FCL 002 Rev 2/2019 Page 1 OF 1 KANSAS
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Initial application (new facility, move, or change of ownership
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CURRENT ADDRESS
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Street Address City State Zip
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL_forms/FCL_002_Individual_Background_Check_Request.pdfView duplicates
obtain written approval from the secretary before making any change in any of the following
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the school district at least 90 days before the anticipated date of any proposed change
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FC_Residential_Center_Group_Boarding/Res_Center_Grp_Boarding_Regs.pdf
placed in care, a report of the name, address and birthdate shall be filed with the Kansas
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(B) the name, address and telephone number of a physician to be called in case of
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FC_Regs_Laws/Gen_Regs_122-132_pg27.pdfView duplicates
KANSAS LAWS AND REGULATIONS FOR ATTENDANT CARE FACILITIES FOR CHILDREN AND YOUTH July 2015 Foster Care and Residential Facility Division 555 SW Kansas Avenue, 2nd Floor Topeka, KS
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FC_AttendantCare/15Attendant_Care_All_Sections.pdf
appropriate UNIN screen(s). 2. Mass Change Instructions for the Medical Programs - A mass change run will be performed on 11/18/99 which will
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https://content.dcf.ks.gov/EES/KEESM/Implem_Memo/2000_0101_COLA.pdfView duplicates
appropriate UNIN screen(s). 2. Mass Change Instructions for the Medical Programs - A mass change run will be performed on the evening
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https://content.dcf.ks.gov/EES/KEESM/Implem_Memo/2004_0101_COLA.pdfView duplicates
State of Kansas ADOPTIVE PLACEMENT AGREEMENT PPS 5343 Department for Children and Families Rev
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a. Change of address
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Name Address Telephone Type of Information
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Residential Address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5343.pdf
or a change ownership (adding or removing a foster parent
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licensing worker (name, address, phone number, email address) FCL 401
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• A move or change of ownership indicates an
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL_forms/FosterHomeInitialLicensingApplicationChecklist9-16.pdfView duplicates
HOW DO I REPORT A CHANGE OF ADDRESS TO THE KANSAS PAYMENT CENTER
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HOW DO I CHANGE FROM DIRECT DEPOSIT TO PREPAID DEBIT CARD
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https://www.dcf.ks.gov/services/CSS/Documents/KPC_FAQs for Payment Received_v2.pdf
Complete this form or go on-line at www.dcf.ks.gov to apply
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Daytime Phone: Message Phone: Home Address: City: Zip: Mailing Address (if different): City: Zip: Suspicion-based drug
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-3100_9_grandparents_as_caregivers_application07-17.pdfView duplicates