Ariz. Admin. Code § R9-16-805 - Certification Renewal
A. From the date of
issuance, a CHW certification is valid for two years.
B. At least 30 calendar days before the
expiration date of a certification, an applicant shall submit to the
Department:
1. A renewal application in a
Department-provided format that contains:
a.
The applicant's name, home address, telephone number, and e-mail
address;
b. The applicant's
certification number and date of expiration;
c. Since the previous certification
application, whether the applicant has been convicted of a felony or a
misdemeanor involving moral turpitude in this or another state;
d. If the applicant was convicted of a felony
or a misdemeanor involving moral turpitude:
i.
The date of the conviction,
ii. The
state or jurisdiction of the conviction,
iii. An explanation of the crime of which the
applicant was convicted, and
iv.
The disposition of the case;
e. Whether the applicant has had, within two
years before the renewal application date, a certificate suspended or revoked
by any state;
f. An attestation
that:
i. The applicant has completed 24 hours
of continuing education required in
R9-16-806 and documentation of the
completed continuing education is available upon the Department's
request;
ii. The applicant
authorizes the Department to verify all information provided in the renewal
application packet;
iii. The
information submitted as part of the renewal application packet is true and
accurate; and
iv. The applicant's
signature and date of signature.
2. A fee specified in
R9-16-810.
C. Documentation of an applicant's conviction
of a felony or a misdemeanor involving moral turpitude in this or another state
that includes the information specified in subsection (A)(1)(d) issued by the
prosecuting state or jurisdiction.
D. An applicant who does not submit the
documentation and the fee in subsection (B) shall apply for a new certificate
in R9-16-804.
E. The Department shall review the
application and required documentation for renewal certification as a CHW
according to
R9-16-808 and Table 8.1.
Notes
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