Page 495

468 10. A copy of professional licenses and/or certification such as a Registered Nurse license, Physician’s license, Certified Nurse Aid certification, etc.; 11. A copy of the Barrier determination or Revocation notice issued to the individual by the BCP or department identifying the barring crime and/or condition; 12. An explanation of how the individual and/or provider intend to ensure the health, safety, and welfare of recipients of services will be adequately protected. This may include plans for supervision, prohibition of certain duties within the entity, etc.;and 13. A comprehensive rationale for why the department should grant the variance. This may include an additional applicant’s statement, explanation why the provider believes the applicant should be placed in or continue in their position, etc. 4290-1 B. ACTIONS ON A BACKGROUND CHECK VARIANCE REQUEST APPLICATION All complete Background Check Variance Request Applications are reviewed by the CCPO Eligibility and Benefits Unit Public Assistance Analyst (PAA) II or PC II and the Department of Health (DOH) Variance Review Committee. A determination of complete or incomplete must be made within thirty (30) calendar days of the date the Background Check Variance Request Application is date stamped received. 1. Incomplete Background Check Variance Request Application Within two (2) business days of receipt, the Designee will review the Background Check Variance Application for completeness. When information is missing, an Incomplete Background Check Variance Application letter, identifying all missing information, is issued to the person initiating the request, either the individual or provider, and sent by regular mail. The individual must be given at least thirty (30) calendar days to provide the needed information. The Designee must assist the individual and/or provider with understanding the process, timeframes, or required documentation needed. The Designee will contact the applicant by telephone if no contact has been received from the individual/provider or documentation