MISSOURI DEPARTMENT OF SOCIAL SERVICES CHILDREN’S DIVISION FOSTER FAMILY PROFILE
HOUSEHOLD COMPOSITION As Specified 13 CSR-35-60.030
FULL NAME ( USE INITIALS FOR BIOLOGICAL AND ADOPTED CHILDREN)	SEX	AGE
LIST ANY PETS IN THE HOUSEHOLD
Describe how you structure your environment so that it is safe and healthy for a child. As required by 13 CSR 35-60.040 and As required by 13 CSR 35-60.050
Describe how you express positive feelings toward a child both verbally and physically. As required by 13 CSR 35-60.030
Describe how you recognize and respond appropriately to a child’s verbal and physical expressions of needs and wants. As required by 13 CSR 35-60.050
Describe how you consistently use appropriate techniques to discipline a child and refrain from using corporal punishment on any child in the custody of the Children’s Division. As required by 13 CSR 35-60.050
FOSTER FAMILY PROFILE CONTINUED
Describe how you guide a child towards independence. As required by 13 CSR 35-60.050
Describe how your family works with a child(ren) and their birth family, including parents and siblings. As required by 13 CSR 35-60.030
Describe your family's educational practices (i.e. home schooling, public/ private school). As required by 13 CSR 35-60.030
This is a smoking non-smoking household.
FOSTER PARENT ETHNIC AND RACIAL BACKGROUND As required by 13 CSR 35-60.030
FOSTER PARENT 1	FOSTER PARENT 2
FOSTER PARENT LIFESTYLE (i.e. RELIGIOUS PREFERENCES, SEXUAL ORIENTATION, FAMILY ACTIVITIES, etc) As required by 13 CSR 35-60.030
FOSTER PARENT 1	FOSTER PARENT 2
FOSTER PARENT EMPLOYMENT (List Occupation)As required by 13 CSR 35-60.030
FOSTER PARENT 1	FOSTER PARENT 2
Additional comments
FOSTER PARENT 1 SIGNATURE	DATE SIGNED
FOSTER PARENT 2 SIGNATURE	DATE SIGNED
THANK YOU FOR YOUR TIME.