KANSAS DEPARTMENT OF SOCIAL AND REHABILITATION SERVICES
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Please address referrals or questions to the appropriate staff below
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72
Regulation 8 -- Change of Placement Purpose
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https://www.dcf.ks.gov/services/PPS/Documents/ICPCtrainingmanual.pdf
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
: When submitting an application, either an initial or renewal, do I need to have all documents
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also submit documents via fax at (785)296-8609 or by sending them to the following address
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FAQ.pdf
Services FC/AD NOTIFICATION OF MOVE/PLACEMENT/CHANGE PPS 5120 REV. July 2023 Page 1 of 3
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Previous Placement Name and Address
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Change of status for sibling(s) remaining in the home
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5120 .pdf
Section I: Check the box if this is a Change of Venue case and send the PPS 5110 to both
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Enter the name, address and telephone number, pager number or cell phone number and
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5110_Instr.pdf
State of Kansas Adoption Exchange Child Status
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E-mail address
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Change of Venue (when that venue is moved to another contractor
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Name of new contractor: Date of change of venue
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5315.pdf
may be or has been subject to a name change at the time of adoption; the party requesting
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this Authorization with the final decree of adoption verifying a change of name, if any
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5365.pdf
new application shall be required for each change of ownership, sponsor, or address of the facility
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FC_AttendantCare/Regulations_for_Attendant_Care.pdf
Foster Care Bill of Rights- Page 1 of 6
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The purpose of the Gail Finney
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(10) address the court regarding any proposed placement or placement change in accord with KSA 38-2262, and
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5138.pdf
• Establishing or enforcing of an order
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• Learning more about the Family Violence Indicator
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What if I am not sure
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The laws and regulations that govern the CSS program may change overtime
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https://www.dcf.ks.gov/services/CSS/Documents/CSS 5000.pdf