§6 ch3: Resource Family Assessment and Licensing Process

Attachment E:  Resource Provider Family Renewal Assessment Recording Outline

Summary of Contacts: Include date of contact, and with whom contact was made.

Summary of Placements: Include resource provider strengths and weaknesses around following issues:

  1. Children’s behaviors
  2. Relationship with birth parents
  3. Relationship with agency

Summary of Changes Since Last License Issuance:  Include family’s coping to particular change:

  1. Health (mental, physical, emotional)
  2. Marital
  3. Financial/employment
  4. Family composition
  5. Own children’s behavior
  6. House move

Summary of Resource Provider Training Participation:  Include dates, titles, number of hours attended, taught by whom, under whose auspices, location. (Not applicable to all licensed relative providers who choose not to receive the PPMN.)

Summary of References:

  1. Highway Patrol (arrests and convictions)
  2. CA/N Central Registry
  3. Documentation of Case.net review
  4. Family Care Safety Registry report
  5. Family Support Division (FSD)
  6. School (of children currently in the home)

Evaluation:  (Include compliance with licensing rules)

Recommendation:

Signature of Worker and Date Signed

Approval of Supervisor Including Signature and Date

Signature of Resource Provider and Date Signed

Chapter Memoranda History: (prior to 1/31/07)

Memoranda History: