Referral for Permanent Custodianship Subsidy Checklist
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This checklist guides the CWCMP through referring a family to receive
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Case Management Provider Contact Agency: Name: Email
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6149.docx
The PPS 3031 serves as a service plan for families to receive soon after a child or children
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a copy of the ISP (either via digitally/email or printed/hard copy); thus, it is imperative
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_3000_Forms/PPS3031_Instr.docx
Approved for 4 hours of the
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Contact: Crystal Fox Email: crystal.fox@fosteradopt.org Phone: 913-717-0211 Web: https://www.childally.org/kinship Email: learn@childally.org Phone: (785
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https://www.dcf.ks.gov/services/PPS/Documents/KinshipResources.pdf
Individuals Determined to Have Achieved an Employment Outcome
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The provision of services under the individual's IPE has contributed to the achievement of the employment outcome
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https://www.dcf.ks.gov/services/RS/Documents/Policy/SEC_5-1.docx
Section 7 Pre-Employment Transition Services (Pre-ETS
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Protection, use, and release of personal
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or Manager receives a call or email regarding a concern from the Client Assistance Program
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https://www.dcf.ks.gov/services/RS/Documents/Policy/SEC_7-14.docx
DCF REGION: SERVICE COUNTY: PROVIDER: REQUESTOR Name (f, mi., l): SSN: Address
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PPS STAFF NAME: DATE: PHONE: EMAIL: PPS SUPERVISOR AUTHORIZATION: Supervisor or
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_4000_Forms/PPS4007.doc
Telephone # (Cell) City, State Zip: Email address: Permanent Custodians shall use
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Note the following changes and return to the designated office within thirty (30) days of the
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6170.doc
SOUL Family Legal Permanency shall use this form to send updates to the DCF Regional office at the time changes occur
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Note the following changes and return to the designated office
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6320.doc
Child: minor under the age of 18
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Consul/consular officer: foreign government official
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Affairs through http://travel.state.gov/consularnotification or email at consnot@state.gov
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Appendices/Appendix_5E.doc
State Zip: Date Sent to Custodian: Email address: The custodianship subsidy is to be
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Please answer the following questions and return to the designated office within thirty (30
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_6000_Forms/PPS6165.doc