Address Apt. # City State Zip Code Telephone E-mail County B. Do you appoint someone other
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Telephone Address Apt. # City State Zip E-mail State of Kansas Social and Rehabilitation
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https://www.dcf.ks.gov/Documents/Food/ES-3100.8_Application_Redetermination_01-06.pdf
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
you are testifying via WEBEX, be sure your email is provided in this cover letter so I can email the link to you prior to the meeting
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https://www.dcf.ks.gov/Agency/Testimony/Documents/2023/HB 2021 DCF Written Only.pdf
FOSTER HOME LICENSING APPLICATION CHECKLIST An Initial application packet for a foster care license
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Please submit the following DCF forms
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FCL 002 KBI/DCF Background check
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Email Address
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL_401_FFHApplication.pdf
Evaluation Referral Click here to open email to: mailto:SafeCareKS@cmh.edu Once email opens, attach saved form PPS 2450 Rev
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PPS SPECIALIST’S EMAIL ADDRESS
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_2000_Forms/PPS2450.pdf
STUDENT EMAIL ADDRESS EXPECTED DATE TO COMPLETE OR EXIT HIGHSCHOOL CURRENT GRADE LEVEL OF
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IF NO, DO YOU HAVE AN
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PARENT, GUARDIAN, REPRESENTATIVE PHONE CELL PHONE EMAIL ADDRESS 4/2/2019
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https://www.dcf.ks.gov/services/RS/Documents/RS Forms/Pre-ETS_Request_2.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
strong families make a strong Kansas Kansas Department for Children and Families 2013 Annual Report The Kansas Department for Children and Families (DCF) is focused on protecting
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https://www.dcf.ks.gov/Agency/Documents/2013DCFAnnualReport.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
Notification of Grant Award (NOGA) Under Federal Grant Award (ALN) Number 93.472 DCF Award Number
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KS 66603-3444 Phone: (785) 506-7178 Email: jennifer.goodman@ks.gov (2) To Grantee: KVC
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https://www.dcf.ks.gov/Agency/Operations/NOGA/Documents/KVC HFA Family First NOGA SFY24.pdf