N.J. Admin. Code § 8:43I-3.1

Current through Register Vol. 56, No. 21, November 4, 2024

Section 8:43I-3.1 - Application

(a) Each applicant for certification as a personal care assistant shall complete and submit an application/affidavit on a form provided by the Department which shall contain:

1. Personal demographic information containing the applicant's name, mailing address, date of birth, social security number, sex, telephone number and either:

i. The name of the person's employer if the applicant is employed by a health care facility performing duties as a personal care assistant or in a related position; or

ii. The name of the person's PCATCEP;

2. An attestation under oath that the person has not been convicted of any disqualifying offenses as defined by 8:43I-3.3;

3. The applicant's original and legal signature; and

4. The seal and signature of a notary public or other person authorized by law to administer oaths.

(b) Incomplete applications will not be accepted for processing, and will be returned to the applicant for completion. No criminal history record background checks will be released unless the Department is in receipt of a completed application.

(c) Upon receipt of a properly completed application, the Department will issue a written notice to the applicant indicating if the applicant is qualified for a conditional certification pursuant to 8:43I-3.5. Applicants shall present this notice to their employer or prospective employer.

N.J. Admin. Code § 8:43I-3.1