Ronald McDonald House Charities of Southern West Virginia (“RMHC”) conducts a criminal history background check on all individuals (18 years old or older) applying for temporary residence at RMHC. In selecting family members for temporary residence, RMHC screens family behavior and an individual’s suitability for temporary residence among other families. A criminal conviction record that reveals behavior that may adversely affect another individual’s (e.g., other temporary residents, guests, staff, volunteers) health, safety, welfare, and ability to peacefully enjoy the RMHC facility shall result in your application for the temporary residence being denied. For example, and without limitation, convictions of violent crimes, domestic violence, child abuse, sex offenses, illegal drug activity, burglary, and/or identity theft will result in rejection of your application.
This form includes a Criminal History Background Report Authorization form for you to review and sign. EACH family member or overnight visitor (18 years old or older) who intends to apply for temporary residence must separately fill out this form and the Criminal History Background Report Authorization form. Once we receive the completed form, RMHC will have an independent third party conduct a criminal history background check.
RMHC will attempt to obtain and use a criminal history background “consumer report” from a “consumer reporting agency” when considering your application for temporary residence while your child (or family relation) is receiving medical treatment at a Charleston-area medical facility. These quoted terms are defined in the Fair Credit Reporting Act (“FCRA”), a law which RMHC deems to apply to you.¹As an applicant for temporary residence at our facility, RMHC is considering you to be a “consumer” with rights under the FCRA.
Please understand that RMHC solely will obtain a criminal history background report to assist it in determining whether to grant you temporary residence. RMHC is not obtaining a “consumer report” for any other information and will NOT be conducting a credit check.
If RMHC considers any information in the criminal history background report when making a temporary residence decision that directly and adversely affects you, you may request a copy of that report. You also may contact the Federal Trade Commission about your rights under the FCRA as a “consumer” with regard to “consumer reports” and “consumer reporting agencies.”
To assist RMHC in obtaining criminal history background check information, please truthfully and completely answer the following question:
¹ A “consumer reporting agency” is a person or business that, for monetary fees, dues, or on a cooperative nonprofit basis, regularly assembles or evaluates consumer credit information or other information on consumers for the purpose of furnishing “consumer reports” to others, such as RMHC. A “consumer reporting agency” bearing on a consumer’s creditworthiness, credit standing, credit capacity, character, general reputation, personal characteristics, motor vehicle record, or mode of living that is used or collected for the purpose of serving as a factor in establishing the consumer’s eligibility for the particular purpose at hand. A “consumer report” also may include, without limitation, information about your employment history, educational background, or your criminal history background.