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Image of a report. Certification (PPD) Application Summary (PPD-5) Schedule containing information and required signatures for an application. Download about Application Summary (PPD-5)
Image of a report. Certification (PPD) Part I - Entity Information Schedule identifying information about the entity submitting the application. Download about Part I - Entity Information
Image of a report. Certification (PPD) Part II - Site Information Schedule identifying information about the site for the proposed action. Download about Part II - Site Information
Image of an arrow within a box. Reporting (PAS) Authorized Person Designation Statement Form Justice Center Staff... Authorized Persons are approved to submit required pre-employment checks of the Staff Exclusion List (SEL). Learn more about Authorized Person Designation Statement Form Justice Center Staff Exclusion List (SEL) Check
Image of a report. Certification (PPD) Part III - Description of Services Schedule describing the services for the proposed action. Download about Part III - Description of Services
Image of a report. Certification (PPD) Part IV - Resource Allocation Schedule listing budget information and staffing for the proposed service. Download about Part IV - Resource Allocation
Image of a report. Certification (PPD) Part V - Service Capacity Increases Schedule required for capacity increases or transfer of ownership. Download about Part V - Service Capacity Increases
Image of a report. Certification (PPD) Appendix I - Governing Authority Questionnaire Schedule required for each person listed in Part I, Section F. Download about Appendix I - Governing Authority Questionnaire
Image of a report. Certification (PPD) Appendix II - Staff Deployment Matrix Schedule of planned deployment of staff FTEs for the main location and additional locations Download about Appendix II - Staff Deployment Matrix
Image of a report. Certification (PPD) Appendix IV - Character and Competence Schedule of the entity’s character and competence. Must be notarized. Download about Appendix IV - Character and Competence
