Addendum to Declaration for Federal Employment
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A PDF document (75 KB) attached to Nurse Practitioner - Ute Mountain Ute Health Center - Towaoc, CO, from the Indian Health Service. Due Nov 6, 2026, 5:00 PM (UTC-7).
File name: OF-306 - Addendum to Declaration for Federal Employment.pdf
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OMB Approved
Form No. 0917-0028
Expiration Date: 04/30/2025
Addendum to Declaration for Federal Employment (OF 306) Indian Health Service
Child Care & Indian Child Care Worker Positions
===================================================================== Item 16. Agency Specific Questions
(Please print)
Section 231 of the Crime Control Act of 1990, Public Law (Pub. L.) 101-647, requires employment applications for individuals seeking employment in a position involved with the provision to children under the age of 18 of “child care services,” as defined in 42 U.S.C. § 13041(a)(2), contain a question asking whether the individual has ever been arrested for or charged with a crime involving a child and for the disposition of the arrest or charge. Under 42 U.S.C. § 13041(a)(2), the term "child care services" means child protective services (including the investigation of child abuse and neglect reports), social services, health and mental health care, child (day) care, education (whether or not directly involved in teaching), foster care, residential care, recreational or rehabilitative programs, and detention, correctional, or treatment services. Individuals hired for such positions must undergo a criminal history background check. Section 408 of the Indian Child Protection and Family Violence Prevention Act, Pub. L. 101-630, contains a related requirement for positions in the Department of Health and Human Services that involve regular contact with or control over Indian children. The agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes. The law requires the agency conduct an investigation of the character of each individual who is being considered for employment in such a position and prescribe in regulations the “minimum standards of character” that must be met in order for an individual to fill such a position. The regulations specify that “[t]he minimum standards of character shall be considered met only after the individual has been the subject of a satisfactory background investigation,” which includes a criminal history background check. 42 C.F.R. § 136.406.
To assure compliance with the above laws, the following questions are added to the Declaration for Federal Employment:
1.
Have you ever been arrested for or charged with a crime involving a child? [If “YES”, provide the date, explanation of the violation, disposition of the arrest or
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