Caregiver background checks are to be completed by a regulated facility/entity on their employees and contractors. This includes employees who provide direct care and may also include housekeeping, maintenance, dietary and administrative staff, if those persons are under the entity's control and have regular, direct contact with clients served by the entity.
Background Check Process
As the license holder/legal representative you must do the following:
- Have the employee or contractor complete a Background Information Disclosure (BID), F-82064.
- Review Wisconsin Department of Justice (DOJ), Background Check & Criminal History Information and complete a Wisconsin Criminal History Record Request by using either:
Mark "Caregiver-General" under Request Purpose. Mail completed form along with appropriate fee payable to "Department of Justice" and self-addressed stamped envelope to:
Crime Information Bureau
Attn: Record Check Unit
PO Box 2688
Madison, WI 53701-2688
If you have an account with DOJ, you may request this information using the Wisconsin Online Record Check System.
Please do not submit forms for your employees to the Division of Quality Assurance (DQA).
Keep on File
A complete caregiver background check consists of the following documents:
- A Background Information Disclosure (BID), F-82064.
- A response from the Department of Justice (DOJ) Wisconsin Criminal History Record Request, either a "no record found" response or a criminal record transcript.
- A "Response to Caregiver Background Check" letter from the Department of Health Services (DHS) that reports the person's administrative finding or licensing restriction status.
These three items are to be retained with the employee's records and to be made available when requested by DQA staff for survey purposes.
Other documentation must be obtained by the entity when information is needed to complete the background check, such as other state's conviction records, military discharge papers, arrest and conviction disposition information from local clerks of courts or tribal courts, etc.
For more detailed information, see Chapter 2 of the Wisconsin Caregiver Program Manual, P-00038 (PDF).