Effective as of April 1, 2012

Note: The Pennsylvania Child Abuse History Clearance form has been revised/updated. The previous version of the form (CY 113 12/99) will continue to be accepted for one year from the effective date of this notice, which is April 1, 2012. The revised/updated version of the form is (CY 113 (UF) 6/11). The form number is located in the bottom right hand corner of the form.

The form CANNOT be submitted electronically via email or online. Once the form is completely filled out it must be printed and mailed to:

ChildLine and Abuse Registry
Department of Public Welfare
PO Box 8170
Harrisburg, PA 17105-8170

You can print as many copies of the form as you need. The Department of Public Welfare’s Office of Children, Youth and Families – ChildLine and Abuse Registry will accept copies of the form as long as the applicant’s original signature is on the form when it is mailed in to our office.

1. The instructions for how to complete the Pennsylvania Child Abuse History Clearance form are now included on page three of the form and can be printed for easy reference when completing the form. Failure to comply with the instructions that are attached to the form will cause considerable delay in processing the results.

2. Applicants can now type their information directly onto the form or the form can be printed and the information can be hand written onto the form.

3. If the information is typed directly onto the form, the information will NOT be able to be saved on a computer unless the computer has a licensed version of the acrobat adobe software. Therefore, please be sure to print the completed form before closing the document so that the information typed on the form is not lost.

4. If you have trouble accessing the form you may need to download the latest version of Adobe Reader, which is available free on the internet.

NOTE: ALL information that has been entered directly onto the form will be lost if you close the form prior to printing the form (if your computer does not have a licensed version of the Acrobat Adobe software).

Once the form is received in the ChildLine and Abuse Registry’s Background Check Unit, the results of the Pennsylvania Child Abuse History Clearance will be mailed to the applicant’s address that was noted on the form within 14 days from the date that the clearance is received in that office.

CY113 form – English Child Abuse Clearance

CY113 form - Spanish Child Abuse Clearance

For questions related to the Pennsylvania Child Abuse History Clearance, please contact the ChildLine Verification Unit at 717-783-6211 or toll free at 1-877-371-5422.


Below is the link to the Pennsylvania Criminal Record Check form (SP4-164):
Pennsylvania State Police Request for Criminal record Check Form (SP4-164)

Applicants can also go to the Pennsylvania Access To Criminal History website and apply for their criminal record check online with the Pennsylvania State Police at:

If you have questions about the Pennsylvania State Police Request for Criminal Record Checks form (SP4 164), please call: (717) 783-9973 or toll free 1-888-783-7972.


All of the following individuals are now required to submit Federal Bureau of Investigation (FBI) criminal history background checks in addition to child abuse and Pennsylvania State Police background checks as a condition of employment/approval:
• Prospective foster and adoptive applicants and their adult household members;
• Individuals who want to operate child care facilities;
• Individual who want to work in child care facilities;
• Individuals seeking to operate child care services;
• Individuals applying for employment with a significant likelihood of regular contact with children;
• Self-employed family day care providers;
• Family day care home household members age 18 and over who live in the home at least 30 days in a calendar year;
• Community Rehabilitation Residential (CRR) host home families; and
• Respite provider families.

Current employees and providers of child care facilities are not required to obtain FBI clearances as a condition of continued employment by the same legal entity or continued operation. Employees may transfer to another child care service under the same organization without having to obtain FBI clearances as a condition of transferring. This follows the same procedures already in law under the Child Protective Services Law.

An employee hired on a provisional basis will have to submit proof of application for an FBI criminal history clearance in addition to the current provisional hiring requirements in the Child Protective Services Law. The length of the provisional hire period is unchanged. Pennsylvania residents may be hired on a provisional basis for a single period of no more than 30 days. Out-of-state residents may be hired on a provisional basis for a single period of no more than 90 days.

Prospective employees applying to engage in occupations with a significant likelihood of regular contact with children, in the form of care, guidance, supervision or training must obtain background checks as a condition of employment. These individuals, including but not limited to social service workers, psychiatrists, hospital personnel, counselors and therapists, librarians and doctors. Any additional requirements surrounding provisional hiring periods or licensing implications related to the completion of background checks for these individuals should be directed to the appropriate licensing entity.

The Department of Public Welfare is utilizing Cogent Systems to process fingerprint-based FBI criminal background checks. The fingerprint based background check is a multiple step process. For more information and to begin the registration process, go to For question about your FBI Clearance, please contact the FBI/Adam Walsh Unit at 717-783-6211 or 1-877-371-5422.

*The Department of Education also utilizes Cogent Systems to process finger print based FBI criminal background checks for prospective employees of public and private schools. Under Act 114 of 2006, ALL prospective school employees, school contractors and student teachers are to use the Department of Education system. This includes but is not limited to: Teachers, School Administrators, Substitute Teachers, Teaching Assistants, PIAA Sports Officials, School Bus Drivers, and Student Teachers.
Applicants may register online at:

For more information regarding Act 114, and background check requirements for public schools, private schools and student teachers go to the Pennsylvania Department of Education website or contact the Department of Education at RA-PDE-SchoolService@pa.Gov.