📝 The Background Screening Form Most ALFs Forget — And Why It Can Cost You
When it comes to background screening in assisted living, most facilities focus on the Clearinghouse, Level 2 results, and the 5-year renewal cycle. But there’s one step that consistently gets missed — and AHCA has begun citing it more frequently:
👉 The employee’s Attestation of Compliance form.
This isn’t paperwork for your binder.
It’s a legal requirement.
And if it’s missing, incomplete, or outdated, you will get cited.
What the Law Actually Says
Under F.S. 435.05(2), every covered employee must:
- Attest under penalty of perjury that they qualify for employment
- Agree to notify the employer immediately if they are arrested
- Confirm that they have not committed any disqualifying offenses
This is non-negotiable.
And AHCA reinforces it through its rules.
What AHCA Requires You to Have on File
Per 59A-35.090(d), every facility must keep the:
Attestation of Compliance With Background Screening Requirements
AHCA Form 3100-0008 (July 2024)
This form documents three critical pieces of information:
- The employee meets the Level 2 background screening requirements
- The employee has not had a break in service longer than 90 days from a screened position
- The employee agrees to notify the employer immediately if arrested
This is not optional.
This form must be signed by the employee upon hire and kept in their staff file.
The 90-Day Break-in-Service Rule
This is where many facilities get caught.
If an employee has been out of a Level 2 screened position for more than 90 days, they must go through new screening.
The attestation form forces the employee to confirm this.
AHCA reviews this closely — and if the form is missing, it creates two compliance problems:
- No attestation
- No verification of recent screening status
Facilities get hit for both.
Surveyors Will Ask for This Form
During a survey, AHCA may:
- Pull staff files
- Look for the correct version of Form 3100-0008
- Check the signature and date
- Confirm the 90-day statement
- Compare it against Clearinghouse records
If the form isn’t there, or if it’s an older version, it’s an automatic citation.
Common Mistakes Operators Make
Here are the issues I see most often in facilities:
❌ Using outdated versions of the form
❌ Form not signed or dated by the employee
❌ Believing the Clearinghouse status replaces the attestation
❌ Employee had a break in service over 90 days, but no updated screening
❌ Form is completed but not stored in the staff file
❌ Administrator signs it — instead of the employee
These are avoidable problems that show up constantly during surveys.
How to Fix This Easily
Here’s what you should do right now:
✔️ Download the current AHCA Attestation of Compliance form
✔️ Add it to your new-hire onboarding packet
✔️ Audit all employee files for the July 2024 version
✔️ Have any missing or outdated forms re-completed
✔️ Add the 90-day screening verification to your hiring checklist
✔️ Train your team on what this form is and why it matters
This takes less than an hour and protects you from an unnecessary deficiency.