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 PLEASE COMPLETE THIS FORM FULLY INCOMPLETE APPLICATIONS WILL BE RETURNED Cdph Ca 2017

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hi I'm going to guide you through the CD pH 322 transmittal application for criminal record clearance form this information is required by the California Department of Public Health licensing and certification criminal background section to fulfill its obligations and following the guidelines for requesting Live Scan services for use by the Department of Justice for criminal record clearance this form is a one-page application that requires information about the individual applying for criminal record clearance licensee information and facility and/or agency information the California Health and Safety Code Division 2 chapter 2 section 1 to 65.5 to a B requirements for the licensed intermediate care facilities specifically ICF / DD ICF / DD h an ICF / DD in states that the criminal record clearance shall require the applicant to submit electronic fingerprint images and related information of the facility owners administrator or manager and any direct care staff or any other adu

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