| Task |
Yes/No |
Date/Initial |
Notes |
| Application Process |
| Did applicant sign consent for background investigation? |
|
|
|
| Is application complete? |
|
|
|
| Did applicant sign and date application? |
|
|
|
| Did applicant leave criminal questions blank? |
|
|
|
| Did applicant indicate a criminal record? |
|
|
|
| Did applicant explain why he or she had left past jobs? |
|
|
|
| Did applicant explain gaps in job history? |
|
|
|
| Did applicant clearly identify previous employers? |
|
|
|
| Did applicant provide supervisor names? |
|
|
|
| Were there excessive changes? |
|
|
|
| Interview |
| Did applicant explain excessive changes? |
|
|
|
| Leaving past jobs: Did applicant explain
satisfactorily? |
|
|
|
| Leaving past jobs: Was reason consistent with
application? |
|
|
|
| Employment gaps: Did applicant explain
satisfactorily? |
|
|
|
| Employment gaps: Explanations consistent with
application? |
|
|
|
| "Our firm has a standard policy of background checks
and drug tests on all applicants. Do you have any concerns you would like to share with me
about our procedure?" |
|
|
Response: |
| "When we contact past employers, pursuant to the
release you have signed, would any of them tell us you were terminated, disciplined, or
not eligible for rehire?" |
|
|
Response: |
| "When we contact past employers, pursuant to the
release you have signed, what do you think they would tell us about you?" |
|
|
Response: |
| "When we contact the courthouse or police department,
would we locate any criminal convictions or pending cases?" |
|
|
Response: |
Reference Checks
(by employer or third party) |
| Have references been checked for at least the last five
years, regardless of whether past employers will give details? |
|
|
|
| Have efforts been documented and placed in the file? |
|
|
|
Discrepancies between information located and what
applicant reported on application:
a. dates/salary/job title/duties
b. reason for leaving |
|
|
|
| Background Check |
| Submitted for background check? |
|
|
|
| Check completed? |
|
|
By: |
| Background check reviewed for discrepancies/issues |
|
|
|
| NOT CLEAR or SATISFACTORY, action taken per policy and
procedures. |
|
|
Describe: |