1

·          Visit the family’s home to conduct a basic assessment. 

·          Explain to the family:

-        DCF licensing regulations and requirements (provide a copy to the family)

-        the need for the family’s cooperation with the Department in the licensing process. 

·          If the family appears to be an appropriate resource, provide the following forms which must be completed for licensure: 

-        DCF-354, “Application for Foster Care or Adoption”

-        DCF-357, “Physician’s Statement for Foster Care or Adoptive Applicant”

-        DCF- 2109, “Information Consent Form for Foster Care or Adoption” (complete as applicable for a special study assessment)

-        DCF-2111, “Disciplinary Agreement”

-        DCF-2112, “Confidentiality Agreement”

-        State and FBI fingerprint cards for any household member age 16 years or older.

-        Other licensing forms applicable for that family;  e.g., DCF-446, “Auxiliary Heating Systems”. 

Full-time babysitters or caregivers in the home who are not members of the household must also submit a medical clearance (DCF-357), and state and FBI fingerprint cards.

2

·          Complete a search in LINK, CMS and VPS to determine if the family has been previously known to DCF as either a foster parent or a protective services client.  If so, obtain and review any closed records. 

When conducting the search, include all names used by the family members including previous married names, maiden names and aliases. 

·          Request a name search by the state police and local police of all adults in the home and any full-time babysitters or caregivers.  (Fingerprint cards will be processed by the FASU licensing worker during the licensing assessment.)

3

·          Complete and submit DCF-2144, “Special Study Preliminary Assessment” to his/her Social Work Supervisor and Program Supervisor for their review and approval. 

This form includes two sections, “Child Background Data” and “Basic Assessment of the Home”.

4

·          Upon receipt of the supervisory approvals, forward the following to FASU for completion of the assessment for licensure: 

-          Original DCF-2144 (Preliminary Assessment) 

-          Signed DCF-354 (Application for Licensure) 

-          Results of the local and state police name searches. 

·          File copies of the above in the child’s record.

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