Section 5, Chapter 1 (Case Records and Filing), Subsection 4 – Resource Home Records

Effective Date:  5-1-19


Documentation and file maintenance are as important in resource provider files as they are for foster youth’s case files. No child-specific information should be placed in the resource file with the exception of the CD-104 located inside the front cover of the file. The following is a guideline for file set up and maintenance.

Forms Section (Yellow)

  • Assessment Application, CS-42
  • Resource Home and Safety Checklist, CS-45
  • Out of County Home Assessment Request, CD-174
  • Resource Parent Acknowledgment and Assurances Form, CD-108
  • Well Water Check (Health Department), if applicable
  • Discipline Agreement, CD-119
  • Safe Sleep Practices, CD-117
  • Notification of Hazards, CD101; Swimming Pool, Trampoline, household smokers, etc.
  • Current Authorization for Release of Information, SS-6
  • Current Vendor Licensure/Placement Resource Report, formerly referred to as the SS-60, now the Vendor Licensure/Approval and Renewal screen in FACES.
  • Sanitation Inspection, CS-101j, if applicable
  • Fire & Safety Inspection, if applicable
  • Resource Family Exit Interview, CD-112

HIPAA (White) (Information in this section is not available to the public)

  • Resource Provider Health Insurance Portability and Accountability Information, CD-194
  • Foster/Adoptive Household Member Physical And Mental Health Report, CW-215
  • Psychological Evaluations/Therapists Reports
  • TB Test

Background Section (Green)

Correspondence (White)

  • Letters to Foster Family
  • Any other written correspondence (including business E-mail)

Training (Buff)

  • All Training Certificates
  • Training sign in sheets
  • Training record screens
  • Resource Family In-service Training Request, CD-114
  • All flyers and notifications of In-service training opportunities

Contracts/Licensing (Yellow)

  • Alternative Care, CM-3
  • Professional Parenting, CM-14
  • Respite, CM-10
  • Elevated Needs Level B Respite, CM-9
  • Elevated Needs Level B, CM-8
  • Level A Foster Care, CM-3 Amendment
  • Medical Home, CM-3 Amendment

Family Assessment (White)

  • STARS Initial In-Home Consultation
  • Resource Provider Family Study and Addendums
  • Personal Reference Questionnaire, CS-101f Utilized at initial licensure and only at re-licensure if warranted
  • School Reference Request, CS-101e Utilized at initial licensure and at re-licensure for all children in the home. Do not place foster youth’s CS101e in the resource provider file
  • Employer Reference Questionnaire, CS-101c Utilized at initial licensure and only at re-licensure if warranted
  • Reassessments
  • Professional Family Development Plan, CD-100
  • Outdated CD-56’s
  • Quarterly Summaries, CD-118

OHI Reports (Pink)

  • Case Name
  • Date of Report
  • Incident Number
  • Expungement Date

Administrative (White)

  • Resource Home Adverse Action Report, CS-20
    • CA/N Check (Should only be in this section with a CS-20)
  • Notification of Resource Home Adverse Action, CS-20a
  • Alternative Care Grievance Review Request, CS-70
  • Service Delivery Grievance Form, CS-131
  • Notification Letter for Adoption and Guardianship Subsidy Denial, CD-87
  • Application for Fair Hearing, CD-53
  • Withdrawal of Request for Hearing, CD-54

Narrative (Blue)

  • Dictate when a Family is licensed/re-licensed
  • Dictate when a child moves in and out
  • Record all home visits and meetings with resource provider family
  • Record when training notices have been mailed
  • Record when foster parents have participated in training
  • Record any licensing concerns noted and action taken
  • Document closing narrative
  • Level A/Level B/Medical Staffing Outcomes (non-child specific)

Emergency Plan/Disaster Plan (Red)

  • Required information as outlined in memo CD06-33

Note: italics indicates this must be in all records

The following items are viewed for the assessment process, but are not kept in the case file:

  • Directions to the home, including MapQuest print outs.
  • Copies of Social Security cards, birth certificates, school diplomas, car titles, driver’s licenses, and STARS/Spaulding homework.
  • Bank account numbers, bank account statements, tax filing forms.
  • The Financial Worksheet provided in the STARS curriculum Step 6 is the worksheet to be used to determine stable finances and money management. However, the worksheet is a part of the STARS homework and is not to be kept in the file.
  • Child-specific information including court orders and the Child Assessment and Service Plan, CS-1
  • Outdated fingerprint results