FP-1020 10/21 Page 1 of 1
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Kansas Department for Children and Families
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Instructions: *REQUIRED FIELDS Please Fill in ALL Lines on this Form
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*Have You ever been fingerprinted for DCF
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FP-1020 With Waiver.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
Form OGC-1002 (RFP - Attachment A) REV 07/14
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Email
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D. Geographic Area To Be Served, Target Population, and Estimated Number To Be Served
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E. Federal Employer Identification Number (FEIN
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https://www.dcf.ks.gov/Agency/Operations/Documents/RFP-AttachA-GrantAppInfoSheet(OGC-1002)accessible.pdf
TITLE IV-B CHILD AND FAMILY SERVICES PLAN
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U.S. Department of Health and Human Services
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This Child and Family Services Plan (CFSP) is the report for the five-year time period Fiscal Year
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https://www.dcf.ks.gov/services/PPS/Documents/Other/TitleIVBStatePlan.pdfView duplicates
be sent to the mailing address or email listed above with appropriate payment (see Payment
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Return Results by: Encrypted email (list if different than above): Postal Mail
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https://www.dcf.ks.gov/Agency/Operations/Documents/OBI/OBI_1011_CAN_ROI.pdf
U.S. Department of Health and Human Services
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Docking State Office Building, 5 th Floor Topeka, Kansas 66612-1570
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SECTION II: SAFETY AND PERMANENCY DATA
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E-mail: Deanne.Dinkel@dcf.ks.gov
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https://www.dcf.ks.gov/services/PPS/Documents/Other/FinalVersionSWAssessment_February2015.pdf
***Document to be used when child is legally free for adoption
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Does the Indian Child Welfare Act apply
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☐ Relinquishment Accepted and Approved by Agency
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Date waiver email sent
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5400_Fillable.pdf
with a unique identifier from your school via email or mail you must apply for the 2020-2021
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School Lunch Program and received a letter via email or mail from your school with a unique
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https://www.dcf.ks.gov/Documents/P-EBT/P-EBT_FAQ_2021.pdf
Prevention Provider Spotlight: Horizons Mental Health Center
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Community Provider Spotlight: Kansas Coalition against sexual & domestic violence
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One of the ways the agency
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Email us at
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https://www.dcf.ks.gov/services/PPS/Documents/FF-newsletters/August 2020_Prevention in Kansas Newsletter.pdf
EMAIL
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555 S Kansas Ave Topeka, KS 66603
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Kansas Department for Children and Families Foster Care Licensing and Background Checks Division
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320 S Broadway St Pittsburrg, KS 66762
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/Foster Care Licensing and Background Checks Divison Contact.pdf