Paulette Cecilia Pierce

I have a Degree in Education, from the University of Alberta. I taught for 20 years consecutively for Living Waters Catholic School Division and 15 years for High Prairie School Division. I recently retired from the field. I have a Diploma in Social Work as well from Grant Macewan. I m looking forward to a new challenge in this new field.

• The information you provide on this form is collected under the authority of the Child, Youth and Family Enhancement Act and managed in compliance with the Freedom of Information and Protection of Privacy Act. The information will be used to search for an intervention record about you. We will not release this information for any other purpose. We will not release this information to anyone but you. You will need to provide a photo or scanned copy of your identification for verification purposes only. The copy of your identification will be deleted once the check is completed. If you have any questions about the collection of this information, you may ask the staff member who completed this form for you.
• Alberta Children's Services Ministry cannot ensure that the information on this form is reliable for screening an applicant for employment. The Ministry assumes no liability arising from using this information. Anyone using the information does so at their own risk and must consider all the information provided on the back of this form.
• 1 Personal Information
• My name is: legal name of person requesting a record check (surname) first name middle name
• My address is: (mailing address)
• Postal Code Phone (Residence) Phone (Work) Gender Birthdate (mm-dd-yyyy)
• Email Address
• All other names I have used are: other (surname and maiden names used) first name
• Names, birthdates of all my children/children for whom I have acted as a parent (not foster children) (if now an adult, provide full name when a child)
• Child's Surname Child's First Name Child's Middle Name Child's Gender Birthdate (mm-dd-yyyy)
• By clicking this box I, ________________, state that the information in this form is true to the best of my knowledge as of today. Date (mm-dd-yyyy)
• 2 Request for an Intervention Record Check
• I am applying to work directly with children for the following organization(s), and I want to know about any record of my being involved with Intervention Services in Alberta which indicates that I might have caused a child to need intervention.
• Organization Type of Position Organization Type of Position
• I am applying for a residential facility licence or to work in a Child and Youth Facility as defined in the Child, Youth and Family Enhancement Act. I want to know about any record of my being involved with Intervention Services which indicates that I might have caused a child to need intervention. In the last five years I have resided in Alberta and
• (name of any other province, territory, jurisdiction or country if applicable)
• I reside with someone who is applying to provide care to a child who is in the care or custody of a Director as defined in the Child, Youth and Family Enhancement Act. I want to know about any record of my being involved with Intervention Services which indicates that I might have caused a child to need intervention. In the last five years I have resided in Alberta and
• I am planning to become a ________________ to a child. I want to know about any record of my being involved with Intervention Services which indicates that I might have caused a child to need intervention. In the past five years I have resided in Alberta and
• I had a previous Intervention Record Check completed Date (mm-dd-yyyy)
• I, ____________________________, hereby consent to having an Intervention Record Check completed in Alberta and any other province, territory, jurisdiction or country that I have listed above. Date (mm-dd-yyyy)
• 3 For Office Use Only
• Using the names and birthdates you supplied:
• As of today, I can find no Intervention Services record in Alberta indicating that you might have caused a child to need intervention.
• As of today, I can find no Intervention Services record in Alberta or any other province, territory, jurisdiction or country listed above indicating that you might have caused a child to need intervention.
• There is an Intervention Services record in Alberta indicating that you might have caused a child to need intervention.
• There is an Intervention Services record in ________________ indicating that you might have caused a child to need intervention. Below is a summary of your involvement up to today.
• 4 Summary of Involvement
• Enter Summary of Involvement
• Name of Person who completed Intervention Record Check
• Name of Worksite
• Worksite Address
• City Province Postal Code Office Phone Number
• The photo or scanned copy of the identification of the applicant has been deleted.
• By clicking this box I, ________________, state that the results of record check in this form is true to the best of my knowledge.
• Date (mm-dd-yyyy) Signature
• What's in Intervention Services' records?
• Intervention Services records contain information about the services provided to a child. The records are used to:
• Organize information gathered about the child
• Plan services for the child
• Provide a person with information about the services they received as a child.
• The focus of the record is the child. Adults are referred to in the record only as they relate to the child and the services provided. The record is not written with the intent that it might be used to screen an adult for a position working with children.
• Who can get the information?
• Intervention Services records are confidential and information must not be released except for the purposes set out in the Child, Youth and Family Enhancement Act. The Act allows Intervention Services to give information to someone for the purpose of providing services to the child. This would be someone like a teacher, doctor, psychologist or foster caregiver.
• Any person named in a record has the right to obtain information about themselves that is in the record. The requester may ask for copies of records about themselves under the Freedom of Information and Protection of Privacy Act (FOIP). But such a request gives an adult limited information from an Intervention Services record since all “third party” information is removed. In other words, all information about every other person is taken off the record before the requester sees it.
• What about record checks for job applicants?
• Some organizations require information from an intervention record check before allowing an employee or volunteer to work with children. Intervention Services will complete a check for the person so they don’t have to make a formal request under FOIP. But since these records are not written for this purpose, the information provided might not be very useful.
• To ask for a check, the requester fills out an Intervention Record Check (form attached). By signing the form, the person states, “Because I am applying to work directly with children for the following organization(s), I want to know about any record of me being involved with Intervention Services which indicates that I might have caused a child to need intervention”.
• The requester should call the Intervention Services office where they live Children's Services Office or email the mailbox in their region listed below to find out how to have a check completed in their area. They need to provide identification to prove they are the person named on the form. For example, you should have identification that includes your birth date and signature.
• Intervention Services states on the form whether its records indicate that the person might have caused a child to need intervention and returns the completed form to the person. Then the person decides whether to give the information to the organization.
• How do I get a blank form?
• For a blank form please contact your local Children's Services Office or email:
• CS.IRCCalgary@gov.ab.ca
• CS.IRCCentral@gov.ab.ca
• CS.IRCEdmonton@gov.ab.ca
• CS.IRCNorth@gov.ab.ca
• CS.IRCSouth@gov.ab.ca
• What should organizations know about checks?
• If your organization is considering requiring prospective employees or volunteers to obtain an intervention record check:
• You must realize that the records are not intended for screening purposes and might not provide information very useful for that purpose. For instance:
• Under the Child, Youth and Family Enhancement Act, a child might need intervention services for reasons other than abuse. So a person might place a child in need of intervention without abusing the child.
• The record might indicate that a person with the same name and unknown birth date might have placed a child in need of intervention. Therefore, it is not possible to tell whether the applicant is the person in the record.
• The staff member who reads the record might infer that the person might have placed a child in need of intervention when the writer of the record did not intend to imply that.
• Intervention Services might have received several complaints about the person but never found any evidence that a child needed intervention. Therefore, the callers had serious concerns but Intervention Services found nothing to indicate on the record that the person might have placed a child in need of intervention.
• The person might have placed a child in need of intervention but the record has been destroyed because Intervention Services did not provide services to the child.
• Intervention Services has records for Alberta only so the records do not provide information if the person placed a child in need of intervention in another province or country.
• The person might have been a victim of circumstances and had little choice at the time other than to place the child in need of intervention.
• The director will request a record check from another province if the applicant is going to work in a residential facility and has provided a consent to complete such a record check.
• Your organization needs to recognize that the record focuses on the child’s need and the services provided. So information on the record about other people might not clearly describe how they were involved.
• You should not use the information on the form as the sole reason to refuse a position but only as an indicator of areas to explore in your screening process. You should verify any problematic information by other contacts and consider it in the context of:
• The type of position the person is applying for
• When the problem occurred
• How the problem was resolved
• What has happened since the problem.
• If you make it a blanket policy to refuse any applicant whose form states they might have caused a child to need intervention:
• You are unfair to an applicant who has worked to resolve their issues and to make changes in their life.
• You encourage applicants to ask Intervention Services to remove information from its records. To remove this information would be inappropriate for the child: the child should be able to expect Intervention Services to have a complete record of its services to the child.
• How can I find out more?
• For more information about intervention record checks, contact the Regional Children's Services Office or Delegated First Nation Agency. For more information about FOIP, contact the Information and Privacy Branch at 780-427-2805. To be connected toll-free to any Alberta Government number, call 310-0000.