Prevention and Protection Services

Appendices and Miscellaneous Forms

Listing of key staff
Form Number	Form Date	Form Name	Form	Other Languages
ADM-3465	12/2011	Invoice and Timesheet Purchase of Service	xls
Appendix 0A		Expanded History Check Letter	doc pdf
Appendix 0B	01/2024	Critical Incident Review Staff Interview	doc pdf
Appendix 0C	07/2019	Critical Incident Review Observations	doc pdf
Appendix 0D	01/2025	Initial TDM Protocol	doc pdf
Appendix OD1	01/2025	Placement Stability TDM Protocol	doc pdf
Appendix 0E	01/2025	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	10/2019	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 0Q	07/2025	TDM Brochure	pdf	spapdf
Appendix 0R	07/2025	Family Meeting Brochure	pdf	spapdf
Appendix 1A	07/2025	Kansas Intake Guidance	doc pdf
Appendix 1B	07/2025	Factors to Consider Before Leaving a Child at Home Alone	pdf	spapdf
Appendix 1C	10/2012	Child Abuse and Neglect-Protective Services Alert Report	doc pdf
Appendix 1E	07/2021	Adult Protection Services Initial Assessment Guide	doc pdf
Appendix 1J	01/2023	Disability/Special Needs Table	doc pdf
Appendix 2A	07/2016	Kansas Statute Annotated- Sexual Abuse Definitions	doc pdf
Appendix 2B	07/2025	Guide for Assessment and Decisions	doc pdf
Appendix 2E	01/2025	DCF Case Finding History	doc pdf
Appendix 2F	07/2013	Six Areas of Family Life for Assessment	doc pdf
Appendix 2G	07/2016	KIDS Upload Instructions	doc pdf
Appendix 2H	01/2021	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	01/2021	Lasting Safety Tips Sheet	doc pdf
Appendix 2L	07/2017	Factors to Guide the Plan of Safe Care	doc pdf
Appendix 2N	07/2022	My Three Houses/Three Pages	doc pdf	spadoc spapdf
Appendix 2N	07/2022	My Three Houses/One Page	doc pdf
Appendix 2O	01/2021	Fairy Wizard Instructions	doc pdf	spadoc spapdf
Appendix 2P	01/2020	Fairy Wizard Template	doc pdf
Appendix 2W	01/2020	Ecomap Template	doc pdf
Appendix 2Z	07/2021	Copying 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 3C		Ecomap Symbols	pdf
Appendix 3D	07/2013	Medical List	doc pdf
Appendix 3E		Time Line Example	doc pdf
Appendix 3F	10/2012	Early Reunification Prognosis Indicators	doc pdf
Appendix 3G	01/2024	Foster Parent Report to the Court	doc pdf	spadoc spapdf
Appendix 3H	07/2012	Case Plan Documentation Checklist	doc pdf
Appendix 3I	07/2023	Mental Health Workflow	doc pdf
Appendix 3J	10/2012	Child Welfare Mental Health Referral Guide	doc pdf
Appendix 3JI	07/2025	Screening Tool for Federal Benefits	doc pdf
Appendix 3K	07/2019	Request for Initial Mental Health Assessment/Transfer of Services	pdf
Appendix 3L	10/2012	Social Emotional Screening Tool	doc pdf
Appendix 3M	01/2025	Family Mobile Crisis Line	doc pdf	spadoc spapdf
Appendix 3N	01/2018	Family Finding Search Websites	doc pdf
Appendix 3Q	10/2012	Case Review Timeline	doc pdf
Appendix 3S	04/2018	Permanency Staffing Guide	doc pdf
Appendix 5A	07/2020	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 5F	10/2012	Requesting SS Card	doc pdf
Appendix 5G	01/2021	Notification to Parent Considering Relinquishment	doc pdf
Appendix 5G1	01/2021	Acceptance of Relinquishment of Parental Rights	doc pdf
Appendix 5G2	01/2021	Refusal of Relinquishment of Parental Rights	doc pdf
Appendix 5H	07/2024	Consent for Release of Information	doc pdf	spadoc spapdf
Appendix 5J	01/2025	Relinquishment of Minor Child to Agency	doc pdf
Appendix 5K	10/2012	OPPLA CA	doc pdf	spadoc spapdf
Appendix 5L	10/2012	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 5Q	01/2023	Authorization to Disclosure Information, Including Child(ren)'s Individual Identifiable Health Information	doc pdf	spadoc spapdf
Appendix 5R	07/2019	Checklist for Request for Consent to Adopt	doc pdf
Appendix 5S	01/2024	Best Interest Staffing for Children in Foster Care Brochure	doc pdf
Appendix 5T	01/2017	Adoption from Foster Care Brochure	doc pdf
Appendix 5U	07/2014	Disability Determination Referral to Kansas Legal Service	doc pdf
Appendix 5V	07/2014	Guide to Understanding SSI and the DCF/KLS Contract	doc pdf
Appendix 5W	01/2017	Preparing Children for Adoption	doc pdf
Appendix 5Y	07/2019	Letter to Parents Considered at a BIS	doc pdf
Appendix 5Z	07/2018	Normal Phases of Pre-Finalization	doc pdf
Appendix 6A	07/2016	Permanent Custodianship Subsidy Brochure	pdf
Appendix 6B	01/2014	Adoption Assistance Brochure	pdf
Appendix 6C	01/2025	Legal Fee Reimbursement for Adoption	doc pdf	spadoc spapdf
Appendix 6D	02/2018	Annual Adoption Assistance Review-Second Notice	doc pdf	spadoc spapdf
Appendix 6E	07/2017	Adoption Assistance Repayment Agreement	doc pdf
Appendix 6F	07/2023	Adoption and Permanent Custodianship Information	doc pdf
Appendix 7A	07/2015	Youth Advisory Council Handbook	doc pdf
Appendix 7B	10/2012	Application for KYAC Membership	doc pdf
Appendix 7C	01/2020	National Youth in Transition Database	doc pdf
Appendix 7C Definitions	01/2020	Federal Question Definitions	doc pdf
Appendix 7E	07/2020	Checking and Clearing Credit History for Youth	doc pdf
Appendix 7F	01/2015	Certification for Identification Card	pdf
Appendix 9B	01/2026	ICPC Supervision Report-90 Days	doc pdf
Appendix 9C	10/2012	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	07/2023	Adult Protective Services Statutes	doc pdf
Appendix 10B	07/2016	APS Guidelines to consider when making a finding	doc pdf
Appendix 10C	7/2021	Records to Obtain During Investigation	doc pdf
EP Appendix A		Kansas AFDC Needs Standards	doc pdf
EP Appendix B	10/2012	Computer Systems	doc pdf
EP Appendix D	08/2016	Computer Systems-WARDS Users Handbook	doc pdf