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
Click here to enter a date
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Age(s) of the Child(ren
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What has happened that led the reporter to call DCF today
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In order to elicit information regarding potential domestic violence
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Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_1000_Forms/PPS1001.pdf
**Indirect Costs may not exceed 10% of the Grant Budget
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**A copy of any previously approved Amendment(s) and/or Renewal(s), as well as a NEW FFATA form, must be included with this request
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https://www.dcf.ks.gov/Agency/Operations/NOGA/Documents/Harvesters Amendment 1, 2, 3 FY22-24.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
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
SHANNON CONNELL, FOOD SECURITY AND UTILITY ASSISTANCE DIRECTOR
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out by teams in 36 service centers
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Economic and Employment Services (EES) provides a variety of programs that can help
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https://www.dcf.ks.gov/Agency/Testimony/Documents/2023/1.19 H WF DCF SNAP.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: TFI
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https://www.dcf.ks.gov/Agency/Operations/NOGA/Documents/TFI Family First NOGA SFY24.pdf
: • Locating information • Establishing or enforcement of an order • Modifying a child support amount • Reporting new information • Learning more about the Family Violence Indicator
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https://www.dcf.ks.gov/services/CSS/Documents/CSS5000 final 1.17.2019 v2.0.pdf