FACILITY:
______
CCI -
FOSTER CARE SERVICES
*FPs are counted as CCI staff ( must have all items plus addtl FC rules; can have 15 hrs training)
*FP staff are counted with CCI staff
*FC are counted with CCI Children / DATE:
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FOSTER PARENT NAME
DATE OF ACCEPTANCE
NAME OF FC
DATE OF FC PLACEMENT
290-9-2-.07(3) / 1303 / (3) Orientation prior to application
to include:
(a) Purpose & services
(b) Approval process
(c) Limit to # of kids, permissible discipline
(d) Roles and responsibility of F.P.
290-9-2-.07(3) / 1303 / (e) Description of children served by agency
(f) Support services available
(g) Info on reimbursement for expenses
290-9-2-.07(4) / 1311 / (4) Training for Prospective F.P.
(a) Grievance P & P
(b) Annual training
15 hrs training (kids over 12 months) &
8 hrs training (kids under 12 months)
290-9-2-.07(4) / 1311 / (c) Behavior management and discipline
(d) Child abuse recognition, reporting & investigation procedures
(e) Characteristics of children served, developmental needs & special needs
(f) Medical emergency & managing meds
290-9-2-.7(5) / 1317 / (a) Home Study
Names of family members
Address
Phone #
Driver’s License #
Proof of auto insurance / Date: / Date: / Date:
290-9-2-.07(5) / 2. Motivation for foster parenting
290-9-2-.07(5) / 3. Description of family members:
(i) Date & place of birth
(ii) Physical description
(iii) Family background and history
(iv) Current relationships w/immediate and extended family members
(v) Education
(vi) Social involvements
(vii) Personal
Characteristics:
(i)Personality
(II) Interests & hobbies
(III) Emotional stability
290-9-2-.07(5) / 4. Evaluation of marriage and family life:
(i) Verified date & place
of marriage (certif.)
(ii) Assessment of marital relationship
(iii) Family interaction patterns
(iv) Previous marriages (divorce decree)
290-9-2-.07(5) / 5. Evaluation of parenting practices:
(i) Parent knowledge, attitudes & skills
(ii) Discipline practices
(iii) Child rearing practices
290-9-2-.07(5) / 1323 / 6. Evaluation of physical & mental health:
(i) Health history and condition each person
(ii) Doc. of physical exam of all adults over 18 yrs. old within one year
(iii) Health statement for all others
(iv) Informal eval. of mental health of each
(v) TB & VDRL on all over 16yrs.
290-9-2-.07(5) / 1324 / 7. Evaluation of understanding of and adj. to foster parenting:
(i) Role of F.P. & issues in caring for F.C.
(ii) Attitude toward child’s parents & visits
(iii) Expectations of the F.C. both intellectual & physical
(iv) Antic. Adjustment of F.F. to F.C.
(v) Willingness to cooperate w/CPA
(vi) Support network & single parent network
290-9-2-.07(5) / 1325 / 8. Finances and occupation:
(i) Employment history, family daycare home
(ii) Financial stability of family
(iii) Projected financial impact of child
290-9-2-.07(5) / 1326 / 9. Home and Community:
(i) Description of neighborhood
290-9-2-.07(5) / 1326 / (ii) Physical space in home including:
(I) Space & sleeping arrangements
I. Only bedrooms used for sleeping
II. Max of 2 per full size bed, & only of same sex & only under age 5
III. No child under 1 yr. sleep in room w/adult
IV. Kids over age 3 of different sexes must sleep in different bedrooms
V. Kids have adequate space for clothes and personal possessions
290-9-2-.07(5) / 1326 / (II) Home maintained for health & safety
(III) Hazardous items not accessible
(IV) Firearms locked away from children
(V) Swimming pool is fenced & supervised
(VI) Smoke alarms present & functioning
(VII) Water supply & sewage
(VIII) Pets inoculated
(IX) Gas heaters vented
290-9-2-.07(5) / 1326 / (iii) Assessment of community resources, schools, religion, recreation and
medical & mental health facilities
290-9-2-.07(5) / 1327 / 10. Religion
290-9-2-.07(5) / 1328 / 11. CRC on all family over 18 years
290-9-2-.07(5) / 1329 / 12. Pre-service training F.P. or family may have received
290-9-2-.07(5) / 1330 / 13. Three Character references:
(i) One reference from a family member
(ii) One ref. From other foster agency or reference from former employer if worked with children w/in last 5 years, one former employer
290-9-2-.07(5) / 1332 / 14. Child applicant would consider:
1. Sex,
2. Age
3. Ethnicity
4. Physical
Medical or emotional parameters
1333 / 15. Date completed, name and signature
290-9-2-.07(5) / 1335 / (b) Notification of Approval in writing
290-9-2-.07(5) / 1336 / (c) Location of the Homenear agency for regular visits
290-9-2-.07(6) / 1337
1338
1339 / (6) Services Prior to Care Placement
(a) Selection of home for a particular child based on assessment of child’s total needs and how well that home can meet the needs
(b) Kids of same family kept together if possible & appropriate
(c ) Placement considerations include religion and cultural activities of the child
290-9-2-.07(6) / 1340 / (d) Agency discuss prospective placement of a particular child w/F.P. by
anticipating adjustment and problems & any special services to be provided. Document this.
290-9-2-.07(6) / 1341 / (e) Preplacement activities btn child and F.F. shall be documented in child & family record
290-9-2-.07(6) / 1342 / (f) Placement agreement w/child, F.P., parent/guardian, CPA & signed by all adults:
  1. Authorization for care
  2. Authorization for medical care for child

290-9-2-.07(6) / (g) Written agreement w/F.P regarding: payment of board, arrangements for medical care, clothing incidental expenses, visits by parents, discipline, advance notice of removal when placements are terminated by F.P. and emergency procedures
290-9-2-.07(7) / 1373 / (7) Services During the Foster Care Placement
(a) Plan of Care for F.C. & F.F. w/in 30 days
1. Reevaluated & reviewed in case review conference every 6 months
2. Involvement of child, F.P., Agency & legal custody holder documented
290-9-2-.07(7) / (b) Case plan shall include:
1. Reason for present placement
2. Preliminary discharge plan
3. Special care & services arranged for or provided for directly
290-9-2-.07(7) / 4. Time limited goals and objectives for child & family:
method of achieving &
method of evaluating obtainment of goals (i) Who is resp. for carrying out objectives with F.C., birth parents, F.P. & agency
(ii) Method of evaluating and changing goals as needed
290-9-2-.07(7) / 5. Visitation plan, w/changes documented
(i) Provisions for visits btn parents/children
(ii) Parent/child informed of visitation plan
290-9-2-.07(7) / (c) Home finding services only – they don’t have to do their own case plan but must have the state’s in the case file.
290-9-2-.07(7) / (d) Agency has health & dental program:
1. Physical exam w/in 72 hrs or w/in 1 yr.
290-9-2-.07(7) / 2. Dental exam, over age 3, or w/in 6 mos.
290-9-2-.07(7) / 3.Correction/improvement of health/dental defects (annual physical, semi-annual dental)
4. Immunizations
290-9-2-.07(7) 290-9-2-.07(7) / (e) Provide academic or vocational training as per child’s ability/aptitude & must attend
290-9-2-.07(7) / 1344 / (f) Monthly home visits shall include F.C. and F.P. by agency
290-9-2-.07(7) / 1346 / (g) Anuual eval. Of the strengths/needs of F.F. & assessment of best ways to maximize the F.C. exper. For the F.F. & F.C.
Eval. shared w/F.F. w/sig. of F.P. on Eval.
290-9-2-.07(7) / 1346 / (h) Doc. of supervision of placement:
1. Adjustment of child to F.F. &
family to F.C.
2. Progress made on treatment plan goals
3. New problems that may have arisen & actions taken toward solution
4. Contacts & issues w/other resources
5. Agency updates on approp. of family
6. required annual training
290-9-2-.07(7) / 6. Doc. of annual training by F.P. after initial placement, training relevant to types of children in their home
290-9-2-.07(7) / (i) Termination of agency care determined by casework study/planning w/child & family &/or agency responsible for that child
290-9-2-.07(8) / (8) Discipline and Behavior Management
(a) Child training, discipline & beh. mgmt. by F.P. shall be approp. to age, intelligence, emotional makeup & past experience
(b) Techniques shall be positive in nature unless, when correctly & consistently used have been shown to be ineffective
290-9-2-.07(8) / 1403 to 1408 / (c ) Discipline that is prohibited & not used:
1. Excessive, unreasonable work tasks that are not related to child’s misbehavior
2. Denial of meals & hydration
3. Denial of sleep
4. Denial of shelter, clothing or essential personal needs
5. Denial of essential services
6. Verbal abuse, ridicule or humiliation
290-9-2-.07(8) / 1409
to / 7. Chemical or mechanical restraints
8. Denial of communication & visits w/family unless as per case plan or court order
9. Corporal punishment
10. Confinement where it may cause physical or emotional discomfort
11. Confinement not age appropriate to child & must be supervised to ensure safety
290-9-2-.07(8) / (d) Children shall not discipline other kids
290-9-2-.07(9) / (9) Maintenance of Foster Care Records
(a) Maintain separate records for each foster home begun at application
290-9-2-.07(9) / (b) Foster Home record includes:
1. Application
2. Home study
290-9-2-.07(9) / 0949 / 3. Medical reports for each member of family
290-9-2-.07(9) / 0950 / 4. Summary narrative of dates/content material of C.W. contacts
5. References
290-9-2-.07(9) / 0952 / 6. Annual eval. of F.H., F.F., and placements
7. Placement history of the F.H., kids placed, dates in & out & reason for discharge
290-9-2-.07(9) / 0954 / 8. CRC on all adults over 18 years
290-9-2-.07(9) / 0957 / (c ) F.H. records maintained 3 yrs
290-9-2-.07(9) / 0959 / (d) Maintain separate record for each child:
1. Name, sex, race, birth date, place of birth
2. Name, address, phone, marital status of parent or guardian
3. Name, address, phone of F.P. with now
290-9-2-.07(9) / 4. Legal documents, birth cert., court status, agreements & consents
5. Social history of the family & parent past
6. Medical history, health & psych. Records
7. Educational records
290-9-2-.07(9) / 8. Plan of Care
9. Summary of each 6 month case review reflects contacts w/status of all family in relation to placement plan, achievements & changes in goals or services
10. Summary of child’s contacts w/family, quality of relationship & child’s coping
290-9-2-.07(9) / (e) In child & F.F. record following termination of placement:
1. Date of termination, reason, name, phone, address & rela. Of person assuming respon.
2. Termination summary incl. services provided, growth & accompl., assessed needs not met w/service possibilities
3. Aftercare plans that show who must follow through.
290-9-2-.08 / (f) Family/child records maintained 3 years
290-9-2-.08 /

Agency Records & Reports

(1) Maintain records & submit timely reports
(2) Maintain permanent listing of children
(3) Records are confidential
(4) Records kept current and available
290-9-2-.08 / (5) Submit timely financial statements & board minutes
290-9-2-.08 / Special Reports w/in 24 hrs(5 days writing)

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