It is the policy of Multicultural Community Services to prohibit contracting of individuals with a conviction or employment history of abuse, mistreatment, or neglect. I certify that I do not have an employment history of abuse, mistreatment, or neglect of individuals placed under my care, nor have I been convicted of any offense(s) involving violence or inappropriate behavior with others. I understand that my obligation as a health care worker in the Commonwealth of Massachusetts and/or an independent contractor of Multicultural Community Services is to report any suspicion of abuse, mistreatment, or neglect of any individual through the proper channels. Further, I certify that I have read, understand, and agree to comply with agency policies and procedures regarding client welfare, health, and safety. I understand that falsification of this document may result in disciplinary action up to and including loss of contract.