ࡱ> ORNQ GLbjbj-- DNOeOe9. L L 8D$~5(]]]]G$I$I$I$I$I$I$$j' *vm$9m$]]4$cccR]]G$cG$ccr"T#]2iXO#3$$0$]#z*;(*##*#Hcm$m$c$*L W: IMPORTANT INFORMATION FOR APPLICANTS TO THE NURSING PROGRAM Licensing Eligibility When you near completion of the nursing education program you will make application to a State Board of Nursing (in Washington State Nursing Care Quality Assurance Commission) to take the licensing examination. In order to minimize potential problems nursing graduates might experience in obtaining a nursing license, it is important to understand the relationship of nursing programs to the licensing process. Schools of nursing do not have the power to grant licensure as a Registered Nurse (RN) or Licensed Practical Nurse (LPN). The colleges nursing program is approved by the Washington State Nursing Care Quality Assurance Commission to provide education and training, which qualifies graduates to take a state licensing examination. In addition to completing a nursing education program, State Boards of Nursing also have the right to inquire about aspects of your personal life that might have a bearing on your ability to practice as a licensed nurse. One part of this application asks applicants to answer yes or no to a series of questions. If any of the questions are answered Yes, full details must be furnished on a separate (8-l/2 x 11 inches) page and attached to the application for licensure. The Nursing Commission will investigate and has the power to refuse licensure. We believe it is important for you to be aware of these questions prior to starting the program. Consult the Washington State Nursing Care Quality Assurance Commission (360) 236-4700 or online for details regarding these questions. Application Questions: 1. Do you have a medical condition which in any way impairs or limits your ability to practice your profession with reasonable skill and safety? 2. Do you currently use chemical substance(s) in any way which impair or limit your ability to practice your profession with reasonable skill and safety? 3. Have you ever been diagnosed with, or treated for, pedophilia, exhibitionism, voyeurism or frotteurism? 4. Are you currently engaged in the illegal use of controlled substances? 5. Have you ever been convicted, entered a plea of guilty, no contest, or a similar plea, or had prosecution or a sentence deferred or suspended in any state or jurisdiction in connection with: The use or distribution of controlled substances or legend drugs? A charge of a sex offense? Or any other crime, other than minor traffic infractions (including DUI, or reckless driving)? 6. Have you ever been found in any civil, administrative or criminal proceeding to have: Possessed, used, prescribed for use, or distributed controlled substances or legend drugs in any way ? other than for legitimate or therapeutic purposes? Diverted controlled substances or legend drugs? Prescribed controlled substances for yourself? committed any act involving moral turpitude, dishonesty or corruption? 7. Have you been found in any proceeding to have violated any state or federal law or rule regulating the practice of a health care profession? 8. Have you ever had any license, certificate, registration or other privilege to practice a health care profession denied, revoked, suspended, or restricted by a state or federal or foreign authority? 9. Have you ever surrendered a credential like those listed in number 8, in connection with or to avoid action by a state, federal or foreign authority? 10. Have you ever been named in any civil suit or suffered any civil judgment for incompetence, negligence, or malpractice in connection with the practice of a health care profession? If you answered yes to any of the above, full details must be furnished to the Nursing Commission. The laws of Washington do not allow community college programs to discriminate in their admission process based on difficulties in any of the areas covered by these questions. Therefore, it is possible that a student could be admitted to, and successfully complete the programs and not be eligible for licensure. The Nursing Commission will not discuss the possible action it might take regarding eligibility for licensure until the time that the candidate makes official application for the examination. Therefore, if you have any questions regarding this requirement, it is recommended that you discuss these with the Nursing Program Director prior to entering the Nursing Program. Washington State Board of Nursing WA State Department of Health WABON 111 Israel Road S.E.,Tumwater, WA Mailing Address: PO Box 47864 Olympia, WA 98504-7877 Phone:360.236.4700(call center) Fax:360.236.4738 Email: HYPERLINK "mailto:nursing@doh.wa.gov" nursing@doh.wa.gov Students may also go online for more information  HYPERLINK "http://www.doh.wa.gov/LicensesPermitsandCertificates.aspx" http://www.doh.wa.gov/LicensesPermitsandCertificates.aspx DSHS SECRETARYS LIST OF CRIMES AND NEGATIVE ACTIONS FOR USE BY ALL Programs Administered by DSHS, including DSHS State Employees in Covered Positions w/ Access to Vulnerable People [EXCEPT ALTSA HCS Providers; ALTSA RCS Providers; DDA Providers, including DSHS employees working in a SOLA; and DSHS employees with access to sensitive information] Crimes: A person who has a crime listed below is denied unsupervised access to vulnerable adults, juveniles, and children. If (5 or more years) appears after a crime, the person is automatically denied unsupervised access unless 5 or more years has passed since the date of conviction. After 5 years, an overall assessment of the persons character, competence, and suitability to have unsupervised access will determine denial. Abandonment of a child Abandonment of a dependent person not against child (5 or more years) Abuse or neglect of a child Arson Arson Domestic Violence Assault 1 Assault 1 Domestic Violence Assault 2 Assault 2 Domestic Violence Assault 3 Domestic Violence Assault 3 not Domestic Violence (5 or more years) Assault 4 violation of RCW 9A.36.041(3) Assault 4/simple assault (5 or more years) Assault 4 Domestic Violence (5 or more years) Assault of a child Burglary (5 or more years) Burglary Domestic Violence (5 or more years) Child buying or selling Child molestation Coercion (5 or more years) Coercion Domestic Violence (5 or more years) Commercial sexual abuse of a minor/ Patronizing a juvenile prostitute Communication with a minor for immoral purposes Controlled substance homicide Criminal mistreatment Custodial assault (5 or more years) Custodial interference Custodial sexual misconduct Dealing in depictions of minor engaged in sexual explicit conduct Drive-by shooting Drive-by shooting Domestic Violence Endangerment with a controlled substance Extortion 1 Extortion 2 (5 or more years) False statements, fraud (5 or more years) Forgery (5 or more years) Harassment (5 or more years) Harassment Domestic Violence Hate Crime Homicide by abuse Homicide by watercraft Identity theft (5 or more years) Incendiary devices (possess, manufacture, dispose) Incest Indecent exposure/Public indecency (Felony) Indecent liberties Kidnapping Kidnapping Domestic Violence Leading organized crime (5 or more years) Luring Malicious explosion 1 Malicious explosion 2 Malicious explosion 3 (5 or more years) Malicious harassment Malicious placement of an explosive 1 Malicious placement of an explosive 2 (5 or more years) Malicious placement of an explosive 3 (5 or more years) Malicious placement of imitation device 1 (5 or more years) Manslaughter Manslaughter Domestic Violence Murder/Aggravated murder Murder Domestic Violence Patronizing a prostitute (5 or more years) Permitting Commercial Sexual Abuse of a Minor Possess depictions minor engaged in sexual conduct Possess explosive device (5 or more years) Promoting Commercial Sexual Abuse of a Minor Promoting pornography (5 or more years) Promoting prostitution 1 (5 or more years) Promoting prostitution 2 (5 or more years) Promoting suicide attempt (5 or more years) Promoting Travel for Commercial Sexual Abuse of a Minor Prostitution (5 or more years) Rape Rape Domestic Violence Rape of child Reckless endangerment (5 or more years) Reckless endangerment Domestic Violence (5 or more years) Registered sex offender Residential burglary (5 or more years) Residential burglary Domestic Violence (5 or more years) Robbery Selling or distributing erotic material to a minor Sending or bringing into the state depictions of a minor Sexual exploitation of minors Sexual misconduct with a minor Sexually violating human remains Stalking (5 or more years) Stalking Domestic Violence (5 or more years) Theft (5 or more years) Theft of a firearm (5 or more years) Theft of a Motor Vehicle (5 or more years) Theft from a Vulnerable Adult (5 or more years) Trafficking Unlawful imprisonment (5 or more years) Unlawful imprisonment Domestic Violence (5 or more years) Unlawful use of bldg for drug purposes (5 or more years) Use of machine gun in a felony Vehicular assault Vehicular homicide (negligent homicide) Viewing Depictions of a Minor Engaged in Sexually Explicit Conduct Violation of child abuse restraining order Violation of civil anti-harassment protection order Violation of protection/no-contact/restraining order Violation of the Imitation Controlled Substance Act (manufacture/deliver/intent - 5 or more years) Violation of Uniform Controlled Substance Act (manufacture/deliver/intent - 5 or more years) Violation of the Uniform Legend Drug Act (manufacture/deliver/intent - 5 or more years) Violation of the Uniform Precursor Drug Act (manufacture/deliver/intent - 5 or more years Voyeurism Pending Crime - A person who has a pending crime on the Secretarys List is denied unsupervised access while awaiting a decision by a court, administrative entity, or governmental entity. Upon conviction or acquittal by the court, the Secretarys List is applied. Negative Action means a court order, court judgment, or an adverse action taken by an agency, in any state, federal, tribal, or foreign jurisdiction, which results in a finding against the applicant. A "negative action" includes the denial, suspension, revocation, or termination of a license, certification, or contract for the care of vulnerable population, including children, vulnerable adults, and people with mental and developmental disabilities. The following, nonexclusive, negative actions will result in denial of unsupervised access to vulnerable adults, juveniles, or children. An order or final notification issued by a court or state agency that an individual abused, neglected, abandoned, or exploited a child, juvenile, or vulnerable adult. A government agency denial, termination, or revocation of a contract or license based on failing to care for children, juveniles, or vulnerable adults. A surrender, relinquishment, revocation, suspension, termination, or denial of an individuals contract or license in lieu of a government agency taking action against the individual for failing to care for children, juveniles, or vulnerable adults. The following type of court orders entered against an individual for abuse, sexual abuse, neglect, abandonment, domestic violence, exploitation, or financial exploitation of a vulnerable adult, juvenile, or child: ' A permanent vulnerable adult protection order / restraining order, either active or expired, issued by a Washington court ; ' A sexual assault protection order issued by a Washington court ; ' A permanent civil anti-harassment protection order, either active or expired, issued by a Washington court ; and An order similar to any of the above that was issued by a court in any state, fRk l Ul+./ABCuv๚ooY>45>**䴳ʴ+5>**䴳ʴ%䴳ʴ/󰪳.󰪳.05P^=󰪳.󰪳.5B*ʴ^3334󰪳.󰪳.5B*ʴ^333䴳ʴ䴳ʴ5Cʴ<Rl  UlOSn&{ & Fd1$7$8$H$^`gdSX & Fd1$7$8$H$gdSX 1$7$8$H$gdSX d1$gdSX$d1$7$8$H$a$gdSX{ ga[z*+MCu 1$7$8$H$gd@u. 1$7$8$H$gdSX & Fd1$7$8$H$^`gdSX1$7$8$H$^gdSX     ktgd@u.$k*3$5$]k^a$gd9 b$mD3$5$^ma$gdisJ 1$7$8$H$gdSX  jks..//4455x6|6b78L7L8L9L:Ljh g>U)h9 bh\B*CJOJQJ^JaJphh9 bh9 b5\Uh@u.CJOJQJ^JaJh@u.CJaJh@u.56CJ\]aJh@u.6CJ]aJh@u.5CJ\aJh@u.h9 b5CJ\aJh9 b5CJ\aJ%hSX5>*B*CJPJ^JaJph#6} 'Z < U h *!I!`!!!!!gd@u.!"5"_"l""""" ##,#D#f###### $8$@$W$n$$$$ %F%%gd@u.%%%%%&@&t&&&&#'O'|''''(*(e(~(((()W)v))))gd@u.)**A*m****+I+i+|+++,J,,,,-D-n----./^12  & F gd@u.gd@u.22345x6`7b79L;LL?LALBLDLELFLGLgdisJ$k*3$5$]k^a$gd@u.gd@u. & Fgd@u.  & F gd@u.ederal, tribal, or foreign jurisdiction. 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