Downloading a Form to Your Computer

  1. Right Click for PC or Ctrl + Click for Mac on the PDF link and click “Save link as” from the menu.
  2. Select the folder you want to save the file in and then click "Save."
  3. Navigate to the folder you saved the file in and Right Click for PC or Ctrl + Click for Mac, then select "Open With" from the menu and select Adobe Acrobat Reader DC.

    Note: Open the PDF file from your desktop or Adobe Acrobat Reader DC application. Do not click on the downloaded file at the bottom of the browser since it will not open the PDF in Adobe Acrobat Reader DC. It will try to open the file in the browser that results in the same browser error message.

    If still having trouble viewing or downloading a form, click here.

Effective Date: 
10/2019

Documents

 

Instructions

Updated: 1/2019

 

Purpose

This form is used to request a background check.

Procedure

When to Prepare When must I complete the background check request?

Each person at your operation who is required to have a background check must complete all required background checks prior to having direct access or providing direct care to the children in care.

How does a child care operation submit a background check request?

If your operation is a licensed child care center, school-age program, before- or after-school program, licensed child care home, registered home or residential care provider, your operation must submit your background check requests via the internet.

If your operation is a listed family home, employer-based child care operation or shelter operation, your operation may submit your background check requests via the internet, email the form to CBCUbackgroundchecks@dfps.state.tx.us, fax the background check request form to 512-339-5871, or mail the background check form to:

Texas Health and Human Services
Commission Centralized Background Check Unit
P.O. Box 149030, Mail Code 121-7
Austin, TX 78714-9030

Transmittal and Fee

Submit background check requests to: dfps.state.tx.us/Child_Care/Search_Texas_Child_Care/ppFacilityLogin.asp.

Is there a fee for processing background check requests?

Yes. You must pay a $2 fee for each person listed on this form or submitted via the internet. Submit the appropriate Fee Schedule for your operation, along with the fee(s), to:

Texas Health and Human Services Commission
Accounts Receivable
P.O. Box 149055
Austin, TX 78714-9055

Failure to submit fee payments can result in adverse action including suspension or revocation.

If a fingerprint check is required, a separate fee for obtaining a fingerprint check must be paid to the DPS Fingerprinting Service Center for each person obtaining a fingerprint check at the time of the fingerprinting appointment.

For information on that fee and scheduling a fingerprint-based check, see the Centralized Background Check Unit Fingerprinting page at https://hhs.texas.gov/doing-business-hhs/provider-portals/protective-services-providers/child-care-licensing/child-care-licensing-background-checks/fingerprinting.