Fingerprint Requirement for Background Check, FD-258 660-05-65-85

(Revised 1/1/20 ML 3572)

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All applicants/providers and anyone the age of 18 or over living in the foster facility, other than foster care recipients, are subject to mandatory state and nationwide background checks. Individuals who provide respite care in the facility of a provider or those acting substitute caregivers are also subject to the state and nationwide background check requirement.

Fingerprints need not be taken and a nationwide background check need not be made if an individual:

• Has resided continuously in this state for eleven years or since reaching age 18, whichever is less;
• Is on active United States military duty or has resided continuously in this state since receiving an honorable discharge; or
• Is excused from providing fingerprints under rules adopted by the Department.

The fee for fingerprinting is the responsibility of the individual. The individual is responsible to complete the fingerprint cards, in addition to SFN 466 and SFN 467, and return all three forms to the HCBS Case Manager. The forms are reviewed for completion and are sent to the Aging Service Division for processing.

Fingerprint cards can be completed at their local Police or Sheriff’s office or local Human Service Center. There is a small fee for fingerprinting services. The fee for fingerprinting is the responsibility of the applicant/provider.

Copies of this form can be obtained from the Aging Services Division Office by contacting the AFC Program Administrator.