AGING AND DISABILITY SERVICES ADMINISTRATION

2006 AFH "Dear Provider" Letters

November 30, 2006

ADSA: AFH #2006-011
BACKGROUND AUTHORIZATIONS SUBMITTED BY MAIL

Dear Adult Family Home Provider:

This letter contains information for providers who submit Background Authorization (DSHS 09-653) forms to the Background Check Central Unit (BCCU) by mail.

Effective January 1, 2007, you must:

• Mail a copy of the completed form to the BCCU for processing; and
• Retain the original in your home.

You may begin mailing copies of the completed forms to the BCCU immediately.

Effective January 1, 2007, the BCCU will:

• Begin using a document imaging system to process background checks; and
• Image and shred the hard copy of the forms received by mail.
• Continue to mail the results letter to you.

If you currently fax requests for background checks:

• The process remains unchanged and results letters will continue to be faxed to you.

If you opt to begin submitting requests via fax, you must provide your current fax number to:

Business Analysis and Applications Unit
PO Box 45600
Olympia, WA 98504-5600
FAX: (360) 725-2645

DO NOT mail or FAX the completed forms to the contact listed above. This is only for the purposes of supplying a FAX number. Submit all background authorization forms to:

Background Check Central Unit
PO Box 45025
Olympia, WA 98504-5025
FAX: (360) 902-0292

Please contact your RCS Field Manager if you have any questions regarding this letter.

Sincerely,

Joyce Pashley Stockwell, Director
Residential Care Services

cc: DSHS Background Check Central Unit (BCCU)
RCS Business Analysis and Applications Unit