Who Must Pass a Background Check
Under 10A NCAC 13G and G.S. 131D-4.3, background checks are not limited to paid staff — the requirement extends to anyone with regular, unsupervised access to residents. DHSR treats this broadly: operators, staff in any role, and volunteers who interact with residents without direct staff supervision all fall under the requirement. A facility that checks paid staff but not volunteers with resident contact has a documentation gap that surveyors can cite.
The check is a condition of employment (or volunteer service), not a periodic credentialing item — it must be completed before the individual has unsupervised access to residents. DHSR does not recognize a probationary period during which an unchecked individual works with residents while the check processes, except where DHSR has specifically authorized a short provisional window in writing.
Background Check Applies to All Who Have Unsupervised Resident Access
Background checks are a condition of employment. DHSR does not allow a new hire to begin unsupervised resident care while their criminal history check is pending, except where the agency has specifically authorized a provisional window in writing. Operators who allow provisional unsupervised work before the check clears are creating a documentation deficiency regardless of the check result.
What the Background Check Covers
DHSR requires three components as part of the background check process for NC family care homes. Each component serves a different purpose, and a check is not complete if any one of the three is missing from the documentation file. Some components are run by the employer directly; others are facilitated through NC SBI or DHSR. Operators should verify the current submission process for SBI fingerprint checks with DHSR, as the submission pathway may be updated by the agency.
All three checks — criminal history, fingerprint, and sex offender registry — must be documented before the individual has unsupervised access to residents. DHSR inspects the check records as a package: a file with only one or two of the three components present is treated the same as a file with no check at all for the missing component.
| Component | What It Checks | Who Runs It |
|---|---|---|
| Criminal history check | NC SBI criminal history database (and equivalent multi-state search where applicable); conviction records, pending charges, and registry flags | Employer-initiated through NC SBI or authorized background check vendor; DHSR may also run independently during licensure review |
| Fingerprint check | NC SBI fingerprint database; provides identity-verified criminal history match beyond name-based search, required for certain role categories | Submitted through NC SBI via DHSR-designated process; operator should verify current fingerprint submission pathway with DHSR regional office |
| Sex offender registry review | NC Sex Offender and Public Protection Registry; confirms individual is not a registered sex offender in NC at time of hire and at each periodic recheck | Employer at hire and at each 5-year recheck; NC registry is publicly searchable; document the date and source of each search |
DHSR does not treat a partial background check package as a complete check. If the criminal history check is on file but the sex offender registry search is undocumented, the inspector will cite the missing component the same as if no check were run for that element. Document the date, source, and result for every component and keep all three in the same staff file.
Disqualifying Offenses
Not every criminal record bars employment in a family care home — but certain offense categories are automatically disqualifying under G.S. 131D-4.3 with no waiver path available. DHSR does not have discretion to approve employment for an individual with a conviction in a permanently disqualifying category, and operators who knowingly employ someone with a disqualifying offense are in direct violation of the licensure standard.
The list below reflects the categories of offenses DHSR treats as disqualifying under the applicable statute and regulations. Operators should confirm current statutory language with G.S. 131D-4.3 and DHSR guidance, as the offense list can be amended by the General Assembly. Offenses not on the disqualifying list do not automatically bar employment — DHSR may review them on a case-by-case basis depending on circumstances.
For the categories listed below, DHSR has no authority to grant a waiver, exemption, or provisional employment authorization. Conviction in a permanently disqualifying category is an absolute bar regardless of time elapsed, rehabilitation, expungement status, or the individual's employment history in other settings. Operators must not rely on the individual's representation that their record is clean — documentation from the check itself is what controls.
| Offense Category | Disqualifying? | Notes |
|---|---|---|
| Crimes against persons (assault, battery, homicide, kidnapping, robbery) | Yes — permanent bar | Applies to felony and qualifying misdemeanor convictions; any conviction in this category is permanently disqualifying |
| Sex offenses (any offense requiring registry) | Yes — permanent bar | Any offense that results in NC Sex Offender Registry listing is permanently disqualifying; see also registry-check requirement below |
| Financial crimes against a vulnerable adult (embezzlement, financial exploitation) | Yes | Includes misappropriation, embezzlement, and exploitation where the victim was a vulnerable or elderly adult |
| Felony drug offenses within the lookback window | Yes — time-limited | Felony drug convictions within the applicable lookback period are disqualifying; confirm current lookback window with DHSR as it may be updated by regulation |
| Substantiated abuse/neglect/exploitation as perpetrator in DSS registry | Yes | A substantiated finding in the NC DSS central registry as the responsible party is independently disqualifying, separate from any criminal conviction |
| Other felonies / misdemeanors not listed above | No automatic bar | DHSR may review other convictions on a case-by-case basis; operators should consult DHSR before making a hiring decision on an ambiguous record |
An active listing on the NC Sex Offender and Public Protection Registry is independently disqualifying regardless of the underlying conviction's status. If an individual is currently on the registry — even if their conviction is under appeal, the sentence was suspended, or they were convicted in another state — they may not work in a family care home. The sex offender registry check is not a formality; it catches disqualifying status that the criminal history check alone may not surface for out-of-state convictions.
The 5-Year Recheck Rule
Background checks in NC family care homes are not one-and-done at hire. DHSR requires periodic rechecks on a 5-year cycle — the same criminal history check and sex offender registry review that runs at hire must be repeated every five years for every staff member, volunteer, and operator who remains in a position with resident access. A clean background check at hire does not satisfy the recheck requirement; only a dated check from within the current 5-year window does.
The recheck obligation is a standing compliance requirement, not a triggered one. DHSR does not require an event (a new charge, a complaint) to mandate a recheck — the 5-year anniversary of the prior check is itself the trigger. Operators who treat background checks as a one-time hire formality will accumulate overdue rechecks over time and face documentation deficiencies across their entire staff roster.
| Trigger | Required Check | Window |
|---|---|---|
| New hire or volunteer start | Criminal history check + sex offender registry review (+ fingerprint if applicable to role) | Before first day of unsupervised resident access (or within DHSR-authorized provisional window if applicable) |
| Every 5 years from prior check | Criminal history recheck | By anniversary of last completed criminal history check; no grace period for late rechecks |
| Every 5 years from prior check | Sex offender registry recheck | Same cycle as criminal history recheck; document date and source of each registry search |
| Change of role to direct-care position | Criminal history check + sex offender registry review | Before assumption of direct-care duties in the new role; does not reset the 5-year cycle if a recent check is already on file |
The 5-Year Cycle Is a Minimum — Internal Policies Can Be More Frequent
DHSR sets the 5-year recheck as the compliance floor. Operators can run rechecks more frequently as an internal policy (annually, every 3 years, upon any report of a staff incident) without triggering a citation for over-compliance. Homes that run more frequent rechecks typically find that DHSR treats this favorably during inspections as evidence of an active oversight culture. DHSR will not cite a facility for running a check outside of the required cycle.
Documentation DHSR Inspects
Conducting the background check is necessary but not sufficient — the documentation that proves the check was completed, what it found, and when it was run is what DHSR actually inspects. A check run but not documented is functionally the same as no check at all from an inspection standpoint. DHSR surveyors will ask to see the specific document (check result, date of search, source) for each staff member — a verbal assurance from the operator that checks were run is not acceptable.
The table below reflects the documentation components DHSR expects to find in each staff member's file. Retention requirements should be verified with DHSR directly; the general expectation is that check records are retained for the duration of employment plus an additional period (confirm the current standard with your DHSR regional office).
| Document | What It Must Show | Retention |
|---|---|---|
| Pre-hire background check result | Date the check was run, agency or database searched, pass/fail disposition, name of individual checked | Duration of employment + additional retention period per DHSR guidance; verify current requirement with regional office |
| Sex offender registry check record | Date of search, registry searched (NC Sex Offender and Public Protection Registry), result (listed / not listed) | Same as criminal history check; retain separately as a dated entry in the staff file |
| 5-year recheck record | Date recheck was run, agency, result; must be labeled as a recheck (not a hire check) to allow DHSR to verify the cycle | Retain until superseded by next recheck, then retain prior recheck per DHSR retention floor |
| Declination or exemption documentation (if any) | DHSR authorization date and scope, name of authorizing DHSR official, period covered; no self-generated exemptions | Duration of employment; must be in file before unsupervised resident access begins under any exemption |
DHSR treats a missing background check record the same as a missing background check. If the result paper is lost, the vendor portal account has expired, or the record was filed in a personal email rather than the staff file, the inspector has no way to verify the check was run and will cite accordingly. Store every check result in the staff member's physical or digital file at the time it is received, not after the fact.
Organize Files So Rechecks Are Visible Without Manual Calculation
DHSR surveyors work through staff files quickly during an inspection. A file where the most recent check date is buried in a stack of documents, or where the recheck due date has to be calculated by the inspector from the hire date, creates a slower, more adversarial review. Files that show each check date clearly — with the next recheck date visible — communicate that the operator is managing the requirement actively, not reactively.
Track Background Check Dates the Same Way You Track CPR Renewals
Background check tracking belongs on the same compliance calendar as training expirations — the 5-year recheck window closes on a fixed date, and missing it creates the same documentation deficiency as a lapsed CPR card. CareTrack puts both on the same dashboard.
- Per-staff background check date and 5-year recheck due date tracked automatically from the date of last check
- Sex offender registry recheck dates on the same calendar as criminal history recheck dates
- Notification emails before recheck windows close so no staff member's check lapses undetected
- Documentation log with check date, agency, and pass/fail result for each staff member
- DHSR-ready export so rechecks are documented without manual spreadsheet management for every inspection