The CFS 689 form serves as a pivotal document within the State of Illinois, particularly within the scope of child welfare and safety. Mandated by the Illinois Department of Children and Family Services, this document is designed for individuals who are either seeking employment, wish to volunteer in positions, or engage in programs not licensed by the DCFS, particularly where such roles may involve contact with children. This form functions as an explicit authorization for a background check, specifically accessing the Child Abuse and Neglect Tracking System (CANTS). This system holds records that could indicate whether an individual has a history of being involved in incidents of child abuse or neglect. The form requires comprehensive personal information, including current and past residences, alternate names, and consent for the DCFS to release findings to the specified agency requesting the check. It underscores the state's commitment to child safety, ensuring that individuals with a history of abuse or neglect are identified before they take on roles that place them in proximity to children. The process outlined within the document, including where and how to submit the form, along with the requisite details like mailing addresses and contact numbers, ensures a streamlined approach to conducting these vital background checks.
| Question | Answer |
|---|---|
| Form Name | Form Cfs 689 |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | Springfield, Neglect, DCFS, resided |
CFS 689
6/2001State of Illinois
Department of Children and Family Services
AUTHORIZATION FOR BACKGROUND CHECK
Child Abuse and Neglect Tracking System (CANTS)
For Programs NOT Licensed by DCFS
NOTE: Do not use this form if you are an applicant for licensure or an employee/volunteer of a licensed child care facility. Please contact your licensing representative.
Name:
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Date of Birth: |
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Gender (circle): Male |
Female |
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Current Address: |
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Street/Apt # |
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List all addresses at which you have resided in the past five years:
List maiden name and/or all other names by which you have been known: (last, first, middle)
I hereby authorize the Illinois Department of Children and Family Services to conduct a search of the Child Abuse and Neglect Tracking system (CANTS) to determine whether I have been a perpetrator of an indicated incident of child abuse and/or neglect or involved in a pending investigation. I further consent to the release of this information to the agency listed below.
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Mail this request to: |
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Department of Children and Family Services |
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406 E. Monroe – Station # 30 |
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Signed |
Date |
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Springfield, IL 62701 |
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Please type, use bold letters or label:
(Agency Name)
(Contact Person)
(Address)
(City/State/Zip)
(Submitting Agency Fax Number): 618.692.0685