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Prevention and Protection Services

Appendices and Miscellaneous Forms

​ ​ ​​​​​​
Listing of key staff
Form Number Form Date Form NameFormOther Languages
ADM-346512/2011Invoice and Timesheet Purchase of Service xls  
Appendix 0A
Expanded History Check Letter doc  pdf  
​​Appendix 0D
​01/2025​Initial TDM Protocol​doc  pdf​
​Appendix OD1​01/2025​Placement Stability TDM Protocol​doc  pdf​
​Appendix 0E​07/2026
​Initial TDM Meeting Scheduling Form doc  pdf​​
​Appendix 0F​10/2019​Initial TDM Worker Quick Presentation​doc  pdf​
​Appendix OF1​01/2025​PS-TDM Worker Quick Presentation Outline    ​doc  pdf​
​Appendix OF2​01/2025​PS-TDM Supervisor Guide​    ​doc  pdf​
​Appendix OF3​01/2025​TDM Key Elements​doc  pdf​
​Appendix 0G​10/2019​Supervisor Consultation for Initial TDM Meeting ​doc  pdf​
​Appendix 0H​10/2019​Supervisor Guide to Initial TDM Meeting​doc  pdf​
​Appendix 0I​10/2019​Worker's Guide for an Effective TDM Meeting​doc  pdf​
​Appendix 0J​10/2019​Guide for Discussion of Risk and Safety Assessment Initial Removal TDM​doc  pdf​
​Appendix 0K​04/2026
​Tips for Supervisors for Effective TDM​doc  pdf​
​Appendix 0L​10/2019​Tips for Workers for Effective TDM​doc  pdf​
​Appendix 0M​01/2025​Initial TDM Form ​doc  pdf​spadoc  spapdf
​Appendix 0N​07/2025​Meetings with Families​doc  pdf​
​Appendix 0P​01/2023​Family Meeting Map ​doc  pdf​​
​Appendix 0Q04/2026
​TDM Brochure​pdf​spapdf
Appendix 0R​07/2025​Family Meeting Brochure ​pdf​spapdf​
​Appendix 1A​07/2026
Kansas Intake Guidance​doc  pdf​
​Appendix 1B04/2026
​Factors to Consider Before Leaving a Child at Home Alone pdf ​spapdf
​Appendix 1C10/2012​​Child Abuse and Neglect-Protective Services Alert Report​doc  pdf ​
​Appendix 1E​07/2026
​Adult Protection Services Initial Assessment Guide​doc  pdf​
​Appendix 1J01/2023​Disability/Special Needs Table ​doc  pdf ​
​Appendix 2A​07/2016​Kansas Statute Annotated- Sexual Abuse Definitions​doc  pdf​
​Appendix 2B07/2026
Guide for Assessment and Decisions d​oc​ 
pdf
​
Appendix 2E​​07/2026
DCF Case Finding History​​doc  pdf​
Appendix 2F​​07/2013Six Areas of Family Life for Assessment​​doc  pdf​
​Appendix 2G04/2026
​KIDS Upload Instructions​doc  pdf​
​Appendix 2H​04/2026
​Safety Assessment​doc  pdf​
​Appendix 2I​01/2017​Interview Guide for Runaway and Truant Children​doc  pdf​
​Appendix 2J​01/2017​Caregiver Protective Capacity Factors​doc  pdf​
Appendix 2K​04/2026
​Lasting Safety Tips Sheet​doc  pdf​
​Appendix 2L​07/2017​Factors to Guide the Plan of Safe Care​doc  pdf​
​Appendix 2N07/2026
​My Three Houses/Three Pages  ​doc  pdf​
spadoc  spapdf
​​Appendix 2O
​04/2026
​Fairy Wizard Instructions​doc  pdf​spadoc  spapdf
​Appendix 2P

​04/2026
​Fairy Wizard Template​doc  pdf​
​Appendix 2Q
​07/2026
​Immediate Safety Planning Guide
​doc
pdf
​
​Appendix 2W​04/2026
​Ecomap Template​doc  pdf​
​Appendix 2Z​07/2021Copying from Microsoft Word into KIDS​​doc  pdf​
​Appendix 3A​01/2018​Fatherhood Involvement Guide ​doc  pdf​
​Appendix 3B​01/2020​Basic Genogram Symbols​doc  pdf ​
​Appendix 3D
07/2013​Medical List ​doc  pdf ​
​​Appendix 3F
10/2012​
​Early Reunification Prognosis Indicators​doc  pdf ​
​Appendix 3G01/2024​Foster Parent Report to the Court ​doc  pdf ​spadoc spapdf
​Appendix 3H07/2012​​Case Plan Documentation Checklist​doc  pdf ​
​Appendix 3I​07/2023​Mental Health Workflow​doc  pdf​
​Appendix 3J10/2012​​Child Welfare Mental Health Referral Guide ​doc  pdf ​
​Appendix 3JI​07/2025​Screening Tool for Federal Benefits​doc pdf​
​Appendix 3K07/2019​Request for Initial Mental Health Assessment/Transfer of Services ​pdf​​ ​
​Appendix 3L10/2012​​Social Emotional Screening Tool​doc  pdf ​
​Appendix 3M​01/2025​Family Mobile Crisis Line​doc  pdf ​spadoc  spapdf
Appendix 3N01/2018​​Family Finding Search Websites ​doc  pdf ​
​Appendix 3Q7/2026
​Case Review Timeline​doc  pdf ​
​Appendix 3S
04/2018​​Permanency Staffing Guide ​doc  pdf ​
​Appendix
3T
07/2026​​KS Child and Family Wellbeing System Core Competency Framework
​doc
pdf​
​
​Appendix 5A​04/2026
​Icebreakers Brochure​pdf ​spadoc  spapdf
​Appendix 5B​01/2025
​Non-Licensed Placement​ Crisis Support Information Acknowledgement​
​doc  pdf            ​spadoc  spapdf
​Appendix 5C​07/2021​Relative Placement Assessment​doc  pdf​
​Appendix 5D​04/2018​Supervisor Consultation Guide ​doc  pdf​
​Appendix 5E​01/2013​Consular Notification and Access Fact Sheet​doc  pdf​
​Appendix 5F10/2012​Requesting SS Card​doc  pdf​
​Appendix 5G04/2026
​Notification to Parent Considering Relinquishment​doc  pdf ​
​Appendix 5G104/2026
​Acceptance of Relinquishment of Parental Rights​doc  pdf​
​Appendix 5G2​04/2026
​Refusal of Relinquishment of Parental Rights ​doc​  pdf​
​Appendix 5H04/2026
​Consent for Release of Information​doc  pdf ​spadoc​ spapdf
​Appendix 5J01/2025​Relinquishment of Minor Child to Agency ​doc  pdf ​ 
​Appendix 5K 10/2012​​OPPLA CA​doc  pdf ​spadoc spapdf
​Appendix 5L 04/2026
​Custodianship CA​doc pdf ​spadoc spapdf
​Appendix 5M​01/2014​Referral to DCF for Continued Services​doc  pdf​
​Appendix 5O​01/2020​Kansas Foster Parents' Rights​doc  pdf​
​Appendix 5P​07/2019​Educational Stability Process Map​doc   pdf​
​Appendix 5Q01/2023​Authorization to Disclosure Information, Including Child(ren)'s Individual Identifiable Health Information​ ​doc​  pdf spadoc​  spapdf
Appendix 5R​​04/2026
​Checklist for Request for Consent to Adopt ​doc  pdf​
Appendix 5S​04/2026
​Best Interest Staffing for Children in Foster Care Brochure​doc  pdf​
Appendix 5T​​04/2026
​Adoption from Foster Care Brochure​doc  pdf​
Appendix 5U​04/2026
​Disability Determination Referral to Kansas Legal Service​doc  pdf​
​Appendix 5V04/2026
​Guide to Understanding SSI and the DCF/KLS Contract​doc  pdf​
​Appendix 5W04/2026
​Preparing Children for Adoption
​doc  pdf​
​Appendix 5Y04/2026
​Letter to Parents Considered at a BIS​doc  pdf​
​Appendix 5Z04/2026
​Normal Phases of Pre-Finalization ​doc  pdf​
​Appendix 6A04/2026
​Permanent Custodianship Subsidy Brochure ​doc pdf ​
​Appendix 6B04/2026
​Adoption Assistance Brochure doc​ pdf ​
Appendix 6C​04/2026
​Legal Fee Reimbursement for Adoption​doc  pdf​spadoc  spapdf
Appendix 6D​04/2026
​Annual Adoption Assistance Review-Second Notice doc  pdf​​spadoc  spapdf
Appendix 6E​04/2026
​Adoption Assistance Repayment Agreement​doc  pdf​
​Appendix 6F

04/2026
​Adoption and Permanent Custodianship Information​doc  pdf​
​Appendix 7C
​07/2026
​NYTD KS Youth Survey
pdf​​
​
​Appendix 7D
​07/2026
NYTD KS Follow-up Youth Survey
​pdf
​
​​Appendix 7E
04/2026
​Checking and Clearing Credit History for Youth​doc  pdf ​
Appendix 7F​​01/2015​Certification for Identification Card​pdf​
​Appendix 9B01/2026
​ICPC Supervision Report-90 Days​doc  pdf​ ​
​Appendix 9C10/2012​​ICPC Supervision Report-30 Days​doc  pdf ​
Appendix 9D​07/2015​​Interstate Compact on the Placement of Children Articles and Regulations​doc  pdf ​
Appendix 9F​​07/2014​ICPC Medial Card Process​xls   pdf​
Appendix 9G​​07/2013​Sample Reg 7 Court Order​doc  pdf​
Appendix 9H​​07/2014​ICPC Referral Checklist​doc  pdf​
​Appendix 9I​07/2016​Interstate Compact on Adoption and Medical Assistance​doc  pdf​
Appendix 10A​​04/2026
​Adult Protective Services Statutes​doc  pdf ​
​Appendix 10B​04/2026
​APS Guidelines to consider when making a finding​doc​  pdf ​
​Appendix 10C​04/2026
​Records to Obtain During Investigation​doc  pdf​
​​​EP Appendix D
08/2016​Computer Systems-WARDS Users Handbook​doc  pdf ​
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