-342, P.O. Box 149030, Austin, TX 78714-9030. The fax number for submissions is 512-438-2731. Make sure to send the form along with initial, renewal, and change of ownership applications.
What should I do if I find incorrect information on my background check?
If you discover that the information obtained from the Texas Department of Public Safety (DPS) is incorrect, you should contact the Texas DPS Crime Records Service. Their mailing address is P.O. Box 4143, Austin, TX 78765-4143. It is crucial to address any discrepancies promptly to ensure accurate records are maintained.
Do I have the right to access and correct my information?
Yes, you have the right to request access to the information that the Texas Department of Aging and Disability Services obtains about you. You can also ask for corrections if any information is found to be incorrect. For more details, you can contact Regulatory Services - Agency Licensing at 512-438-2630.