1 Provider’s Name: Month: Provider’s E-mail: Year: List all foster
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Child #1’s Name: Hourly Rate: For DCF Use Child #2’s Name: Hourly
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https://www.dcf.ks.gov/services/PPS/Documents/FY2022DataReports/Public Website Documents/5828e-CCEPP Timesheet.pdf
State of Kansas PPS 5325 Department for Children and Families REV 10/12 Prevention and Protection Services Page 1 of 1 (This form
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E-mail address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5325.pdf
DEPARTMENT FOR CHILDREN AND FAMILIES Foster Care Licensing and Background Checks Division PO BOX 1424
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Signature of CPA Social Worker Telephone Number Fax Number E-mail Address
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FCL_forms/FCL_408_FFHExceptionWorksheet.pdf
V. HOW TO – DCF Administration TASKS
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Appendix C – Technical Document – Interest Report for 1099
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Appendix D – Technical Document – AFCARS Element 65
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Appendix E – Banking – How to Download
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_EP_D.pdf
State of Kansas Department for Children and Families Prevention and Protection Services Foster Care Eligibility Redetermination
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PPS 5425A REV Jan 2014 Period Under Review
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E-Mail Address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5425A.pdf
(not needed for Imprest or SinglePay
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above within the first 10 days of each month after services are
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provide 10 working days’ notice if need exists to terminate this agreement early
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_2000_Forms/PPS2833.pdf
State of Kansas Department for Children and Families PPS 6130 Prevention and Protection Services REV July 23 ADOPTION ASSISTANCE AGREEMENT
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Check the appropriate box below: This
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6130.pdf
State of Kansas Department for Children and Families Prevention and Protection Services WARDS
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Accountant at bottom of Worksheet and e-mail Worksheet(s) with attachments (if applicable
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5927B_Instr.pdf
State of Kansas PPS 8400F Department for Children and Families 1/2023 Prevention and Protection Services Page 1 of 19
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Staff Secure Facility (SSF) Site Visit Tool
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_8000_Forms/PPS8400F.pdfView duplicates
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