Page 1 of 4 State of Kansas
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Send copy to: State of Kansas Guardianship Program
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E-mail address
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I. REFERRAL INFORMATION (completed by DCF
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Address (facility, state, city, county & zip code
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10600.pdf
State of Kansas PPS 5927A Instructions Department for Children and Families Rev. October
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Accountant at bottom of Worksheet and e-mail Worksheet with attachments (if applicable) to
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5927A_Instr.pdf
Chapter 2: Family Foster Home Descriptions
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Levels of Service (Level of Care/LOC
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Intensive Family Foster Home (Intensive 1 & Intensive 2
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HCBS Waiver Family Foster Home (HCBS – I/DD
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https://www.dcf.ks.gov/services/PPS/Documents/FY2022DataReports/MiscWebPostings/Placement_Standards_August_2022.pdf
State of Kansas PPS 8400D Department for Children and Families REV. 1/2023 Prevention and Protection Services Page 1 of 18
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Instructions: The Site Visit Tool is to be completed at
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_8000_Forms/PPS8400D.pdf
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
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
SERVICE DESCRIPTION
APPENDIX C: ASSESSMENT - VOCATIONAL ASSESSMENT KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES Rehabilitation Services PAYMENT-FOR-PERFORMANCE - VOCATIONAL
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https://www.dcf.ks.gov/services/RS/Documents/service_descriptions/Service Descriptions 712023/Vocational Assessment_servicedescription.pdfView duplicates
FCL 402S DEPARTAMENTO DE NIÑOS Y FAMILIAS DE KANSAS Rev. 02/21 Foster Care Licensing (Licencias para acogida de menores
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PO Box 1424 Topeka, Kansas 66601-1424
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Email
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 402S Family Foster Home Renewal Application in Spanish.pdf
DEPARTAMENTO DE NIÑOS Y FAMILIAS DE KANSAS
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Foster Care Licensing (Licencias para acogida de menores
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PO Box 1424 Topeka, Kansas 66601-1424
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SOLICITUD DE CIERRE DE UN HOGAR
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Dirección: Email
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 406S Family Foster Home Request to Close in Spanish.pdf
DEPARTAMENTO DE NIÑOS Y FAMILIAS DE KANSAS Foster Care Licensing (Licencias para acogida de
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a la siguiente Persona: Título: Email: Dirección: Agencia: Dirección: Marque una o más de
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 000S Release of Compliance History in Spanish.pdf