Get Report Of Administrator Qualifications For Family Care Homes - Ncdhhs

Filling out the Report Of Administrator Qualifications For Family Care Homes is a crucial step for individuals seeking to manage family care homes in North Carolina. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently online.

Follow the steps to successfully complete the report online.

1. Click ‘Get Form’ button to access the Report Of Administrator Qualifications for Family Care Homes in the online editor.
2. Enter the facility's name in the designated field at the top of the form.
3. Provide your name and phone number, ensuring all information is accurate.
4. Fill in the address section with your street, city, state, zip code, and county.
5. Input your birth date and Social Security number in the respective fields, keeping in mind the voluntary nature of providing your Social Security number.
6. Indicate whether you or your partner are affiliated with any health and human services departments by checking 'Yes' or 'No'.
7. Circle your highest grade completed from the education section, and list the credit hours beyond high school if applicable.
8. Detail your work history, including employer names, addresses, job titles, supervisors, dates employed, number supervised, reasons for leaving, and duties performed for each job. (You may add additional employers as necessary.)
9. Provide your email address and fax number for communication purposes.
10. If applicable, list any completed on-the-job training programs approved by the Department of Health and Human Services.
11. Answer whether you have ever been convicted of offenses other than minor traffic violations and provide the required criminal background report.
12. List three references, including their full names, mailing addresses, and phone numbers, who can attest to your qualifications.
13. Attach copies of all required documents such as exam results, diplomas or certificates, reference letters, and criminal background report.
14. Review all entered information for accuracy before proceeding.
15. Sign and date the form, certifying that the provided information is true.
16. Once completed, you can save any changes made, and download, print, or share the form as needed.

Complete your Report Of Administrator Qualifications for Family Care Homes online today to ensure a smooth application process.