OCFS-3914. Health and Safety Equipment and Substitute Care Expenditure Log

Form OCFS-3914, the Health and Safety Equipment and Substitute Care Expenditure Log, is a record of expenditures spent on health and safety equipment and substitute care services for children in foster care. It is utilized by Child Protective Services (CPS) offices, Foster Care Review Boards (FCRBs), and other agencies to ensure that the health and safety of children in foster care is being appropriately managed and monitored.

The form consists of several sections, including the name of the child in care, the provider and program to which the expenditure was made, the date of the expenditure, the payment amount, and the purpose for which the expenditure was made. Additionally, the form requires a detailed description of the purchase, a signature of approval from the authorizing agency, and the signature of the vendor to whom payment was made.

Important fields in this form include the name of the child in care, the provider and program to which the expenditure was made, the date of the expenditure, and the payment amount. The form also requires detailed descriptions of the purchase and any additional information to ensure accuracy. Additionally, this form must be completed and signed by the authorizing agency and the vendor to whom payment was made.

An example of when this form would be used would be if a child in foster care needed to purchase a new mattress. The child’s guardian or foster home would need to fill out the form and submit it to the CPS office for approval. Once approved, the payment would be made to the vendor and the form would be signed by both the agency and vendor.

The purpose of the form is to ensure that all expenditures on health and safety equipment and substitute care services are properly tracked and accounted for. This form also serves as a record of the purchase and helps to ensure that the child in foster care is receiving the necessary services and equipment.

In addition to the form, additional documents may need to be filled out and submitted in order to complete the transaction. These documents may include receipts, invoices, and other documents as required by the authorizing agency. There may also be other forms and alternatives available for similar services or purchases.