LDSS-4809. Initial Foster Child Eligibility Checklist

Form Initial Foster Child Eligibility Checklist is a New York State Office of Children and Family Services form designed to help facilitate the process of determining eligibility for foster care. It is used to assess a child’s eligibility for the services and supports of foster care. The form consists of a series of questions covering a variety of topics including the child’s age, family composition, educational status, health and mental health status, and any history of victimization.

Important fields in this form include the child’s name, date of birth, current address, and family composition. Additional information to be provided includes the age at which the child entered foster care, the child’s current grade level, any history of hospitalizations, any medical or mental health diagnoses, any history of victimization, and any legal proceedings involving the child. Additional sections may include information about the child’s parents or other family members, the child’s current guardian or foster family, and any additional information that may be helpful in determining the child’s eligibility for foster care.

An example scenario where this form would be used is when a child is referred to an agency for placement in foster care. When a child is referred to an agency, the agency staff will use the Initial Foster Child Eligibility Checklist to determine the child’s eligibility for foster care. This form allows the agency to assess the child’s needs and develop a plan for providing the necessary services and supports for the child.

Specific instructions for filling out this form include providing accurate and complete information about the child’s age, family composition, educational status, health and mental health status, and any history of victimization. It is important to provide accurate information as it will be used to determine the child’s eligibility for foster care.

Related forms and alternatives for similar transactions and purposes may include the Adoption Eligibility Assessment Form and the Foster Care Eligibility Assessment Form. The Adoption Eligibility Assessment Form is used to assess a child’s eligibility for adoption, and the Foster Care Eligibility Assessment Form is used to assess a child’s eligibility for foster care. Additional documents that may be required to complete the form include court or legal documents, medical records,