Grant proposals must be submitted using the online DCF application form. Below is a searchable list of forms used by programs and DCF staff. 3. The form also requests other needed information that needs to be faxed or mailed to the agency in order for the application to be processed. The DCF is divided into eleven sections and each section contains multiple questions to capture various performance indicators of the school. Open the document in the online editor. The Department of Children and Families (DCF) is happy to provide in-person Mandated Reporter Training to your organization or facility. New Document Sales users will need to create a login and password in order to search for products, place and track orders. This approval is recognized and accepted by most states to satisfy court, legal, and employment requirements. PLEASE NOTE : DCF recommends using the Windows Internet Explorer web browser to complete the Mandated Reporter Online Report form. Your document will be reviewed by a financial aid counselor and changes will be reflected on your Offer Letter. Online Mandated Reporting This toll free number is available 24/7. As an alternative, you may access a computer at your local library, contact your local DCF Service Center or call toll free at 1-888-369-4777. For more information, contact us at 2-1-1 or 1-800-505-1000 Monday - Friday 8am - 5pm Complete the form, making any adjustments you need to your enrollment status, housing status, work-study, and federal loans. No Comments (when filled in online, this field will expand to accept as much information as needed): SECTION 2-A: Self-Care and General Oversight Assessment NOTE: This section must be completed by a licensed health care provider and must include a face-to-face examination and interview with the resident. Select the fillable fields and add the requested details. You can contact the DCFS hotline by phone at 800-25-ABUSE (800-252-2873) or visit the DCFS website to make an online report. The online application for the Low Income Energy Assistance Program (LIEAP) is available from Monday, January 4, 2021 at 8am CST through Wednesday, March 31, 2021 at 5pm CST. If you are homeless & need housing, call 1-800-479-6151 during regular business hours or dial 2-1-1 after … Using our platform filling in CT DCF-136 usually takes a … Complete the form as best you can. How to fill out and sign dcf 136 form online? Tagalog |
Social Security number and date of birth. Sign the form. MEET ALL REQUIREMENTS (check the appropriate box below, sign and return this form to child care center). Read the recommendations to find out which information you must give. Kreyòl |
eligibility. Please complete the requested information and a Foster Care Team Member will contact you as soon as possible. About Us. Nights, weekends, and holidays please call the Child-at-Risk Hotline at (800)792-5200. DCF analysis can be applied to value a stock, company, project, and many other assets or activities, and thus is widely used in both the investment industry and corporate finance management. Easily fill out PDF blank, edit, and sign them. DCF 56 (Foster Home Licensing), Adoption Investigation Report to Circuit Court, Adoption Assistance High School Information, Child Record Checklist - Child Care Centers, Request for Confirmation of Child's Indian Status, Notice of Involuntary Child Custody Proceeding Involving an Indian Child, Staff Orientation Checklist - Group Child Care Centers, Volunteer Training Confirmation - Group Child Care Centers, Request for Emergency Detention or Pick-up Orders, Child to be Removed from Foster Home, Treatment Foster Home, or Group Home, Kinship Care Referral for Child Support Services, inship Care Referral for Child Support Services, Continuing Education Record - Independent Reading-Video Viewing, Out-of-Home Care Support Plan Evaluation / Revision, Staff Continuing Training Record Child Welfare Programs, Exceptions Panel Second License Application, Adolescent Assessment / Placement Stabilization Center Admission, Adoptive Placement Checklist - Child Placing Agencies International, Adoption Assistance Agreement Amendment Payment Reduction - Termination, Residential Care Center Policy / Procedure Checklist, Residential Care Center Child Abuse and Neglect Reporting and Confidentiality Responsibilities, Residential Care Center Statutorily Reportable Death, Electronic Deposit Authorization for Provider Payment, Notice to Foster Parents Regarding Confidentiality of Records, Out-of-Home Placement Notification or Recommended Placement Notification, DCF Scholarship Application for Youth in Out-of-Home Care, Foster Parent Insurance Program - Damage Claim Checklist, Kinship Care Denial of Payment and Appeal Rights, Foster Care or Treatment Foster Care License Revocation, Initial Licensing Checklist - Family Child Care Centers, Independent Living Services Checklist (Optional), Staff Orientation Checklist - Family Child Care Centers, Notice Of County's Intent Not to Pursue Extension of Dispositional Order, Adoptive Placement Checklist - Child Placing Agency - Domestic, Adoption Portfolio Contents Acknowledgement, Infant Relinquishment - Questions About You and the Infant, Notification of Child's Removal from Foster Home, Notification of Child's Removal From Foster Home - Child in Home for Six Months or More - Emergency, Medication Administration Record - Group Homes for Children, Building Inspection Report - Licensed Child Care Centers and Certified School-Age Programs, Policy Checklist - Family Child Care Centers, Subsidized Guardianship High School Information, Subsidized Guardianship Checklist / Routing, Policy Procedure Checklist - Group Homes for Children, Medical Services Consent - Child Welfare Facilities, Staff Volunteer Orientation Documentation - Group Homes, Resident Orientation Documentation - Group Home, Intake Information Group Home Resident Under 6 Years of Age, Fire Safety and Emergency Response Documentation Residential Care Centers for Children and Youth, Fire Safety and Emergency Response Documentation - Group Homes, Fire Safety and Emergency Response Documentation - Shelter Care Facility, Notice of Client Change of County Residence, Advance Notice of Termination of Adoption Assistance, Notice of Decision on Adoption Assistance Eligibility Status, Advance Notice of Termination of Subsidized Guardianship at Age 18, Voluntary Placement Agreement for an Indian Child, Documentation of Caseworker Face to Face Contact with Child, Wisconsin Works (W-2) Overpayment Recoupment Notice, Wisconsin Works (W-2) Repayment Agreement, Child Care Cash Collections/Repayments CARS Profile #9006, School Enrollment and Attendance Information Release, Request for Permission to Inspect Monthly Wisconsin Works (W-2) Report, Refugee Cash Assistance Eligibility - Notice of Decision, Refugee Cash Assistance Ineligibility - Notice of Decision, Refugee Cash Assistance Ineligibility - Notice of Decision - Bosnian, Refugee Cash Assistance Ineligibility - Notice of Decision - Hmong, Refugee Cash Assistance Ineligibility - Notice of Decision - Somali, Refugee Cash Assistance Ineligibility - Notice of Decision - Russian, Refugee Cash Assistance Termination - Notice of Decision, Refugee Cash Assistance Work Programs - Notice of Referral, Refugee Cash Assistance Sanctions - Notice of Decision, Refugee Cash Assistance (RCA) Participation Agreement, Refugee Case Assistance (RCA)Participations Agreement, Refugee Cash Assistance (RCA)Participation Agreement, Refugee Cash Assistance Repayment Agreement, Sample Refugee Cash Assistance Overpayment Notice Letter, Guardian's Application for Child Support Services, Parent's Application for Child Support Services, Request for Privacy Protection (Child Support), Confidential Information Release Authorization (Child Support), Request for Re-Issuance of a Stale-Dated Check (Child Support), Request for Abandoned Funds (Child Support), Wisconsin Works (W-2) Participation Agreement, Authorization for Disclosure of Confidential Information, Request for a Wisconsin Works (W-2) Fact-Finding Review, Wisconsin Works (W-2) Agency Fact-Finding Review, Wisconsin Works (W-2) Work Training Site Agreement, Domestic Abuse Screen Self-Administered Version, Wisconsin Works (W-2) and Related Programs Registration, Emergency Assistance Application - Part 1, Emergency Assistance Application - Part 1, Wisconsin Works (W-2) and Related Programs Authorization of Participant Representation, Household Budget Worksheet for Wisconsin Works (W-2), Wisconsin Works (W-2) and Related Programs Application, Child Care (CC) Client Overpayment Notice, Child Enrollment and Health History - Certified Child Care, Regulatory Agency Approval/Acknowledgement to Operate Child Care Business, Regulatory Agency Approval / Acknowledgement to Operate Child Care Business, Child Care Online Systems (CCPP/CSAW) Access Request for Agency Staff Only, Certification Application-Family and In-Home Child Care Programs, Standards and Checklist-Family/In-Home Child Care Certification, Amendment Request to Extend Care to Residents 18 years of Age and over, but under 21 years of age, Application and Affidavit for Professional License, Application and Affidavit for Recreational License, Initial Licensing Checklist - Group Child Care Centers, Child Record Checklist - Certified Child Care, Multipurpose Home Study Report - Couples / Single (With Instructions), Multipurpose Home Study Update / Recertification (With Instructions), Multipurpose Home Study Update / Recertification, Multipurpose Home Study Report - Couples / Single, Acceptance of Child Care Payments - DCF 201 Statement of Understanding and Agreement, Staff Continuing Education Record - Child Care Centers, Staff Health Report - Child Care Provider, Other Activity Notification/Permission - Child Care Centers, Alternate Arrival/Release Agreement - Child Care Centers, Staff Record Checklist - Group Child Care Centers Confidential - Do Not Post, Staff Record Checklist - Family Child Care Centers, Written Translation Professional Services Contract Request for Services, In-Person Interpreter Professional Services Contract Request for Services, Voluntary Transition to Independent Living Agreement, Voluntary Placement Agreement for Shelter Care, Request by Shelter Care Facility to Accept Voluntary Placements and/or to Provide Respite Care Services, Supervised Independent Living (SIL) Rate Setting, Residential Care Center (RCC) Extend Care Funding Application, Notice of Initial Determination of Substantiated Child Maltreatment and Right to Request a Review, Scheduled Review of the Initial Determination of Child Abuse and/or Neglect, Notice of Final Determination of Child Abuse and/or Neglect and Right to Request an Appeal-Review Occurred, Notice of Final Determination of Child Abuse and/or Neglect and Right to Request an Appeal-No Response, Notice of Final Determination of Child Abuse and/or Neglect and Right to Request an Appeal-Review Occurred, Licensor Guide to the Online Foster Parent Independent Living Training, Family History Questionnaire Medical / Genetic, Family History Questionnaire Medical / Genetic - Pregnancy and Delivery Information, Employer Confirmation of Earnings and Hours for Client, Employer Confirmation of Earnings and Hours for Provider, Special Needs Adoption Program (SNAP) Referral Checklist, Extended Relative and Non-Relative Search and Engagement Consent, Request for Child Protective Services Background Check for Certain Purposes, Public Adoptions Request for Specialized Services or Residential Care Center Placements, Request for Taxpayer Identification Number and Certification, Child Care Agency Annual Summary: Certification Contract Function Only, 2017 DCF / DFES Worker's Compensation Coverage Application, 2017 DCF / DFES Worker's Compensation (Declines Coverage), Performance Outcome Payment Claim Denial Decision Appeal Form, Subsidized Guardianship of Children with Special Needs One time Expense Reimbursement, Child Welfare Request for Exception - Age, Wisconsin Works Trial Employment Match Program - Employer Agreement, Birth Parent Request for Adoptee's Identity, Health and Safety Checklist - License Exempt Program DCF 251, Information Required to Monitor School-Run, License-Exempt Child Care Centers, External SPARC Sign In Authorization Request, Report to the Court on the Adoption Investigation, Reasonable and Prudent Parent Standard Review, Reasonable Prudent Parenting Decision Record, Child Welfare Licensing Shelter Care Extension, Access Request - WEBi Foodshare & Automated Case Directory, Access Request - WEBi Employment Programs, Staff Record Checklist - License Exempt Child Care. Welcome to Florida Department of Children and Families Automated Community Connection to Economic Self Sufficiency (ACCESS). pdf Note Includes Self-Employment. You cannot use a Chromebook, phone or iPad to use this form - it must be done from a Mac or PC. E-Mail us: DCF.COVID-19@ct.gov As a child care provider, you may need to file a report of suspected child abuse or neglect with the Department of Children and Families (DCF). This document is temporary and, upon expiration, must be specifically renewed. Child Support Helpline: 1-800-786-3214 Code, W-2 Agency Time Limit Extension Denial Record, W-2 Agency Time Limit Extension Approval Record, Subsidized Guardianship Amendment Request - Option to Continue Current Rate, Wisconsin Shares Special Needs Inclusion Rate Request, Reschedule Review of the Initial Determination of Child Abuse and/or Neglect, Incident Report for Program Integrity Site Visit, Caregiver Background Checks Substantially Related Investigation Report for Child Welfare Agencies, Information Provided to the Wisconsin Adoption and Permanence Support Program, Licensing Checklist - Child Placing Agencies, Licensing Checklist - Shelter Care Facilities, Licensing Checklist - Residential Care Centers DCF 52, Foster Home Record Checklist - Child Placing Agencies, Request to Clarify Specific and Limited Circumstances Prior to Submitting an Application to Operate a Level 5 Exceptional Treatment Foster Home, Child Description for Adoption Recruitment, Child Record Checklist - Shelter Care Facilities, Personnel Record Checklist - Shelter Care Facilities, Residential Care Center General Personnel Record Checklist, Resident Record Checklist - Residential Care Centers for Children and Youth, Services and Accommodations to Help You Do Your W-2 Activities, Adoption Assistance Rate Determination and Application for Tribal or Customary Adoptions, Interstate Compact on the Placement of Children (ICPC) Worker Statement Regarding Proposed Placement Resource, Information for Out-of-Home Care Providers, Part A, Information for Out-of-Home Care Providers, Part B, Kinship Care Caretaker Application (for Milwaukee County Residents), Kinship Care Documentation of Child's Residence (for Milwaukee County Residents), Pre-Camp Training Documentation - Day Camps, Counselor-To-Child Ratio Worksheet Day Camps for Children, Child Record Checklist - Certified Child Care, Daily Attendance Record - Child Care Centers, Daily Attendance Record - Licensed Child Care Centers, Assessment and Treatment Plan - Residential Care Centers for Children and Youth, Child Record Checklist - Day Camps for Children, Staff Record Checklist - Day Camps for Children, Counselor-to-Child Ratio While Swimming Worksheet Day Camps for Children, Staff-to-Child Ratio While Swimming Worksheet Group and Family Child Care, Civil Rights Service Delivery Discrimination Complaint, Review of the Use of Child Welfare Funding, Notification of the Removal of a Child from the Custody of his or her Parent and Placement into Out-of-Home Care, Guide for Foster Parents and Other Physical Custodians to Provide Information at Court Proceedings, Joint Court Ordered Kinship Care and Foster Care Application, Ordering Information - Child Welfare Licensing Initial Application Packets, Authorization to Consent to Medical Treatment, Relative Caregiver Agreement Child Placed in Out-of-Home Care by Agency, Independent Living Transition to Discharge (ILTD)Plan, Application for Certification and Child Placement Level 5 Foster Home, Wisconsin Works W-2 Formal Assessment Agreement, National Youth in Transition Database (NYTD) Survey for Wisconsin Youth Age 17, Job Access Loan, W-2 Auxiliary Payment and/or Performance Outcome Payment Claim Approval Designation, Child Placing Agency (DCF 54) Registration, Assessment/Stabilization Center Registration, Request for Emergency Service Funds for DMCPS Families, Request for Child Protective Services (CPS) Background Check, Child and Adolescent Needs and Strenghts (CANS) Results 5-21, Child and Adolescent Needs and Strengths (CANS) Results 0-5, Licensor Guide to the Web-Based Foster Parent Pre-Placement Training, Removal of Records Receipt - Child Care Centers, Application to DCF Exceptions Panel for Exception to Foster Parent Training Requirements, Wisconsin Child Care Regulatory System (WISCCRS Access Report), Application for Assistant, Employee, Substitute or Volunteer, Notice of Noncooperation with Program Requirements, Intensive In-Home Services Extension Request, Child and Adolescent Needs and Strengths (CANS) 5-21 Amendment Confirmation of Needs Subsidized Guardianship/Adoption Assistance, Child and Adolescent Needs and Strengths (CANS) 0-5 Amendment Confirmation of Needs Subsidized Guardianship/Adoption Assistance, Subsidized Guardianship Amendment Request - Confirmation of Needs Behavioral Characteristic, Subsidized Guardianship Amendment Request - Confirmation of Needs Physical - Personal Care Characteristics, Subsidized Guardianship Amendment Request - Confirmation of Needs Emotional Characteristics, Subsidized Guardianship Amendment Request, Request for Approval of Foster Care Maintenance Rate Over $2,000 per Month, National Youth in Transition Database (NYTD) Survey for Wisconsin Youth Age 19, Assessment and Discharge Summary - Respite Group Homes, WI Shares Child Care Subsidy Admin SharePoint Site External User Access Request (Non-CSAW Users), Subsidized Guardianship (SG) Program Application and Decision, Subsidized Guardianship (SF) Program Application and Decision, Policy - Procedure Checklist - Child Placing Agency, Child Care Certification Agency Review Questionnaire, Rehabilitation Review Appeals Report Instructions, Subsidized Guardianship Amendment Request - Age Birth to 5 Child and Adolescent Needs and Strengths (CANS) Version, Subsidized Guardianship Amendment Request - Age 5-21 Child and Adolescent Needs and Strengths (CANS) Version, Subsidized Guardianship Amendment Request - Confirmation of Needs Emotional Characteristics (Ages Birth to 5), Subsidized Guardianship Amendment Request - Confirmation of Needs Emotional Characteristics (Ages 5 to 21), Subsidized Guardianship Amendment Request - Confirmation of Needs Behavioral Characteristics (Birth to 5), Subsidized Guardianship Amendment Request - Confirmation of Needs Behavioral Characteristics (Ages 5 to 21), Subsidized Guardianship Amendment Request - Confirmation of Needs Physical/Personal Care Characteristics (Birth to 5), Subsidized Guardianship Amendment Request - Confirmation of Needs Physical/Personal Care Characteristics (Ages 5 to 21), Notice of Extension of Informal Disposition Agreement, Notice of Termination of Informal Disposition Agreement, Notice to the District Attorney of Cancellation of Informal Disposition Agreement, Address Information Request for Department of Motor Vehicles, Basic Education, Technical College, or Other Confirmation of Classes, BPI Investigation Tracking Database Access Request, Residential Care Center Regisration Requirement (DCF 52) Checklist, Confidential Information Release Authorization, Documents Submitted at Fact Finding Review, Request for Address of Wisconsin Works (W-2) Recipients Involved in Legal Proceedings, Certification Regarding Debarment and Suspension Instructions, Supervised Independent Living (SIL) Placement Referral, At Risk Pregnancy (ARP) Medical Information/Verification, YoungStar Case Management System Access Request, Rehabilitation Review Panel Decision Report with Instructions, Rehabilitation Review Application Instructions, Child Care Agency Annual Summary: All Contract Functions, Request for Waiver of Eligibility Restrictions for Child Care Assistance, Initial Assessment Case Reading Protocol and Review Tool, Daily Attendance Record - Certified Child Care, Affidavit of Lost, Destroyed, or Stolen checks or Benefits, Declaration of Paternal Interest Revocation, Court Inquiry on Declaration of Paternal Interest, Staff Continuing Education Record -Child Care Centers, Incident Report - Regulated Child Care Centers, Transportation Permission - Child Care Centers, Informed Consent for Observation or Testing by an Outside Agency - Child Care Centers, Authorization to Administer Medication - Child Care Centers, Intake for Child Under 2 Years - Child Care Centers, Licensing Checklist - Group Child Care Centers DCF 251, Licensing Checklist - Family Child Care Centers DCF 250, Licensing Checklist - Day Camps for Children, Staff-to-Child Ratio Worksheet Group Child Care Centers, ICPC Report on Children's Placement Date or Change or Placement, Alternate Arrival / Release Agreement - Child care Centers, Foster Home Agreement Child Placed in Out-of-Home Care by Agency, Foster Parent Insurance Program - Claim of Loss or Damage, Foster Parent Insurance Program Verification of Claim, Court Report for Centralized Birth Record, Family History Questionnaire Medical/Genetic - Pregnancy and Delivery Information, Family History Questionnaire Medical/Genetic, Sanitation Checklist - Residential Care Centers, Fire Safety Inspection - Residential Care Centers, Community Advisory Committee Documentation, Personnel Record Checklist - Child Placing Agencies, Foster Child Record Checklist Child Placing Agency, Child Welfare Facility Staff Health Report, Adoption of Children with an Adoption Assistance Agreement One Time Expense Reimbursement, Safety and Emergency Response Documentation - Family Child Care Centers, Safety and Emergency Response Documentation - Group Child Care Centers, Application to DCF Exceptions Panel for Exception to Ch.