Adoption Child Profile and Website Registration Match Form
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Check One) Initial Referral Profile Update, CH
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Phone: Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5310.docx
Disability Determination Referral to Kansas Legal Services Child age birth to 17 years Child/Youth – age 18 to 23 years Child’s Name: DCF Case Number: SSN Street Address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_5U.doc
The Child Care Exception Payment (CCEP) Program is a supplement to Foster Care Child Care (FCCC) funding
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FCCC funding must be used first where applicable
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E-mail of Childcare Provider
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/5258B.docx
Introduction and Purpose of the RFI 5
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Exempt From Disclosure (Protected, Confidential, or Proprietary) 8
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Appendix A – High Level Process Flow Attached
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DCF RS is seeking a commercial off
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https://www.dcf.ks.gov/Agency/Operations/Documents/RS RFI.DOC
Name of person completing this form
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E-mail address
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Child’s Name: MATCH ID: Facts Client ID
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Is this child a member of a sibling group
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Move child to the private site (child will not
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5315.doc
Youth Residential Center II (YRCII) Site Visit Tool
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Instructions: The Site Visit Tool is to be completed at in-person site visits for initial reviews, 90-day reviews and annual reviews
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_8000_Forms/PPS8400G.doc
Checkboxes – Completed by DCF Check the boxes
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Use the email subject line: FF_county abbreviation_Lastname_Firstname_4310_Closure Document
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FACTS email inbox
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Family First email inbox
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4310_Instr.doc
Cell Phone: Email Address
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How many people live in your household
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Are you responsible for caring for a disabled person daily
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Do you have minor children who are temporarily out
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https://content.dcf.ks.gov/EES/KEESM/Appendix/E-6FAETSelfAssessment06-19.docxView duplicates
Kansas Department of Corrections - Juvenile Services Division
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On behalf of the minor child
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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.doc
A. Social Security Benefits: Yes No If yes, amount
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Anticipated date of youth’s high school graduation
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PPS Administration Use Only for Approval
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6301.doc