5-Tier 1 CNACI Child Care Checklist.pdf

This document is a Background Investigation form from the Oklahoma City Area Indian Health Service. The form requires employees to disclose all states they have lived and/or worked in during the past 7 years, with a comprehensive checklist of 37 states including Alabama, Alaska, California, Texas, New York, and others. The form provides a checkbox list for employees to mark their state residency and work history, along with a signature and date line for verification. Employees can also check a box if they have not lived or worked in any of the listed states during the specified 7-year period.