Form LDSS-7041, the Environmental Hazards Statement, is a form used to evaluate any potential environmental hazards present in a home or other residence. It is used by the New York State Office of Children and Family Services to assess the safety of a home in order to determine if a family or individual is eligible to receive certain services or benefits.
Form LDSS-7040, the “Environmental Hazards Guidance Sheet,” is a New York State Office of Children and Family Services form used to assess the potential for environmental hazards in a home. It is intended to be filled out and used by caseworkers in child protective services, foster care, and adoption services.
Form LDSS-7031, also known as the Transmittal for Parent Locator Service Search, is an official form used to conduct a nationwide search for the location of a parent for the purpose of establishing paternity and/or obtaining child support. It is used by local departments of social services, child support enforcement units, and other child support agencies in New York State.
Form LDSS-7019, Illness Injury and Indicators of Abuse Log, is a form used by the New York State Office of Children and Family Services (OCFS) to document any signs of physical, emotional, or sexual abuse, neglect, or maltreatment that a child may have experienced. This form is intended to be filled out by any person who has observed or come into contact with the child in question and may have witnessed signs of possible abuse or maltreatment.
Form LDSS-7018, Notification of Foster Care Level of Care and Room and Board Payment, is a form used by the New York State Office of Children and Family Services to determine the amount of payment for foster care level of care and room and board. This form is completed by the foster care provider and is used to provide information regarding the payment amount and the services provided to the foster care recipient.
Form “Plan for Fire, Disaster or Other Emergency Evactuation of Residents Operator or Substitute Caretaker” is a document used by residential care providers to ensure their facility is prepared for any emergency situation that may arise. It is used to create a plan of action for an evacuation in case of fire, disaster, or other emergency.
Form LDSS-7015, Amendment to a Fully Executed and Approved Adoption Subsidy Agreement, is a New York State Office of Children and Family Services form used for making changes to a previously approved and executed adoption subsidy agreement.
Form FTHA Personal History of Applicant Family Type Home for Adults is a document used to provide information and evidence related to the applicant's family history to the Office of Children and Family Services for adult group home licensure.
Form LDSS-7005-S, the New York State Office of Children and Family Services (OCFS) Medication Error Report Form, is used to document and report medication errors that occur in the administration of medication in a child care setting.
The form consists of four sections: Section 1 is for identifying the child, Section 2 is for identifying the medication error, Section 3 is for identifying the health care professional, and Section 4 is for identifying the facility. It is important to fill out all sections completely and accurately.
Form LDSS-7005, the Medication Error Report Form, is a form used by the New York State Office of Children and Family Services to record medication errors that occur in residential care facilities.
The form is composed of several sections, including the facility name, the name and contact information of the person submitting the form, the date the error occurred, the name of the person affected, and the type, description, and outcome of the error. These sections provide necessary information for the agency to record and investigate the incident.
