Foster Care - Home Inspection Checklist Page 4
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5Foster Care – Child Placing Agency Checklist
Parent Requirements
Over age 21
501-12-5-1-c
Legal residents of US
501-12-5-1-d
Legally married or single applicants
501-12-4-1
Agency owners/directors/governing body are not certified to provide proctor or respite care services
501-12-5-3
Parents do not provide child care or other DHS licensed services in the certified home
501-12-4-8.f
Parents provide safety training to children initially and annually thereafter
501-12-7-13
Parent File Requirements
Signed copies of code of conduct, confidentiality agreement and R-501-12 compliance agreement for
each parent in the parent files
501-12-4i, ii, iii
Updated annually
501-12-4-6.a
Signed initial and renewal applications
501-12-4-1 and 501-12-4-6
Current background clearance forms approved by OL for each household member over age 18 in all
certified foster homes.
501-12-4.b (screenings cannot be transferred from other agencies 501-12-4-4)
Written statement of financial viability for each household with supporting documentation
501-12-4-c
Income statement updated annually
501-126.d
Training:
CPR/First Aid training
Pre Service Training
R501-12 Rules
Policy and procedure training and
Annual training
All training is completed PRIOR to making any placements in the home
501-12-14-4&5 [NOTES]
Medical reference for each parent completed by licensed physician, physician’s assistant or nurse
practitioner
501-12-4-2
Medical reference annually or personal health statement if unchanged since last certification
501-12-4-6b
3 acceptable letters of reference
501-12-4-3
Investigations, allegations, criminal activity (OL notified)
501-12-4-4.d
Homestudy and annual updates are signed by a licensed social worker
501-12-4-5.b and 501-12-4-6-e (see licensor
guide for homestudy content requirements)
Original contractual agreement with each parent
501-12-14-8
Written notification of parent’s rights and responsibilities with signed copy located in parent file
501-12-
14-11
If previously licensed/certified in past 3 years: written reference letter from each agency
501-12-4-7
Written emergency plan
501-12-8
Current vehicle Insurance
Current Driver’s licenses
Nov. 2014
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