Attachment 0002 - C-1 Packet Cover Sheet (Checklist).pdf

This document is a requirements checklist for Respite Care Provider applicants under IMCOM (Installation Management Command).

The checklist is organized into four categories of submission requirements. Section A covers core application and declaration documents, including the IMCOM Form 30 application, OF 306 Declaration for Federal Employment (with specific items 1, 8-13, 16, and 17a required), and DD Form 2981 for basic criminal history and statement of admission. Section B requires supporting personal and work history documents: a resume or application in contractor format detailing experience matching required qualifications, IMCOM Worksheet 29 for residency history, and U.S. Government Form I-9 for proof of citizenship or employment eligibility with supporting documents such as a passport or birth certificate. Section C mandates verifications and screenings including DA Form 5018-R for consent to release treatment information, IMCOM Worksheet 30A background check request checklist, and professional reference checks in contractor format requiring verification from at least two professional references. Section D specifies qualifications and mandatory training requirements: proof of education, license, or certification (such as degree, RN/LPN license, or CNA certificate); CPR certification from a course with hands-on skills assessment; and three training certificates—AT Level I, OPSEC, and iWATCH—all of which must be current and dated within the last 12 months.