State of Kansas Department for Children and Families Prevention and Protection
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Change of Placement Purpose
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(2) The identity and address or addresses of the parents or legal guardian
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_9D.pdf
Preferred Name to be addressed by
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Transfer Level of Service (Change in staff responsible for the case: FC/RE/AD to aftercare
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Change of venue or tribal court jurisdiction
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Mother’s Address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3006.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
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
Department for Children and Families Kansas Laws and Regulations for Juvenile Crisis Intervention Centers JUNE 2024-A
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following terms and definitions shall apply
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/Juvenile Crisis Intervention Center Laws and Regulations June 2024-A.pdfView duplicates
☐ Change of Child Placing Agency Name
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☐ Change of program type
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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.pdf
List of suggested bidders, including name, address and e-mail address if available
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weaknesses of each proposal with an attempt to address items including (but not limited to
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https://www.dcf.ks.gov/Agency/Testimony/Documents/2017/2017 Session DCF Testimony to House Federal and State Affairs on HB 2201.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
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
Notification of Grant Award (NOGA) Under Federal Grant Award (CFDA) Number 93.558 DCF Award Number EES-2021-JAG-01 THIS AGREEMENT MADE THIS DAY BETWEEN Kansas Department for
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https://www.dcf.ks.gov/Agency/Operations/NOGA/Documents/Jobs for America's Graduates JAG NOGA SFY21.pdf