Section 6, Chapter 17 (Respite), Subsection 9, – (Case Recording)

17.9     Case Recording

A case file will be maintained for individuals who provide respite care only. If the respite care resource has a foster care license, documentation specific to respite services are maintained in their licensing case file under a cover sheet labeled Respite. Respite care is a contracted service. An active foster care license is not necessary in order for an individual to be awarded a cooperative agreement for Respite services.

17.9.1  Composition

The composition of the Respite Care Provider case file should include the following:

Forms Section (Yellow)

  • Application to Provide Respite Care, CS-RC-1
  • Respite Care Provider Approval, CS-RC-3
  • Foster Respite Care Provider Checklist, CS-RC-2
  • Respite Provider Evaluation/Payment Invoices, CD-111
  • Resource Parent Discipline Agreement, CD119
  • Safe Sleep Practices, CD-117
  • Notification of Hazards, CD-101, if applicable

HIPAA (White)

Correspondence (White)

  • Letters to Respite Provider Family
  • Any other written correspondence (including business e-mail)

Training (Buff)

  • Training record screens (this is only applicable to the Elevated Needs Level B Respite Providers who are required to complete eight (8) hours of Elevated Needs Level B respite training.)

Contracts (Yellow)

  • Cooperative Agreement for the Purchase of Respite Care Services with the Children’s Division, CM-10
  • Cooperative Agreement for the Purchase of Respite Care for Elevated Needs Level B Foster Parents, CM-9

OHI Reports (Pink)

The cover sheet should include:

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

Narrative (Blue)

  • Dictate when a family is awarded or renewed a cooperative agreement for respite care services.
  • Record background screenings were completed
  • Record all home visits and meetings with Respite Resource family
  • Record when training notices for Elevated Needs Level B Respite Providers have been mailed
  • Record when Elevated Needs Level B Resource Provider has participated in training
  • Record any cooperate agreement or qualifications concerns noted and action taken
  • Document closing narrative

Placed Inside and attached to the front flap of the file folder:

  • Placement Report for Foster Home Record, CD104

17.9.2  Initial Recording

The initial recording should document the date the CM-10 was signed by the family and worker.  The worker should also meet with the family’s biological/adopted children separate from the parents to discuss their feelings on sharing their household.  The date the vendor was opened in the system should also be noted. Document that the background screenings were completed for all household members age 17 and older:

  • Fingerprints
  • CA/N Check
  • Case.Net Check
  • Family Care Safety Registry
  • Sex Offender List by Address

17.9.3 Subsequent Recording

Subsequent recording will include:

  • Document respite placements made utilizing the CD-104
  • Document contacts with the family
  • Document any staff concerns with the family
  • Document any trainings attended. 

A summary should be completed yearly and prior to issuance of a new cooperative agreement. The summary will include:

  • Any concerns or issues noted during the past year
  • Number and types of placements made
  • Changes in household composition (i.e. divorce, death, illnesses, adoptions, births, etc.)
  • Changes to the physical environment (moves, additions, remodels, etc)
  • Training attended
  • Background screenings to be completed every two years
  • The date of the licensing worker’s home visits (which must occur a minimum of once a year prior to the new cooperative agreement being issued)
  • Contact with the family’s biological/adopted children (separate from the parents)
  • Document discussion of any cooperative agreement or qualification issues, placement concerns, and any other issues/concerns noted by the Resource Development Worker
  • Discussion of any hotline reports, incidents, issues or concerns involving the Respite Resource family and any action taken.  It should also be noted if no action was taken and why
  • If there are concerns and reasons to close the respite provider, the contract unit must be contacted to close the respite care cooperative agreement for services, CM-9 or CM-10. Request to close the cooperative agreement must occur prior to June 30; the end of fiscal year

17.9.4 Documentation of Contact with Children in Division Custody

When a staff member makes a visit at the respite provider’s home, contact with all household members should be documented.  However, only initials should be utilized when making reference to children in Division custody.  This is true of all current and previous placements in the household.  Resource family records are not confidential and may be requested by the public.  Using initials only will maintain confidentiality of the children in Division custody.

The Placement Report for Foster Home Record, CD-104, shall be maintained in the forms section of the file with the names, placement and removal dates of all children in the resource family home.  This form will be removed prior to the records being made public.

17.9.5 Documentation of Criminal History

Staff should not list specifics in the narrative section of the file when documenting criminal history.  The narrative should simply reflect one of the following:

  • Fingerprint based criminal background check results meet eligibility requirements;
  • Fingerprint based criminal background check results do not meet eligibility requirements; or
  • Fingerprint based criminal background check results require further review to determine if applicant is precluded from licensure.

17.9.6 Closing Summary

There should be a summary completed whenever a respite resource home is closed.  For those closed voluntarily, the narrative should include why the family chose to close/not have their cooperative agreement renewed as well as any concerns or strengths of the family noted by staff.  For those closed due a cooperative agreement or qualification issues that led to not renewing the cooperative agreement and any other concerns, the information should be documented clearly.  The date of the exit interview and the discussion with the family should be documented in the closing summary also.

The contract unit must be contacted to close a cooperative agreement for respite services; CM-9 and CM-10 prior to June 30, end of fiscal year.

Memoranda History:

CD09-07, CD10-20, CD14-17, CD15-75, CD18-16