Facility Name: Licensed Program Type: Facility Address: License Number: I/we request an
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each request is to increase capacity, expand the age range, or to change the living units
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 057 Amendment Facilities.pdf
KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES
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Who Should use this form: This form
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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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Street Address
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 002 Individual Background Check.pdf
assistance for failure to report a change for cash or medical assistance purposes, unless the change was also required to be reported for
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https://content.dcf.ks.gov/EES/KEESM/current/keesm9123.htmView duplicates
KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES Foster Care Licensing 500 SW Van Buren Street 2 nd Floor Topeka, Kansas 66603 Website: http://www.dcf.ks.gov REQUEST FOR TRANSFER OF
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Address
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 655 Request to Transfer Sponsoring Child Placement Agency.pdf
FCL 100 Rev. 09/25 KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES Foster Care Licensing 500 SW Van Buren Street 2 nd Floor Topeka, Kansas 66603 Website: http://www.dcf.ks.gov
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 100 Request to Withdraw Application.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
NOTE: Once an initial address record is created, an update to an address for a child in foster care will generally
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If the user is recording a change in an Address, the
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https://content.dcf.ks.gov/ees/KEESWebHelp/NonMedical-KEESWebHelp/Contact_Summary_-_PPS.htm
KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES Foster Care Licensing 500 SW Van Buren Street 2 nd Floor
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Physical Address of Home (Street Address
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Mailing Address if different from Above
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 662 Relative and Non-related Kinship Renewal Application.pdf
KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES Foster Care Licensing 500 SW Van Buren Street 2 nd Floor Topeka, Kansas 66603 Website: http://www.dcf.ks.gov REQUEST FOR PROGRAM
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Address
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 007 Request for Program Review.pdf
FCL 004 Rev. 09/25 Kansas Department for Children and Families Foster Care Licensing and Background Checks Division
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Physical Address of the Family Foster Home City Zip Code County
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 004 NOSF for Sponsoring Agency Fillable.pdf