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.docxView duplicates
Transitional Living Program (TLP) 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/PPS8400E.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
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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This site visit tool will score the policy and
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_8000_Forms/PPS8400F.doc
Child Care Providers: The Child Care Exception Payment (CCEP) Program is a supplement to Foster Care Child Care (FCCC) funding
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You must initial each box on
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E-mail of Childcare Provider
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https://www.dcf.ks.gov/services/PPS/Documents/FY2023DataReports/Public Website Documents/5258b_CCEPP CCProvAgreement.docx
Prevention and Protection Services KIPS Investigation ID: PPS 10600
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to KGP Telephone 785-587-8555 Worker E-mail address Telephone Number I
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Yes No If yes, what is
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10600.doc
Community Integration Program (CIP) 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/PPS8400A.doc
Quality Residential Treatment Program (QRTP) 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
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_8000_Forms/PPS8400H.doc
Please email this enrollment form along with a copy of your child support order, income
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If yes, how would you like to receive the surveys: ☐Text ☐Email ☐Both, text & email
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https://www.dcf.ks.gov/services/CSS/Documents/CSS Enrollment Form.pdfView duplicates