Agency Schedule Detail

Authorization Number : 50740136

Agency Series No. : DDDMDA-10

Status : Active

Agency Web Link :

Agency : DDD

Confidential Description : May contain SSN and other confidential information

Division : DDDMDA

Vital Description :

Section :

Record Title : Provider Certification Records

Revision : 0

Record Description : Certificates provided to individuals, providers, agency facilities, or county boards that have successfully passed Department review for certification, program, medication administration, certification qualifications, and/or services provided. This includes all applications for certifications and needed documentation for review.

Retention Period	Retention Justification	Media Code	Method of Disposal
Retain until scanned and saved electronically.		Paper	Shred
Retain for 5 years after certification ends.		Electronic	Delete

Approvals

Status	Name	Title	Date
Approved	Stephanie Deters	Records Officer	6/13/2024 3:52:28 PM
Approved	Terri Dittmar	Record Administrator	6/14/2024 8:41:30 AM
Approved	Martin Meeks	State Auditor	6/14/2024 9:25:11 AM
Approved	Fred Previts	State Archivist	6/18/2024 4:59:47 PM

Notes

Date	Reason	User