(Revised 5/1/19 ML 3549)
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All applicants/providers and anyone age 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 as substitute caregivers are also subject to the state and nationwide background check requirement.
The applicant is responsible to complete the form and return to the County Social Service Agency. The form is reviewed for completion and is sent to the Aging Services Division for processing.
An electronic copy of this form may be obtained at http://www.nd.gov/eforms/.