CHILDREN’S CHOICE, INC.
RESOURCE FAMILY HOME STUDY
DATA COLLECTION SHEET PART II
Name: ______Completed By: ______
Address: ______
______
Town/CityCountyZip Code
Phone Number: ______Date: ______
I.Introduction to Children's Choice
A.Purpose of home study: foster/adoption
- To educate applicants sufficiently that they can make an informed decision about fostering and/or adopting a child.
- To learn enough about the applicants so that the social worker can make a reasoned decision about approving them as foster/adoptive parents and placing a particular child in the home.
B.Procedure of Home Study II
1.Interviews: The home study consists of a series of interviews and discussions with the applicants. If a couple is applying, a separate interview with each spouse is required. The person conducting the home study is also required to meet each person, both adults and children living in the home. The social worker should schedule as many interviews as necessary to feel comfortable in recommending the acceptance (or rejection) of the family.
2.Documentation: For families interested in adoption, an adoption application will be given to the family that will include an outline for an autobiography and form for FBI Criminal Clearances for the applicant(s) and all adults over the age of 18 living in the home. (if applicable)
- Home Study format must be translated into a written narrative that includes each one of these headings and the applicable questions/responses in each heading category.
CC 3:2C
Rev. 10/07
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C.Agency Information
- Christian Mission, Values, and Philosophy.
- Review referral sources of children placed in foster care and/or needing adoption.
- Explain the process that moves Children's Choice foster children to adoption and other special needs children in the state (and nation) needing adoption.
D.Children's Choice Explanations of Foster/Adoptive Parents
- Emotionally stable individuals.
- If married, that relationship is stable and satisfying.
- Realistic expectations of a foster/adopted child.
- Parenting skills or willingness to acquire such skills (discipline without corporal punishment, desire to help a child learn life skills).
- Willingness to work effectively with the foster/adoptive child’s birth parents.
- Willingness to discuss permanency with the child.
II.Topics for Discussion
Record responses to questions in the spaced provided so that each question/response can be addressed in the written narrative:
A.Motivation
1.Why are you now interested in providing foster care and/or becoming adoptive parents?
2.If infertile, state medical picture of fertility facts and applicants’ understanding and attitude about their infertility?
3.What factors led to the decision to become a resource parent at this time and any problems expressed in arriving at this decision?
4.Do you think you would have similar feelings toward a foster or adopted child as toward a child who was born to you?
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5.Do you think you would have different feelings toward a foster child than toward a child who was born to you?
6.What are some of the difficulties you see fostering a child or raising a child?
7. Would it be difficult for you to accept and encourage the child’s relationship with his/her biological parents?
- What are some of the positives you see in foster care and adoption? (Look for answers like: I would like to share my life and love with a child who needs a home).
9.How will you discuss foster care and/or adoption with a child placed in your home? (Look for answers that speak to the developmental needs of the child. At 5 or 6, I would probably say…. At a later date I’d say…)
10.How do you discuss permanency with a child?
11.If they have children: Do you anticipate any problems developing between the children living with you and a foster/adoptive child?
12.How will your schedule differ if a foster/adoptive child comes to live with you?
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13.Have you ever known anyone who was a foster or adoptive parent? How did you feel about the manner in which they were raising their children?
B.Strengths and Weaknesses
1.How do you see yourself (strengths and weaknesses)?
2.Do you have the ability to communicate and solve problems? (Give example)
3.What are some ways you cope with problems?
4.Are there any medical/health conditions that might affect your ability to care for the child?
5.What were your happiest/saddest experiences of life?
6.How do you express anger?
7.How do you express affection?
8.How do you handle stress?
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9.Have you ever experienced the death of someone close to you? How did you deal with this loss?
10.Do you have an emotional support network (neighbors, friends)?
C.Family Relationships
1.Family history including description of early home life.
2.What do you see as the positive aspects of how you were raised?
3.What are some of the ways that you would raise your children that are different from the way your parents raised you?
4.Current relationships with own family and in-laws (note any problem areas).
5.Any serious health or personal problems in family background?
6.Extended family’s awareness and reactions to plans of fostering and the potential of providing permanency to a child.
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D.Marital Relationships
1.How do you describe your courtship and marriage?
2.Please describe each other’s strengths and weaknesses and what they like/do not like about each other?
3.What is the stability and maturity of your marriage as well as any problems?
4.Are there any previous marriages and if so, please explain and give some background?
E.Social Supports
1.Do you have a good relationship with your friends?
2.What do you like to do for leisure activities (group activities, sports, civic affairs, hobbies)?
- Who are your supports?
F.Spiritual Life
1.What is your religious practice and affiliation?
2.How would you raise your child spiritually?
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3.How would you raise a child with a different religious affiliation than yours?
G.Neighborhood and Community
1.How long have you lived in your current neighborhood?
2.What kind of relationship do you have with your neighbors?
3.What type of community resources are there available (i.e. scouts, support groups-school, special education, church programs)?
H.Education and Employment
1.Highest level of education for each applicant.
2.Type of employment.
- Stability of employment.
*4. Please list employment history for previous 10 years.
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5. If both parents plan to work after the child’s placed, describe childcare
arrangements.
6. Obtain employment reference
I.Financial Status
1.Review Resource Parent Home Study Financial Statement left at Home Study I.
- Does the family’s financial situation allow for an additional financial responsibility of a child?
*3. Has either applicant ever filed for bankruptcy?
If yes collect documentation and explore reason.
Do the applicants have any liens or bankruptcy findings either presently or
within the past 10 years?
If yes, what is the date and location of the filing.
What was the reason for the bankruptcy or lien?
Have payments been made as arranged?
Has the bankruptcy been satisfied?
If yes, when?
If not, when is it anticipated to be satisfied?
***Additional documentation required – if yes to question 3 obtain documentation of bankruptcy or liens.
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*4. Please document any other outstanding debt such as car loans, credit card payments etc.
***Additional documentation required – collect documentation of all outstanding debt for example credit card bills, car payments etc.
***Obtain credit report – 1 free report is accessible per year at either Transunion, Equifax, or Experian.
5.If your resource parent reimbursement/subsidy check should be late, could your finances sustain your foster child for a brief period?
6.Review the Children's Choice billing/reimbursement schedule.
7.For adoption – is subsidy necessary?
8.Obtain copies of last tax return, income verification, and 2 most current
pay stubs.
*9. Obtain lease agreement or monthly rental payment documentation OR
purchase or sales agreement and documentation of monthly mortgage
payment.
*10. Obtain copies of deeds and award letter from social security if applicable.
J.Child Care Philosophies/Abilities
1.What have you enjoyed most about being a parent?
2.What you enjoyed least about being a parent?
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3.Have you ever been a caretaker for someone else’s child? If yes, who and how long?
a.How was that different from parenting your own child?
*b. Have you ever served as a resource parent with another agency?
If yes, please provide detailed information of previous history as a
resource parent including the number and types of children served.
***Additional documentation required – Foster parent registry check.
*c. Have the applicants ever applied to be foster/kinship parents?
If yes when and with what agency?
What is the status of approval or disapproval?
4.What behavior in children do you like best/least?
5.How were you disciplined as a child? What were some of the techniques/methods used by your parents? What do you think were negative/positive?
6. How do you discipline your own children?
7.Do you and your spouse differ in disciplinary techniques? If so, how?
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8.Understanding that physical punishment (hitting, spanking) and demeaning treatment are not permitted by Children's Choice, what disciplinary methods would you think appropriate for the following actions by a foster/adoptive child?
a.Bedwetting
b.Hitting another child
c.Swearing
d.Refusal to eat vegetables
Record the responses of the applicants to the following scenarios:
8.You find your four-year-old foster/adoptive child exploring his/her genitals, what would you say and do?
9.How would you answer the question “Where do babies come from?” posed by your seven-year-old child?
10.Knowing that the birth family visit for your pre-school age foster daughter is court ordered, how would you deal with your child’s tantruming when it is time to leave for these visits?
11.After returning from these visits the child exhibits many acting out behaviors. How would you deal with this?
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12.A 3 year old foster child in your home begins biting and hitting your two younger biological children. You discover this by finding bite marks on the children. What would you say and do?
- You walk by your twelve year old foster son’s room and inadvertently observe him masturbating to a pornographic magazine. What would you do?
K.Type of Child Desired
1.Age:
2.Gender:
3.Nationality:
4.Racial Preference:
5.How many children would you like to foster/adopt?
6.What type of health problems, if any, can your family accept (major vs. minor) and (correctable vs. non-correctable)?
***Address children best suited for the home.***
7.Are there any health factors in birth families that you cannot accept (physical and mental)?
8.What are your expectations of the child?
***Address expectations of the parent/child relationship.
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9.If your foster child needs therapy/counseling, how willing would you be to participate?
10.Will transporting the child to medical appointments cause any conflicts or problems for you and your family?
L.Criminal and Child Abuse Clearances
1.Have you sent or received criminal and child abuse clearances for everyone in the household age 14 and older?
*2. Have applicants ever been the subject of a child abuse report?
If yes when, where, and what were the circumstances?
3. Copies of your clearances will be included with your home study and sent to the referring county when and if you become an adoptive parent.
*4. Has either applicant ever been arrested for a crime?
If yes when, where, what was the charge, what were the circumstances, and what was the outcome?
*5. Do applicants have any criminal charges or judicial proceedings pending?
If yes when, where, what was the charge, what were the circumstances, and what was the outcome?
*6. Do applicants have any convictions?
If yes when, where, what was the conviction, what were the circumstances, and what was the outcome?
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*7. Do applicants have any history of drug or alcohol abuse?
If yes, what substance was used and when?
Is there any current drug or alcohol use?
If yes, what substance and how often?
*8. Do applicants have any record of drug or alcohol related arrests?
If yes when, what was charge, what were circumstances, and what was the
outcome?
*9. Do applicants have any record of drug or alcohol related hospitalizations?
If yes when, what were the circumstances, and what was the treatment?
***If drug arrest was not a felony, homestudy worker must get approval from Children’s Choice and DHS chain of command.
*10. Review Disclosure Statement.
M.Medicals
1.Have you obtained the required physical to become a foster/adoptive parent?
2.Children's Choice Medical Report received?
3. Do the applicants take any prescription medication?
If yes, what medication and for what condition?
N.Mandatory Safety Items
Review the mandatory safety items checklist completed in Home Study I and inspect any items that were not in compliance.
Document compliance by marking the current date next to the remediated item.
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O.Policies and Procedures
Review the policies and procedures packet left at the home as part of Home Study I and secure the applicants signature on each policy and on the Home Study Policy Checklist (CC 3:2D).
(The review of these policies and procedures may require an additional interview with the applicant that may take place at the applicants home or in the Children's Choice office.)
P.Impressions and Recommendations
* General statement of recommendation (positive or negative) by the writer of
the home study.
***Homestudy narrative must address the ability of the parent to cooperate with the agency***
Q.Approval
Statement written by the Program Coordinator making final recommendation for regular, specialized, treatment level foster care and/or adoption.
INSTRUCTIONS TO HOME STUDY WORKER: Thorough gathering of this information from each applicant may require additional on-site visits to the home or interview with the applicant(s) in the Children’s Choice office. This data is to be translated into a narrative report written according to the categories listed above with the included subtopics addressed. The narrative will be added to the application materials and resource noted on the resource parent application sheet. The typed narrative will be filled in the home study section of the resource parent file.
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