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
Acknowledgment of Referral / Change / Closure
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Address
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SECTION V Case Status Change
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☐ Court venue change (custody only / services transfer to another region
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☐ Family did not sign Family Case
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4205.docx
(a) “Administrator” means the individual employed by a facility who is responsible for the
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means intervention techniques designed specifically to address the consequences of trauma in
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FC_StaffSecured/Staff_Secure_Facilities_Regulations.pdf
move to new state New Address: Child-only move to new state New Address: Reason: Family new phone/email New
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_9000_Forms/PPS9121.doc
SMART Vendor ID: Street Address: City, ST Zip: For Services with or without a Provider
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herein; to discuss with provider any change in client’s or agency’s status/plan; and to
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_2000_Forms/PPS2833.doc
Department for Children and Families REV. July 2022
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Prevention and Protection Services Page 1 of 13
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I think that these things could change if
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3059.docx
VR) services, KRS emphasizes strategies that will address the needs of people with the most
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and Family Services coordinate to address the employment and/or post-secondary education
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https://www.dcf.ks.gov/services/RS/Documents/SP-Word/4.11(d)_Strategies_includes_IE.doc
EES Program Administrators
September 22, 2011
Page 5 of 8
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M E M O R A N D U M
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SUBJECT: Implementation Instructions - KEESM Revision #49
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Potential Resources – See Summary of Changes item
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https://content.dcf.ks.gov/EES/KEESM/Implem_Memo/Implementation Memo Rev 49final_9-29-11.docxView duplicates
does not have the right to appeal a change in policy, and therefore the matter should be
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Name Address Signature
https://content.dcf.ks.gov/EES/KEESM/Appendix/B-4 2023 FA Allotment Motion to Dismiss.docView duplicates