Like many services that families of people with disabilities depend on, regulations regarding background checks are set by the individual states. Unsuspecting families may be told that all workers must pass a "background check" but depending on where you live, that could mean a host of different things. The figure below from a recent government study shows the variety of state policies.
Life on "the road" of caregiving for adults who have Down syndrome.
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Mardra Sikora (Facebook)