Our Services

Information for Staff

Camp Chihopi
August 8-11, 2014

Providing a fun, rewarding and safe camp experience for the campers of Camp Chihopi is the primary goal of our exceptional staff. At Camp Chihopi, the staff strives to pay particular attention to the individual camper in an atmosphere of friendship, relaxation, and support. The camp is a well-supervised environment with 1 staff member for every 3 to 5 campers and with rules that apply to both campers and staff.

Camp Chihopi seeks volunteers who are enthusiastic role models for children, enjoy an outdoor environment, desire an opportunity for personal growth, and most importantly, who are compassionate in their interactions with children adapting to life after transplantation. Chihopi staff should have respect for each other and all campers, and display appropriate behavior by respecting personal property, promoting good sportsmanship and adhering to camp rules.

Application Process
Security Clearances
Medical Clearance
Orientation

Application Process

Please review the description for each role that interests you. Then print the form(s) and complete the staff application for that position. After completing the application, please fax, scan/email, or “snail mail” to the addresses below. Completed applications must be received by Monday, June 30, 2014. In-person or telephone interviews for first-time applicants and CITs will be completed in early July.

CIT applicants please note: The application process for a CIT position has additional requirements. Please read the CIT application process carefully if you are applying for this position. If you have any questions, please call Bev Kosmach at 412-692-6115.

Send your completed application by June 30, 2014 to:
Beverly Kosmach-Park
Children’s Hospital of Pittsburgh of UPMC
Faculty Pavilion, 6th floor
4401 Penn Ave
Pittsburgh, PA 15224
Email: beverly.kosmach@chp.edu
Fax: 412-692-6116

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Security Clearances

All Camp Chihopi staff 18 years and older must have security clearances within the last two years (valid to August 12, 2014). Staff who are accepted for positions at camp must submit their verified security clearances to Bev Kosmach by July 15, 2014. The University of Pittsburgh Medical Center mandates that security clearances be obtained every 2 years. There are no exceptions to this rule. Staff are strongly encouraged to begin the security clearance process as soon as possible as the process may take up to 8 weeks.

Camp Staff 18+ years of age who are residents of PA:
All camp staff 18 years of age and older who are residents of Pennsylvania should first complete and submit a State Police Criminal Record Check (PDF).

When your approved form is returned, then complete and submit the Act 33 Clearance Form (PDF) as instructed.

You must also complete the Act 73 Clearance Form online at https://www.pa.cogentid.com/index_dpw.htm.

Act 34 Clearance Form: Request for Criminal Record Check
This record check can be completed by:

  1. Accessing the PA Criminal History website or
  2. Using the attached form on the Camp Chihopi website

Website: Access the PA Criminal History website
The website application is easy, quick, and self-explanatory. You should be able to complete and submit this form in less than 5 minutes.

  • Home page: click on the “Record Check” tab, top center of page.
  • Then click “New record check.”
  • For the drop-down “Reason for Request,” click on Volunteer.
  • The $10 fee must be paid by credit card.

Paper form: Print and complete the form Request for Criminal Record Check (PDF).

  • On the right side of the form, 3rd section down, check the box: “Individual/criminal justice agency.”
  • Under the REASON FOR REQUEST section, check the last box “Volunteer.”
  • Enclose a certified check or money order (no personal checks or cash) for $10 payable to the “Commonwealth of Pennsylvania.”
  • Mail the Request for Criminal Record Check form to:
    PA State Police
    Central Repository – 164
    1800 Elmerton Ave.
    Harrisburg, PA 17110-9758

This form will be processed through the State Police, then returned to you.

Act 33 Clearance Form: Pennsylvania Child Abuse History Clearance
After receiving the processed “Request for Criminal Record Check,” (above) complete the Act 33 Clearance Form: Pennsylvania Child Abuse History Clearance (PDF).

  • Section 1: contact information, SS#, etc.
  • Purpose of clearance: check Volunteers
  • Previous names used
  • Previous addresses since 1975
  • Household members since 1975
  • Sign the form
  • Mail the following items:
    1. PA Child Abuse History Clearance (Act 33 Clearance)
    2. Processed Request for Criminal Record Check
    3. $10 money order (no cash or checks!) payable to the Dept of Public Welfare
  • The above items should be mailed to:
    Childline and Abuse Registry
    Dept of Public Welfare
    PO Box 8170
    Harrisburg, PA 17105-8170

Act 73 Clearance Form: FBI Criminal Background Check
Act 73 of 2007 requires that any prospective employee/volunteer of a child care service must obtain a fingerprint based FBI clearance in addition to the child abuse (Act 33) and Pennsylvania State Police criminal history record checks (Act 34). To comply with Act 73 requirements of Children’s Hospital of Pittsburgh of UPMC, please complete the following:

Payment Information: The fee for this record check is $27.50. No cash, personal, or business checks are accepted. This fee can be paid by:

  1. Money orders are made payable to Cogent Systems.
  2. Payment made online at www.pa.cogentid.com using a credit or debit card

Registration:

  • The applicant must register prior to going to the fingerprint site. Walk in service without prior registration will not be provided at any fingerprinting location.
  • Registration is available online 24 hours/day, seven days per week at www.pa.cogentid.com.  
  • Telephone registration is available at 1-888-439-2486 Monday through Friday, 8 am to 6 pm EST.
  • During the registration process, all demographic data for the applicant is collected (name, address, SSN, etc.); there is no data entry required at the fingerprint collection site.

Log In:

  • Access the website www.pa.cogentid.com  
  • Click on the Pennsylvania Department of Public Welfare (DPW) icon on the right side of the web page.
  • Under ‘Print Locations and Sites,’ click on the ‘Print Locations and Hours’ to find a site that is most convenient to you. Most of the sites are UPS stores. You may go to any site to have your fingerprints scanned. However, you must register through the Cogent website prior to going to a fingerprint location.
  • After deciding on a convenient location, you can begin the registration process.

Register:

  • Click on ‘Register Online’ located on the main DPW page. On the following Applicant Registration page, you will only need to complete all fields highlighted in yellow and marked with a red asterisk. Please note that for the field marked ‘Reason Fingerprinted’ you will need to select ‘Employment with Significant Likelihood of Regular Contact with Children’ from the drop down box. You are going to be a volunteer, but this is not a selection.
  • The applicant will pay a fee of $27.50 for the fingerprint service and to secure the Criminal History Record. Applicants may make their payment online at www.pa.cogentid.com using a credit card or debit card. Money orders or cashier’s checks payable to Cogent Systems will be accepted on site for those applicants who do not have the means to pay electronically. No cash transactions or personal checks allowed.

Obtain Fingerprints:

  • Report for your scheduled appt at the location that is convenient for you.
  • After completing the prints at the fingerprinting location, your background will be processed by the FBI and sent to the Department of Public Welfare (DPW). The DPW will then send you your results via the mail.
  • The original information sent to you via the DPW needs to be submitted to Bev Kosmach, Director, Camp Chihopi.

Submit Approved Act 33, 34, and 73 Forms

  • The processed PA Child Abuse History Clearance and Criminal Check will be returned to you in 4-8 weeks.
  • Copy the forms and fax (412-692-6116), scan/email (Beverly.Kosmach@chp.edu), or snail mail to:
    Bev Kosmach-Park
    Department of Transplant Surgery, 6FP
    4401 Penn Ave.
    Pittsburgh, PA 15224

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Camp Staff 18+ years of age who are NOT residents of PA:
Out-of-state applicants who are 18 years of age must first complete Form FD-258 (FBI Criminal History) (PDF)

When your approved form is processed and returned to you, complete and submit the Act 33 Clearance Form (PDF)

STEP 1: FORM FD-258, FBI Criminal History
This is the FBI background check that requires fingerprints

Form FD-258:

  • You can print this form from the Camp Chihopi website or you can find a form by “Googling” FD-258 and print the form directly from an internet site. Some police stations are fingerprinting by computer now rather than ink (a system called IAFIS – Integrated Automated Fingerprinting Identification System), but you must take the card with you.
  • Obtain fingerprints: Take the fingerprint form to a local state police station or other location. There are many UPS stores that have fingerprinting services. If you live in Ohio, for example, you can Google “UPS fingerprinting Ohio locations” to search for a store that is convenient to you.

Processing:

  • If you get fingerprinted at a state police station, ask them to process your prints as they usually do for someone who is being investigated.
  • If you received a fingerprint card from a UPS location, submit it to your local state police department for processing.
  • After processing your fingerprints, you should receive a letter or form from the state police that provides criminal clearance.
  • Make a copy of this form and send with your Act 33 Clearance (next step) as described below.

Please note: If you live close to the PA border, you can get fingerprinted and processed very easily through a system called COGENT. The background check is done completely on line, although you still have to go to a UPS site in PA for fingerprinting. The instructions for COGENT are attached at the end of this document.

STEP 2: Act 33 Clearance Form: Pennsylvania Child Abuse History Clearance
After receiving the processed fingerprinting form, please complete the Act 33 Clearance Form: Pennsylvania Child Abuse History Clearance (PDF).

  • Section 1: contact information, SS#, etc.
  • Purpose of clearance: check Volunteers
  • Previous names used: complete
  • Previous addresses since 1975: complete
  • Household members since 1975: complete
  • Sign to form
  • Mail the following items:
    1. PA Child Abuse History Clearance (Act 33 Clearance)
    2. Processed Form FD-258
    3. $10 money order (no cash or checks!) payable to the Dept of Public Welfare
  • The above items should be mailed to:
    Childline and Abuse Registry
    Dept of Public Welfare
    PO Box 8170
    Harrisburg, PA 17105-8170

STEP 3: Submit Approved Forms for Camp

  • The processed PA Child Abuse History Clearance will be returned to you in 4-8 weeks.
  • Copy the forms and fax (412-692-6116), scan/email (Beverly.Kosmach@chp.edu), or snail mail to:
    Bev Kosmach-Park
    Department of Transplant Surgery, 6FP
    4401 Penn Ave.
    Pittsburgh, PA 15224

COGENT: This is a fingerprinting and background check system used in PA. If you are a non-PA resident, you can use this system (see below) to obtain fingerprints, but you must come to PA for fingerprinting. If this is convenient for you, it is a very easy way to obtain a background check. If not, please follow the directions in Step 1 on the first page of this document.

Act 73 Clearance Form: FBI Criminal Background Check (PDF)

Payment Information: The fee for this record check is $27.50 No cash, personal, or business checks are accepted. This fee can be paid by:

  1. Money orders are made payable to Cogent Systems.
  2. Payment made online at www.pa.cogentid.com using a credit or debit card

Registration:

  • The applicant must register prior to going to the fingerprint site. Walk in service without prior registration will not be provided at any fingerprinting location.
  • Registration is available online 24 hours/day, seven days per week at www.pa.cogentid.com.
  • Telephone registration is available at 1-888-439-2486 Monday through Friday, 8 am to 6 pm EST.
  • During the registration process, all demographic data for the applicant is collected (name, address, SSN, etc.); there is no data entry required at the fingerprint collection site.

Log In:

  • Access the website www.pa.cogentid.com  
  • Click on the Pennsylvania Department of Public Welfare (DPW) icon on the right side of the web page.
  • Under ‘Print Locations and Sites,’ click on the ‘Print Locations and Hours’ to find a site that is most convenient to you. Most of the sites are UPS stores. You may go to any site to have your fingerprints scanned. However, you must register through the Cogent website prior to going to a fingerprint location.
  • After deciding on a convenient location, you can begin the registration process.

Register:

  • Click on ‘Register Online’ located on the main DPW page. On the following Applicant Registration page, you will only need to complete all fields highlighted in yellow and marked with a red asterisk. Please note that for the field marked ‘Reason Fingerprinted’ you will need to select ‘Employment with Significant Likelihood of Regular Contact with Children’ from the drop down box. You are going to be a volunteer, but this is not a selection.
  • The applicant will pay a fee of $27.50 for the fingerprint service and to secure the Criminal History Record. Applicants may make their payment online at www.pa.cogentid.com using a credit card or debit card. Money orders or cashier’s checks payable to Cogent Systems will be accepted on site for those applicants who do not have the means to pay electronically. No cash transactions or personal checks allowed.

Obtain Fingerprints:

  • Report for your scheduled appt at the location that is convenient for you.
  • After completing the prints at the fingerprinting location, your background will be processed by the FBI and sent to the Department of Public Welfare (DPW). The DPW will then send you your results by mail.
  • The original information sent to you via the DPW needs to be submitted to Bev Kosmach, Director, Camp Chihopi.

UPMC Employees
Employees of Children’s Hospital/UPMC do not have to update their clearance status because the hospital maintains current updates.

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Medical Clearance

All staff who are transplant recipients must have routine labs done between May 1, 2014 and August 1, 2014 to attend camp. If you receive care at Children’s, your lab report will be accessed for you. You do not need to do anything. If you receive care as an adult at UPMC or another hospital in your local area, please have your lab results faxed by July 29, 2014. If your care is managed by a transplant center other than UPMC or Children’s, please have your doctor or transplant coordinator send a copy of your most recent check-up or medical assessment as well as a letter stating you are healthy enough to attend camp. These should be faxed (412-692-6116) to the attention of Bev Kosmach-Park, Department of Transplant Surgery, Children’s Hospital of Pittsburgh.

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Orientation

All staff are required to attend a mandatory orientation session and dinner meeting on Thursday, August 7 from 6-8:00 p.m. at Children’s Hospital of Pittsburgh. More information will be sent to staff in mid-July. Staff are responsible for roundtrip transportation to Pittsburgh and lodging in the Pittsburgh area on Thursday night, August 7.

 
 
Last Update
March 18, 2014
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Last Update
March 18, 2014
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