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AFL 11-06 Page 2 January 6, 2011

The following link to the California Department of Justice website may assist you in locating a live scan vendor.

http://ag.ca.gov/fingerprints/publications/contact.php

Once the live scan process is complete, please submit the CDPH 325 Criminal Record Clearance Submission listing the owners, administrators, and proof of live scan to the Centralized Applications Unit. The CDPH 325 form can be found using the following link:

3Criminal Record Clearance Submissions: CDPH 325 (PDF)

All individuals identified above who have not already completed the criminal record clearance process should mail the CDPH 325 on or before March 31, 2011 to:

Department of Public Health Licensing and Certification Program Centralized Applications Unit P. O. Box 997413, MS 3402 Sacramento, CA 95899-7413 Attention: Imelda Ruiz

Failure to comply with the above may result in a delay or denial of license renewal.

If you have any questions, contact Elena Marquez, Chief of the Centralized Applications Unit at (916) 552-8756.

Sincerely,

Original Signed by Pamela Dickfoss

Pamela Dickfoss Acting Deputy Director Center for Health Care Quality

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http://www.cdph.ca.gov/pubsforms/forms/CtrldForms/cdph325.pdf

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