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Click here or scroll down to respond to this candidateCandidate's Name
Care AdministrationBackground Screening ResultProvider Name:Printed by: Jennifer DouvierLicense Number:This individual's eligibility status as of 5/23/2024 is provided below. The employer must retain a hard copy of this result in the individuals employee file. If we become aware of a change in an individuals eligibility status, an email notification will be sent to the most recent employer of record in the Clearinghouse or the last provider to submit a screening request through the Clearinghouse. It is recommended health care and/or service provider employers check the screening results of staff regularly as an individuals status may change based on information received. If you become aware of an event that may change the employees eligibility please contact your specified Candidate's Name Care Administration, at PHONE NUMBER AVAILABLE The employer must take the appropriate action when a change in status occurs in accordance with Section 435.06, Florida Statutes. Applicant Name: SSN: Date of Birth: Race: Sex:ROSALINA A LATONA XXX-XX-7348 3/9/1966 ASIAN FEMALE Retained Prints Expiration Date: 1/1/2029Clearinghouse Screening Available?: YesCandidate's Name Care Administration EligibilityEmployment History (as reported to Floridas Background Screening Clearinghouse by provider employers.)EmploymentMedicaid / MedicareParticipating ProviderEligible 1/15/2024EmploymentNon-Medicaid / MedicareParticipating ProviderEligible 1/15/2024PositionMedicaid ProviderEnrollmentAgency ReviewRequiredPositionAHCA Provider/FacilityLicensureEligible 1/15/2024Type Item Status Eligibility Determination DateAVAIL HOME CARE - 30211956 Home Health Aide 05/13/2024 AVAIL HOME CARE - 30212023 Home Health Aide 05/13/2024 ANGELS CHILD HOMECORPORATION INC. - 23524636ZEmployee or StaffPerson01/27/2024 01/31/2024Provider Position Hire Date End Date5/23/24, 11:19 AM AHCA BGS - Background Screening Result https://apps.ahca.myflorida.com/bgsweb2/Profile/PrintVerificationForm/3424394 1/2 Print Event: 233424394 Print Date: 5/23/2024PHILAM HOME CARE INC -30211253Home Health Aide 01/22/2024CORA JOHN STAFFING & CAREMANAGEMENT INC - 30212258Home Health Aide 01/09/2024CORA JOHN STAFFING & CAREMANAGEMENT INC - 30212258Home Health Aide 01/09/2024VISITING ANGELS - 30211314 Home Health Aide 10/25/2023 11/06/2023 AROUND THE CLOCK HOME CAREINC - 30211705Home Health Aide 09/26/2022Provider Position Hire Date End Date5/23/24, 11:19 AM AHCA BGS - Background Screening Result https://apps.ahca.myflorida.com/bgsweb2/Profile/PrintVerificationForm/3424394 2/2 |
