LDSS-3026. Chronological Admission and Discharge Register

Form Chronological Admission and Discharge Register is a NYS Office of Children and Family Services Form. It is used to record all admissions and discharges of children in an out-of-home setting. It is a mandatory form for all out-of-home settings and must be completed in full for each admission or discharge of a child.

The form consists of the following sections: child's name, date of admission, date of discharge, admission authorization, admission status, provider name, location of admission, and discharge authorization. Additionally, there are fields for the child's age, gender, and ethnicity. These sections are all necessary for the accurate completion of the form.

Important fields in this form include the child's name, date of admission and discharge, admission and discharge authorization, and the provider name. Accurate completion of these fields is vital in order to ensure that the child's admission and discharge records are properly tracked and that the out-of-home setting is compliant with NYS Office of Children and Family Services regulations.

This form would be used in an example scenario where a child is admitted into an out-of-home setting, such as a foster home or group home. The provider would complete the form in full, including the child's name, date of admission and discharge, admission and discharge authorization, provider name, and other pertinent information. Completion of the form is necessary for the proper tracking of the child's admission and discharge records, and any inaccuracies or omissions could lead to complications or delays in the admission and discharge process.

Related forms that may exist for similar transactions include the Chronological Admission and Discharge Summary, which records all admissions and discharges of children in an out-of-home setting, and the Chronological Summary of Preplacement Assessments, which records all preplacement assessments of children in an out-of-home setting. Additional documents that may be necessary for completing the form could include the child's birth certificate or other proof of identification, and a signed authorization from the parent or guardian for the child's admission or discharge.