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Get Staff Exclusion List
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How to fill out the Staff Exclusion List online
Completing the Staff Exclusion List is an essential step for providers to ensure the safety of children in care programs. This guide offers clear, step-by-step instructions to help users accurately fill out the form online.
Follow the steps to complete the Staff Exclusion List online effectively.
- Click the ‘Get Form’ button to obtain the Staff Exclusion List and open it in your preferred editor.
- In Part 1, enter the applicant's information. This includes their last and first name, alien registration number (if applicable), social security number (if available), job title, and date of birth. Ensure that this section is completed accurately.
- Provide the program name and address, as well as the license or registration number of the facility.
- Move to Part 2, which requires the authorized person's information. Fill in their name, work email, facility/provider name, phone number, and the license or registration number.
- Once you have filled out all required fields, review the information for accuracy to ensure there are no errors.
- Finally, save your completed form. You can choose to download, print, or share it as needed.
Start completing documents online today to promote safety in your childcare programs.
The Staff Exclusion List (SEL) contains the names of individuals found responsible for serious or repeated acts of abuse and neglect in New York State. They are prohibited from being hired by any agency or provider under Justice Center jurisdiction.
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