Illinois caregiver background checks: the registry, fingerprints and waivers

Your written list of direct care positions

"For purposes of the Act and this Part, the health care employer shall establish a policy defining which unlicensed employees provide direct care." 955.140 The rule tells you what to weigh: each position’s duties in its job description, whether the person is required to be, or has the opportunity to be, alone with clients to help with personal needs (other than on infrequent or unusual occasions), and whether the job involves physical contact with clients. The fingerprint process may be used only for positions the Act covers. 955.140(a); 955.165(d)(1)

Caregivers are the clear case. The rules do not settle whether an agency manager or supervisor who gives care only when a caregiver is off sick is in a direct care position or falls under “infrequent or unusual occasions”. CareRulebook’s manual writes covering visits into those job descriptions and treats the roles as direct care positions; that is our choice, and the question is on our list for IDPH. The agency manager and supervisors →

A person licensed by the Department of Financial and Professional Regulation or IDPH under another Illinois law is outside Part 955. For any position that needs a state professional license, Part 245 has you check the license is active with that department before hiring and file the verification. 245.30(c)(2)

The rule names the sites: "the Illinois Sex Offender Registry, the Department of Corrections' Sex Offender Search Engine, the Department of Corrections' Inmate Search Engine, the Department of Corrections Wanted Fugitives Search Engine, the National Sex Offender Public Registry, and the website of the Health and Human Services Office of Inspector General". They show whether the applicant has been adjudicated a sex offender, been a prison inmate or committed Medicare or Medicaid fraud. 955.165(c) The rule’s list is not closed (“including without limitation”), and the links are in the registry’s web application. IDPH’s checklist lists the same six, calling the HHS Office of Inspector General site its exclusions database.

IDPH names this step in its own guidance. Its Guidance for Common Deficiency Findings names failure to conduct six website verifications as a common Health Care Worker Registry survey finding, and explains that it applies even when the new hire is already Eligible: "The new hire or rehire does not need another background check, HOWEVER, you are required to check the six registries in the web portal." IDPH, Guidance for Common Deficiency Findings (archived March 21, 2026)

IDPH’s instructions for an Eligible hire: open the Livescan Requests section of their profile, run each search and tick each box if the person is not found, then click “Print”, not “Save”, because saving creates a new livescan request. If you click “Save” by mistake, delete the request. Put the printout in the employee file. IDPH deficiency guidance

Part 955 does not list a search result itself among the bars to employment; the bars are the convictions and findings in the next sections. The file rule only says the screen print shows you "found no results from those web sites that would prevent the employee from being hired", without saying which results would. 955.220(c) So what you do if a search finds the person is for your own policy. CareRulebook’s manual does not hire someone found on a sex offender registry, the wanted fugitives search or the exclusions database into direct care, and has the manager weigh an inmate search result; that is our policy choice, not rule text.

"A health care employer or long-term care facility may conditionally employ an applicant for up to three months pending the results of a fingerprint-based criminal history records check" The same rule adds: "During this time, the employee shall have adequate supervision, which is the type and frequency of supervision required to prevent abuse, neglect, or theft regarding patients, clients, or residents." 955.165(l)

The rule does not say what adequate supervision looks like in a client’s home. Part 245 adds that no worker gets an assignment before passing a competency evaluation on the first five hours of training. 245.71(c)

The disqualifying offenses

The list in 955.160 is long and specific, so read it in the rule rather than from a summary. It includes, among others, homicide offenses, kidnapping and unlawful restraint, sex offenses, assault and battery, criminal abuse or neglect of an elderly person or a person with a disability, theft and identity theft, financial exploitation of an elderly person or a person with a disability, forgery, robbery, burglary and home invasion, arson, weapons offenses, some cannabis and controlled substance offenses, methamphetamine offenses, practicing nursing without a license and animal cruelty, plus substantially equivalent offenses in other states or under federal law. 77 Ill. Adm. Code 955.160

Part 955 sorts disqualifying offenses into three appendices: Appendix A offenses are always disqualifying except through IDPH's appeal process; Appendix B offenses may be considered for a rehabilitation waiver; Appendix C offenses may be considered for a waiver when the person applies. Part 955, Appendices A to C

For convictions in other states, the bar applies once you become aware of the conviction, verified by court records, state agency records or an FBI check. "This shall not be construed to mean that a health care employer has an obligation to conduct a criminal history records check in other states in which an employee has resided." 955.150(b) The fingerprint check itself runs against Illinois State Police and FBI criminal history databases. 225 ILCS 46/33(b)

Convictions that are not disqualifying

"The Health Care Worker Registry will indicate only those criminal convictions that are disqualifying under the Act. Nothing in this Part shall prohibit the health care employer from developing policies concerning employment of individuals whose criminal history records checks indicate convictions for offenses that are not disqualifying." 955.165(o) Our suggestion: take legal advice before turning someone down for a conviction that is not on the list.

A new conviction after you hire

The registry keeps watching. If the State Police report a new disqualifying conviction for a worker already fingerprinted, the registry emails the worker's last known employer and records the offense, and the worker can no longer work as an employee unless they obtain a waiver. 955.165(n) Our suggestion: make sure the email address on your portal account is one someone reads every working day.

A waiver is between the worker and IDPH. The worker applies to IDPH on its form, with a work history or resume for the last five years if previously employed, a written explanation of each conviction (what happened, how long ago, who was involved, their age then and other circumstances), proof that fines are paid and any probation or parole completed, proof of any court-ordered rehabilitation program, and fingerprint-based check results. References are optional. 955.260

IDPH marks the registry to show a waiver is pending, acts within 30 days after it has all the necessary information, enters the decision on the registry and tells the person in writing which offenses are waived or not. 955.270(f) Until a waiver is granted, the person may not work in direct care once you have IDPH’s notice of disqualifying conditions. 955.280 IDPH automatically revokes a waiver if the person is convicted of another disqualifying offense. 955.270(h)(1)

Your policy on employing people with waivers

"A health care employer is not obligated to employ or offer permanent employment to an applicant, or to retain an employee who is granted a waiver." But you must have a policy: "The health care employer shall develop policies concerning employment of individuals who have been granted waivers." 955.210 CareRulebook’s manual has the agency manager consider each applicant with a waiver individually, looking at IDPH’s written decision, the offense, the time since and the duties of the job, and record the decision and reasons. That is one way to write it; the rule leaves the content to you.

The background check documents go in the employee's personnel file or another secure location IDPH can access. 955.220(d) The files are open to IDPH inspection. 955.220(a) On the fine for missing files, the Act and the rule are worded differently: the Act says "A fine of up to $500 may be imposed by the appropriate agency for failure to maintain these records." 225 ILCS 46/50, while Part 955 says "A fine of $500 shall be imposed for failure to maintain these records." 955.220(a)

These records matter beyond the survey. If you ever send IDPH a report about a worker for review of a possible abuse, neglect or theft finding, IDPH asks for "Proof of initial and annual health care worker employment verifications and the initial fingerprint-based background check", along with your background check policy. IDPH FAQ (archived March 21, 2026) CareRulebook’s manual keeps them under Policy 3.5 and Policy 3.6, personnel records.

The form is what IDPH hands you, so our suggestion is to answer each question as printed, even where it reaches further back than the rule. A conviction is not an automatic bar to the license: "In determining moral character, the Department may take into consideration any convictions of the applicant or supervisor for criminal offenses, but such convictions shall not operate as a bar to licensing." 245.130(b)(2) Misrepresentation on the application may be cause for denial or later revocation. Form 445104, page 8

If an owner or manager will also give hands-on care, that position is assessed for the caregiver checks like any other. Who can be the agency manager →