Change in status with sponsoring agency in regard to health and safety standards
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Change in operation (e.g., name change, address, telephone numbers, ownership, household members
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https://content.dcf.ks.gov/ees/KEESM/Robo04-22/Robo_04_01_22/keesm10034.htmView duplicates
to: Date of Change: Name of New Payee: Payee’s Phone: Address of
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Other Changes: Type: Date of Change: Multi-Month Distribution
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5928.doc
This is a mutual turnaround form to be used as documentation for both EES and RS. It can be initiated by EES or RS
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_____I request a consultation to discuss
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_____ Not eligible for RS based on
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https://content.dcf.ks.gov/EES/KEESM/Appendix/R-5_EES-RS_Monthly_Communiction_Report_01-21.docxView duplicates
in the Summary of Change, special provisions are
being provided
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The MMIS spenddown claim
process will accommodate the change
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https://content.dcf.ks.gov/EES/KEESM/Implem_Memo/2004_1001_keesm_rev_20.htmView duplicates
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
(a) “Child placing agency” or “agency” means an association, organization, or corporation receiving, caring for, or finding homes for orphans or deprived children who are under 16 years
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FC_ChildPlacingAgencies/Child_Placing_Agencies_Regulations.pdf
Change in countable resources does not impact eligibility until next review
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address change
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change in hours of care needed/used, including if child care is no longer being used or has
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https://content.dcf.ks.gov/EES/KEESM/Implem_Memo/CC Policies at Application, Change and Review.docxView duplicates
AS THE SOUL FAMILY LEGAL PERMANENCY RESIDENTIAL CUSTODIAN: (initial each statement
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______I have received a copy of the PPS 6320, SOUL FAMILY LEGAL PERMANENCY Change Status Form
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6302.doc
Initial Request Change Suspend / Terminate Date Effective: Date Effective: Date Effective
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Mentor Name: NA SSN & DOB: Address: Phone #: Email: Will the Mentor be the
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_7000_Forms/PPS7210.doc
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