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
Department for Children and Families REV 10/22/21 Prevention and Protection Services Timesheet Page 1 of 1
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Provider’s Name: E-mail: Month: Address where care occurs: Year
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/5828E.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
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.pdfView duplicates
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
State of Kansas Authorization to Disclose Information Appendix 5Q Department for Children
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orally, in paper documents, or electronically by e-mail, fax machine, or data entry into the
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_5Q.pdf
Section 11 / Part 12 Effective Date: February 1, 2016 Length of document: 35 pages
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Rate: $750 Use service code 150
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SERVICE DESCRIPTION
APPENDIX C: ASSESSMENT - VOCATIONAL ASSESSMENT
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https://www.dcf.ks.gov/services/RS/Documents/service_descriptions/Contracts/Section 11 Part-12_Vocational_accessment.pdf
“Family foster home” means a child care facility that is a private residence, including any adjacent grounds, in which a licensee provides care for 24 hours a day for one or more
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https://www.dcf.ks.gov/services/PPS/FCL/Documents/FC_Regs_familyfosterhome/Regulations_for_Family_Foster_Homes_for_Children.pdf
Proposed Budget
Training
Grantee Agency:
E-Mail
Phone Number
Fax Number
Grant Number
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If the requested funding change is less than 10% of the (original) line item amount from which
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https://www.dcf.ks.gov/Agency/Operations/Documents/Revision(OGC-1008.4).xlsView duplicates
Signature:
Fax Number
Phone Number
E-Mail
Street Address*
Total Expense
Description
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The Budget Itemization Report is MANDATORY - Vendor accounting ledgers will NOT be accepted
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https://www.dcf.ks.gov/Agency/Operations/Documents/Contract Itemization Report (OGC-2004).xls