Childcare Disqualification Regulations Declaration Form
SCHOOL: HARPENDEN ACADEMY

The Department for Education (DfE) has issued a number of recent updates to its Statutory Guidance “Keeping Children Safe in Education”.
https://www.gov.uk/government/publications/disqualification-under-the-childcare-act-2006

These updates require organisations that provide care for pupils under the age of 8, to ensure that staff working in these settings are not disqualified from doing so under the Childcare (Disqualification) Regulations 2009. Reference:
http://www.legislation.gov.uk/uksi/2009/1547/schedule/3/made

A person may be disqualified through:
1. having certain orders or other restrictions placed upon them
2. having committed certain offences
3. living in the same household as someone who is disqualified by virtue of 1 or 2 above (this is known as disqualification by association)

You are required therefore to sign the declaration below confirming that you are not disqualified under those Regulations. You do not have to disclose convictions, cautions, reprimands or final warnings that are “protected” as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013) If you fail to complete and return the form, this will be regarded as a disciplinary matter, which may result in dismissal and if you are a job applicant the offer of employment will be withdrawn.
 
A disqualified person is not permitted to continue to work in a setting providing care for children under age 8, unless they apply for and are granted a waiver from Ofsted.  
Reference:
http://www.ofsted.gov.uk/resources/applying-waive-disqualification-early-years-and-childcare-providers

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Name: *
Post: *
Section 1 - Orders of other restrictions
Have any orders or other determinations related to childcare been made in respect of you? *
Have any orders or other determinations related to childcare been made in respect of a child in your care? *
Have any orders or other determinations been made which prevents you from being registered in relation to childcare, children’s homes or fostering? *
Are there any other relevant orders, restrictions or prohibitions in respect of you as set out in the Schedule 1 of the Regulations? These are summarised in the following document:www.gov.uk/government/publications/disqualification-under-the-childcare-act-2006 *
Are you barred from working with Children (Disclosure and Barring Service (DBS))? *
Are you prohibited from Teaching? *
Section 2 – Specified and Statutory Offences
Have you ever been cautioned, reprimanded, given a warning for or convicted of:
Any offence against or involving a child? (A child is a person under the age of 18) *
Any violent* or sexual offence against an adult?* a violent offence in this context is murder, manslaughter, kidnapping, false imprisonment, ABH or GBH *
• Any offence under the Sexual Offences Act? *
Any other relevant offence? A summary of relevant offences is available from the following link www.gov.uk/government/publications/disqualification-under-the-childcare-act-2006 *
Have you ever been cautioned, reprimanded, given a warning for or convicted of any similar offence in another country? *
Section 3 – Disqualification by association
To the best of your knowledge, is anyone in your household* disqualified from working with children under the Regulations? *household – includes family, lodgers, house-sharers, household employeesThis means does anyone in your household have an Order or Restriction against them as set out in Section 1 or do they have an unspent conviction, namely a caution, reprimand, warning or conviction for any offence in Section 2 that is not protected as defined above  Guidance on whether a conviction is spent can be found here www.gov.uk/government/publications/new-guidance-on-the-rehabilitation-of-offenders-act-1974. *
Section 4 – Provision of Information
If you have answered YES to any of the questions above you should provide details below in respect of yourself, or where relevant the member of your household. You may supply this information separately if you so wish, but you must do so without delay.
Details of the order, restriction, conviction, caution etc.
The date(s) of these
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The relevant court(s) or body(ies)
Section 5 – Declaration
In signing this form, I confirm that the information provided is true to the best of my knowledge and that:
• I understand my responsibilities to safeguard children.
• I understand that the information provided on this form will be retained on my personal file
• I understand that I must notify my Headteacher immediately of anything that affects my suitability including any cautions, warnings, convictions, orders or other determinations made in respect of me or unspent convictions (including convictions/cautions that are not protected) of the same for a member of my household that would render me disqualified from working with children.
• I understand that I must notify the Headteacher immediately if there are any changes or additions to the information I have supplied on the form that may occur in future.
Print Name (signature) *
Date
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