CD11-91/OEC-20 – October 17, 2011
The registration application used by FCSR is modified to meet the needs of DSS registered family home providers. The form (CD-125), entitled “Department of Social Services, Child Care Provider Registration Background Screening Request” (FCSR/DSS form), will be used to register the applicant and/or household member in the FCSR. This form may be downloaded from the Children’s Division E Forms intranet site at http://www.dss.mo.gov/cd/info/forms/index.htm. When using FCSR forms downloaded from the Intranet, be sure to include the county name and address on the form.
The FCSR maintains an internet web site that may be searched to determine if an individual is registered with the FCSR. Before requiring a provider or household member to complete the FCSR/DSS form, staff is instructed to check the FCSR website by following these steps:
- Go to https://webapp03.dhss.mo.gov/fcsrnet/SearchForm.aspx
- Enter the individual’s social security number;
- The resulting message will say either “SSN xxx-xx-xxxx was found on the DHSS database” or “SSN xxx-xx-xxxx was not found on DHSS database”
If the individual’s SSN is not found, the individual must complete an FCSR/DSS form and mail it to: Missouri Department of Health and Senior Services ATTN-Fees Receipts Unit P.O. Box 570 Jefferson City, MO 65102
One form must be completed for each individual to be registered and screened. There is a processing fee for each submitted form and the fee must accompany the submitted forms to the above address. DSS staff is not required, nor expected to accept fees on behalf of individuals registering with the FCSR. If a provider/household member submits the form and fee to their local FSD/CD office, staff should instruct the provider/household member to forward the information to the DHSS address above. The return address is printed on the FCSR/DSS registration form.