MISSOURI DEPARTMENT OF SOCIAL SERVICES CHILDREN’S DIVISION TEMPORARY ALTERNATIVE PLACEMENT AGREEMENT (TAPA)	Case Name:
Case/Incident Number:
TAPA Begin Date:
TAPA End Date: (No later than 90 days from begin date)
This is a Temporary Alternative Placement Agreement (TAPA). A TAPA is a voluntary agreement between parents/legal guardians, Children’s Division, and a willing and able relative/family friend to provide a temporary, out of home placement for a child if the parent parent/legal guardian is temporarily unable to provide care or support for their child due to an identified safety concern for the child. This agreement is entered into under the authority of Missouri law. §210.123 RSMo.
Child(ren) Involved:	DOB:
Parent(s)/Legal Guardian(s)--Name, DOB, Household Address, Contact Number(s):
Diversion Placement Provider(s)--Name, DOB, Household Address, Contact Number(s), and Relationship to the Child(ren):
What immediate safety threat(s) to the child(ren) exists? Be child and behaviorally specific:
What are the child(ren)’s vulnerabilities to the safety threats and what are the concerns with the parent/caretaker’s protective capacities? Be individually specific:
What actions has the parent/legal guardian taken in the past to keep the child(ren) safe when the safety threat(s) have occurred? What supports have been utilized in the past (or presently) to keep the child safe?
Facts and Circumstances that Led to the Implementation of the TAPA:
What needs to happen for this TAPA to successfully end and the child(ren) to safely return to the parent(s)/legal guardian(s)? Identify the behaviorally specific changes that the parent(s)/legal guardian(s) needs to make to ensure the child’s safety and welfare upon returning home. Identify the specific tasks that need to be completed by each involved party. Identify the timeframe for completion of all agreed upon tasks and behavioral changes:
What safety-related resources/support services are currently in place or still need to be referred to assist with the behavioral changes needed to resolve the threat(s) of safety to the child(ren)? What services will the Children’s Division offer to the family? What supports have been utilized in the past that can be utilized during the TAPA to eliminate the safety threat(s)? Identify the current service providers and/or the specific services the family still needs to be connected with, as well as how these services/resources will assist with resolving the threat(s) to safety:
What is the plan for visitation and contact for each parent and all child(ren) with the participation of all parties? The visitation plan should be agreeable by all parties and made in the best interest of the child and/or sibling group:
What steps should the family and/or safety network members take in the event this TAPA is violated or other concerns for child safety arise?
Provide the name(s) and contact information of all individuals who must be immediately notified if this TAPA is violated or there are concerns for the safety of the child(ren) involved in this plan:
By agreeing to this TAPA, parent(s)/legal guardian(s) agree and understand the following: All parties will cooperate with the Children’s Division and participate in all services as provided in this agreement. This includes, but is not limited to: permitting the Children’s Division to make announced and unannounced home visits, allowing the Children’s Division to have personal contact with the child(ren), completing background checks, and participating in all scheduled team decision making meetings. The parent(s) or legal guardian(s) acknowledge that they have been advised that the Children’s Division or juvenile officer may take additional action within their authority under law, and that advice does not constitute a basis for the parent(s) or legal guardian(s) to claim that this TAPA is not voluntary or was coerced. The child(ren) shall reside in the State of Missouri for the duration of this agreement unless the child requires medical treatment in another state that is not reasonably available within Missouri. The Children’s Division must be notified immediately of any change in the circumstances of the child(ren), the diversion placement provider(s), and/or the parent(s)/ legal guardian(s). The parent(s) or legal guardian(s) may withdraw from this agreement by giving at least five days written notice of their intent to terminate this agreement to the Children’s Division and the diversion placement provider. This agreement would remain in effect until the expiration of the five day notice period. Children’s Division retains the authority to refer this case to the juvenile office with a recommendation for further action at any time. The Children’s Division will notify the juvenile officer that this TAPA has been implemented and send a copy of this TAPA form to the juvenile officer. This TAPA is not binding on the juvenile officer unless the juvenile officer is a signatory to this agreement. The juvenile officer retains the authority to exercise discretion to take appropriate action within the juvenile officer’s authority under law. This TAPA will automatically expire without further action at 11:59 pm on the 90th day from the date that the last of the parent(s)/ legal guardian(s) signed this agreement, unless the parties to this agreement enter into a new TAPA before this TAPA expires. This agreement will end upon the entry of an order of a court having jurisdiction over the child(ren) that conflicts with the provisions of this agreement. A court order pertaining to the care, custody or control of the child(ren) shall always supersede this agreement. Parent(s)/Legal Guardian(s), initial & date acknowledgement of above requirements: Initial Date Initial Date

By agreeing to this TAPA, the diversion placement provider(s) agree and understand the following: All parties will cooperate with the Children’s Division and participate in all services as provided in this agreement. This includes, but is not limited to: permitting the Children’s Division to make announced and unannounced home visits, allowing the Children’s Division to have personal contact with the child(ren), completing background checks, and participating in all scheduled team meetings. The diversion placement provider(s) agree to have the child(ren) reside in his/her/their home for the duration of this agreement and to provide the necessary food, clothing, education, medical care and shelter that the child(ren) may require for the duration of the agreement. The diversion placement provider(s) agree to remain a resident of Missouri for the duration of this agreement. The diversion placement provider(s) shall have the authority to make the day-to-day decisions for the care of the child(ren) for the duration of this agreement, as provided in this agreement, and shall further have the authority to make educational and medical decisions for the child(ren). The diversion placement provider(s) shall consult with the child(ren)’s parent(s), legal guardian(s) and the Children’s Division before making decisions pertaining to the child(ren) other than routine day-to-day decisions necessary to care for the child. The child(ren) shall reside in the State of Missouri for the duration of this agreement unless the child requires medical treatment in another state that is not reasonably available within Missouri. The Children’s Division will be notified immediately of any change in the circumstances of the child(ren), the diversion placement provider(s), and/or the parent(s)/ legal guardian(s). Children’s Division retains the authority to refer this case to the juvenile office with a recommendation for further action at any time. The Children’s Division will notify the juvenile officer that this TAPA has been implemented and send a copy of this TAPA form to the juvenile officer. This TAPA is not binding on the juvenile officer unless the juvenile officer is a signatory to this agreement. The juvenile officer retains the authority to exercise discretion to take appropriate action within the juvenile officer’s authority under law. This TAPA will automatically expire without further action at 11:59 pm on the 90th day from the date that the last of the parent(s)/ legal guardian(s) signed this agreement, unless the parties to this agreement enter into a new TAPA before this TAPA expires. This agreement will end upon the entry of an order of a court having jurisdiction over the child(ren) that conflicts with the provisions of this agreement. A court order pertaining to the care, custody or control of the child(ren) shall always supersede this agreement. Diversion Placement Provider(s), initial & date acknowledgement of above requirements: Initial Date Initial Date

We understand, have helped develop, agree to cooperate, and fully participate in all services offered in this TAPA:
Parent/Guardian (Print and Sign)	Date
Parent/Guardian (Print and Sign)	Date
Diversion Placement Provider (Print and Sign)	Date
Diversion Placement Provider (Print and Sign)	Date
CD Worker (Print and Sign)	Date
CD Worker E-Mail Address	CD Worker Phone Number
CD Supervisor (Print and Sign)	Date
Other (Print and Sign)	Date