State of Kansas Department for Children and Families Prevention and Protection Services FLEX FUND REQUEST
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PPS 4007 January 2015 Page 1
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**SEND ONLY PAGE 1 TO PROVIDER
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EMAIL
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4007.pdf
Part II: Narrative Section 1: Goals, Objectives and Activities - Screen 2
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Specify the objectives to be achieved and the time frame for achieving them
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Goal(s) from Section 1.1: Goal 1
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https://www.dcf.ks.gov/services/RS/Documents/State Plan for Independent Living 2014-2016/FINAL Text Alternative for Table 1 2.pdf
Email
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B. Type of Agency ☐Public ☐Private Non-Profit ☐Private Profit
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C. Official Authorized to Sign Application
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F. Type of Application ☐New ☐Revision ☐Continuation of Grant
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https://www.dcf.ks.gov/services/RS/Documents/OIB_AttachmentA.pdf
HI - Home Interview OI - Office Interview CMA - Case Management Activities ET- E-mail To
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From LT - Letter To LF - Letter From EF- E-mail From
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10200.pdf
FCL 000 03/21 KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES Foster Care Licensing PO Box 1424 Topeka, Kansas 66601-1424 500 SW Van Buren Street 2 nd Floor Topeka, Kansas
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Email: Address
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL 000 Release of Compliance History.pdf
Notification of Grant Award (NOGA) Under Federal Grant Award (CFDA) Number 93.472 DCF Award
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KS 66603-3444 Phone: (785) 506-7178 Email: Jennifer.goodman@ks.gov (2) To Grantee: DCCCA
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https://www.dcf.ks.gov/Agency/Operations/NOGA/Documents/DCCCA Family First NOGA SFY24.pdf
State of Kansas Department for Children and Families Prevention and Protection Services Soul Family Legal Permanency Change in Status Form PPS 6320 07/24 Page 1 of 1
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Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6320.pdf
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
Chapter 2: Family Foster Home Descriptions
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Levels of Service (Level of Care/LOC
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HCBS Waiver Family Foster Home (HCBS – I/DD
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Chapter 3: All Family Foster Homes
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https://www.dcf.ks.gov/services/PPS/Documents/CWHandbookofServices/placementservicestandardsmanual.pdf
The 2022 regular session of the legislature passed
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House Bill 2510 containing two sections setting forth
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that the Department for Children and Families (DCF
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DCF in August across the state
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https://www.dcf.ks.gov/Agency/Testimony/Documents/2023/DCF PBC Implementation Plan 2023.pdf