Free Ldss 3370 PDF Template

1. What is the LDSS-3370 form used for?

   The LDSS-3370 form is used for conducting a Statewide Central Register Database Check in New York State. It's mainly required for individuals applying for positions or roles where they will be in close contact with children, such as adoption, foster care, family and group family day care, among others. This check helps determine if an applicant or any household member has been involved in child abuse or maltreatment cases.

2. Who needs to complete the LDSS-3370 form?

   Any individual applying for roles or positions including adoption, foster care, or various child care providers must complete this form. Additionally, household members who are 18 years of age or older are also required to provide their information and signatures if the application is for adoption, foster care, and family or group family day care services.

3. How do you complete the agency information section of the form?

   Completing the agency information involves writing the three-digit agency code in the top left box, followed by the Resource ID (RID) or Child Care Facility System (CCFS) Number next to it, depending on your situation. The clearance category letter code is placed in the middle box. Provide the agency phone number for contact purposes. The rest of the section is filled with the agency's name, liaison (contact person), and address details.

4. What information is required in the applicant/household member area?

   All adults and children living in the household, whether related to the applicant or not, must be listed in this section of the form. This includes full legal names (last, first, and middle), any maiden names, aliases, or previous married names, their relationship to the applicant, gender, and date of birth. If there are no other household members, write "NONE" below the "Maiden/Alias" section.

5. What address history is needed on the LDSS-3370 form?

   Applicants must provide a 28-year address history for themselves and any household member who is 18 and older if the form is for adoption, foster care, and family and group family day care applications. For all other categories, only the applicant’s address history is necessary. Complete addresses including street name, city, and dates of residence are required. If there are gaps in the address history, supplemental pages should be attached, ensuring timelines are consecutive and accounted for.

6. Whose signatures are required on the LDSS-3370 form?

   The requirement for signatures varies based on the category: for adoption, foster care, and family and group family day care, signatures from the applicant and any household member over 18 are needed. For other categories, only the applicant’s signature is required. All provided signatures must match the names listed in the Applicant/Household Member Area of the form and be dated within the last six months.

7. How do you submit the LDSS-3370 form?

   Once completed and reviewed for accuracy and legibility, the LDSS-3370 form should be mailed to the Statewide Central Register’s specified address: P.O. Box 4480, Albany, N.Y. 12204-0480. Ensure that the form includes all necessary signatures and that a check for the applicable fee accompanies it if required by the category of your application.

8. How do you order a supply of LDSS-3370 forms?

   You can order more LDSS-3370 forms by accessing the OCFS-4627 Request for Forms and Publications either through the Intranet or Internet links provided in the instructions sheet. Complete the request form and mail it to the Office of Children and Family Services, Resource Distribution Center at the address given. If you have trouble accessing the forms online, an automated forms hotline is available for assistance.

9. Who can I contact for questions about completing the LDSS-3370 form?

   If you have questions or require further clarification on how to properly complete the LDSS-3370 form, you can contact the Statewide Central Register (SCR) at the phone number provided in the instructions: 518-474-5297. They can assist with any inquiries you may have regarding the completion and submission process of the form.

Filling out the LDSS-3370 form correctly is crucial for ensuring accurate and timely processing. However, individuals often make mistakes during this process. Here are seven common errors:

1. Not providing complete agency information. This includes inaccurately recording the three-digit agency code or not including the correct Resource I.D. (RID) or Child Care Facility System (CCFS) number, which is essential for identification and processing.
2. Illegible handwriting or unclear typing. All information should be easy to read. If the details are not legible, it could lead to inaccuracies in data entry and processing, causing delays.
3. Omitting details about all household members. It’s essential to list everyone in the household, including children and adults, whether they are related to the applicant or not, to assist in obtaining an accurate background check.
4. Incomplete address history. For certain categories like Adoption, Foster Care, and Family and Group Family Day Care, address history for the last 28 years is required for the applicant and household members aged 18 and above. Missing details or not covering the entire period can be a significant oversight.
5. Using PO Box numbers instead of complete addresses. Post Office Box numbers are not accepted; complete street addresses must be provided to ensure thorough checks.
6. Signature discrepancies. All signatures need to match the names recorded in the Applicant/Household Member Area. Signing with a different name or nickname can invalidate the form.
7. Not including a check for the required fee when applicable. Some categories require a fee, and forgetting to include the certified check, money order, or other accepted payment types can delay processing.

By avoiding these mistakes, individuals can improve the chances of their LDSS-3370 form being processed smoothly and efficiently. It’s always recommended to review the form multiple times and ensure all information is accurate and complete before submission.

Filling out the LDSS-3370 form can seem like a daunting task, especially when you're unsure about the other documents you might need to accompany it. Whether you're applying for a position that involves working with children, adopting, becoming a foster parent, or running a daycare, it's crucial to have all your documents in order. Let's dive into some of the key forms and documents often used alongside the LDSS-3370 form to make this process smoother and ensure you're fully prepared.

• OCFS-4627 Request for Forms and Publications: Before you can even submit the LDSS-3370, you may need to obtain it, along with other relevant forms. The OCFS-4627 serves this purpose, allowing agencies and individuals to request the necessary paperwork from New York State's Office of Children and Family Services.
• SCR Request for Information Form (OCFS-3909): This form is particularly useful for child-care providers and agencies looking to get detailed reports from the Statewide Central Register on a specific case or individual. It's an essential tool for those doing in-depth background checks or following up on specific concerns.
• Child Abuse Mandated Reporter Form (LDSS-2221A): When working in an environment with children, individuals are often required to report any suspicions of abuse or maltreatment. This form is designed for educators, healthcare professionals, and childcare providers to report such incidents officially.
• Medical Statement of Child in Child Care Form (OCFS-6001): For those running daycare facilities or in foster care or adoption processes, this form helps record the health status of a child under their care. It includes immunization history, allergies, and specific health needs, ensuring the child receives the proper care while in the facility or home.
• Authorization for Release of Information Form: Although not specific to the Office of Children and Family Services, this generic form allows for the release of personal information from previous employers, educational institutions, or other agencies. It is often necessary for comprehensive background checks associated with the LDSS-3370 form.

As you navigate the requirements for working with or caring for children in New York, it's essential to understand the relevance of each document or form you are required to fill out. By preparing these forms thoughtfully and accurately, you are taking an important step toward ensuring the safety and well-being of children under your care or within your organization. Remember, the goal is not just to complete paperwork but to uphold a commitment to creating safe environments for our children.

• The OCFS-4627 Request for Forms and Publications form is similar to the LDSS-3370 form as both are part of the New York State Office of Children and Family Services' administrative processes. The OCFS-4627 form is used for ordering a supply of forms, including the LDSS-3370, indicating a logistical connection in the procurement of necessary documentation for child welfare services.

• Employment background check forms utilized by various agencies share a resemblance with the LDSS-3370 form, as they both collect applicant's personal information and historical data to perform a check for any concerning records. However, the LDSS-3370 specifically checks the Statewide Central Register Database for child abuse or maltreatment reports, demonstrating its specialized purpose within the spectrum of background checks.

• The Fingerprint Consent Form used in many sectors for thorough background checks parallels the LDSS-3370 form in purpose—both aim to safeguard vulnerable populations by screening individuals’ backgrounds. While the LDSS-3370 form searches child abuse databases, fingerprint forms typically scan criminal databases, amplifying security measures from different angles.

• The Form I-9, Employment Eligibility Verification, though primarily used to verify the legal authorization to work in the United States, is similar to the LDSS-3370 form as it necessitates personal and identification information from individuals for verification purposes. Both forms serve as a means to legitimize an individual's eligibility for a specific role or benefit, be it employment or in the context of child care services.

• Adoption application forms compare to the LDSS-3370 as they both involve rigorous checks and the provision of detailed personal information. These applications assess suitability for adopting or fostering children, paralleling the LDSS-3370's purpose of ensuring the safety of children in care environments by screening for any history of abuse or maltreatment.

• The Child Care Program Licensing Application shares similarities with the LDSS-3370 form since both are integral to the process of evaluating the suitability of environments where children are cared for. Licensing applications evaluate the facility and provider qualifications, while the LDSS-3370 assesses the personal backgrounds of those involved in child care.

• Tenant screening applications are akin to the LDSS-3370 form in their collection of personal information, previous addresses, and the requirement for background checks. While their primary focus is on financial reliability and rental history, both forms ultimately aim to ensure the suitability of individuals for specific responsibilities or roles.

• Volunteer application forms for nonprofit organizations, especially those serving children or vulnerable populations, resemble the LDSS-3370 form. They both gather personal details and history to screen for any potential risks, ensuring the safety and well-being of those served by the organization.

• The Driver's License Application Form shares some procedural similarities with the LDSS-3370, as both require personal identification details and history for the purpose of a background check—though for markedly different reasons. The driver’s license application seeks to verify one's legal and safe ability to operate a vehicle, while the LDSS-3370 is concerned with child safety in care settings.

When it comes to filling out the LDSS-3370 form, whether you're a daycare provider, applying for foster care, adoption, or any other service that requires a background check through the Statewide Central Register Database Check, accuracy and attention to detail are paramount. To ensure your form is processed smoothly and without unnecessary delay, here are five dos and don'ts to keep in mind:

• Do ensure all information is legible and complete. The form mandates clarity in all entries to facilitate accurate data entry and results.
• Do use the correct codes and classifications for your agency and the type of application you're submitting, such as the three-digit agency code and the appropriate clearance category letter code.
• Do provide a comprehensive address history for the required period (last 28 years for most categories), including full street names and cities, without leaving any gaps in the timeline.
• Do include all household members on the form, detailing their relationship to the applicant, full names, gender, and date of birth, regardless of their relation or lack thereof.
• Do ensure that all signatures correspond to the names provided in the Applicant/Household Member Area and are dated correctly, recognizing that the form will not be accepted if the signatures are older than six months.

• Don't use abbreviations or incomplete addresses; the form requires the full name of the agency, full street addresses, and no P.O. Box numbers.
• Don't forget to include additional pages if you run out of space on the form for address histories or listing all household members. However, do not use another LDSS-3370 form for this additional information.
• Don't leave any sections blank that are applicable to your situation. If a section does not apply, clearly mark it as “NONE” to indicate it was not overlooked.
• Don't send the form without reviewing it for completeness and legibility. Incomplete or illegible forms will be returned, causing delays in processing.
• Don't overlook the payment requirements if applicable to your category. When a fee is required, include the correct amount and ensure the payment is made out accurately to the New York State Office of Children and Family Services.

Adhering to these guidelines will facilitate a smoother processing experience and help avoid delays or the inconvenience of having to correct and resubmit your LDSS-3370 form. Always double-check with the guidelines provided by the Office of Children and Family Services or the specific requirements listed on the form's instructions to ensure compliance with the latest regulations.

When discussing the LDSS-3370 form, several misconceptions can lead to confusion and mistakes. Below are seven common misconceptions about the form and clarifications to help ensure it is filled out accurately and effectively.

• Only the applicant needs to provide personal information.
  

  This is incorrect. The form requires information on all household members, including children and adults, related or not related to the applicant. This comprehensive data collection helps in obtaining an accurate response from the Statewide Central Register.

• Post Office boxes are acceptable for the address section.
  

  Actually, complete street addresses are mandatory. The form specifies that P.O. Box numbers are not acceptable, requiring street name, number, and apartment number if applicable, to ensure precise location information.

• Signature dates on the form are not significant.
  

  Contrary to this belief, the form stipulates that the SCR will not accept a form if a signature date is more than 6 months old, underlining the importance of up-to-date information and recent acknowledgment from the individuals involved.

• Any household member can serve as the agency liaison.
  

  This section must be filled out by a person external to the applicant’s immediate circle, as the liaison cannot be the applicant or a relative of the applicant. This rule ensures impartiality and prevents conflicts of interest.

• There’s no need to list every address for the past 28 years if applying for certain categories.
  

  Incorrect. For Adoption, Foster Care, and Family and Group Family Day Care applications, it's essential to list addresses for the last 28 years for the applicant and household members 18 years or older. For all other categories, this detailed history is only required for the applicant.

• The form is solely for the use of daycare providers.
  

  The LDSS-3370 form serves a broader purpose, catering to a variety of roles beyond daycare providers, including but not limited to prospective employees, foster care, and adoption applicants. Each category has specified requirements on the form.

• A digital version of the signature is acceptable.
  

  All signatures on the LDSS-3370 must correspond to the names recorded in the Applicant/Household Member Area, implying the necessity for handwritten, original signatures rather than digital ones to authenticate the document accurately.

Recognizing these misconceptions is the first step towards completing the LDSS-3370 form correctly, ensuring that all the required information is accurately presented and in compliance with New York State's Office of Children and Family Services guidelines.

Filling out the LDSS-3370 form correctly entails understanding and adhering to specified instructions to ensure accurate processing by the Statewide Central Register (SCR). Here are key takeaways that should be kept in mind:

• All information provided on the LDSS-3370 form must be legible and complete. This ensures that the data can be accurately entered into the system, allowing for correct results. The person filling out the form should double-check for any incomplete or unclear sections as these errors lead to the form being returned for corrections.
• The form requires detailed personal information not only about the applicant but also about all household members, regardless of their relation to the applicant. This includes full legal names, maiden names if applicable, aliases, relationship to the applicant, gender, and complete date of birth. Including comprehensive information assists in obtaining an accurate and thorough background check from the database.
• Address history is vital and must be meticulously recorded to cover the previous 28 years. For categories such as Adoption, Foster Care, and Family and Group Family Day Care, this requirement extends to all household members who are 18 years old and above. Accurately listing all past addresses without leaving any gaps ensures proper scrutiny during the background check process. Physical addresses are required; P.O. Box numbers are not acceptable.
• Understanding and properly filling out the section on the type of application (clearance category) and accompanying fees is crucial. Depending on the purpose of the background check—such as employment in a daycare, foster care application, or volunteer work—different sections of the form will apply, and different fees may be required. Correctly identifying the clearance category and including the correct fee (if applicable) ensures that the application is processed for the correct type of check without unnecessary delays.

By carefully following these guidelines, applicants can aid in the efficient processing of their LDSS-3370 form, facilitating a smoother path towards employment, volunteering, or caregiving roles within sensitive environments like child care. Remember, accuracy and thoroughness are key to successfully completing and using the LDSS-3370 form.