Date: To: (facility CAO) (name of facility
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you have any questions, please contact: (APS Specialist) Telephone Number: E-Mail Address
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_10000_Forms/PPS10125.doc
Name of person completing this form
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E-mail address
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Please mark the box for the action to be taken on the family
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(If changes to composition (i.e. marriage, divorce, birth of a child, ect
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5325.doc
MANDATED REPORTER TRAINING
Presented by the Kansas Department for Children and Families
SW gather lots of information during their investigation and assessment
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https://www.dcf.ks.gov/Agency/Training/testparent/Documents/Mandated Reporting.pptView duplicates
Department for Children and Families Prevention and Protection Services
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Provider’s Name: E-mail: Month: Address where care occurs: Year: List all
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/5828E.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.docxView duplicates
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
State of Kansas PPS 5927A Instructions
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Department for Children and Families Rev. October 2019
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Accountant at bottom of Worksheet and e-mail Worksheet with attachments (if applicable) to
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5927A_Instr.docx
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