Devereux Therapeutic Foster Care

Fax

FOSTER PARENT WEEKLY PROGRESS REPORT

Child: Last First Middle
Foster Parent: Weekly Documentation Period:
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Child’s Measurable Objectives
Ratings: 1- No Progress 2- Minimum Progress 3- Moderate Progress 4- Substantial Progress
Goal 1. / SUN / MON / TUE / WED / THUR / FRI / SAT
Weekly Summary:
______
Goal 2. / SUN / MON / TUE / WED / THUR / FRI / SAT
Weekly Summary:
______
Goal 3. / SUN / MON / TUE / WED / THUR / FRI / SAT
Weekly Summary:
______
Goal 4. / SUN / MON / TUE / WED / THUR / FRI / SAT
Weekly Summary:
______
Weekly Accomplishments:
Behavior Management/ Discipline techniques/ Interventions utilized this week?
Contacts you have had this week with others about your child:
Who:______Reason: ______Date:______Time: ______
Who:______Reason: ______Date:______Time: ______
Who:______Reason: ______Date:______Time: ______
Who:______Reason: ______Date:______Time: ______
Who:______Reason: ______Date:______Time: ______
Who:______Reason: ______Date:______Time: ______
Who:______Reason: ______Date:______Time: ______
Is your child having problems eating? Yes No
Description:______
Is your child having problems sleeping? Yes No
Description:______
Any new behaviors? Yes No
Description:______
Academic Support:
Is your child attending school as required? Yes No
Did your child miss any days this week? Yes No Description:______
______
Any behaviors at school? Yes No Description:______
______
Any educational meetings, appointments, events, and or activities this week? Yes No (If yes please review the types below and provide a brief description/ summary)
Types:
[1]Caregiver advocacy with teacher or other school official [2]Staff advocacy with teacher or other school official
[3] Caregiver educational surrogate training [4]Community education enrichmentactivity [5]IEP Meeting [6]In-home educational enrichmentactivity[7]Parent-Teacher Conference [8] PTA Attendance[9]Tutoring Attendance[10]Other types School meeting, conferences, or staffing
Type:____ Date: ______Description: ______
______
Type:____ Date: ______Description: ______
______
Type:____ Date: ______Description: ______
______
Did your child see their therapist this week? Yes No If no why?
Did your child attend a psychiatric appointment this week? Yes No Date
Did your child’s medication change? Yes No If yes, what is your child currently taking?
Was your child ill this week? Yes No Did your child go to the doctor? Yes No
If yes, is your child on any prescribed or over the counter medication? Please list them:
Did your child have contact with family members this week? Yes No
If yes, what kind of contact (visit, phone, or letter) with whom, and on what date?
Was your child on respite this week? Yes No
Please state the family that the child was on respite with and dates:
Please put the date that your child received his/ her allowance:
Please list the amount of allowance received:

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Foster Parent Signature DateBFS Case Manager Date

Child Name: ______Weekly Documentation Period: ______