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
Rev. 6/17/2019 1 Guide to Foster Care Child Care in FY2020 for a Child in DCF Custody Place Out of Their Home
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Scan and e-mail completed FC-Child Care Application & documentation to
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https://www.dcf.ks.gov/services/PPS/Documents/Foster Care - Child Care Guide for CMPs and CPAs.pdf
Kansas Social Services Block Grant Proposed State Plan for SFY 2020 SSBG Proposed State Plan
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555 S. Kansas Ave., Topeka, KS 66603-3444, 785-296-0761, email Daniel.Lewien@ks.gov
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https://www.dcf.ks.gov/Newsroom/Documents/ProposedSSBG_StatePlanSFY2020.pdf
Position/Title of individual completing referral
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Email address of individual completing referral
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Phone number of individual completing referral
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Which services are you interested in
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https://www.dcf.ks.gov/services/RS/Documents/RS Forms/General.Referral.Pre-ETS.pdf
State of Kansas Department for Children and Families IS-4315 Economic and Employment Services
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Employment Services (ES) Referral to Vocational Rehabilitation (VR) Client
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CN Email
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https://content.dcf.ks.gov/EES/KEESM/Forms/IS-4315EmploymentServicesReferraltoVocationalRehabilitation08-21.pdfView duplicates
DOB APPROVAL STAMP (If Required) Revised 05/03/2022
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Department for Children and Families Rebecca Gerhardt 785-296-3825
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Agency Agency Contact Contact Phone Number
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https://www.dcf.ks.gov/Newsroom/Documents/Economic_Impact_Statement-Rules_and_Regulations-JCIC 9-22-2023.pdf
Kansas Department of Social and
Rehabilitation Services
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Prepared by:
SRS Office of Financial
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Docking State Office Building, 915 S.W. Harrison, Topeka, KS 66612; (785) 296-6217; e-mail
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https://www.dcf.ks.gov/Agency/Documents/SSBG_StatePlan_SFY2012.pdf
State of Kansas Department for Children and Families Prevention and Protection Services Appendix 9D July 2015
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Conversion of Intrastate Placement into Interstate Placement; Relocation
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_9D.pdf
(Donor must have picture ID to show to collection site personnel
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Type of Test to Be Conducted: Drug Test (NIDA/5) Panel
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Normal Collection - H39 Screen 5, PCP
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852-5201 or email
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https://content.dcf.ks.gov/ees/KEESM/Forms/ES-4108_Collection_Site_Passport.pdfView duplicates
Send a scan of the form to the EBT Unit as an attachment to an e-mail to DCF.EBTMAIL@ks.gov
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portions of the form are completed, email the completed form to the Administrative Office
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-3142EBT_Ben_Repay05-22.pdfView duplicates