Auditors repeated their criticisms Wednesday of the state agency charged with performing background checks on daycare providers, saying it did not follow up on issues raised by the reviews.

The Department of Public Health uses “a highly manual process” to conduct background checks and communicates the results using “paper memoranda,” according to the audit report.

The Auditors of Public Accounts first raised issues with DPH’s background check process in a December 2012 report covering 2008 and 2009. Auditors noticed the agency licensed two new daycare centers before completing background checks on all employees.

In February, when Raising Hale first reported on the background-check issues, DPH declined to comment.

In the latest report, covering 2010 and 2011, auditors found instances where the agency’s legal office raised issues based on the background checks, but either found no evidence the agency acted on that information or followed up after acting.

The agency agreed with recommendations from the auditors and has begun changing procedures accordingly.