Attachment F - OP-35-A_Background_Check_Fingerprinting_Procedures.pdf

OFFICE OF MANAGEMENT INFORMATION SERVICES

DHHR OMIS OP-35-A

Revised February 10, 2025

CONTRACTOR BACKGROUND CHECK AND FINGERPRINTING PROCEDURES

In accordance with WV State Code 15-2D-3, the Director of the Division of Protective Services (DPS) requires any service provider or contractor whose employees are regularly employed on the grounds or in the buildings of the Capitol complex (this includes any State office building) or who have access to sensitive or critical information, to submit to a fingerprint-based state and federal background inquiry through the State repository.

WVDPS Form 12-26 must be completed as instructed and returned to the WVDPS before fingerprints are submitted to IdentoGo.

IdentoGo conducts the checks on behalf of the State of WV and can be found online at: https://www.identogo.com/locations/west-virginia or by calling 1 (855) 766-7746.

Service providers and their employees who are not current residents of the State of West Virginia are required to complete state and federal fingerprint-based background checks at their own expense. The results of state and federal background checks will be returned to and stored by the DPS and will be treated as confidential. According to federal law, any unfavorable results will only be shared by the DPS with the individual whose check results in a rejection of employment.

IdentoGo offers applicants multiple methods for fingerprinting:

• Live Scan Fingerprinting at location nearest the individual

• On-site fingerprinting for groups of 25 or more requires 2 weeks’ notice to set up these special print sessions.

• Individuals who do not have access to a scanning location will need to get a hard card print.

Fingerprint cards must be sent to the following address:

IDENTOGO

CARDSCAN DEPARTMENT

6840 CAROTHERS DRIVE STE 650

FRANKLIN, TN 37067-9929

Individuals will need to include the WV Service Code for Division of Protective Services (located on the WV Service Code Form). Note: It may take several weeks for DPS to receive these backgrounds.

Attachment F https://www.identogo.com/locations/west-virginia

ATTACHMENT A - DHHR OMIS OP-35

Revised September 25, 2024

IdentoGo accepts the following methods of payment:

• Prepayment options: e-check and credit card (Visa and MasterCard);

• Onsite payment options: personal check, credit card (Visa and MasterCard) and money order, escrow and invoice accounts;

• Account options: prepaid or credit billing accounts for private agencies and employers, credit billing accounts for governmental agencies are available.

Should vendors and/or contractors conduct fingerprint-based background checks for their employees and have results within the past three years, a list of authorized staff assigned to a project may be submitted identifying their corresponding state and federal results as favorable or unfavorable to the DHHR contact shown below.

OMIS Director of Compliance and Reporting Employee Record Check Department of Health and Human Resources Office of Management Information Services 321 Capitol Street, Suite 200 One Davis Square Charleston, WV 25301 Individual Background and Fingerprint Check Instructions:

1. Complete the following sections of the WV Division of Protective Services Form 12-26:

a. Check the Background Inquiry Box

b. Name (Last, First, MI)

c. Address (Home)

d. Phone (Home or Cell)

e. Agency Awarding Contract/Contact Name/Phone (Refers to the State of WV employer)

f. Company Name/Contact Name/Business Phone

g. Type of Work (Identify as IT)

h. Building # (if working onsite identify specific location; if working remotely, put remote)

i. Applicant’s Signature (Can be written or electronic)

Attached to this procedure are the WVDPS Form 12-26, the Privacy Act Statement, and the IdentoGo Service Code Form. These documents must be given to the applicant prior to being fingerprinted. The

ATTACHMENT A - DHHR OMIS OP-35

Revised September 25, 2024

WVDPS Form 12-26 must be completed and received by the Division of Protective Services prior to approval of any background information.

Vendor applicants must make an appointment by calling the toll-free number 1 (855) 766-7746 or registering online at www.identogo.com.

Large groups can be accommodated, but prior arrangements must be made with IdentoGo. The web site lists multiple locations across the United States for fingerprinting. Payment must be received at the time of fingerprinting and the fee is the responsibility of the vendor or contractor holding the contract.

Prepayment is available once an account with IdentoGo has been set up.

All background checks must be WV state and federal fingerprint-based checks to be acceptable.

http://www.identogo.com/

WVDPS FORM 12-26 Revised 5/2019

DIVISION OF PROTECTIVE SERVICES CAPITOL POLICE

STATE OF WEST VIRGINIA

ACCESS CARD/ID BADGE/BACKGROUND INQUIRY

REQUEST FORM

Access Card Number

Contractor/Vendor Press

Background Inquiry Access Card ID Badge Expiration: _______________________ Photo attached (contractors only)

Modification Cancel Card Card Returned Card not returned

Please report lost or stolen access cards/ID Badges immediately to the Division of Protective Services access card coordinator at 558-4443, or the main office at 558-9911. Replacement cost for a lost or stolen access card or ID Badge is $10.00 (cash, money order, or check payable to Division of Protective Services). Email forms with photos to: margaret.m.cash@cappd.wvsp.gov

Please print the following personal information:

Name: (Last, First, M.)

Mailing Address:

Home Phone: Cellular Phone: Date of Birth:

A g e n c y A w a r d i n g C o n t r a c t/C o n t a c t N a m e/P h o n e :

Company Name/Contact Name/Business Phone:

Type of Work: Building # Work Area:

Driver’s License Number/State:

Vehicle Information:

Year Make Model Color Vehicle License Number

Person to contact in case of an emergency:

Relationship: Phone Number:

Building Access Requested

B u i l d i n g : 0 1 0 3 0 4 0 5 0 6 0 7 0 9 1 0 1 1 1 5 1 6 1 7 2 0 2 1 2 2 2 3 2 4 2 5 2 7 3 2 33 34 36 37 53 54 74 84 86 88 97 Plaza East DNR Forks of Coal DOH Weston DOH Dry Branch Economic Development

Access Time Requested: Public Hours M-F Extended Business Hours (530am- 7:30pm) M-F Extended Business Hours (530am- 7:30pm) M-SSH 24/7 Access needed on: Saturdays Sundays Holidays Access needed in other Buildings: Yes No If yes, which buildings:____________________

Agency Access Card Coordinator Signature Date Requesting Agency Phone Number

Applicant Background Inquiry

Pursuant to West Virginia Code 15-2D-3 (e), service providers, such as vendors or contractors, whose employees are regularly employed on the grounds or in the buildings of the Capitol complex, or who have access to sensitive or critical information, are required to submit to a fingerprint based criminal history investigation completed by both the West Virginia State Police and Federal Bureau of Investigation. Privacy Act Statement Attached.

Applicants are required to complete this application and forward the same to the Division of Protective Services before fingerprints are submitted at IdentoGo (Idemia). Applicants have the opportunity to complete or challenge the accuracy contained in the FBI identification record. The procedures for obtaining a change, correction, or updating of your FBI criminal history record are set forth in Title 28, Code of Federal Regulations (CFR), Section 16.34.

Applicant’s Signature:

mailto:margaret.m.cash@cappd.wvsp.gov

NONCRIMINAL JUSTICE APPLICANT’S PRIVACY RIGHTS

As an applicant who is the subject of a national fingerprint-based criminal history record check for a noncriminal justice purpose (such as an application for employment or a license, an immigration or naturalization matter, security clearance, or adoption), you have certain rights which are discussed below. All notices must be provided to you in writing. 1 These obligations are pursuant to the Privacy Act of 1974, Title 5, United States Code (U.S.C.) Section 552a, and Title 28

Code of Federal Regulations (CFR), 50.12, among other authorities.

• You must be provided an adequate written FBI Privacy Act Statement (dated 2013 or later) when you submit your fingerprints and associated personal information. This

Privacy Act Statement must explain the authority for collecting your fingerprints and associated information and whether your fingerprints and associated information will be searched, shared, or retained. 2

• You must be advised in writing of the procedures for obtaining a change, correction, or update of your FBI criminal history record as set forth at 28 CFR 16.34.

• You must be provided the opportunity to complete or challenge the accuracy of the information in your FBI criminal history record (if you have such a record).

• If you have a criminal history record, you should be afforded a reasonable amount of time to correct or complete the record (or decline to do so) before the officials deny you the employment, license, or other benefit based on information in the FBI criminal history record.

• If agency policy permits, the officials may provide you with a copy of your FBI criminal history record for review and possible challenge. If agency policy does not permit it to provide you a copy of the record, you may obtain a copy of the record by submitting fingerprints and a fee to the FBI. Information regarding this process may be obtained at https://www.fbi.gov/services/cjis/identity-history-summary-checks and https://www.edo.cjis.gov.

• If you decide to challenge the accuracy or completeness of your FBI criminal history record, you should send your challenge to the agency that contributed the questioned information to the FBI. Alternatively, you may send your challenge directly to the FBI by submitting a request via https://www.edo.cjis.gov. The FBI will then forward your challenge to the agency that contributed the questioned information and request the agency to verify or correct the challenged entry. Upon receipt of an official communication from that agency, the FBI will make any necessary changes/corrections to your record in accordance with the information supplied by that agency. (See 28 CFR 16.30 through 16.34.)

• You have the right to expect that officials receiving the results of the criminal history record check will use it only for authorized purposes and will not retain or disseminate it in violation of federal statute, regulation or executive order, or rule, procedure or standard established by the National Crime Prevention and Privacy Compact Council.3

1 Written notification includes electronic notification, but excludes oral notification.

2 https://www.fbi.gov/services/cjis/compact-council/privacy-act-statement

3 See 5 U.S.C. 552a(b); 28 U.S.C. 534(b); 34 U.S.C. § 40316 (formerly cited as 42 U.S.C. § 14616), Article IV(c);

28 CFR 20.21(c), 20.33(d) and 906.2(d).

Updated 11/6/2019 https://www.fbi.gov/services/cjis/identity-history-summary-checks https://www.fbi.gov/services/cjis/identity-history-summary-checks https://www.edo.cjis.gov/ https://www.edo.cjis.gov/ https://the/ https://www.fbi.gov/services/cjis/compact-council/privacy-act-statement

WV Division of Protective Services Use Only

Fingerprint Service Code Form

Please bring one of the identification documents from the list below to your enrollment appointment.

Driver's License issued by a State or outlying possession of the U.S.

Driver's License PERMIT issued by a State or outlying possession of the U.S.

State ID Card (or outlying possession of the U.S.) with a seal or logo from State or State Agency Federal ID Card with a seal or logo from a Federal agency Government ID Card with a seal or logo from local government agency Commercial Driver's License issued by a State or outlying possession of the U.S.

Department of Defense Common Access Card Employment Authorization Card/ Document (I-766) with Photo Foreign Driver's License (Mexico and Canada only) Foreign passport Military Dependent's Identification Card Permanent Resident Card / Green Card (I-551) Merchant Mariner Card (MMD) Military ID Card Passport Book or Card Enhanced Tribal Card (ETC) Visa Uniformed Services Identification Card (Form DD-1172-2)

Service Name: Division of Protective Services

To Schedule your ten-minute fingerprint appointment, simply visit https://uenroll.identogo.com and enter the following Service Code

228NXJ

Service Code is unique to your hiring/licensing agency. Do not use this code for another purpose.

Don’t have access to the Internet? You can still schedule an appointment by calling 855-766-7746 http://www.identogo.com/ https://uenroll.identogo.com/