for Amendment Use this form to request a change of the family foster home license capacity
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Submit the completed request and supporting documents to DCF.FCLExceptions@ks.gov
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Address
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 407 Family Foster Home Request for Amendment.pdf
☐ Change of Child Placing Agency Name
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Agency Name: Licensed Program Type: Facility Address: License Number: I/we request an
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 652 Amendment for CPA 8.24.pdf
wing amendment ty pes) �R_ e_n_e _w_a_l _-�I I Change t o Award v' I .-I E-x- t- en_ s_i-on
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2025 by an d between JAG-K, who se address is PO Box 4199, Topeka, KS 66604 , hereinafter
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https://www.dcf.ks.gov/Agency/Operations/NOGA/Documents/Jobs for America's Graduates Amend Extension FY26.pdf
Foster Care Licensing Division: 555 SW Kansas Avenue, 2nd Floor Topeka, KS 66603
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wants the department to display the address and the telephone number of the individual's
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/Regulations GBH and Residential Centers 8.24-A.pdf
Notification of Grant Award (NOGA) Under Federal Grant Award (CFDA) Number 93.575 DCF Award Number EES-2025-KEHSCCP-09 THIS AGREEMENT MADE THIS DAY BETWEEN Kansas Department
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https://www.dcf.ks.gov/Agency/Operations/NOGA/Documents/KU Project Eagle CCP NOGA FY25.pdfView duplicates
FOSTER CARE LICENSING DIVISION Physical Address: 500 SW Van Buren Topeka, KS 66603 Website
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form shall also be used to update any information as necessary, i.e., name or address change
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 002 Individual Background Check.pdf
care. trauma-informed care. “We are not here to change the “We are not here to change the whole dynamic of the family. whole dynamic of
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Please use the same address for questions
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https://www.dcf.ks.gov/services/PPS/Documents/SE Resources/FunctionalFamilyTherapy_FTTForm_Brochure.pdf
Physical Address of Facility (Street Address
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Mailing Address if different than above
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License Number: Dates of Operation: Address on the previous/current license: SECTION VII
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 651 CPA Application.pdf
Please indicate any other information which you would like us to know in the comments section below
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I. Problems with Compliance Environmental non-compliance
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 750 Request to Close a Licensed Facility or CPA.pdf
State of Kansas Department for Children and Families Prevention and
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______I have received a copy of the PPS 6320, SOUL FAMILY LEGAL PERMANENCY Change Status Form
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Street Address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6302.pdf