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main content Foster Care Licensing

Forms

Family Foster Home Forms
FCL 000​ Release of Compliance History *Updated 09/2025
FCL 000S Release of Compliance History in Spanish *Updated 09/2025
FCL 001 Compliance Action Plan *Updated *09/2025
FCL 001S Compliance Action Plan in Spanish *Updated 09/2025
FCL 004 NOSF for Sponsoring Agency *Updated 09/2025
FCL 007 Request for Program Review *Updated 09/2025
FCL 007S Request for Program Review in Spanish*09/2025

FCL 401  Family Foster Home Application *Updated 09/2025
FCL 401  Family Foster Home Application SPA *Updated 09/2025
FCL 402​ Family Foster Home Renewal Application *Updated 09/2025
FCL 406​ Family Foster Home Request to Close *Updated 09/2025
FCL 406S​ Family Foster Home Request to Close in Spanish *09/2025
FCL 407​​  Family Foster Home Request for Amendment *Updated 09/2025
FCL 408​  Foster Family Home Exception Request​ *Updated 09/2025
FCL 655​​​​  Request for Transfer of Sponsoring Child Placement Agency (CPA) *Updated 09/2025
FCL 655S Request for Transfer of Sponsoring Child Placement Agency (CPA) in Spanish *Updated 09/2025
FCL 655.1 Family Foster Home Release of Information *09/2025
FCL 656​  Child Placing Agency (CPA) Withdrawal of Sponsorship *Updated 09/2025
 

Agency/Facility Forms
FCL 000 Release of Compliance History *Updated 09/2025
FCL 000S​ Release of Compliance History in Spanish *Updated 09/2025
FCL 001 ​ Compliance Action Plan *Updated 09/2025
FCL 001S Compliance Action Plan in Spanish *Updated 09/2025
FCL 004 Notice Of Survey Findings (NOSF) for Sponsoring Agency *Updated 09/2025
FCL 007 Request for Program Review *Updated 09/2025
FCL007S​ Request for Program Review in Spanish *Updated 09/2025
FCL 051  Application for Facilities *Updated 09/2025
FCL 057 Amendment for Facilities *Updated 09/2025
FCL 058​ Request for Exception for Facilities​ 
FCL 100​  Request to Withdraw Application *Updated 09/2025
FCL 200 Group Boarding Home (GBH) and Residential Center (RC) Annual Training Log for Non-Providers 
FCL 201  Group Boarding Home (GBH) Residential Center (RC) Annual Training Log for Providers 
FCL 202 Group Boarding Home (GBH) and Residential Center (RC) New Hire Training Log for Providers 1
FCL 203 Group Boarding Home (GBH) and Residential Center (RC)​ New Hire Training Log for Non-Providers 
FCL 204 Detention and Secure Care Annual Training Log 
FCL 205​ Detention and Secure Care New Hire Training Log 
FCL 651  CPA Application *Updated 09/2025
FCL652  Amendment for CPA *Updated 09/2025
FCL657  CPA Request for Exception​ *Updated 09/2025

FCL 660 Relative and Non-Related Kinship Waiver*Updated 09/2025
FCL 660 Relative and Non-Related Kinship Waiver Spanish *Updated 09/2025
FCL 660.1 Family Foster Home and Non-related Kinship-Relative Comparison *Updated 09/2025
FCL 661 Relative and Non-Related Kinship Application *Updated 09/2025
FCL 661 Relative and Non-Releated Kinship Application Spanish *Updated 09/2025
FCL 662​ Relative and Non-related Kinship Renewal Application *Updated 09/2025
FCL 662S Relative and Non-Related Kinship Renewal Application *Updated 09/2025
FCL 662S Relative and Non-related Kinship Renewal Application Spanish *Updated 09/2025
FCL 750​ Request to Close a Licensed Facility or CPA *Updated 09/2025

Background Check Forms
FCL 002​ Individual Background Check *Updated 09/2025
FCL 002S​ Individual Background Check 
    
 
Optional Forms
FCL 005 Yearly Mechanical Safety Check 
FCL 009/a Heath Status Form 
FCL 009.1 Health Status for Persons Working or Volunteering in a GBH or Residential Center 
FCL 009.1 Health Status for Persons Working or Volunteering in a GBH or Residential Center​ 

FCL 010 Authorization For Emergency Medical Care
FCL 011  Fire and Tornado Drill Record *Updated 09/2025
 
FCL 030​ Regulatory Complaint Intake 
FCL 054 Continuous Dental Care *Updated 09/2025
FCL 059​​ Health Assessment for Foster Parents' Children *Updated 09/2025
FCL 300 Foster Family Budget *Updated 09/2025
FCL 404​ Sample Menu *Updated 09/2025
  
FCL 410  Book or Video Report *Updated 09/2025
FCL 410S Book or Video Report in Spanish *Updated 09/2025
Supplemental Form *Updated 09/2025

​Guidance Documents

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