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UNCLASSIFIEDULAW ENFORCEMENT SENSITIVE (When Completed) <br />Does the contingency plan have a date documenting the last time the responsible facility manager/administrator <br />reviewed the policy to ensure it remains current, and relevant to the facility's operation? <br />(' Yes (- No <br />If'Yes`, Date of Last Contingency Plan Review <br />Does the facility's contingency plan include the USMS prisoners housed at the facility? <br />C' Yes (- No <br />Staff Background Checks <br />Does the facility verify identity of employees, contractors and volunteers prior to hiring via: <br />Fingerprints (' Yes (- No Social Security Number i Yes (` No Date of Birth C' Yes ( No <br />Are initial background checks completed for all employees, contractors, and volunteers prior to hiring? <br />(^ Yes C^ No <br />Does the facility conduct re -investigations of employees, contractors, and volunteers? <br />(- Yes (' No <br />C <br />No <br />If 'Yes', how often? (Every 2 years, every 5 years, every 10 years, or more than 10 <br />years) <br />Does the background check include verification of: <br />No <br />Derogatory civil records? <br />Employment history for the past five (5) years? <br />C Yes <br />C' No <br />Residency for the past three (3) years? <br />C Yes <br />C No <br />Credit history to ensure no current delinquency? <br />i Yes <br />No <br />Credit history to ensure no unresolved liens? <br />(- Yes <br />( No <br />Credit history to ensure no accounts in collection? <br />C Yes <br />C No <br />Credit history to ensure no court-ordered judgments ? <br />r Yes <br />( No <br />Does the background check include verification that there are no'. <br />Felony convictions? <br />C1 Yes <br />C <br />No <br />Disqualifying misdemeanor convictions? <br />(' Yes <br />C' <br />No <br />Derogatory civil records? <br />C Yes <br />( <br />No <br />Alcohol dependencies? <br />C` Yes <br />C <br />No <br />Drug dependencies? <br />(' Yes <br />C' <br />No <br />Reporting/investigating Staff Misconduct <br />How many administrative allegations of staff misconduct were reported since the last USMS DFR (if applicable)? <br />L. <br />How many criminal allegations of staff misconduct were reported since the last USMS DFR (if applicable)? <br />NOTICE: This document is intended FOR OFFICIAL USE ONLY and may contain LAW ENFORCEMENT SENSITIVE OR CONFIDENTIAL information <br />which is for the sole use of the intended recipients} Any unauthorized review, use, disclosure, or distribution is prohibited If you are not the intended <br />recipient, please contact the sender and destroy all copies of this document Any Protected Health Information contained in this document is to be used <br />only to aid in providing healthcare services to federal prisoners. Any other use is a violation of Federal HIPAA Law and/or the Privacy Act and will be <br />reported as such. <br />UNCLASSIFIEDBLAW ENFORCEMENT SENSITIVE (When Completed) <br />Page 6 of 22 <br />Form USM -218 <br />Rev 07/21 <br />