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OCFS-5300B-S - Declaración del Posible Padre o de la Posible Madre de Crianza de Emergencia
Prospective Emergency Foster Parent Statement
Spanish
Foster Care
Forms
2020
OCFS-5183D-S - Reporte Médico del Solicitante de Cuidado Temporal/Adopción (Primera y Segunda Parte)
Foster/Adoptive Applicant Medical Report (Part 1 and Part 2)
Foster/Adoptive Home Certification or Approval Process
Spanish
Foster Care
Forms
2018
OCFS-5183E-S - Formulario de Revisión de Seguridad
Safety Review Form
Foster/Adoptive Home Certification or Approval Process
Spanish
Foster Care
Forms
2019
OCFS-5300A - Emergency Foster Home Application
English
Foster Care
Forms
2020
OCFS-5300B - Prospective Emergency Foster Parent Statement
English
Foster Care
Forms
2020
OCFS-5300D - Expedited Home Study Checklist for Caseworker
English
Foster Care
Forms
2020
OCFS-5300D - Expedited Home Study Checklist for Caseworker
English
Foster Care
Forms
2020
OCFS-5183F-S - Formulario de Composición del Hogar y Relaciones Entre el Grupo Familiar
Household Composition and Relationships Form
Foster/Adoptive Home Certification or Approval Process
Spanish
Foster Care
Forms
2019
OCFS-5183I-S - Características de Recursos
Resource Characteristics
Part of the OCFS-5183 certification approval packet.
Spanish
Foster Care
Forms
2019
OCFS-5183G-S - Ejemplo de Plantilla de Genograma
Genogram Sample Template
Foster/Adoptive Home Certification or Approval Process
Spanish
Foster Care
Forms
2019
OCFS-5183J-S - Acuerdo del Padre/Madre de Crianza Temporal con la Agencia Autorizada
Foster Parent Agreement With Authorized Agency
Part of the OCFS-5183 certification approval packet.
Spanish
Foster Care
Forms
2019
FFPSA Goal Monitoring Worksheet
English
Foster Care
Forms
2019
OCFS-4777 - Federal Foster Care Candidacy Determination Form
This form is used to Determination or six-month Redetermination Foster Care Candidacy reimbursement.
English
Foster Care
Forms
2019
OCFS-5183L-S - Reautorización Anual−Evaluación y Determinación
Annual Reauthorization Assessment and Determination
Annual Reauthorization Assessment and Determination
Spanish
Foster Care
Forms
2019
OCFS-5183C-S - Informacion del Registro de Adopcion para Familias
Family Adoption Registry Information
Foster/Adoptive Home Certification or Approval Process
Spanish
Foster Care
Forms
2019
OCFS-5183B-S - Solicitud de Padres de Crianza o Adoptivos
Foster/Adoptive Parent Application
Foster/Adoptive Home Certification or Approval Process
Spanish
Foster Care
Forms
2019
OCFS-5183L - Annual Reauthorization Assessment and Determination
Annual Reauthorization Assessment and Determination
English
Foster Care
Forms
2019
OCFS-5183J - Foster Parent Agreement With Authorized Agency
Part of the OCFS-5183 certification approval packet.
English
Foster Care
Forms
2019
OCFS-5183F - Household Composition and Relationships Form
Foster/Adoptive Home Certification or Approval Process
English
Foster Care
Forms
2019
OCFS-5183C - Family Adoption Registry Information
Foster/Adoptive Home Certification or Approval Process
English
Foster Care
Forms
2019
OCFS-5183A - Self Assessment
Foster/Adoptive Home Certification or Approval Process
English
Foster Care
Forms
2019
OCFS-5183B - Foster-Adoptive Parent Application
Foster/Adoptive Home Certification or Approval Process
English
Foster Care
Forms
2019
OCFS-5183G - Sample Genogram Template
Foster/Adoptive Home Certification or Approval Process
English
Foster Care
Forms
2019
OCFS-5183H - Personal References
Foster/Adoptive Home Certification or Approval Process
English
Foster Care
Forms
2019
OCFS-5183I - Resource Characteristics
Foster/Adoptive Home Certification or Approval Process
English
Foster Care
Forms
2019
OCFS-5183E - Safety Review Form
Foster/Adoptive Home Certification or Approval Process
English
Foster Care
Forms
2018
OCFS-5183H-S - Referencias Personales
Personal References
Part of the OCFS-5183 certification approval packet.
Spanish
Foster Care
Forms
2019
OCFS-5183J-HC - Akò Paran Fanmi Dakèy la Avèk Ajans Otorize a
Foster Parent Agreement With Authorized Agency
Part of the OCFS-5183 certification approval packet.
Haitian Creole
Foster Care
Forms
2018
OCFS-5184 - OCFS-5184 Foster Care Placement Verification Form
This form verifies that the individual named on said form was in the custody of the Commissioner of the identified LDSS, in out of home care in a foster care placement for more than six months, prior to aging out of foster care.
English
Foster Care
Forms
2018
OCFS-5183A-S - Autoevaluación
Self Assessment
Foster/Adoptive Home Certification or Approval Process
Spanish
Foster Care
Forms
2019
OCFS-3920-S - Herramienta de Indicadores de Tráfico Sexual Infantil
Child Sex Trafficking Indicators Tools
The Child Sex Trafficking Indicators Tool is to be used for the comprehensive screening for compliance with the policy Requirements to Identify, Document, Report, and Provide Services to Child Sex Trafficking Victims. This policy was to be compliant with the Preventing Sex Trafficking and Strengthening Families Act.
Spanish
Foster Care
Forms
2018
OCFS-3920 - Child Sex Trafficking Indicators
The Child Sex Trafficking Indicators Tool is to be used for the comprehensive screening for compliance with the policy Requirements to Identify, Document, Report, and Provide Services to Child Sex Trafficking Victims. This policy was to be compliant with the Preventing Sex Trafficking and Strengthening Families Act.
English
Foster Care
Forms
2018
OCFS-3922-S - Denuncia de una Víctima de Tráfico Sexual Infantil a una Agencia de Orden Público
Law Enforcement Report of a Child Sex Trafficking Victim
The Law Enforcement Report Of A Child Sex Trafficking Victim Form is to be used for compliance with the policy Requirements to Identify, Document, Report, and Provide Services to Child Sex Trafficking Victims. The policy is to be compliant with the Preventing Sex Trafficking and Strengthening Families Act.
Spanish
Foster Care
Forms
2018
OCFS-3921-S - Herramienta para la Rápida Detección de Identificadores
Rapid Indicator Tool
Herramienta para la Rápida Detección de Identificadores (para identificar a niños que posiblemente sean víctimas de tráfico sexual)
Rapid Indicator Tool (to identiy childfren who may be sex trafficking victims)
Spanish
Foster Care
Forms
2016
OCFS-4930ASFA-S - Solicitud de Servicios de Huellas Dactilares
Request for Fingerprinting Services
Spanish
Foster Care
Forms
2017
OCFS-4743a - Foster Parent Request for the Release of the Social Security Number of a Child in Foster Care for Purposes of Section 8 Rental Assistance
English
Foster Care
Forms
2017
OCFS-4415 - Re-entry Into Foster Care for Youth Age 18 and Over Eligibility Checklist
English
Foster Care
Forms
2016
OCFS-4743 - Foster Parent Request for the Release of the Social Security Number of a Child in Foster Care for Income Tax Purposes
English
Foster Care
Forms
2016
OCFS-4922 - Transition Plan
English
Foster Care
Forms
2015
OCFS-2981 - Application Cover Sheet for Operating Certificate Request
English
Foster Care
Forms
2008
OCFS-3921 - Rapid Indicator Tool To Identify Children Who May Be Sex Trafficking Victims Or At Risk Of Being A Sex Trafficking Victim
The Rapid Indicator Tool To Identify Children Who May Be Sex Trafficking Victims Or At Risk Of Being A Sex Trafficking Victim form is to be used for compliance with the policy Requirements to Identify, Document, Report, and Provide Services to Child Sex Trafficking Victims. The policy is to be compliant with the Preventing Sex Trafficking and Strengthening Families Act.
English
Foster Care
Forms
2016
LDSS-4810 - Re-determination of Title IV-E Eligibility Checklist (Foster Care)
English
Foster Care
Forms
2014
OCFS-0711 - Childs Medical Record
English
Foster Care
Forms
2016
LDSS-4809 - Initial Foster Child Eligibility Checklist
English
Foster Care
Forms
2018
LDSS-3424 - School District Notification of Financial Responsibility for Educationally Handicapped Foster Child Placed in a Child Care Institution (WORD)
Form to be completed for a child in foster care who is also educationally disabled to determine financial responsibility.
English
Foster Care
Forms
2018
LDSS-3424 - School District Notification of Financial Responsibility for Educationally Handicapped Foster Child Placed in a Child Care Institution (PDF)
Form to be completed for a child in foster care who is also educationally disabled to determine financial responsibility.
English
Foster Care
Forms
2018
LDSS-3806 - Notice to be Given Applicants for or Recipients of Services When Requesting Social Security Numbers (WORD)
English
Foster Care
Forms
2005
LDSS-3806 - Notice to be Given Applicants for or Recipients of Services When Requesting Social Security Numbers (PDF)
English
Foster Care
Forms
2005
LDSS-0850 - Consent for Childs Special or Emergency Medical or Surgical Treatment (By Parent or Guardian) (WORD)
English
Foster Care
Forms
2010
LDSS-0850S - Consentimiento para Proveer Tratamiento Especial a un Niño(a) o Tratamiento de Emergencia Medica o Cirugia (para el Padre-Madre o Guardian-Tutor(a)
Spanish
Foster Care
Forms
2010
LDSS-0882 - Consent for Childs Routine Medical and Dental Care (WORD)
English
Foster Care
Forms
2005
LDSS-0882S - Consentimiento para la Atención Medica y Dental de Rutina del Niño(a) (PDF) Consent for Child's Routine Medical and Dental Care
Spanish
Foster Care
Forms
2010
LDSS-0893 - Boarding Home Register (WORD)
English
Foster Care
Forms
2014
OCFS-3917 - Transition Plan Amendment for youth age 18-21
English
Foster Care
Forms
2015
OCFS-4948 - Attorney Notification of a Childs Change of Foster Care Placement (WORD)
English
Foster Care
Forms
2011
OCFS-2113 - Notice of Foster Home or Adoptive Home Closure
English
Foster Care
Forms
2013
LDSS-7031 - Transmittal for Parent Locator Service Search (WORD)
English
Foster Care
Forms
2008
LDSS-7031 - Transmittal for Parent Locator Service Search (PDF)
English
Foster Care
Forms
2008
Youth Voice Questions (WORD)
English
Foster Care
Forms
LDSS-4055 - Residential Placement Assessment Form
English
Foster Care
Forms
2018
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