Mississippi Administrative Code
Title 18 - HUMAN SERVICES
Part 7 - Division of Family & Children Services Licensing Requirements
Chapter 1 - Licensing Requirements Manual for Residential Child Caring and Child Placing Agencies
Section 18-7-1-XIX - APPENDIX
Child Abuse Central Registry Check

Purpose

This form provides information to the Child Abuse Central Registry to request a check for prior substantiated abuse/neglect reports regarding applicants for foster parents, adoptive parents, or employees of residential child care facilities, child placing agencies, or day care centers.

Instructions

All requests for Child Abuse Central Registry Checks should be submitted in the enclosed format. This standards example form includes all of the necessary information and authorization to process a background check through the Department Child Abuse/ Neglect Central Registry.

The enclosed example should be used by all agencies and child caring facilities, excluding The Department employees, when making a request for a background check of the Central Registry. All agencies and child caring facilities should use that enclosed example format in its entirety, on your agency's official letterhead to request background checks. All Central Registry requests received without the requested information and authorization will be returned unprocessed to the requesting entity.

Submit the form to Mississippi Department of Human Services, Division of Family & Children Services. The bottom section will be completed by Protection Department staff and will be returned to the sending agency. If you have questions regarding this form you may contact the Department's Central Registry at 601-359-4487.

Please be advised that you must provide a self addressed stamped envelope or your central registry request will not be processed.