South Carolina caregiver background checks: residency, registries and the 2026 offense list

Ways to run the state check

"Criminal record checks required pursuant to this article must be conducted by the State Law Enforcement Division or by a private business, organization, or association which conducts background checks" if that entity "utilizes current criminal records obtained from the State Law Enforcement Division or the Federal Bureau of Investigation" (S.C. Code 44-7-2920). In practice that gives two routes for the state check:

• SLED CATCH. SLED’s online search of South Carolina criminal records. A SLED CATCH name-based South Carolina record check costs $25, plus an online service fee ($1.43 from July 1, 2026). These are SLED’s fees, not ours (SLED CATCH, Fees). "SLED CATCH is a name-based search only." It covers South Carolina records only, and SLED says a name-based result can differ from a fingerprint-based one, for example when someone has used an alias (CATCH, Search Expectations). "SLED CATCH does not check for persons registered as sex offenders." (CATCH, Registered Sex Offenders)
• A background check company. Allowed if it uses current SLED or FBI records. Get the company’s confirmation of that in writing; its price is its own, not a state fee. By our reading a company report does not replace the registry searches either, unless it shows both registries by name.

Section 44-7-2920 also says "An applicant shall submit with the application one complete set of the applicant’s fingerprints on forms specified or furnished by the State Law Enforcement Division." (44-7-2920). DPH’s fingerprint instructions are written for "direct caregiver applicants who require a state and federal background check" (DPH, Background Checks for Direct Caregivers). By our reading, fingerprints are taken for the federal check only, as DPH’s page describes. That is not settled.

The federal fingerprint check through DPH

DPH acts as the channel for federal checks under the check law (S.C. Code 44-7-2940). DPH’s page sets out the steps:

1. A valid relationship first. SLED requires one before the applicant is fingerprinted: "acceptable documentation includes an application for employment at the facility or proof of current employment at the facility" (SLED memo, August 23, 2023).
2. Two notices. DPH says "the direct care entity shall provide the applicant with the following notices": the Noncriminal Justice Applicant’s Privacy Rights and the FBI Privacy Act Statement. Applicants are told they may challenge the accuracy or completeness of their record, out-of-state records with the FBI’s CJIS Division and South Carolina records with SLED at (803) 737-9000 (DPH, Important Information).
3. The authorization form. You complete DPH’s Verification of Application and Authorization for Background Check form and email it to HQCBC@dph.sc.gov. Then "Healthcare Quality staff will provide the service code for undergoing the background check at an approved vendor." DPH names IdentoGO as an approved vendor (DPH, Important Information).
4. The fee. For state and FBI fingerprint checks under 44-7-2910, DPH lists $30.25 per employee, paid directly to the fingerprint vendor. That is a state-listed fee, not ours (DPH FY2026 Fees and Fines Report). The statute says any FBI fee "must be paid by the individual direct caregiver or the direct care entity" (44-7-2920).
5. The answer. DPH cannot send in-home care providers the record itself. "SLED has directed the Department to make an eligibility determination regarding caregivers for these direct care entities and provide such determination to the applicable direct care entity." Keep it in the caregiver’s file (DPH, Background Checks for Direct Caregivers).

The statute sets no deadline for commencing the federal check after employment. CareRulebook’s manual sends DPH’s form within five business days after the caregiver starts; that timing is the manual’s, not the law’s.

The two registries (Class I)

A caregiver must "not have adverse findings on the Sex Offender Registry or Nurse Aide Registry" (R.60-122 §405.F). The rule does not say when to search, which searches DPH accepts or what to keep as evidence.

• Sex Offender Registry. A CATCH report does not check for registered sex offenders. SLED says the S.C. Sex Offender Registry, which covers people living or working in South Carolina convicted of sex offenses in any state, can be searched free of charge. (SLED CATCH, Registered Sex Offenders)
• Nurse Aide Registry. SCDHHS’s Medicaid manual links the South Carolina CNA registry lookup at cna365.examroom.ai (SCDHHS, Personal Care scope, D.6). R.60-122 does not name a lookup.

CareRulebook’s manual searches both before employment, saves or prints each result page showing the name searched, the date and the result, and files it in the staff record. That is the manual’s method until DPH says which searches it accepts. Whether any listing on either registry is an "adverse finding" is not settled.

Deciding about a record

The list in §405.G is the floor, not the whole decision. "A direct care entity may consider all information revealed by a criminal record check as a factor in evaluating a direct caregiver’s application to be employed by or contract with the entity." (S.C. Code 44-7-2910(A)(1)). So you may decline someone whose record is not on the list, as long as your decision is consistent and lawful; the rule does not tell you how.

Three things the rule leaves open, each on our list of questions for DPH:

• When the ten years start. The rule counts "within ten (10) years of providing in-home care to clients" but not from what: the conviction or plea, the offense, or the end of a sentence. CareRulebook’s manual counts from the conviction or plea.
• Out-of-state and federal convictions. The theft-type bar refers to offenses "as described in Title 16, Chapter 13" of South Carolina law (§405.G.1). By our reading, a similar conviction elsewhere should be treated the same way; DPH has not said.
• Telling the applicant. The rule is silent. DPH’s page says applicants may challenge their record with SLED or the FBI (DPH); CareRulebook’s manual tells them privately which record a decision rests on.

Drug tests: before hire and at random

• Before hire (Class I). A five-panel urine, hair, saliva or blood screen for cannabis, cocaine, amphetamines, opiates and phencyclidine, reviewed by a nurse, the administrator or human resources or hiring staff. "Persons shall not be eligible for employment as a caregiver unless and until they have a negative test." "The test must not be taken earlier than thirty (30) days before the provider’s offer of employment as a caregiver to the person." A positive test bars employment unless a physician states it came from a prescribed medication (R.60-122 §402.B).
• Random testing. "A licensed in-home provider and an individual employed as an in-home caregiver by a licensed in-home care provider are subject to random drug testing." (S.C. Code 44-70-70). The rule covers the people who signed the application and all caregivers, and lets you choose the method: "The provider’s policies and procedures must address random drug testing and describe the procedure chosen." (§402.C). A caregiver with a positive random test does no caregiving until a physician’s statement or a later negative test (§402.C).
• Records. Keep the lab’s result, or for a test you run in your office: name, date, time and signature of the person tested and of the reviewer, the kit’s manufacturer and model, the date, time and result, and the kit’s lot number and expiration date (§402.B.1-5, C.1-5).
• The policy DPH reads. The random drug testing policy is the one policy DPH asks for with the application: "A copy of your Random Drug Testing Policy", with both initial and renewal applications (Form 1307).

The rule sets no testing frequency or percentage for random tests. CareRulebook’s manual asks you to choose one and writes it into Policy 2.3, which also comes as its own file to attach to DPH’s form. What DPH receives, and when, is on the license application page; how the policy fits the rest of the manual is on South Carolina policies and procedures.

Already licensed: your current caregivers

The 2026 rule applies to every provider from May 22, 2026, with no transition period (R.60-122 §101). Section 405 says what "A caregiver must" be, so by our reading it applies to caregivers you already employ, not only new hires:

• No new criminal check is needed for someone who has stayed in direct care work: the check is not repeated while the person remains employed by or under contract with a direct care entity (S.C. Code 44-7-2920).
• Re-read the results you hold against the 2026 list, especially for violent crimes, which the old rule did not list as such (§405.G.4).
• Run both registry searches for any current caregiver without them on file, since the old rule named no registry (2014 text).

DPH has not published guidance on how it will inspect existing agencies against the new rule. More on the 2026 changes for existing agencies is on the South Carolina home care guide.

Records, renewal and fines

• Staff records. "The provider shall maintain accurate information on all staff members including, but not limited to, current address, phone number, training, all drug test results, criminal background checks, and self-assessments." (R.60-122 §403). CareRulebook’s manual keeps them in Policy 2.4.
• Another employer’s records. One direct care entity may give another the personnel records of current or former caregivers, including disciplinary matters and reasons for termination, and is presumed to act in good faith. The entity receiving them must still run its own criminal record check. (S.C. Code 44-7-2930)
• Checked at renewal. "shall verify that a direct care entity is conducting criminal record checks as required in this article before the department issues a renewal license for the direct care entity" (S.C. Code 44-7-2940). The statute does not say how DPH verifies this.
• Fines. Violating the direct caregiver check law brings a civil fine of $100 for the first violation and $500 for each later one, paid before the license is renewed. (S.C. Code 44-7-2950). Under R.60-122, §402.A carries no (I) or (II) mark, so by our reading a missed check is a Class III violation there, while §405.F-G are Class I (§205.D). Penalties run from $100 to $5,000 per violation (§205.F).

The people who sign the license application

Each person who signs the application needs a SLED name-based criminal record check no older than 90 days when DPH receives it. (R.60-122 §103.G). No license if a signer must register as a sex offender or has a conviction or plea for abuse, neglect or exploitation of a vulnerable adult, unlawful conduct toward or cruelty to children, any violent crime, any other drug-related felony, or forgery, embezzlement or breach of trust with fraudulent intent. Signers must report such convictions to DPH immediately. (§103.G.1-2). Each signer takes a 5-panel urine, hair, saliva or blood drug screen (cannabis, cocaine, amphetamines, opiates, phencyclidine) no earlier than 30 days before DPH receives the application, reviewed by an unrelated person. A positive test means denial unless a physician confirms a prescribed medication. (§103.H)

Signers stay subject to random drug testing (§402.C). A signer who may also have client contact needs the caregiver checks on this page too, by our reading of the "direct caregiver" definition (44-7-2910(B)(2)). The application itself, including when the signers’ checks go to DPH, is on the license application page, and the fees on South Carolina license cost and timeline.

Not settled yet

Points the rule and statute leave open. Each is on our list of questions for DPH, and CareRulebook’s manual states its own reading until DPH answers:

• Which Sex Offender Registry and Nurse Aide Registry searches DPH accepts, what evidence it wants on file, and whether any listing is an "adverse finding".
• Whether DPH accepts another state’s own check for an applicant with 12 months of residency there, given that checks must use current SLED or FBI records (44-7-2920).
• Whether the fingerprint sentence in 44-7-2920 applies to every caregiver applicant or only to those needing a federal check.
• Whether a caregiver may have client contact before DPH’s eligibility determination arrives.
• When the ten years in §405.G start, and how out-of-state convictions are treated.