State of Kansas PPS 8400A Department for Children and Families REV. 1/2023 Prevention and Protection Services Page 1 of 19
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Community Integration Program (CIP) Site Visit Tool
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_8000_Forms/PPS8400A.pdf
Include: Name, Agency, Mailing Address, Telephone Number, Fax Number and E-mail Address
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phone and/or email if available
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Family new phone/email
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Child-only new phone/email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_9000_Forms/PPS9121.pdf
How many people live in your household
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Are you responsible for caring for a disabled person daily
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Microsoft TEAMS – Please provide a valid email address for the invitation
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https://content.dcf.ks.gov/EES/KEESM/Appendix/E-6 Self-AssessmentFormFillable.pdfView duplicates
ES-1653 Rev. 4-13 C-15 Page 1 Out of Home Relative Provider Enrollment Thank you for your interest in becoming a DCF child care provider for related
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https://content.dcf.ks.gov/EES/KEESM/Appendix/ES-1653.pdfView duplicates
Page 1 of 19 FCL 403
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of Applicant/Licensee (exactly as it appears on the license) Telephone Number Email Address
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Surveyor’s Signature Agency Represented Email Address Date
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 403 FFH Survey Instrument-CPA.pdf
What are the barriers to the
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Individuals who wish to submit comments in writing may email
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To request a sign language interpreter or other accommodation for the hearing, please email
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https://www.dcf.ks.gov/services/RS/Documents/KRS_Public_Hearing.pdf
KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES
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Foster Care and Residential Facility Licensing Division
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APPLICATION FOR LICENSE TO OPERATE A RESIDENTIAL FACILITY FOR CHILDREN
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Email Address
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL_forms/FCL_051_ApplicationToConductResidentialFacility.pdf
c. Issue a reply to the requesting email stating whether the request is approved or denied
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d. Send the return email response within 1 hour of the complete exception request being
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/Emergency Afterhours Over Capacity Exceptions.pdf
B. Who is the child in Foster Care being added to or
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This form provides a method to add or remove a child on Foster Care Child
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Phone Email Street Address
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Representative Contact Email
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-1512FC-CC Change Form.pdfView duplicates
ARCare Trusts and supplemental needs/care trusts are exempt as a resource
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These trusts do not need to be submitted to the Food Assistance Program Manager for TANF or food assistance
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https://content.dcf.ks.gov/EES/KEESM/Appendix/B-6_Request_for_Trust_Annuity_Clearance_05-16.pdfView duplicates