ORIGINAL DCS FORM/ ACCEPTS 3RD PICT FOR PREFERRED RESPONS ADDITIONAL STATE CONTACT INFO EMAIL ADDRESS OWN FORM? NOTARY? SIGNATURE FEE? FEE INFO LETTERHEAD PARTY ID? EMPLOYMENT? TRANSMITTAL E TIME COMMENTS ? REQUIRED? REQUESTS? Additional contacts: Alabama State Jon Perdue, Phone: (334) Department of Human Program 242-9500 Fax: jon.perdue@d Resources, Family Manager (334) 242-0939 hr.alabama.gov Services Division AL FORM Phone: (334) or Alabama 242-9500 NO YES NO NO NO NO YES YES MAIL ONLY Harold Brown harold.brown Attn: Office of Child FORM Fax: (334) 242- 334-353-3477 @dhr.alabama. Protective Services INSTRUCTIONS 0939 or harold.brown gov 50 Ripley Street @dhr.alabama.g Montgomery, AL ov 36130 Alabama central registry website Kenneth Should include State of Alaska Saucier agencies cover Office of Children's ocsbackground letter or Photo ID Services AK FORM 06- scanned, Phone: (907) check@alaska. of Applicant. Alaska central Alaska APSIN Unit (Adam 9437 NO YES YES NO NO YES YES faxed, or 30 Days 269-4026 gov Must be signed registry website Walsh checks) mailed and include DOB, 323 East 4th Ave. Fax: (907) 269- SSN, and all Anchorage, AK 99501 4098 known aliases. Their registry is Tufa Avegalio local and not CFSD available online. American Tufanua You must e-mail Samoa Avegalio: the agency to tavegalio@dhs request the s.as form. Jermaine Arizona Department of Additional Moore-Tabron Child Safety For contacts: Jermaine.Moor employment/ Submit to Yvonne Santos eTabron@azds DCSCentralRegi Attn: AWA volunteer DCSCentralRegi Arizona AZ Form 1083a NO NO NO NO NO NO NO Phone: (602) c.gov [email protected] P.O. Box 6123, Site purposes, [email protected] 364-4255 Leticia Chavez Code CO 10-19 please use DCS- v in PDF form Arizona central leticia.chavez@ Phoenix, AZ 85005- 1083A form registry website azdcs.gov 6030 Arkansas Child Background and YES Phone: (501) ARAbuseNegle Maltreatment Central $10 or Fill the Reports Fact Along with Arkansas 682-0405 ctRecords@dhs Registry AR CENTRAL $11 using “Registry Sheet YES YES NO YES notarized YES YES 30 days .arkansas.gov P.O. Box 1437, Slot S REGISTRY FORM the online Check Form” authorization Fax: (501) 682- 566 portal and email Arkansas central form 0407 Little Rock, AR 72203 registry website Updated on 06/22/2021 California Department Phone: (916) of Justice Must be 210-4092 CA FORM BCIA California CACI- Attn: Bureau of typewritten, California 4057 central registry [email protected] Criminal Information & NO NO NO YES $15 NO NO NO please see 30 days Fax: 916-227- website .gov Analysis CACI instructions on 6364 CA Instructions P.O. Box 903387 the form Sacramento, CA 94203- 3870 Background Investigation Unit Background Shauna Sayer Division of Early Care Inquiry Colorado and Learning, CDHS Colorado central Checks: cdhs_o CO Form NO YES NO YES $35 NO YES YES Mail 4-8 weeks Phone: (303) registry website ec_background 866-4694 1575 Sherman Street, investigation@ Garden Level Denver, state.co.us CO 80203-1714 Department of Use form DCF- Completed Children and Families 3031 for: letters should Lisa Daymonde Avg:1-2 Care Line Use Form DCF- Daycare, be faxed to: weeks, Connecticut DCF.Backgroun 3033 for Employment, 860-560-7071, Connecticut Email: NO NO NO NO NO YES YES can take central registry [email protected] Attn: Background Adoption and Internship, or emailed: Lisa.Daymonde up to 4 website Check Unit Foster Care Mentor, DCF.Backgroun @ct.gov weeks 505 Hudson Street Volunteer, [email protected] Hartford, CT 06106 Other v Beth Kramer OCCL, Criminal History Delaware Email: Unit central beth.kramer@ beth.kramer@ Attn: Concord Plaza, Through the Delaware Delaware Portal NO YES YES YES $14 NO NO YES 15 days registry/backgro delaware.gov delaware.gov Hagley Building portal und check FAQ Phone: (302) 3411 Silverside Road 739-5884 Wilmington, DE 19810 Delaware Portal Attn: CFSA Child Protection Register YES Phone: (202) [email protected] 30-45 DC Unit 200 I Street SE, DC Form YES YES YES NO NO YES YES Directions for Email FAQ's 727-8885 v days 3rd Floor Washington, employment DC 20003 ACCESS Central Mail Center Keycee P.O. Box 1770 hqw.fs.adamw Email Marshall Ocala, FL 34478-1770 alsh.requests@ Adam Walsh adamwalsh.req Florida DCF Headquarters NO NO YES NO NO NO YES YES myflfamilies.co Request Form- uests@myflfa Phone: (850) 1317 Winewood Blvd. m Fillable- LCPA's milies.com 487-6053 Building 1, Room 202 Tallahassee, Florida 32399-0700 Updated on 06/22/2021 For State/Governm ent agencies Child Protective seeking CPS Services Information Contact: Case history for System(Child Abuse YES Out-of-State CPS Magda Investigation/A Registry) Registry FAQ's Georgia Warner-Hulitt doption/Foster NO YES YES NO NO YES YES YES Email Screening and Links Phone: (404) Care ONLY, 2 Peachtree St, NW Request Form 463-7287 please submit Atlanta, GA 30303 your request to 18th Floor georgiaadamw alshcheck@dhs .ga.gov Bureau of Social https://dphss.g Phone: 671- Services uam.gov/conta 475-2653 or Administration ct-us-2/ 671- Department of Public NO Guam 475-2672 Health Submit request NO YES NO NO NO YES NO NO MAIL or EMAIL Contact: & Social Services on letterhead Linda.rodriguez Fax: 671-477- 194 Hernan Cortez @dphss.guam. 0500 Avenue gov Hagatna, Guam 69610 Department of Human Services Consent to How to Obtain Phone: 808- Child Welfare Services Release Hawaii 832-0609 Hawaii None to be Section Information Must be Background NO YES YES YES NO NO NO NO found 420 Waiakamilo Road, Form mailed Checks Fax: 808-832- Suite 300A 0628 Honolulu, Hawaii Instructions Hawaii's website 96817 Fernando Castro Email: [email protected] Idaho Department of Criminal daho.gov Health and Welfare History Unit crimhist@dhw. Criminal History Unit Consent Release Idaho central Idaho YES YES NO YES $20 NO NO YES Portal or follow Phone: (208) idaho.gov 1720 Westgate Drive, Form registry website instructions for 332-7990 Suite B Mail In Boise, Idaho 83704 Karla Kinzel Karla.kinzel@d hw.idaho.gov Gayle Hopper Department of Authorization Administrator Children and Family for Background Illinois central Meghan Green for the Illinois Services Checks for registry website Illinois lead worker for NO YES NO NO NO NO YES YES Mail or email DCFS, State 406 E. Monroe – Foster Care and the Production Central Station # 30 Adoption Control Unit – Register – Springfield, IL 62701 Updated on 06/22/2021 Gayle.Hopper Meghan.Green For programs @illinois.gov @illinois.gov NOT licensed by DCFS DCFS.689Backg round@illinois. gov Indiana New Letterhead 2018.docx out of state Linda Chagoya requests Iowa DHS Attn: Central 5-10 Email: dhsabuseregist information Abuse Registry, PO Box IA Form 460- Mail or secure business Iowa DHSAbuseRegis [email protected] NO YES NO NO NO NO YES YES 4826, Des Moines, IA 0643 email days, on [email protected] a.us out of state 50305 average a.us criminal history checks Scott Henricks For questions: $15 Director of Scott.Henricks DCF Child Email: Kansas @ks.gov Abuse/Neglect Central NO FEE DCF.CentralRe background Registry FOR [email protected] Kansas central Kansas OBI 1011 Form NO YES NO YES YES YES NO checks division For CPS History P.O Box 2637 STATE registry website checks: Topeka, KS 66601 AGENCIES. Fax and Mail Phone: 785- DCF.CentralReg Fax: 785-296-8609 MARK also accepted 296-3825 [email protected] EXEMPT Cabinet for Health and Family Kentucky central Services/Department registry website for Community Based Erika Bauford, CHFSDCCNBCP Services/Records NO FAQs on new Administrative @ky.gov Management Kentucky NO NO YES YES $10 NO YES YES Use the Portal online system Branch Branch KY Portal effective July 31 Manager 275 East Main Street, 2020 3E-G Frankfort, KY 40621 Phone: 502-564-3834 Fax: 502 564-9554 Louisiana department of Lori Miller Children and Dept. of dcfs.childprote website Children & Family Must use the Louisiana Phone: 225- ctiveservices.dc DCFSCANS NO NO NO YES $25 NO YES NO Services CANS system 342-9928 [email protected] DCFSCANS P.O. Box 3318 Baton Rouge, LA 70821 Phone: (207) State Bureau of NO – follow the Maine NO NO NO YES $15 YES YES YES Fax 15 Days Website 624-7240 Identification website Updated on 06/22/2021 info@informe. State House Station hyperlink and FAX: 207-287- org #42 follow 5282 Augusta, ME04333- instructions 0042 Physical Location: 45 Commerce Drive, Suite 1, Augusta Kevin Keegan Maryland Department Director of Human Services Resource Social Services website Development None to be Administration Maryland YES YES YES NO NO NO NO YES YES Mail Placement and found In-Home Services Instructions Support 311 W. Saratoga Maryland Form Services Street, Room 553 Baltimore, MD 21201 410-767-7910 Massachusetts Department of Fax to: 617- Scan/email to: Children and Families 748-2441 MA.CPS.CHECK Attn: Background Massachusetts Massachusetts MA Form YES YES YES NO NO YES YES YES Email 30 Days @MassMail.Sta Record Check Unit Website Questions: te.MA.US 2 Boylston Street, 5th 857-338-3030 Floor Boston MA 02111 Sarah Gorby Michigan Fingerprint Kelly Maltby Children's Protective Analyst – Department Services Program 517-582-3516 Manager – P.O. Box 30037 Form DHS 1929 Michigan central Michigan gorbys@michig YES YES YES NO NO NO YES YES Email or mail 10 days 517-284-9706 235 South Grand Ave., registry website an.gov maltbyk2@mic Suite 510 MDHHS-DCWL- higan.gov Lansing, Michigan OSCR@michiga 48909 n.gov DHSBackgroun Minnesota Minnesota dStudies@stat Department of Human Lori Steffan: central e.mn.us Services – Office of 651-478-8254 registry/backgro Inspector Minnesota Minnesota Form NO YES NO YES $20 NO YES YES Mail or email und check criminal.backgr General/Background Phone: 651- website ound.check@st Studies Division – PO 431-6625 ate.mn.us Box 64172 – St.