BAS-02

Staff training, experience, and personal qualifications The following staff members has expired on-going health and safety training immediately:<br/> <br/> XXXXX - Has 1 out of 16 hours. Training period expired 09/04/2025.<br/> XXXXX - Has 0 out of 16 hours. Training period expired 10/29/2025.<br/> XXXXX - Has 0 out of 16 hours. Training period expired 10/28/2025.<br/> <br/> The following must complete the initial health and safety assessment:<br/> <br/> XXXXX<br/> <br/> Please provide all training certificates and initial health and safety assessments to People Attentive to Children (PATCH) for processing. Once PATCH has verified, processed the certificates, and updated everyone's hours and assessments, this requirement will be satisfied.<br/>

17-896-16 · Correction status not published

BAS-02

Employment history check Please have XXXXX complete the DHS 959A Self-Certification of Employment and the DHS 959 Employment History Clearance forms and provide them to the Worker for review.<br/> <br/> Employment History Instructions:<br/> <br/> Required individuals shall complete the form DHS 959A "Self Certification of Employment" and list the places of employment within the past three (3) years including periods of unemployment, self-employment, and periods of school attendance. For every place of employment listed, complete and sign Part I of the DHS 959 "Employment History Clearance Form" (EHC) and have the former and/or current employer complete and sign part II.<br/> <br/> Please complete the following information on the form DHS 959A: Date EHC mailed and Date EHC returned. Keep copies of all forms mailed out to former employers. If EHC forms are not returned after the first try, mail out the copy again and log the 2nd date mailed. If forms are not returned after the second try, we will accept the self-certification.<br/> <br/> Please visit the following for the required forms:<br/> http://humanservices.hawaii.gov/bessd/child-care-program/child-care-licensing/child-care-center-Licensing-forms/<br/>