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WSRCC
523 Pear Street SE
Olympia, WA 98501
Contact Us:
wsrcc@wsrcc.org
Phone: 1-888-439-8999 360-754-3329
Fax: 1-360-943-6653
Office Staff: Heather Souve heather@wsrcc.org
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Criminal Background Inquiry Authorization
Again WSRCC does the committee work to ensure the
new criminal background inquiry (CBI) authorization form works with
the adult family home program. The “business as usual” union was not
even in the room this past summer. The document attached is finally
being published by DSHS.
Last time that DSHS changed the CBI there was up to a 3 month delay
until providers from WSRCC met with DSHS officials and brought the
issue to the AFH Advisory Committee. Only our provider
representatives worked to ensure the new forms worked with over 15
other DSHS programs throughout the state to facilitate the new
changes. This form is available for use now. This form will soon be
required for all adult family homes.
Changes have been made to simplify the criminal background
authorization form for adult family home providers. Attached you
will find the new form that can be filled out on the screen and then
faxed to DSHS – 360-902-0292.
Please note the new instructions and
changes to this form.
Of particular note:
1. Nothing has to be completed under Question 3 for an adult
family homes
2. Remember to enter the “A” followed by the home’s license number
for Question 4
3. The word “same” may be appropriate for Question 8 B ---
not the same “name” printed again
4. Previous address on Question 17 B is not necessary for the
adult family home program
5. A phone number is not required for Question 17 C for the
adult family home program
I have also attached the announcement for the improved list for
Crimes and Negative Actions as interpreted by DSHS. Again, we all
need to thank those adult family home volunteers who helped with
this project.
Thank you,
Aaron R. Mountain
Past President
WSRCC
Crimes List Announcement CBI 2008
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