ࡱ> 47/0123'` bjbj{P{P _::2fO; ү xl$F****+\,-Lnj]]]]]]$zh1++11**27771X**nj71nj77IL*ֵ :|I`1XK8 RdH0xK1pLL`-c.^7.L /---6B---x1111   ā       TREATMENT FOSTER CAREDHS FC Worker Load #: FORMTEXT      INITIAL SERVICE PLANDHS FC Worker Name: FORMTEXT      Michigan Department of Human ServicesPOS Agency Name: FORMTEXT      POS Agency Worker Name: FORMTEXT      County of Referral: FORMTEXT      Court Jurisdiction: FORMTEXT      Court Docket #: FORMTEXT      Date Completed: FORMTEXT      Report Date: FORMTEXT      Report Period:Begin Date: FORMTEXT      End Date: FORMTEXT      IDENTIFYING INFORMATIONChild(ren): (List separately) name, date of birth, case number, date entered care, current placement type (if relative care, name and address of relative; if institution, name and address of institution; if foster home, note foster home placement only), date entered current placement, and permanency planning goal. Specify if the child(ren) is Native American and tribal affiliation, if applicable.NameDate of BirthLog NumberCase NumberChild GenderChild RaceHeightWeightHair Color FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Eye ColorReligionDated Entered CareDate of Current PlacementCurrent Placement TypeAnticipated Next Placement FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN Date of Anticipated Next PlacementCurrent Legal StatusFederal Permanency Plan Goal FORMTEXT       FORMTEXT       FORMDROPDOWN Child s Address (if not FH) FORMTEXT      Native American? FORMDROPDOWN If Yes, Tribal Affiliation FORMTEXT      Parent Name(s): Name and relationship to child, date of birth, address/phone (if multiple children are included in this service plan, the names of each mother and father should be listed; name of father or mother should be listed even if whereabouts are unknown). Include any non-parent adults involved in the household that the court may order to participate in the service plan or who will be involved in the service planning. A household contains biological or legal parents. If there is a step-parent that person must be in the household. These households must be designated as participating or non-participating. Indicate Yes or No if the parent is participating in service planning, cant locate/unavailable, deceased, incarcerated, PFFA in place, parental rights terminated, refused, reunification services not need/per count order, or unwilling. Definitions: Cant locate / Unavailable Worker has completed a diligent search for parent(s) with legal right to the child(ren) through such things as Secretary of State inquiry, search of telephone books, US Post Office address search, follow up on leads provided by friends and relatives, legal publication, etc. and has been unable to locate. The parent(s) has refused to respond to mailings from the worker. If there is no legal father, attempts should be made by the worker to identify and locate the putative father in order to establish paternity. (See CFF 722-6, Efforts to Identify and Locate Absent/Putative Parent(s) for more information.) Deceased Is used when the parent is deceased. Incarcerated Worker has confirmed parent(s) with legal rights to the child(ren) is in jail or in prison without access to reunification services for a period of two years or more. Not an Assessment Household There is no legal, biological, or putative parent in the household. Permanent Foster Family Agreement in Place (PFFA) For youth 14 and older that have a PFFA accepted by the court (CFF 722-7) Parental Rights Terminated Is used when parental rights have been terminated. Refused The parent has indicated in writing to the court that he/she does not intend to participate in reunification. Reunification Services not Needed/Per Court Order The court has determined that reunification services no longer need to be offered to the parent. Document court determination that reunification services no longer need to be offered in the reasonable efforts section of the service plan. Unwilling Worker has attempted to engage parent(s) with legal rights to the child(ren) in reunification services through scheduled appointments in the office, in the parents residence, or at a location designated by the parent at least once a month in a six month period as documented in the case file. NameRelationshipChildrenParticipating FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN Parent s Current Address: FORMTEXT      Date of Birth FORMTEXT      Telephone: FORMTEXT      Protective Services Risk Level: FORMDROPDOWN I.LEGAL STATUSThe petition is included in the legal section of the case file and is not repeated in the Legal Status of this file. Summarize the allegations and the disposition in the Reason Child(ren) entered care section of this report.A.Reason child(ren) entered care ( Describe the event or incident that led to the removal and placement of the child(ren). ( Are there prior CPS referrals, investigations, services and / or placement for this family? If yes, then describe. If any child(ren) remain in the family home, indicate the reasons why the child(ren) remaining in the home are safe and what services are being provided to ensure continued safety.   MACROBUTTON [1] Click Here and Type  B.Court History Child(ren): (List separately) name, petition date, petition type, hearing date, hearing outcome, order date, order type, requirements of the court through its order.  MACROBUTTON [1] Click Here and Type  C.Next Court Date  MACROBUTTON [1] Click Here and Type  II.Reasonable EffortsNote:For children who may be Native American, see Services Manual Item 742, Active and Reasonable Efforts. For all other children, see CFF 722-6, Reasonable Efforts. Information from CPS transfer.A.Include services that were provided to the child(ren) and parent(s) to prevent removal.   MACROBUTTON [1] Click Here and Type  B.Include services that were provided to the child prior to TFC placement.   MACROBUTTON [1] Click Here and Type  C.If services were not provided, were not required or if providing services to the family was not reasonable, explain why.   MACROBUTTON [1] Click Here and Type  D.Likely harm to the child(ren) if he/she were to be separated from parents, guardian, or custodian?   MACROBUTTON [1] Click Here and Type  Likely harm to the child(ren) if he/she were to be returned to parents, guardian, or custodian?   MACROBUTTON [1] Click Here and Type  III.Social Work Contacts ( List date, person(s) contacted, role/position, and type of contact (telephone, in person, home visit, office visit, etc.) for each contact, attempted contact, and scheduled, but unkept, appointment. ( Provide a brief narrative statement of the specific reason for the contact. ( If HV or FF contact made, indicate where contact took place. Team Meetings: MACROBUTTON [1] "Click Here and Type"  Supervision: MACROBUTTON [1] "Click Here and Type"  Face-to-face and Home Visits: MACROBUTTON [1] "Click Here and Type"  Other Social Work Contacts:  MACROBUTTON [1] Click Here and Type  IV.Assessment Please complete each section for every household.A.Family Social History and Assessment 1.Family History Describe the family of origin for all caretakers and non-parent adults who are involved in the case. Is there a history of child abuse or neglect and/or placement for the caretaker(s)? How does the caretakers history impact his or her own parenting skills and the current situation? Describe other relevant information about the adult members of the household, including any significant health issues, criminal history, intra-familial relationships. Briefly summarize the adult(s) interaction with child(ren) and with each other, if applicable. Describe the willingness and capacity of the adult(s) to change the situation that brought the child(ren) into foster care.   MACROBUTTON [1] Click Here and Type  2.Family Self Assessment What is familys reaction to the event / removal and the agencys definition of the problem? What is the familys definition of the problem? What is the familys assessment of their functioning? What does the family think would make things better? What resources does the family believe will help meet goals?   MACROBUTTON [1] Click Here and Type  3.Family Resources Identify the relative network resources currently provided or available potential resources, and the resources from the surrounding community. Include an assessment of familys feelings of support from the relative network.   MACROBUTTON [1] Click Here and Type  4.Religious Affiliation (if applicable) What is the religious affiliation of the parent(s) and child(ren)? What is the familys history of participation? What are the participation and attendance requirements? Explain any special dietary requirements, grooming, dress or make-up requirements for the child(ren) in placement.   MACROBUTTON [1] Click Here and Type  5.Family Assessment of Needs and Strengths Address and explain each individual item scored as a need on the Family Assessment of Needs and Strengths for each caretaker and household). Please attach a DHS-146. Identify the needs that are primary barriers to reunification and any substance abuse needs scored. Indicate how the primary barriers are related to the reasons the child(ren) entered care, and The priority for treatment services during the ISP planning period. Address and explain each individual item scored as a strength on the Family Assessment of Needs and Strengths for each caretaker and household); List and describe strengths in the family not identified on the assessment but are present in the family. Describe all other relevant information about the caretakers and non-parent adults, including: Observations on intrafamilial relationships and participants in the case, and The results of the Central Registry and criminal history checks, if available.   MACROBUTTON [1] Click Here and Type  B.Child Social History and Assessment The foster care worker should request information from the child(ren)s family and foster family prior to completing the child(ren)s needs and strengths assessment and social history. 1.Placements during the report period.Describe, for each child(ren) (list separately): name, living arrangement, begin date, end date, reason for replacement, and describe all prior formal and informal placements.  MACROBUTTON [1] Click Here and Type  2.Placement Decision Specify activities to prepare the child for placement. Discuss factors considered in making the placement decision.  MACROBUTTON [1] Click Here and Type  3.Medical and Dental Information Medical, dental and optical appointments and outcomes during report period. Provide information regarding prescribed medications, dosages, name of prescribing Doctor, follow-up appointments, note date medical consents signed and by whom. Indicate any concerns with side effects.  MACROBUTTON [1] Click Here and Type  4.Child History and Current StatusDescribe, for each child under court jurisdiction: A physical description Emotional and physical development Past experiences, and problems, and Hobbies, likes and dislikes, etc., Relationships with siblings, List all prior formal and informal placements. Specify reasons child was placed in TFC.  MACROBUTTON [1] Click Here and Type  Describe interventions utilized to support childs placement.5.Education Information School performance including the current school and grade of the child. Specify activities to support the child in his/her classroom. Indicate frequency of contact with school personnel to assess the childs progress.  MACROBUTTON [1] Click Here and Type  6.Child(ren)s Reaction to PlacementDescribe, for each child under court jurisdiction, their reaction to: the abuse and/or neglect that led to placement, and the placement out of the family home. (Separate from the family reaction) and strategies utilized to assist in the transition.   MACROBUTTON [1] Click Here and Type  7.Child Needs and Strengths AssessmentAddress and explain each individual item scored as a strength or need on the Child Assessment of Needs and Strengths for the child(ren). Please attach a DHS-432-5. Identify the priority needs of the child for service and outline primary treatment goals and interventions to meet the goals. List and describe all strengths of the child whether identified on the assessment or not. Identify the situational concerns, which cannot be identified in consecutive report periods. Discuss scoring outcome of CAFAS/PECFAS Specify the childs behavior management plan.   MACROBUTTON [1] Click Here and Type  8.Placement Informationa.Placement Selection CriteriaRank each from 1 4; 1 being the reason(s) most important to the placement decision, 3 the least important and 4 not applicable. FORMDROPDOWN The case plan which includes the goal of permanence. FORMDROPDOWN The physical, emotional, educational and safety needs of the child(ren). FORMDROPDOWN Proximity to the child(ren)s family. FORMDROPDOWN Placement within relative family network of the child(ren). FORMDROPDOWN Placement with siblings of the child(ren). FORMDROPDOWN The child(ren)s and child(ren)s familys religious preference. FORMDROPDOWN The least restrictive, i.e., most family like setting. FORMDROPDOWN The continuity of relationships. FORMDROPDOWN Availability of placement resources for the purposes of timely placements. FORMDROPDOWN Expressed preferences for placement by the foster child.b.If any Placement Selection Criteria are not met, explain why not.  MACROBUTTON [1] Click Here and Type  9.Placement Resources a.Sibling PlacementIf child(ren) has siblings and who are not placed in the same placement, provide an explanation of the reasons for the split placement and outline sibling visitation plan. Specify visitation plan to maintain sibling connections. Note: If Siblings placements are split, second line supervisory approval is required. The Second Line Supervisor must sign the ISP in the Signature Section. (( If there are no siblings or if siblings are placed together, write N/A.   MACROBUTTON [1] Click Here and Type  b.Sibling and Relative VisitationSpecifically address and evaluate visits between siblings if in separate placements. Specifically address and evaluate any relative visits including visits with adult siblings. Include observations on the quality of visits. Include a discussion of any exceptions (missed appointments, changed appointments, suspension of appointments and changes in supervision status) to the plan during the reports period.   MACROBUTTON [1] Click Here and Type  c.Relative Resources and PlacementIdentify any relative resources (in Michigan and other states per Interstate Compact for Placement of Children ICPC - procedures) with the potential to provide placement for the child, including relatives identified by the parent and child. If a decision has been made regarding relative care placement of the child, include the decision and the rationale for the decision or attach a copy of the DHS-31, Foster Care Placement Decision Notice. (( Attach any completed home studies to this ISP. Discuss any visitation arrangements for relatives.   MACROBUTTON [1] Click Here and Type  d.Planning FamilyDescribe interventions utilized with the planning family to prepare the family for discharge of the child. Specify visitation plan with planning family to prepare the family and child for discharge. If a planning family has not been identify, specify efforts made to identify explaining family.  MACROBUTTON [1] Click Here and Type  e.Best Interests of Current PlacementDescribe the TFC foster parents willingness and capacity to meet the specified needs of the child, and Describe why the current placement is in the childs best interest. Discuss plan to include planning family in treatment.   MACROBUTTON [1] Click Here and Type  10.Residential CareIdentify the plan for services that will allow the youth to be placed in a less restrictive setting. If the youth is 10 years of age or over and is placed in a residential or institutional setting, the worker should document if Wraparound or Assisted Care Efforts were made to prevent the custodial placement. If the child under age 10 is placed in a residential or institutional setting, the worker must document the Wraparound or Assisted Care Efforts made to prevent the custodial placement.. If there were no services provided, explain why not. If the youth is not placed in a residential or institutional setting, write N/A in the space provided.  MACROBUTTON [1] Click Here and Type  C.TFC Foster Parent Input Attach written input from the foster parents/relative caregiver about the child(ren). If a written statement is not available, summarize the foster parent/relative caregiver feedback. Describe interventions utilized by TFC family to support the childs placement and involvement with Parent/Planning Family.   MACROBUTTON [1] Click Here and Type  D.Progress to Date Briefly identify any changes in the family since the child(ren) entered care. Record all referrals made for the family since placement including any services provided by the Agency at the time of placement in the Service Referral Table of the Parent-Agency Treatment Plan and Service Agreement. Describe interventions utilized w/child to support case plan. Discuss community resources identified to support the placement. Discuss any after hour crisis interventions and outcomes.   MACROBUTTON [1] Click Here and Type  E.Respite Plan: Describe respite plan How provider was prepared for the child. How the child was prepared for the respite provider.   MACROBUTTON [1] Click Here and Type  F.Behavior Aide Activities: Describe behavior aide activities with the child and family.   MACROBUTTON [1] Click Here and Type  G.Mental Health Treatment: Summarize childs progress in therapy and treatment goals. Attach mental health progress rpts.   MACROBUTTON [1] Click Here and Type  H.Parenting Time: List all visits between the child identified family. Describe compliance with parenting time plan and sibling visitation, if applicable and any other planned visitation or contacts with appropriate parties. Describe coaching strategies utilized with the birth parent or permanent caregiver and child to assess the caretakers ability to safely care for their child. Describe services and support offered to the birth family or other identified permanent caregiver to prepare for long term placement after discharge. Date, location.   MACROBUTTON [1] Click Here and Type  I.Discharge Plan: Indicate plan for discharge and criteria for discharge.   MACROBUTTON [1] Click Here and Type  *Please see the attached Parent-Agency Treatment Plan and Service Agreement. V.Recommendation to Court (Complete for each child) A.Should Child(ren) Remain in Out of Home Placement? For each child under court jurisdiction, for the period covered by this report, identify case action as continued placement, return home and monitoring, or closure. If the child(ren) should remain in out-of-home placement, describe why it is not in the child(ren)s best interest to be returned home, placed for adoption, or placed within the relative network.   MACROBUTTON [1] Click Here and Type  B.Mandatory Petition for Termination of Parental RightsIf a mandatory petition for termination of parental rights has been filed requesting termination of parental rights at the dispositional hearing, the recommendations should contain either:1.A statement that the agency believes it is in the child(ren)s best interest to terminate the parents rights to the child(ren) and the reasons why; or2.Documentation regarding the compelling reasons why termination of parental rights is not in the child(ren)s best interest.If the Mandatory Petition section is the same for all children, check yes and the appropriate recommendation below. If this section is different for one or more children in the family, check no. Then click in the Child Name section and follow directions to add a section for each child for which the recommendation is different.This recommendation applies to all children: FORMCHECKBOX Yes FORMCHECKBOX NoRecommendation for: FORMTEXT       Enter the child s name.Check Boxes: Check only one box (1  3) and as many a  I as necessary if box 3 is checked.1. FORMCHECKBOX A mandatory petition is not required. If #1 is checked, a petition for termination for parental rights has not been filed. Write N/A in the space below.2. FORMCHECKBOX A petition for termination of parental rights has been filed and it is in the child(rens) best interest to proceed. If #2 has been checked and it is in the best interests of the child to proceed, provide the reasons why in the space below. 3. FORMCHECKBOX A petition for termination of parental rights has been filed and it is not in the child(rens) best interest to proceed. Indicate why termination is not in the best interests of the child by checking as many boxes as apply below:a. FORMCHECKBOX The child is age 14 or over and refuses to consent to his/her adoption.b. FORMCHECKBOX Child in treatment services are not yet completed.c. FORMCHECKBOX The youth is age 18 or over.d. FORMCHECKBOX The supervising agency has not yet provided the services detailed in the prior service plans to make reunification possible.e. FORMCHECKBOX Other. If this is the compelling reason, there must be clear documentation within the service plan of the individual circumstances of the child that necessitates this selection. f. FORMCHECKBOX The parent suffers from a chronic illness and the child is unable to return to the home, but there continues to be a close relationship between the child and parent.g. FORMCHECKBOX There are financial benefits for the child to maintaining parental rights.h. FORMCHECKBOX There is an appropriate relative caregiver to care for the child and the relative caregiver is not willing to adopt the child.i. FORMCHECKBOX Child is an unaccompanied refugee minor.  MACROBUTTON [1] Click Here and Type  C.Recommended Court Orders In this section, write any court orders requested for parental or caretaker compliance with the service plan. If applicable, request that non-parent adults participate and comply with the service plan.   MACROBUTTON [1] Click Here and Type  By signing below on behalf of the Department of Human Services, we agree to those activities outlined above and will assist the family in their efforts to facilitate the Permanency Planning goal. Upon clicking in the name and title field below, the number of additional signature lines for Split Sibling Placement Approval or any other signatures needed may be entered. If siblings are placed in different facilities, second line supervisors must sign to indicate approval.  Name and Title: FORMTEXT *,XZnpr|~J l n վ{sodssY{soNsjLh UhlhmOJQJjh UhmjhmUhlhm5CJOJQJ hlhmhlhm5hlhM:OJQJh8!`hM:B* phfjh8!`h;myB* UphfjhJ}]Ujh Uh;myjh;myUhlhM:5CJOJQJhlhM:CJ hmCJ hT<CJ,Xwn $Ifgd;my -$IfgdN`kd$$IflFG * +    4 layt4sJ $$Ifa$gdv7 $Ifgd;my 0$Ifgd*CJOJQJhlhl>*CJOJQJhlhl5>*CJOJQJ$h8!`hl<B* CJOJQJphfhlhlCJOJQJhlhlOJQJhlhl5OJQJj hlhl5U hl5 hlhlhlhlhl5jhl5UmHnHujhl5UjA hlhl5U    Mkd-$$Iflֈb !**$   +4 laytl$If 6$IfgdY $IfgdY " R T V n p ja $$Ifa$Mkd9$$Ifl0*Y+4 layt4sJ$If$If:kd$$Ifl*++4 layt4sJ $pp$If]p^pa$gdf}Mkd$$Ifl0*X%+4 layt4sJ   $%  $&(2468LNPZ\^`tvxûvjhlUjhlUj\hlU hlhljhlUmHnHujhlUhljhlUhlhl>*CJOJQJh4+hl5>*CJOJQJhl5>*CJOJQJ"h4+hl5>*@CJOJQJ*6*!! =$Ifgdf}kd$$Ifl \$ |D !%*+$$$$4 layt4sJ6^&N =$Ifgdf}"$&(<>@JLNPRTfhxzӽӲӧך׉uuuuu&h4+hl5>*CJOJQJ^JaJ hl5>*CJOJQJ^JaJhlhlCJOJQJjhlUjhlUjhlUjhlUhl hlhljhlUmHnHujhlUj&hlU.NPR,# =$Ifgdf}kdh$$Ifl \$ |D !%*+$$$$4 layt4sJRThz8$$If]^a$gd# $$Ifa$gd#<kd$$Ifl*++4 layt4sJ68:<PRT^`bdxz| "ŨšŨšŨšŨšušjšjhlUjhlUjhlUj~hlUjhlU hlhljhlUmHnHujPhlUhljhlUhlhl>*CJOJQJ&h4+hl5>*CJOJQJ^JaJ hl5>*CJOJQJ^JaJ)8:bD;;;;; =$Ifgd#kdJ$$Ifl ֈL *X`ad  +4 lap<yt4sJ"$&=4 =$Ifgd#kd$$IflֈL *X`ad  +4 lap<yt4sJ =$IfgdY"$(ln "$&BDFHJL۳ǫ쫧{wl{쫧aj&"hlUjh{ UhjhUj&hlUjhlUmHnHujhlUhljhlU&h4+hl5>*CJOJQJ^JaJ&hhl5>*CJOJQJ^JaJ hl5>*CJOJQJ^JaJ hlhlhlhlCJOJQJ&&(n $Ifgd4sJ $$Ifa$gd$$If]^a$gdhICkd$$Ifl*++4 lap yt4sJ$H =$Ifgd#nkd$$IflF *`  +    4 lapytcsVHJLNXMG=$If $<$Ifa$<kd!$$Ifl*++4 layt4sJ =$Ifgd#`kdX!$$IflF *`  +    4 laytcsV,T=$If$IfMkd"$$Ifl0U * G+4 layt4sJ,.BDFPRZhtz.w VqN>Hoboboboboboboboboh8!`hl<B* phfh8!`hl5<>*B* phfh8!`hl<>*B* phf$h8!`hl<B* CJOJQJphf h8!`hl5B* OJQJphfhlhl5OJQJhl5OJQJjhlUmHnHuj %hlhlUj=#hlU hlhljhlhlU"TVX[U=$Ifkd'&$$Ifl\M *F (+4 lap(yt4sJXZ.vw $If^gd0 $If^$If d$If$If<kd'$$IflL*++4 layt4sJ UVqO>?I $$Ifa$:kdl'$$Ifl**+4 layt4sJ $If^gdV $If^gdh $If^HI !!&!(!D!F!H!J!^!`!b!l!n!p!r!!!!!!!ʿ}oh]hO]o]hj)hlhlUjhlhlU hlhljhlUmHnHuj)hlUhljhlUhlhl>*CJOJQJhlhlCJOJQJhlhl5>*CJOJQJhlhlOJQJhVhl<B*phhlhl<B*phh8!`hl<B* phfh8!`hl5<B* phf !Ikd'$$Ifl֞ L $*{+4 layt4sJ $$Ifa$!(!D!F!H!p!!!!oiiii=$Ifkdr($$Iflr AWQ *K b8 +4 layt4sJ $$Ifa$!!!!!!!!!!!!!!" "4"6"8"B"D"b"d"x"z"|""""""""""""" #ź|nhlhl5CJOJQJhlhlOJQJhlhlCJj1hlhlUjE0hlhlUj/hlhlUjQ+hlUhljhlUjhlUmHnHuj*hlhlU hlhljhlhlU&!!!!"F"b""HBB$If<kd@/$$Ifl**+4 layt4sJ=$Ifskd.$$Ifl\ AW*K b2+4 layt4sJ"""""YS$Ifkd2$$Iflֈi#* S+4 layt4sJ=$If$If""#2#4#6#8#hMkd4$$Ifl09 * W+ 4 layt4sJ$If$If<kdv3$$Ifl**+4 layt4sJ ###,#.#0#4#8#:#X#`#$$$$$$$$%%F&G&H&I&Z&o&p&q&s&x&&󨒽󋀋ug\hh5CJOJQJhlh55CJOJQJhlh5B*phjhlh5U hlh5* jh8!`hl<B* CJOJQJphfhlhl5CJOJQJ hlhl$h8!`hl<B* CJOJQJphfhlhl5OJQJj3hlUhljhlUhlhlCJOJQJ8#:#@#Z#\#^#]Mkd5$$Ifl0*+(+4 layt4sJ$IfMkdJ5$$Ifl0*+ ( +4 layt4sJ^#`#$$$$$$$yyyyy$If:kdq6$$Ifl*++4 layt4sJ $If^:kd"6$$Ifl*++4 layt4sJ$$$$$NH?? $$Ifa$$Ifkd6$$Ifl4r %* TW0+4 laf4yt4sJ$$$$%%{{$P$If^`Pa$ $$Ifa$$Ifckd7$$Ifl4F?*L%+    4 laf4yt4sJ%E&F&G&H&r&s&D::: F]^Fckd/8$$Ifl4F?*L%+    4 laf4yt4sJ $$Ifa$N$ & F$Eƀ’Ifa$s&t&u&x&,'-'.'X'Y'Z'['\'pff F]^F[kd8$$Ifl4FD*N&    4 laf4"$ /tF <!D%'()$Ifa$ $$Ifa$$If &+','-'.'/'@'U'V'W'Y'Z'['\']'o'p'q'r''''''''^(_(}(~((((((((()) ) ) ))ߪߟLjthlhCJOJQJ hlhh$h8!`hh5B* CJOJQJphfh55CJOJQJhh5CJOJQJhlh5B*ph hlh5jhlh5Uhlh5CJOJQJhlh55CJOJQJ$h8!`hh<B* CJOJQJphf+\'_'o'p'q'''''' F]^F`kd+9$$Ifl4FD*N&    4 laf4$If ''''$(_(~(((TJ $If^[kd :$$Ifl4FD*%    4 laf4$IfHkd9$$Ifl40D*P(4 laf4(((((((( )^TG F]^Fgd F]^F[kd:$$Ifl4FD*%    4 laf4 $$Ifa$$If5kdx:$$Ifl4*+4 laf4 ) ) ) ))))[)\) $$Ifa$gd8 $Ifgd8:kd4;$$Ifl4*+4 laf4 $If^gd8gd F]^Fgd)))))#)B)C)Y)[)])^)_)p)))))))))))* * * **1*2*3*5*7*8*9*:*********ĹĮĹģˈ}r}ˈ}r}hlh5B*phjhlh5Uhlh55CJOJQJhlh5CJOJQJ hlh5hhlhB*phjhlhU hlhh5CJOJQJhlhCJOJQJhh5CJOJQJhlh5CJOJQJ,\)])^))))))** $$Ifa$$If F]^Fgd`kd;$$Ifl4FD*%    4 laf4 * * *4*5*6*7*:*** $$Ifa$$If F]^FXkd;$$IflFD*%    4 la ********.+/+ $$Ifa$$If F]^FXkdW<$$IflFD*%    4 la ***.+0+1+2+C+X+Y+Z+\+]+x+y+++@,A,B,C,D,E,,,,޲yiS* jh8!`h\a<B* CJOJQJphfh\a<B* CJOJQJphf$h8!`h <B* CJOJQJphf$h8!`hm<B* CJOJQJphf$h8!`h5<B* CJOJQJphf* jh8!`h5<B* CJOJQJphfhlh5B*phjhlh5Uhlh55CJOJQJhlh5CJOJQJ hlh5/+0+1+[+\+]+b+x+B,rH*$ /tF <!D%'()x$If^`xa$"$ /tF <!D%'()$Ifa$$If F]^FXkd<$$IflFD*%    4 laB,,,,,,,,,~uSSS" /tF <!D%'()$Ifgd $Ifgd Mkd%=$$Ifl40D*P(4 laf4 $$Ifa$*$ /tF <!D%'()x$If^`xa$,,,,,,,,,,,, - - ------ -!-"-3-ʼ~wlw~e^VKD hth^ljhth^lUh^lB*ph hvYh^l hbhy hbhWoB*ph hbhWojhbhWoUhlh CJOJQJh 5CJOJQJhlh 5CJOJQJhlh5CJOJQJhlh55CJOJQJ$h8!`h5<B* CJOJQJphfh\a<B* CJOJQJphf$h8!`h\a<B* CJOJQJphf,,------ -|||sQQQ" /tF <!D%'()$Ifgd8 $Ifgd8 F]^Fgdy ukd=$$Ifl4 \D$*p p p 4 laf4 -!-K-L-M-N-O-P-Q-|||sNNN%$ /tF <!D%'()$Ifa$gd8 $Ifgd8 F]^Fgdy ukd >$$Ifl4 \D$*p p p 4 laf43-H-I-J-K-L-M-Q-R-S-p-s-t-u-----------------------..µªµµªµtghlh5CJOJQJhlh55CJOJQJhth5B*phjhlh5U hlh5h*uc5CJOJQJh 5CJOJQJhlh CJOJQJhlh 5CJOJQJhy hlhy hthy jhth^lU hth^lhth^lB*ph%Q-R-S-q-r-s-```" /tF <!D%'()$Ifgd8 $Ifgd8skd>$$Ifl4\D$*p p p 4 laf4s-t--------|||sNNN%$ /tF <!D%'()$Ifa$gd8 $Ifgd8 F]^Fgdy ukd>$$Ifl4 \D$*p p p 4 laf4------```" /tF <!D%'()$Ifgd8 $Ifgd8skd|?$$Ifl4\D$*p p p 4 laf4-------.3.yytkkk $$Ifa$$a$ F]^F^ukd?$$Ifl4 \D$*p p p 4 laf4.2.3.5._.a.c.d.r.s./11111'1<1=1>1@1C1E1F1\1]122222222222222233ͿͿͯ̓xͿͯ̓xͿͯkkh8!`h{|<B* phfhlh5B*phjhlh5U hlh5h8!`hh<B* phfh8!`h5<B* phfhlh55>*CJOJQJhlh55CJOJQJhlh5CJOJQJ$h8!`h5<B* CJOJQJphf$h8!`hm<B* CJOJQJphf*3.4.5.8.].^._.`.a.K[kd@$$Ifl4FD*%    4 laf4 $$Ifa$$IfHkdp@$$Ifl40D*P(4 laf4a.d.s..,/`K & F$Eƀ’IfK & F$Eƀ’If $$Ifa$,//6001115nkdBA$$Ifl4\D*"4 laf4$If  & F$IfK & F$Eƀ’If11?1@1A1B1C1F1]11K & F$Eƀ’If $$If^a$ $$Ifa$$If ]^ 11 2U2iK & F$Eƀ’IfK & F$Eƀ’IfK & F$Eƀ’IfU2222286nkdA$$Ifl4\D*"4 laf4 $$If^a$K & F$Eƀ’If22222222f3K & F$Eƀ’If $$If^a$ $$Ifa$$If ]^f3333386nkd:B$$Ifl4\D*"4 laf4 $$If^a$K & F$Eƀ’If33333333333344R4S4.51525C5X5Y5Z5\5_5a5b555606n66093949E9Z9[9\9^9`999@:櫻櫻q$h8!`h5<B* CJOJQJphfh8!`hva<B* phfh8!`hh<B* phfh8!`hZ<B* phfhlh55>*CJOJQJhlh55CJOJQJhlh5B*ph hlh5jhlh5Uhlh5CJOJQJh8!`h5<B* phf,33333334T4K & F $Eƀ’If $$If^a$ $$Ifa$$If ]^T444.5iK & F $Eƀ’IfK & F $Eƀ’IfK & F $Eƀ’If.5/50515[5\5]5^5_5b55wwqqh $$Ifa$$If ]^nkdB$$Ifl4\D*"4 laf4 $$If^a$ 5166bR & F $Eƀ’If^gdeK & F $Eƀ’If667787[M$If^`R & F $Eƀ’If^gdeR & F $Eƀ’If^gde8773848bT$If^`R & F$Eƀ’If^gdeK & F $Eƀ’If4888bR & F$Eƀ’If^gdeK & F $Eƀ’If8091929391/nkd@C$$Ifl4\D*"4 laf4 $$If^a$R & F$Eƀ’If^gde39]9^9_9`9c99@:A:B:C:D:G:zzn $$Ifa$gd $Ifgd`kdC$$Ifl4FD*%    4 laf4 $$Ifa$$If ]^ @:A:B:C:D:E:G:k:l:n:p: ;!;";#;4;I;J;K;L;M;N;O;P;Q;S;e;f;ɾɾɫקyk`kU`h$85CJOJQJh~5CJOJQJhlh~5CJOJQJhlh~CJOJQJh~hlh~B*ph hlh~jhlh~UhJL$h8!`hh<B* CJOJQJphfhh5CJOJQJhlhh5CJOJQJhlhhCJOJQJhlh5CJOJQJhlh55CJOJQJG:l:m:n:o:p: ;vvj $$Ifa$gdh $Ifgdskd0D$$Ifl4\D*"4 laf4 $$Ifa$gd ;!;";L;M;N;O;P;S;f;;~~~~uuiiY$ & F$Ifa$gd $$Ifa$gd $Ifgd ]^gd~skdD$$Ifl4\D*"4 laf4 f;;;;;;;;<<<<< < < < <,<v<w<<<<<<<<ǺwlwlYIIIh*uc<B* CJOJQJphf$h8!`h_a<B* CJOJQJphfh$85CJOJQJhlh$85CJOJQJhlh$8CJOJQJh$8 hlh$8hlhJLB*ph hlhJLjhlhJLUhlh~CJOJQJ$h~h$8<B*CJOJQJph$h8!`h~<B* CJOJQJphf$h8!`h$8<B* CJOJQJphf;;;;<<< < < <{viii``T $$Ifa$gd8 $Ifgd8 ]^gd$8gd~skd6E$$Ifl4\D*"4 laf4$ & F$Ifa$gd <,<x<=C=D=E=o=p=oj]P ]^gd~ ]^gd$8gd$8skdE$$Ifl4\D*"4 laf4$ & F$Ifa$gd8 $$Ifa$gd8<<<<<<1=4=5=B=C=E=F=W=l=m=n=o=p=q=r=s=t====ݺݧ}vi\NCN\Nh$85CJOJQJhlh55CJOJQJhlh5CJOJQJhlh~CJOJQJ hlh~hlh$8B*ph hlh$8jhlh$8Uhlh$8CJOJQJ$h~h$8<B*CJOJQJphh*uc<B* CJOJQJphf$h8!`h_a<B* CJOJQJphf$h8!`h$8<B* CJOJQJphfh<<B* CJOJQJphfp=q=r=s=v======wskd,>cN$ & F$Eƀ’Ifa$N$ & F$Eƀ’Ifa$,>O>l>>>cVV $ & F$Ifa$N$ & F$Eƀ’Ifa$N$ & F$Eƀ’Ifa$=>>>>>>>>>>>>>>1?2?3?4?5?6?8?ʷ|n`|SE:Eh$85CJOJQJhlh~5CJOJQJhlh~CJOJQJh<h<5CJOJQJhlh<5CJOJQJhlh<CJOJQJhJLhlh5B*ph hlh5jhlh5Uhlh5CJOJQJ$hlh$8<B*CJOJQJph$h8!`h$8<B* CJOJQJphfh<<B* CJOJQJphf$h8!`h5<B* CJOJQJphf>>>>>>>>2?vvjZ$ & F$Ifa$gd< $$Ifa$gd< $Ifgd< ]^skdF$$Ifl4\D*"4 laf42?3?4?5?8?N???(@vvfff$ & F$Ifa$gd $$Ifa$gd $IfgdskdBG$$Ifl4\D*"4 laf48?N??'@(@*@+@<@Q@R@S@U@W@X@Y@~@@@!A"AEAyA{AλvkvvXEXX$h8!`hm<B* CJOJQJphf$h8!`h5<B* CJOJQJphfh$85CJOJQJhlh55CJOJQJhlh5CJOJQJhlhJLB*ph hlhJLjhlhJLUhlh~CJOJQJ$h~h$8<B*CJOJQJph$h8!`h$8<B* CJOJQJphf$h8!`h~<B* CJOJQJphfh~5CJOJQJ(@)@*@T@U@V@W@X@[@~@yywqqhh $$Ifa$$If ]^gdJLgd~skdG$$Ifl4\D*"4 laf4 ~@@@@@@3N$ & F$Eƀ’Ifa$ $$Ifa$$IfnkdHH$$Ifl4\D*"4 laf4@@{A|AUD$$If^`a$U$ & F$Eƀ’If^a$gdeU$ & F$Eƀ’If^a$gde{A|A~AAAAAAAAAAAAA`B{BBBBBBBSCTC൪ൗqaqNN$h8!`h8<B* CJOJQJphfh*uc<B* CJOJQJphf$h8!`h$8<B* CJOJQJphf$h8!`h~<B* CJOJQJphf$h8!`h5<B* CJOJQJphfh$85CJOJQJhlh55CJOJQJhlh5B*ph hlh5jhlh5Uhlh5CJOJQJ$hlh5<B*CJOJQJph|A}A~AAAAAAAA~~uu $$Ifa$$If ]^nkdH$$Ifl4\D*"4 laf4 AAAAA|B3N$ & F$Eƀ’Ifa$ $$Ifa$$IfnkdNI$$Ifl4\D*"4 laf4|BBTCCCDD D D4D5Djh^^ ]^nkdI$$Ifl4\D*"4 laf4 $$Ifa$ $ & F$Ifa$$ & F$Ifa$gd_a TCCCCCCDD D DD1D2D3D5D7D8D9DQDSDuDwDzDDDD EEEEEFEHEIEWEXEڴ|q|||f[jNh;Uj Lh;Uh&5CJOJQJhlh55CJOJQJhlh5B*ph hlh5jhlh5Uhlh5CJOJQJ$h8!`h5<B* CJOJQJphf$h8!`h8<B* CJOJQJphf$h8!`h&<B* CJOJQJphf$h8!`hCj<B* CJOJQJphf#5D6D7D8D;DQDRDSDTDUDXDuDqskdTJ$$Ifl4\D*"4 laf4 $$Ifa$$If $Ifgdv  uDvDwDxDyDzDDxrriii $$Ifa$$IfkdJ$$Ifl4rD * 4 laf4DDDEEFExrlra d($If$If$IfkdpK$$Ifl4rD * 4 laf4FEGEHEZE[EEw($If$If$IfskdwM$$Ifl4\ * *4 laf4XEYEZEEEEEEEEEEEEEF F2F3FAFBFCFDFrFsFFFFFFFFFFFGG#G$G%G&GJGKGYGZG[G\GGGGjw[h;UjYh;UjWh;UjUh;UjSh;Uhlh{|CJOJQJjQh;UjPh;Uhlh5CJOJQJ hlh5jhlh5U1EEEEEEw($If$If$IfskdrO$$Ifl4\ * *4 laf4EEEEE0Fw($If$If$IfskdIQ$$Ifl4\ * *4 laf40F1F2FDFEFpFw($If$If$IfskdJS$$Ifl4\ * *4 laf4pFqFrFFFFw($If$If$Ifskd+U$$Ifl4\ * *4 laf4FFFFFGw($If$If$Ifskd0W$$Ifl4\ * *4 laf4GGG&G'GHGw($If$If$Ifskd!Y$$Ifl4\ * *4 laf4HGIGJG\G]GGw($If$If$IfskdZ$$Ifl4\ * *4 laf4GGGGGGw($If$If$Ifskd\$$Ifl4\ * *4 laf4GGGGGBHCHDHEHVHkHlHmHoHrHsHtHuHHHHHHI!I*I+I/INIOIձǞxeUeh*uc<B* CJOJQJphf$h8!`h&<B* CJOJQJphf$h8!`h~<B* CJOJQJphf$h8!`hy?J<B* CJOJQJphf$h8!`h5<B* CJOJQJphfh&5CJOJQJhlh5B*phhlh55CJOJQJhlh5CJOJQJ hlh5jhlh5Ujx]h;UGGGGGG| $$Ifa$$Ifskd^$$Ifl4\ * *4 laf4GGGHBH|| $$Ifa$$Ifskdy_$$Ifl4\ * *4 laf4BHCHDHnHoHpHqHrHuHHHy $$Ifa$$If  ]^ ]^`kd `$$Ifl4FT *@     4 laf4 HHHHH $$Ifa$$Ifnkd`$$Ifl4\D*"4 laf4HHHHPIIF9 $ & F$Ifa$N$ & F$Eƀ’Ifa$ $$Ifa$$If[kd`$$Ifl4FT *@     4 laf4OIPIIIIIII'J(J*J+JsJtJuJvJwJJJJJJJͺ~k^WLWAWLW^hlh5B*phjhlh5U hlh5hlh5CJOJQJ$hlh5<B*CJOJQJph* jh8!`h8<B* CJOJQJphf$h8!`h8<B* CJOJQJphf$h8!`hm<B* CJOJQJphf$h8!`h5<B* CJOJQJphf$h8!`h<<B* CJOJQJphfh<<B* CJOJQJphfh5<B* CJOJQJphfI'JsJtJuJvJ:0 ]^[kdua$$Ifl4FT *@     4 laf4 $$Ifa$$ @@$Ifa$gd8N$ & F$Eƀ’Ifa$vJJJJJJJJJJKzKKxxh$ & F$Ifa$gd" $ & F$Ifa$[kda$$Ifl4FT *@     4 laf4 $$Ifa$$If$a$  ]^ JJJJJJJJJKKaLbLcLdLeLvLLLLLLLLLLLLL񸥸ˋuqdYKKdKhlh~5CJOJQJh"5CJOJQJhlh~CJOJQJhTQfhlh5B*phjhlh5U hlh5$hlh5<B*CJOJQJph$h8!`hN<B* CJOJQJphf$h8!`h"<B* CJOJQJphfhlh5CJOJQJhlh{|5CJOJQJh~5CJOJQJhlh55CJOJQJKaLbLcLdLLLLLLvvmaa $$Ifa$gd $Ifgd  ]^ ]^[kdkb$$Ifl4FT *@     4 laf4 $$Ifa$$ & F$Ifa$gd" LLLLM8Q$ & F$Eƀ’Ifa$gd $$Ifa$gd $Ifgd`kdb$$Ifl4FT *@     4 laf4MuNNNN $$Ifa$gd$ & F$Ifa$gd$ $Ifa$gd8Q$ & F$Eƀ’Ifa$gdLuNvNxNyNNNNNNNOOOO O O O OOOO O!O*O|xk`R`RkR?$h8!`h*uc<B* CJOJQJphfhlh*uc5CJOJQJh*uc5CJOJQJhlh*ucCJOJQJh*uc hlh*uch~hlh~B*phjhlh~U hlh~hlh~CJOJQJ$hlh~<B*CJOJQJph* jh8!`h8<B* CJOJQJphf$h8!`h8<B* CJOJQJphf$h8!`h~<B* CJOJQJphfNNNO O O OOOwnbb $$Ifa$gd $Ifgd  ]^ gd*uc  ]^ gd~ ]^gd~`kdac$$Ifl4FT *@     4 laf4OO O!OOOHPIPyyym $$Ifa$gd*uc$ & F$Ifa$gd $$Ifa$gd $Ifgd`kdc$$Ifl4FT *@     4 laf4*OOOPPGPHPJPKP\PqPrPsPtPuPvPwPxPzPPPЭ}yreXM?4?h~5CJOJQJhlh55CJOJQJh*uc5CJOJQJhlh5CJOJQJhlh~CJOJQJ hlh*uchhlhB*ph hlhjhlhU$hlh*uc<B*CJOJQJph$h8!`h <B* CJOJQJphfhP~<B* CJOJQJphfh <B* CJOJQJphfhR<B* CJOJQJphfh*uc<B* CJOJQJphfIPJPtPuPvPwPzPP|vmm $$Ifa$$If$a$gd~  ]^ gd~  ]^ gd`kdWd$$Ifl4FT *@     4 laf4PPPP QAN$ & F$Eƀ’Ifa$ $$Ifa$$If`kdd$$Ifl4FT *@     4 laf4PPPPPPPLQMQQQQQQQQQQQQQҿҬҜyf_T_I_T_?h5CJOJQJhlh5B*phjhlh5U hlh5$hlh5<B*CJOJQJph$h8!`h*uc<B* CJOJQJphfh*uc<B* CJOJQJphfh5<B* CJOJQJphf$h8!`h8<B* CJOJQJphf$h8!`h&<B* CJOJQJphf$h8!`h5<B* CJOJQJphfhlh55CJOJQJhlh5CJOJQJ QMQQQQQ7- ]^`kdMe$$Ifl4FT *@     4 laf4 $$Ifa$gd*uc $ & F$Ifa$N$ & F$Eƀ’Ifa$QQQQQQQQQ/R0Roo$4$If^4`a$`kde$$Ifl4F*"    4 laf4 $$Ifa$$If$a$  ]^ QQQQQQRR\S`SSSXTYTZT[T\TmTTTTTTTTTTTTT溦ynycynyXh"5CJOJQJhlh5B*phjhlh5U hlh5$hlh5<B*CJOJQJph$hq+hm<B* CJOJQJphf'hq+h55<B* CJOJQJphf$hq+h5<B* CJOJQJphfhlh55CJOJQJh&5CJOJQJhlh5CJOJQJhlhNCJOJQJ0RSSSSYTRN$ & F$Eƀ’Ifa$$4$If^4`a$N$ & F$Eƀ’Ifa$YTZT[TTTTTTTUU{$ & F$If`a$gde $$Ifa$$a$ ]^ ]^MkdCf$$Ifl40*"4 laf4 TTTT>UFUZU[UUUUUUUVVVVVVVVFWWWWXXX)X*Xڷ~wlw~waڤN~wlw$hq+h8<B* CJOJQJphfh"5CJOJQJhlh5B*ph hlh5jhlh5Uhlh5CJOJQJhlh55CJOJQJ$hq+h&<B* CJOJQJphfh<<B* CJOJQJphf$hq+hm<B* CJOJQJphf$hq+h5<B* CJOJQJphf$hq+h{|<B* CJOJQJphfUUUVVVV VVV $$Ifa$ F]^F$a$[kdf$$Ifl4FD*%    4 laf4 VVVVmVLN$ & F$Eƀ’Ifa$ $$Ifa$[kdg$$Ifl4FD*%    4 laf4mVFWWWWX $$Ifa$$ & F$Ifa$gd& $ & F$Ifa$N$ & F$Eƀ’Ifa$XXX,X-X.X/X2XVXXXsss__$ & F$If`a$gde $$Ifa$gd8$a$gd& ]^gd& F]^F$a$[kdg$$Ifl4FD*%    4 laf4 *X+X,X-X.X/X0X2X@XUXVXXXXXXXXXXXXXXXY=Y>Y?Y@YAYBYSYhYiYjYkYlY~s~~s~l hlhXhlh&B*phjhlh&U$hq+h&<B* CJOJQJphf!hh&B* CJOJQJphf$hh&5B* CJOJQJphfh&5CJOJQJhlh&5CJOJQJhlh&CJOJQJ hlh& hlh5jhlh5U%XXXXXXXXX>Y?Yu ]^gd& F]^Fgd&$a$gd&[kdg$$Ifl4FD*%    4 laf4 $$Ifa$gd8 ?Y@YAYkYlYmYnYqYYYYymmmYm$ & F$If`a$gde $$Ifa$gd8$a$gdX ]^gdX F]^Fgd&$a$gd&[kd\h$$Ifl4FD*%    4 laf4 lYmYnYoYqY~YYYYYYYYYYYYYYYZZZZZZZZ+Z,ZZڼrg`U`g`rhlhXB*ph hlhXjhlhXU$hq+hX<B* CJOJQJphf!hhXB* CJOJQJphf$hh5B* CJOJQJphf$hh85B* CJOJQJphf$hhX5B* CJOJQJphfh5CJOJQJhX5CJOJQJhlhX5CJOJQJhlhXCJOJQJYYYZZZZZ,ZZ[B\uuueee$ & F$Ifa$gd $$Ifa$gd8 ]^gdX F]^FgdX$a$gdX[kdh$$Ifl4FD*%    4 laf4 ZZ[[2\A\B\C\D\E\F\W\l\m\n\p\q\r\s\u\\\\\\\\\\\\\\ݻsb[ hlh&!h ahXB* CJOJQJphf$h ahX5B* CJOJQJphfhX5CJOJQJhlhXB*ph hlhXjhlhXUhlhXCJOJQJhlhX5CJOJQJ'hq+hX5<B* CJOJQJphf$hq+hX<B* CJOJQJphfh<B* CJOJQJphf B\C\D\E\o\p\q\r\u\\\ue$%$If^%a$gdX ]^gdX F]^FgdX$a$gdX[kd6i$$Ifl4FD*%    4 laf4 $$Ifa$gd8 \\\\\\\\\<]=]|sssss $$Ifa$$a$ F]^Fgd& F]^FgdX$a$gdX[kdi$$Ifl4FD*%    4 laf4 =]>]A]s]t]u]v]y]AHkdj$$Ifl40D*P(4 laf4 $$Ifa$kkdj$$Ifl\D0*%4 la\>]r]s]t]v]x]y]]]P^Q^^^_____*_?_@_A_~___>`±zmbWbIhq+h55<B* phfhlh5B*phjhlh5Uhlh"CJOJQJ!hq+h"B* CJOJQJphf$hq+h<B* CJOJQJphf$hq+h"<B* CJOJQJphf!hq+h5B* CJOJQJphf$hq+h5<B* CJOJQJphfhuUh5aJ hlh5hlh55CJOJQJhlh5CJOJQJy]]Q^____B_C_D_E_H_~_|rrp F]^F$a$[kdk$$Ifl4FD*%    4 laf4 $$Ifa$gd"$ & F$Ifa$gd"$If ~____>`?`@`A`A[kdk$$Ifl4FD*%    4 laf4$If[kdmk$$Ifl4FD*%    4 laf4>`?`A```^a_aaaaa#b$bbbbbbbbbbbbbccccccc'c(cd d ddκκtm h=:hmjh;UmHnHujKohvYUhvYjhvYUjnh;Ujmh;Ujhlh5U'hq+hm<B* CJOJQJhphf'hq+h5<B* CJOJQJhphfhq+h55<B* phf hlh5hlh55$A`D``````^ankdGl$$Ifl4\D*"4 laf4$If^a_a`aaabb.[kd1m$$Ifl4FD*%    4 laf4$Ifnkdl$$Ifl4\D*"4 laf4bbbbbbcccKkdn$$Ifl4֞Dr*4 laf4$If$Ifcccc>d@dBdDddznkdo$$Ifl4\D *4 laf4x$Ifx$If$Ifdd@dDd\d^dde e&e(e*e,evexeff/f0f5f6fDfEfFfGfff6g7g8g>g?gMg˽ˤ˙ˎvivˤ^ˎvivˤjqh;Uh=:hm<B* phfh=:h5<B* phfh=:hmB* phfh=:h5B* phfjph;Ujhlh5Uhq+hm5<B* phfhq+h55<B* phf hlh5hlh55$h=:h=:<B* CJOJQJphf$h=:h5<B* CJOJQJphf!ddeee,e/f$If$If[kdvp$$Ifl4FD*%    4 laf4/f0f1f2f5fGf8g}wwqqq$If$IfkdWq$$Ifl4rDb$ *nf!4 laf48g9g:g;g>gPg5h}wwqqq$If$Ifkddr$$Ifl4rDb$ *nf!4 laf4MgNgOgggg4h5h6hBhChQhRhShhhhhhhhhhhhhhiii%i&i4i5i6iiiiiiiiii˾x h=:h5jxh;Ujwh;Ujvh;Ujuh;Ujth;Uhlh55hq+h5<B* phfhm<B*phhlh5<B*ph hlh5jhlh5Ujrh;U+5h6h7h8h9h:h;h}wwqqq$If$Ifkdqs$$Ifl4rDb$ *nf!4 laf4;hh?hBhThh}wwqqqq$If$Ifkd t$$Ifl4rD$ *f!4 laf4hhhhhhhhjdd^^^^$If$Ifkd u$$Ifl4ֈDb$ *n4 laf4hhhhhhiijdd^^^^$If$Ifkdv$$Ifl4ֈDb$ *n4 laf4ii i!i"i%i7iijdd^^^^$If$Ifkd3w$$Ifl4ֈDb$ *n4 laf4iiiiiiijjjdd^^^^^$If$IfkdHx$$Ifl4ֈDb$ *n4 laf4iijjjjjjjj?k@kFkGkUkVkWkkkkkkkkkkl l;ll?lBlTl}ljdd^^^^$If$Ifkd|$$Ifl4ֈDb$ *n4 laf4}l~llllllllje[[YPPP $$Ifa$ F]^F$a$kd}$$Ifl4ֈDb$ *n4 laf4ll5m6mmmmmmmmmmmmnn2o3ooooooop  >@TVXbdntʿʸ䞸wiwb hlhNjhlh5Ujh;UmHnHuUjh Uh jh Uhlh55 hlhvahlh5B*ph hlh5jhlh5Uhlh5CJOJQJhq+hm<B* phfhq+h5<B* phfhlh55CJOJQJ&lmmmmmmmnoo|vjv #d$$IfgdX$If$^a$ F]^F$a$[kdX~$$Ifl4FD*%    4 laf4 $$Ifa$$If ooooBpkd$$Ifl\ #*f4 la$If$If$If7kd~$$Ifl**4 la      Signature: Date:  FORMTEXT       DHS Local Office Name: FORMTEXT        DHS Local Office Approval: Name and Title: FORMTEXT       Signature: Date:  FORMTEXT      Distribution of Case Plan  MACROBUTTON [2]  Click Here and Type  The local office shall approve, or disapprove, in writing, the ISP for a child in purchased foster care or residential care. The Purchase of Service (POS) agency is responsible for all elements of the service plan where they have accepted responsibility for providing family services per the DHS-3600 (RFF-3600) contract. The local office is responsible for reporting requirements only when the POS agency has not accepted total case responsibility. The report from the local office should not duplicate the POS agency report, but should address those areas for which the POS agency is not responsible per the DHS-3600 contract. Signing the ISP submitted by the POS agency indicates approval. The approved ISP is to be returned to the POS agency within seven days of receipt; a copy is retained in the child s case record. The local office is responsible for knowing what services are being purchased from the POS agency and for monitoring compliance with the DHS-3600. When a noncompliance situation is identified, it is to be brought to the attention of the POS agency both verbally and in writing. If efforts to resolve the area of conflict locally are not successful, the situation is to be brought to the attention of the appropriate Zone Office. If Zone Office is unable to intervene successfully, then Children s Services Administration is to be involved. (See CFF 914, Monitoring Worker Responsibilities for more information.) Use this field to indicate who typed the report, the date typed, etc., as necessary.  FORMTEXT       Department of Human Services (DHS) will not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, sex, sexual orientation, gender identity or expression, political beliefs or disability. If you need help with reading, writing, hearing, etc., under the Americans with Disabilities Act, you are invited to make your needs known to a DHS office in your area.AUTHORITY: P.A. 280 of 1939. RESPONSE: Voluntary. PENALTY: None     DHS-65A (Rev. 3-10) Previous edition obsolete. MSWord  PAGE 1 ,.0<>fhjrpkd$$Ifl\ #*f4 la$If$If 6$If$If jln$If$If$If7kd$$Ifl**4 la02FHJTV JLNTVӪӜڪӕӊtghq+h@ Z:<PRT^`bdJL󶯡}uhlh55hB:hv ^JaJhlh5B*phjh;UmHnHujhlh5U hlh5jhlh5Uhq+h5B* phfhq+hva<B* phfhq+hN<B* phfhq+hm<B* phfhq+h5<B* phf-bd.JLNPTVZiddbbbgdv tkd $$Ifl0*b04 layt~M $If^ $If^ $$Ifa$ LPRVX\^bdhnxz"4$484:4<4F4H4z4|44ķĨxmjhlhPUjhPUmHnHujhPUhPjhPU hlhPh~Mh0J8CJaJmHnHuhv h~M0J8CJaJ!jhv h~M0J8CJUaJhCJaJh~MCJaJhv h~MCJaJh{ jh{ Uh&Z\`bfh4"4J4L4N4$If5$IfK$Ifgdv * !4|)d`gdT<3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% < 00PP:pWo/ =!@"`#$% < 00PP:pWo/ =!@"`#$% 6 00P P / =!@"`#$% < 00PP:pWo/ =!@"`#$% 3 0P P / =!@"`#$% < 00PP:pWo/ =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% 6 00P P / =!@"`#$% 3 0P P / =!@"`#$% DFCWorkerLoadNo,Enter the assigned FC Worker's Load Number CaseInfo.MAIN$$If!vh55 5#v#v #v:V l+55 5/ / / /  / 4yt4sJD FCWorkerName(Enter the name of the assigned FC Worker$$If!vh55 5#v#v #v:V l+55 5/ / / /  / 4yt4sJDPOSAEnter Court ID number assigned.$$If!vh55 5#v#v #v:V l+55 5/ / / /  / 4yt4sJDPOSWEnter Court ID number assigned.$$If!vh55 5#v#v #v:V l+55 5/ / / /  / 4yt4sJDCofREnter PS Case Number $$If!vh55 5#v#v #v:V l+55 5/ / / /  / 4yt4sJDCOJEnter PS Case Number $$If!vh55 5#v#v #v:V l+55 5/ / / /  / 4yt4sJDCDNEnter PS Case Number $$If!vh55 5#v#v #v:V l+55 5/ / / 4yt4sJD DCompletedEnter PS Case Number $$If!vh55 5#v#v #v:V l+55 5/ / / /  4yt4sJQ$$If!vh5+#v+:V l+5+4yt4sJD Date2Enter Date of Reportc$$If!vh55:$#v#v:$:V l+55:$4yt4sJc$$If!vh55:$#v#v:$:V l+55:$4yt4sJvD Text63vD Text63$$If!vh55*5$ 55 5 #v#v*#v$ #v#v #v :V l+55*5$ 55 5 4ytlM$$If!vh5+#v+:V l+5+4yt4sJc$$If!vh5Y5#vY#v:V l+5Y54yt4sJc$$If!vh5X5%#vX#v%:V l+5X5%4yt4sJ$$If!v h555555555 #v :V l+, 5 4yt4sJD0 ChildNameEnter Child's NameAddIdentInfoAutoD Text32Enter Child's Date of BirthD$Text33Enter Child's Case NumbervD$Text56vD Text57vD Text58vD Text59vD Text60jD $$If!v h555555555 #v :V l+5 4yt4sJQ$$If!vh5+#v+:V l+5+4yt4sJ$$If!vh5X5`5a5d5 5 #vX#v`#va#vd#v #v :V l +,5X5`5a5d5 5 4p<yt4sJD Enter Child's NameD$Enter Child's Date of BirthD Enter Child's Case NumberjD Df Dropdown5  Parental HomeLic/Unlic RelativeLegal Guardian Adoptive HomeLic Unrelated Foster Home Ind LivingUnrelated CaregiverOtherDf Dropdown5  Parental HomeLic/Unlic RelativeLegal Guardian Adoptive HomeLic Unrelated Foster Home Ind LivingUnrelated CaregiverOther$$If!vh5X5`5a5d5 5 #vX#v`#va#vd#v #v :V l+5X5`5a5d5 5 4p<yt4sJ^$$If!vh5+#v+:V l+5+4p yt4sJ$$If!vh5` 5 5#v` #v #v:V l+,5` 5 54pytcsVvD Text61vDText62Df Dropdown6 ReunificationAdoption Guardianship1Permanent Placement with Fit and Willing Relative2Placement in Another Planned Permanent Living Array$$If!vh5` 5 5#v` #v #v:V l+5` 5 54ytcsVQ$$If!vh5+#v+:V l+5+4yt4sJDY$Child's Address (if not foster home)c$$If!vh5 5G#v #vG:V l+5 5G4yt4sJDf Dropdown4Native American? Select response. To add additional child(ren) click or tab to Tribal Affiliation field and click Add Child Info button YesNoUnknownPendingDTribeUIf yes, Tribal Affiliation. To add additional child(ren) click Add Child Info button$$If!vh55F55#v#vF#v#v:V l (+55F554p(yt4sJQ$$If!vh5+#v+:V lL+5+4yt4sJ[$$If!vh5*#v*:V l+5*/ 4yt4sJ$$If!vh5{555555#v{#v#v#v:V l+5{5554yt4sJ$$If!vh5K 5b5558 #vK #vb#v#v#v8 :V l+5K 5b5558 4yt4sJD4 parentnameEnter Parent's NameAddParentRowAutoD3 RelationshipEnter Parent's RelationshipDChildren!Enter all children of this parent^Df8Make appropriate participation selection for this parent %1. Yes, participating in reunif. plan&2. No, can't locate or is unavailable.3. No, is incarcerated.4. No, has refused services.5. Parent is deceased.6. No, PFFA in place7. Parental rights terminated28. No, reunification services not needed/per courtorder9. No, unwilling10. Not an assessment household$$If!vh5K 5b552#vK #vb#v#v2:V l+5K 5b5524yt4sJQ$$If!vh5*#v*:V l+5*4yt4sJDText38Enter Parent's Current AddressHDText39iEnter Parent's Date of Birth. To add Parent, click or tab to next field and click Add Parent Row button.,DPPNEnter Parent's Telephone Number. To add Parent, click Add Parent Row button.PopUpPrompt3.MAIN$$If!vh55 555S5#v#v #v#v#vS#v:V l+55 555S54yt4sJQ$$If!vh5*#v*:V l+5*4yt4sJDf Dropdown1%Select Protective Services Risk Level LowModerateHigh Intensiveq$$If!vh5 5W#v #vW:V l+ 5 5W/ 4yt4sJq$$If!vh5+5(#v+#v(:V l+5+5(/  4yt4sJc$$If!vh5+5(#v+#v(:V l+5+5(4yt4sJM$$If!vh5+#v+:V l+5+4yt4sJM$$If!vh5+#v+:V l+5+4yt4sJ$$If!vh5 5T55W5#v #vT#v#vW#v:V l40+5 5T55W5/ 4f4yt4sJ$$If!vh55L5%#v#vL#v%:V l4+55L5%4f4yt4sJ$$If!vh55L5%#v#vL#v%:V l4+55L5%4f4yt4sJy$$If!vh55N5&#v#vN#v&:V l455N5&4f4y$$If!vh55N5&#v#vN#v&:V l455N5&4f4c$$If!vh55P(#v#vP(:V l455P(4f4k$$If!vh555%#v#v%:V l455%4f4M$$If!vh5+#v+:V l45+4f4k$$If!vh555%#v#v%:V l455%4f4M$$If!vh5+#v+:V l45+4f4k$$If!vh555%#v#v%:V l455%4f4e$$If!vh555%#v#v%:V l55%4e$$If!vh555%#v#v%:V l55%4e$$If!vh555%#v#v%:V l55%4c$$If!vh55P(#v#vP(:V l455P(4f4}$$If!vh55p 5p 5p #v#vp :V l4 ,55p 4f4}$$If!vh55p 5p 5p #v#vp :V l4 ,55p 4f4s$$If!vh55p 5p 5p #v#vp :V l455p 4f4}$$If!vh55p 5p 5p #v#vp :V l4 ,55p 4f4s$$If!vh55p 5p 5p #v#vp :V l455p 4f4}$$If!vh55p 5p 5p #v#vp :V l4 ,55p 4f4c$$If!vh55P(#v#vP(:V l455P(4f4k$$If!vh555%#v#v%:V l455%4f4s$$If!vh5555"#v#v":V l455"4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh5555"#v#v#v":V l4555"4f4k$$If!vh555%#v#v%:V l455%4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh5555"#v#v#v":V l4555"4f4$$If!vh55555 #v#v#v#v :V l45555 4f4$$If!vh55555 #v#v#v#v :V l45555 4f4nDf Dropdown2j2. Placement Selection Criteria: select appropriate rank - case plan which includes the goal of permanence 1234$$If!vh5 5*55#v #v*#v#v:V l45 5*554f4jDfq2. Placement Selection Criteria: select appropriate rank - Physical, emotional and safety needs of the child(ren) 1234$$If!vh5 5*55#v #v*#v#v:V l45 5*554f4FDf_2. Placement Selection Criteria: select appropriate rank - Proximity to the child(ren)'s family 1234$$If!vh5 5*55#v #v*#v#v:V l45 5*554f4pDft2. Placement Selection Criteria: select appropriate rank - Placement within kinship family network of the child(ren) 1234$$If!vh5 5*55#v #v*#v#v:V l45 5*554f4PDfd2. Placement Selection Criteria: select appropriate rank - Placement with siblings of the child(ren) 1234$$If!vh5 5*55#v #v*#v#v:V l45 5*554f4tDfv2. Placement Selection Criteria: select appropriate rank - child(ren)'s and child(ren)'s family's religious preference 1234$$If!vh5 5*55#v #v*#v#v:V l45 5*554f4`Dfl2. Placement Selection Criteria: select appropriate rank - Least restrictive, i.e., most family like setting 1234$$If!vh5 5*55#v #v*#v#v:V l45 5*554f44DfV2. Placement Selection Criteria: select appropriate rank - Continuity of relationships 1234$$If!vh5 5*55#v #v*#v#v:V l45 5*554f4pDft2. Placement Selection Criteria: select appropriate rank - Availability of placement resources for timely placements 1234$$If!vh5 5*55#v #v*#v#v:V l45 5*554f4pDft2. Placement Selection Criteria: select appropriate rank - Availability of placement resources for timely placements 1234$$If!vh5 5*55#v #v*#v#v:V l45 5*554f4$$If!vh5 5*55#v #v*#v#v:V l45 5*554f4y$$If!vh555@ #v#v#v@ :V l4555@ 4f4s$$If!vh5555"#v#v":V l455"4f4y$$If!vh555@ #v#v#v@ :V l4555@ 4f4y$$If!vh555@ #v#v#v@ :V l4555@ 4f4y$$If!vh555@ #v#v#v@ :V l4555@ 4f4y$$If!vh555@ #v#v#v@ :V l4555@ 4f4y$$If!vh555@ #v#v#v@ :V l4555@ 4f4y$$If!vh555@ #v#v#v@ :V l4555@ 4f4y$$If!vh555@ #v#v#v@ :V l4555@ 4f4y$$If!vh555@ #v#v#v@ :V l4555@ 4f4y$$If!vh555@ #v#v#v@ :V l4555@ 4f4y$$If!vh555@ #v#v#v@ :V l4555@ 4f4y$$If!vh555"#v#v#v":V l4555"4f4c$$If!vh55"#v#v":V l455"4f4k$$If!vh555%#v#v%:V l455%4f4k$$If!vh555%#v#v%:V l455%4f4k$$If!vh555%#v#v%:V l455%4f4k$$If!vh555%#v#v%:V l455%4f4k$$If!vh555%#v#v%:V l455%4f4k$$If!vh555%#v#v%:V l455%4f4k$$If!vh555%#v#v%:V l455%4f4k$$If!vh555%#v#v%:V l455%4f4$$If!vh5555%#v#v#v#v%:V l5555%4c$$If!vh55P(#v#vP(:V l455P(4f4k$$If!vh555%#v#v%:V l455%4f4k$$If!vh555%#v#v%:V l455%4f4k$$If!vh555%#v#v%:V l455%4f4s$$If!vh5555"#v#v":V l455"4f4s$$If!vh5555"#v#v":V l455"4f4k$$If!vh555%#v#v%:V l455%4f4tDeCheck1tDeCheck1$$If!vh5555555#v#v#v#v#v#v:V l45555554f4D NameofChildAddVBRecommendations$$If!vh5555#v#v#v:V l45554f4k$$If!vh555%#v#v%:V l455%4f4tDeCheck1$$If!vh555n55f!#v#vn#v#vf!:V l455n55f!4f4tDeCheck2$$If!vh555n55f!#v#vn#v#vf!:V l455n55f!4f4tDeCheck3$$If!vh555n55f!#v#vn#v#vf!:V l455n55f!4f4$$If!vh55555f!#v#v#vf!:V l4555f!4f4tDeCheck4$$If!vh555n555#v#vn#v#v:V l455n554f4tDeCheck5$$If!vh555n555#v#vn#v#v:V l455n554f4tDeCheck6$$If!vh555n555#v#vn#v#v:V l455n554f4tDeCheck7$$If!vh555n555#v#vn#v#v:V l455n554f4tDeCheck8$$If!vh555n555#v#vn#v#v:V l455n554f4tDeCheck9$$If!vh555n555#v#vn#v#v:V l455n554f4vDeCheck10$$If!vh555n555#v#vn#v#v:V l455n554f4vDeCheck11$$If!vh555n555#v#vn#v#v:V l455n554f4vDeCheck12$$If!vh555n555#v#vn#v#v:V l455n554f4k$$If!vh555%#v#v%:V l455%4f4G$$If!vh5*#v*:V l5*4D2 AddSignaturesEnter Foster Care Worker's NameAddSignatureAuto$$If!vh5f555#vf#v#v#v:V l5f555/ 4vD Text55$$If!vh5f555#vf#v#v#v:V l5f555/ / 4G$$If!vh5*#v*:V l5*4D,Enter FIA Local Office Name$$If!vh5 555#v #v#v#v:V l5 555/ 4G$$If!vh5*#v*:V l5*4G$$If!vh5*#v*:V l5*4G$$If!vh5*#v*:V l5*4D2 dhssignatureEnter Foster Care Worker's NameAddDHSSignatureAuto$$If!vh5f555#vf#v#v#v:V l5f555/ 4yt~MvD Text55$$If!vh5f555#vf#v#v#v:V l5f555/ / 4yt~MG$$If!vh5*#v*:V l5*4G$$If!vh5*#v*:V l5*4G$$If!vh5*#v*:V l5*4$$If!vh5f555#vf#v#v#v:V l5f5554DText42?Enter Worker Name, Typist Initials, or other information needed$$If!vh5b5#vb#v:V l05b5/ 4yt~MD2A8@8 Normal_HmH sH tH DA@D Default Paragraph FontVi@V  Table Normal :V 44 la (k(No List POP BLANKLINEdx5CJOJQJkHZOZ User Input 11pt$d8(a$CJOJQJkHTOT Captions 6ptd(CJ OJQJkHDO"D Captions 6pt bold5`O2` Captions 6pt boxd<5CJ OJQJkHDOBD Captions 6pt Nbox<DORD Captions 7pt dtCJDOQbD Captions 7pt Bold5`Or` Captions 7pt boxdt<5CJOJQJkH^O^ Captions 7pt NBoxdt<CJOJQJkHPOP Captions 8pt d`CJOJQJkH^O^ Captions 8pt Bold d`5CJOJQJkHFOF Captions 8pt box <DOD Captions 8pt NboxPPOP Captions 9pt dLCJOJQJkHJOJ Captions 9pt BolddLCJFOF Captions 9pt Box dDOD Captions 9pt Nbox 5POP Captions 10pt!d`( OJQJkHLO"L Captions 10pt 2 line "<^O2^ Captions 10pt Bold#d`(5OJQJkHXOBX Captions 10pt box$d`P OJQJkHHO1RH Captions 10pt Nbox%P5LObL Date 08pt &d8(5CJOJQJkH6Oar6 Date 09pt'CJ6Oa6 Date 10pt(CJ2O2 Date 11pt)CJJ @J Footer*dt !CJOJQJkHROR Form Title 10pt+$d8a$ OJQJkH^O^ Form Title 10pt Bld,$d8a$5OJQJkHVOV Form Title 11pt-$d$a$CJOJQJkHLOL Form Title 11pt Bld.d$CJVOV Form Title 12pt/$da$CJOJQJkHbOb Form Title 12pt Bld0$da$5CJOJQJkH4@4 Header 1 !TO"T Letter Text 10pt2$d$a$ OJQJkHFO!2F Letter Text 11pt3dCJXOBX Letter Text 12pt4$da$CJOJQJkHHORH Small Blank Line 5CJTObT User Input 10pt6d8( OJQJkH\Or\ User input 12pt7d((5CJOJQJkH.)@. Page NumberTOT CoState9d8(OJQJ_HkHmH sH tH `O` CoSuppaddress:d8(OJQJ_HkHmH sH tH FB@F Body Text;$a$<B*CJOJQJ>'> Comment ReferenceCJNOaN User Input 09pt=]^CJ44  Comment Text>HH  Balloon Text?CJOJQJ^JaJFV@F \oFollowedHyperlink >*B* phnT20\W6s; g !!" #W$$Y((H*s*+.+k,,-.P/|/0003\3j7799;;>0>?@@CCE,E(GTGG HgHHI>IkKKKL>NjNYYZ[^4^f5mG|!V0n"W7o I ~   #!X!!!!2"j""" #D#y###$S$$$$-%e%%% &?&w&&&'Q''''+(`((():)r)))*L****&+,@AVj~"#$8LMN^rst )*+78 -AUi}'BCWk$8JKLMi}~* + 8 9 T 1{|BCudeo5IWkvAklmnRST~J0123458-./0Z[\]`TUVWh  4567DEFGqrstuvwxy'YZ[^R\8 9 : ; e f g h i l !F!{!!!!!!!!!!!!""""" # # # ###7#z###T$U$V$W$$$$$$$$W%%&]&^&&Y'Z''(V(W(X(Y(((((((f)g)h)i)j)m))))))F*G*H*r*s*t*u*v*y***+++,+-+.+/+0+3+R++@,i,j,k,,,,,,,,,,,,, -.-R-u------.....X.Y.Z.[.^.t...N/O/P/z/{/|/}/~////////"00000000000000001 2z222-3.3/303Z3[3\3]3^3a3w3x3y3z3{3~3333333"4#4$46474l4m4n4444444455555V5W5X5j5k555555555668696:6L6M6n6o6p666666667777 7!7"7#7&7h7i7j7777777777777777v88M99999999999999D:::;;;;;;;;;;;;<==>>>>.>/>0>1>4>D>E>F>G>>?n?o?p??????????/@s@@@@@@@@@@@@@UAVA'B(BCCCCCCCCCCCDDDE*E+E,E-E0EAEBECEDEEEElFFF%G&G'G(GRGSGTGUGXG|GGGGGGHH H H HdHeHfHgHHHHHHHIIIII?IBIRI"JJhKiKjKkKKKKKKKKKKLLLLLLbLcLdLgLLLLLLLwM;NNhNiNjNkNnNNNNNdOeOfOgOjOPPPPPPPPPQQQQRRR(R+R,R-R.RBRnRoRpRqRRRRRRR~SSSSSSTTTTTTUUUUUUUUUUUUUUUUUUUV7V8V9V:V;V>VPVmVnVoVpVqVtVVWWWWW WWWWWWWWWWXXXXXXXXXXXXX YYYYYYYYYYYYYYYYZZZZZ[[[[\\\\\]]]]] ]!]"](])]=]>]?]@]A]X]l]m]n]o]p]q]r]s]]]]]]]]]]]]]]]]]]]]]]^^^^^^^^^2^3^4^5^lamacc'd;dffff008 000-0000-0000-0000-00004000000000000000000 0 0 0 0 60 0 60 0 0 0 0 000T00000000000000=0=0=0=0=0=0=0=0=00=000000000=0=0=0=0=0=00=000000=0=0=00=000=000=00=00=00000000000000000000000000000000!0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 =0 =0 =0 =0 0 =0 0 0 =0 0 =0 0 =0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0!0 0 0 0 0 0 0 0 0 0 0 0 0 00 00!0 00000 0 0 0 000000 0 0 0 00000 0 0 0 0 000 0 0 0 0 0 00 0 00000 0 0 0 00 0 00000 0 00 0 00000 0 00 0 00000 0 00 0 00000 00000 0 0 0 0 0 0 0000 0 0 0 0 0000 0 0 0 0 0 0 0 0 0 0000 0 0 0 0 0 0 0 0 0 00000 00!0 0 0 00 0 0 0 0 0 0 0 0 0 0 00 0 00000 0 0 0 0 0 0 0 00 0 00000 0 0 0 0 00 0 00000 0 0 0 0 0 0 00 0 00000 0 0 0 0 0 0 00 0 00 0 0 00 0 00000 0 000 0 0 0 0 0 0 0 0 0 0!0 00000 0 0 0 0 0!0 00000 0 0 0 0 0 0!0 00000 0 0 0 0 0 0 0  0 0 0 0 0  0  0  0 !0 0000 0 0  0  0 0 0 0 0 0 0 0!0 00000 0 0 0 0 0 0 0  0 0 00!0 00000 0 0 0 0 0 0 0  0 0 0 0 0 00!0 00000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0!0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00000 0 0 00 0 0 0 0 0 0 0  0 0 000!0 00000 0 0 0 0 0  0 0 0 00!0 0000 0 0 0 0 0  0 00 00!0 00000 0 0 0 0 0  0 0 00!0!0000 0 0 0 0 0  0 0 00!0 00000 0 0 0 0 00 00 000!0 00000 0 0 00 0 00000 0 00 0 0 0  0 0 0 0 00 0 00000 0 0 0 00 0 00000 0 00 0 00000 0 0 00 0 00000 0 0 0 0 00 0 00000 0 00 0 00000 0 0 00 0 0 00 0 0 0 0 0 00 0 00000 0 0 0 0 0 0!0 0 0 0!0!0 0 0 0!0!0 0 0 0!0 0 0 0 0 0 0 0 0 0 0 0 0!0 0 0 0!0 0 0 0 0 0!0 0 0 0 0 0!0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00!0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00000 0 000 0 00000#00 0 00 0 0 0 0 00 60 00 00 0 0 0 00 0 00 00 0 0 0 0 0 0 0 00 0 0 0 0 00 60 00 00 0 0 0 0 0 0 0 0 60 0 0 0 0000000000000 000 0 00@000@000@000@000@*0@000!,@AVj~"#$8LMN^rst)*+78 -AUi}'BCWk$8JKLMi}~* + 8 9 T 1{|BCudeo5IWkvAklmnRST~J0123458-./0Z[\]`TUVWh  4567DEFGqrstuvwxy'YZ[^R\8 9 : ; e f g h i l !F!{!!!!!!!!!!!!""""" # # # ###7#z###T$U$V$W$$$$$$$$W%%&]&^&&Y'Z''(V(W(X(Y(((((((f)g)h)i)j)m))))))F*G*H*r*s*t*u*v*y***+++,+-+.+/+0+3+R++@,i,j,k,,,,,,,,,,,,, -.-R-u------.....X.Y.Z.[.^.t...N/O/P/z/{/|/}/~////////"00000000000000001 2z222-3.3/303Z3[3\3]3^3a3w3x3y3z3{3~3333333"4#4$46474l4m4n4444444455555V5W5X5j5k555555555668696:6L6M6n6o6p666666667777 7!7"7#7&7h7i7j7777777777777777v88M99999999999999D:::;;;;;;;;;;;;<==>>>>.>/>0>1>4>D>E>F>G>>?n?o?p??????????/@s@@@@@@@@@@@@@UAVA'B(BCCCCCCCCCCCDDDE*E+E,E-E0EAEBECEDEEEElFFF%G&G'G(GRGSGTGUGXG|GGGGGGHH H H HdHeHfHgHHHHHHHIIIII?IBIRI"JJhKiKjKkKKKKKKKKKKLLLLLLbLcLdLgLLLLLLLwM;NNhNiNjNkNnNNNNNdOeOfOgOjOPPPPPPPPPQQQQRRR(R+R,R-R.RBRnRoRpRqRRRRRRR~SSSSSSTTTTTTUUUUUUUUUUUUUUUUUUUV7V8V9V:V;V>VPVmVnVoVpVqVtVVWWWWW WWWWWWWWWWXXXXXXXXXXXXX YYYYYYYYYYYYYYYYZZZZZ[[[[\\\\\]]]]] ]!]"](])]=]>]?]@]A]X]l]m]n]o]p]q]r]s]]]]]]]]]]]]]]]]]]]]]]^^^^^^^^^2^3^4^5^lamacc'd;djv| 8DJ^jp %+-9?AMSUagiu{}COUWcikw}"$068Hiu{5AGWcivnT|.0XW 2Go; c !!"#W$$Y((H*p*+*+k,,-.P/x/0003X3$444n4~44455X5h55555:6J6p6666j7799;;>,>p??@@CCE(E(GPGGHgHHI:IkKKKL>NfNRRR&RBRNRTRRRSSTTUUUV>VNVtVV WWWWXXX YYYYYZ [\ ]])]5];]X]d]j]]]]]]]^0^'d3d9dfFFFFFFFFFFFFFFFFFFFFFFFFS$S$FFS FS$FFFFS FtF4F4S 333333333333333333333333S$S$S$S$S$S$S$S$S$S$333333333333333G$G$FG$G$G$G$G$G$G$G$G$G$G$G$33FFFFF3FBIKQ!8@0(  B S  ?FCWorkerLoadNo FCWorkerNamePOSAPOSWCofRCOJCDN DCompletedDate2 ChildName Dropdown6parentcaretaker parentname Dropdown1 NameofChild AddSignatures dhssignatureText42-k9_8CR\](df ?}!Kq,IUR]]:df c-dc- fc-Twd-d-lFd-Ndd-,#d- d-,`<<RR2\2\f   < <RR7\7\f8*urn:schemas-microsoft-com:office:smarttagsCity9*urn:schemas-microsoft-com:office:smarttagsState9 *urn:schemas-microsoft-com:office:smarttagsplace;*urn:schemas-microsoft-com:office:smarttagsaddress:*urn:schemas-microsoft-com:office:smarttagsStreet=*urn:schemas-microsoft-com:office:smarttags PlaceName=*urn:schemas-microsoft-com:office:smarttags PlaceType p   2f2f4f4f5f5f7f8f:f;f=f>fff2f2f4f4f5f5f7f8f:f;f=f>fff,Aj$8N^t8C~5IWkv58]` 7G[i !!#7#$$>%W%((j)m)v**0+R+,,,R-u--[.t.~//0011^33M6p6#7&77799;;1>G>??@@BCCC-EEEUG|G H HHH?IRIXKkKKKdLgLLLkNnNgOjOPPRR(RqRRR`SSTTUUUU;V>VqVtVW WWWXXXXYYYY\\])]A]X]s]]]]]^!f1f2f2f4f4f5f5f7f8f:f;f=f>fff7?u}!CKiq 8I1f2f2f4f4f5f5f7f8f:f;f=f>fLfMfff+ZD4<38h2 tMu"GLh2|Q,)! 6?;qyƞx$< 9v$J]kq&&??r'WDL2Ȇ.>E >XTz]T$RgsE]T0        ^        K         @RQ$ G3B~v7P:AYf 0r]_ W8  2 v  I y p%cJ~S#&wMnv=(Js'Z, iGOe9L^Yp;{ | eg"p"w"a#g#w$$S%d:&4+k,Vn.]1^"1%23s2C4U|5|9M:2:;2<T<GX<'q?J5@dAzBHC)D#-D=KD"7EF-Hi ILI [IkIy?J4sJdK2pKJLCMvMt?PgPLwP>Q=RuRn@SVcsVvVqXZvC[&\'\Q ]b"]pv]J}]+^4^"M^^^h^S_8!` a8b.c0c*uc dCdAid,e XeTQf h%h \hch(?i kl l+m2n\oso{Sp Pr\TrmNsxsat"%uzu`OwNxH2y;my| |(|{|f}^~BlOQk."ce%mxRkphO*+=hId'\{6/IzU#>@ .h'D=:b#p{-B~FZmwUDm6q+ P}8!a_5[ o$uN^l~ @Iu\aN @[=~]qs&nP~@[a :}%FlxtvY'n@Ecr:Wo-(C'8f)2d_ahK<pYsy>G0xh^vq|d Xvag0$8pv`%8~Me':$RX1x5KAD`mtNa:9m,@AVj~"#$8LMN^rst )*+8 -AUi}'BCWk$8JKLMi}~5IWkvlmRS23458./Z[\]`UV  67DEFGstuvwxyYZ[^9 : e f g h i l !!!!!!!!"" # # # ###U$V$$$$$$$W(X((((g)h)i)j)m))))))F*G*t*u*v*y*++.+/+0+3+i,j,,,,,,,,,,--....X.Y.Z.[.^.N/O/|/}/~///////0000000000000.3/3Z3[3\3]3^3a3w3x3y3z3{3~3333333"4#4$46474l4m4n4444444455555V5W5X5j5k555555555668696:6L6M6n6o6p666666667777 7!7"7#7&7h7i77777777777777799999999999;;;;;;;;;>>0>1>4>D>E>F>G>o?p????????@@@@@@@@CCCCCCCDD*E+E,E-E0EBECEDEEE&G'GSGTGUGXGGGH H H HeHfHHHHHII=I>I?IBIiKjKKKKKKKLLLLcLdLgLLLLLVPVmVnVoVpVqVtVVWWWWW WWWWWWWWWXXXXXXXXXXXXX YYYYYYYYYYYYYYYZZ[\\\]]]] ]!](]=]>]?]@]X]l]n]p]q]r]s]]]]]]]]]]]]]]]]]]^^^^^^^^?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ\]^_`abcdefghijklmnopqrstuvwxyz{|}~     8 !"#$%&()*+,-.56Q{9:E<=>?@ABCDoGHIJKLMNOPxSTUVWXYZ[\]^_`abcdefghijklmnpqrstuvwyz|}~Root Entry FfI8yData 1Table[WordDocument_SummaryInformation(DocumentSummaryInformation8'Macros`ldIP'iIVBA`ldIP'iIdir__SRP_0 ; __SRP_1__SRP_2 F  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[]^_`abcdefhijklmnopqrstuvwyz{|}~0* pHdTemplateProjectQH@  = | \G J< 9stdole>stdoleP h%^*\G{00020430-C 0046}#2.0#0#C:\WINDOWS\system32\e2.tlb#OLE Automation0MSForms>SFFrms3ED452EE1-E08F-101A-8-02608C4D0BB4EFM20.DLL#Microsoft : ^ Ob Library/;D~1u00}#0#h0 22C7F56E-9DEF-4E9 D-AB321D78C694469H.DOCUME~1\vallejod\LOCA LS@A\VBE\DL.exd3!.E .`M ÂOfficĂOf@ic5‚ 1DF8D04C-5BFA`B-BDER5AAA421@gram Files\CommonG`Sha red\o 11\mso.dll4& 8.0 i@%EB\=ThisDocumentGT TiDcuenU 2 HB1-,B,!^="B+B  NewMaAG+wMaE -rs2/-!) %ToolHelpG.A~Hl6pi2roQ )<=k ClearCaseInfoG CQar a@3eI@2fmI2\/"t,!"C2s "Gi"mo(,"6laBRemovPeRowcBRmvRwWcB/yR 0VPiewtBs#VTi`wcol2R#/a0,"CheckSpelling%Chck@p l Ei`Cg!N%CU/0CPkVaAAddPnt4QG YA@dtPDr@aC5At&"gm2 55a IdN5 I NU-   RY g ddCourtRecPaendsc *6&CuAtU/cmd[dt*o0!s |2Qu)eDHSSignatuTreS&VDdSp.ig a71eX OB2OOu< h 40 70S O :0y%%v n VBL%G(VB$٪$)2{o)mR@[#? y<rU K*yrU~~~~~~~~~~~~] <qC^8   9Ya    9i  ) TemplateProject ThisDocument NewMacrosToolHelp ClearCaseInfoCaseInfo RemoveRow Viewtools CheckSpellingAddParentRowAutoAddIdentInfoAutoAddCourtRecommendationsAutoAddDHSSignatureAutoAddSignatureAutoAddVBRecommendationsF /C:\PROGRA~1\COMMON~1\MICROS~1\VBA\VBA6\VBE6.DLLVBA A i0 F5C:\Program Files\Microsoft Office\OFFICE11\MSWORD.OLBWord a@0FC:\WINDOWS\system32\stdole2.tlbstdole qP.E .`M C:\WINDOWS\system32\FM20.DLLMSForms QQy`n"N1׌iDi 2C:\DOCUME~1\vallejod\LOCALS~1\Temp\VBE\MSForms.exd  1QYpL-[DR?C:\Program Files\Common Files\Microsoft Shared\OFFICE11\MSO.DLLOffice a MAIN  ZYou MUST Save This Document Before Continuing 2Select Save In Folder and HEnter File Name in SaveAs Dialog Box F FColorButtonsLargeButtonsToolTipsViewToolbars FCISP ToolsToolbarShow BordersHide Database Drawing Formsp Fb F Fk F CaseInfoBeginDialog YourFCWLNoTextBox YourFCWN YourPOSA YourPOSW YourCOFR YourCOJ YourCDN YourDC `Enter the following information about this case.Text .DHS FC Worker Load No.: &DHS FC Worker Name: POS Agency Name: POS Worker Name: &County of Referral: &Court Jurisdiction: "Court Docket No.: Date Completed:OKButtonCancelButtonEndDialogCurValuesUserDialog UserInfo FCWorkerLoadNo c:\caseinfo.ini 0GetPrivateProfileString$YourFCWLNo FCWorkerNameYourFCWN POSAYourPOSA POSWYourPOSW CofRYourCofR COJYourCOJ CDNYourCDN DCompleted YourDC Dialog .SetPrivateProfileString FCworkerLoadNo FCWORKERLOADNO  ExistingBookmark FCWorkerLOADNoSetFormResult FCWORKERNAME DCOMPLETEDfĤIx8< Error In Case InfoVBE6.DLL `   S  SEnter Case Information, i.e., FC Case Name, FC Case Number, FC Worker Load #, etc. TemplateProject.CaseInfo.MAINUrU $`anK \=<=xrU~| R  I I 9 a 9a9q AyIyQqA i!qAQy Q1YYa Ya!Iq4K:, < <   :    :|`1x6< |6(,%(%(T%t$ @t  t.:, %(%t$ @t t.:,%(%t$ @t t.:,%(%t$ @t t.:,%(%t$ @t t.:,%(%t$ @t tt$ t tt$ 8Qt@ @ t@ Qt< < c<c@t$ 4t t.(,I%(^%:T%t$ @tt:(,%( %(T,%(,%: %t$ @tt:(,%(8%(T,%(,%: %t$ @tt:(,%(P%(T,%(,%: %t$ @tt:(,%(h%(T,%(,%: %t$ @tt:(,%(%(T,%(,%: %t$ @tt:(,%(%(T,%(,%: %t$ @tt:(,%(%(T,%(,%: %t$ @tt:(,%(%(T,%(,%: !%t$ @tt:(,k%( %(T%(, %: "%t$ @t#t:(,%($%(T%(, %: $%t$ @t#t:(,%(;%(T%(, %: %%t$ @t#t:(,%(S%(T%(, %: &%t$ @t#t:(,%(k%(T%(, %: '%t$ @t#t:(,%(%(T%(, %: (%t$ @t#t:(,%(%(T%(, %: )%t$ @t#t:(,%(%(T%(, %: *%t$ @t#t:(,%(%(TT%(, %: +%t$ @t#t4(,^%(%(TX%(,%t$ @t,t4(,%(%(TX%(,%t$ @t-tKt$ @t.t.t$ @tW%:T4%t$ @t<%?t5<C:,1%:,2%:@%:T4%t$ @t<%At5<C:,1%:,2%:B%:T4%t$ @t<%Ct5<1 @t$ @tW%W%:T4%t$ @t<`1Tt5<?:,1%:,2%:@%:T4%t$ @t<`1Pt5<?:,1%:,2%:B%:T4%t$ @t<`1Lt5<,:,G%t$ @t%t$ @t%T@t$ @tJt,:,@%t$ @tF< O2)t6<  X@ @<L`\dhPlTXxHt< |k__SRP_3oCaseInfo R&8ToolHelpNewMacros \d(v ",\=6=xME46 LL*L*LLL<8<<<P `@oSEnter Case Information, i.e., FC Case Name, FC Case Number, FC Worker Load #, etc. TemplateProject.CaseInfo.MAINick Cle@l on FP^hdP`dPb` ButPd\ PfX Ph8T popPjPPlL3. `( mati\% hP0XHxr 0@< 00@, 2.@ DO@ 2\@0 b#@ ti@H \G@` E0@x 2E@ BB@ :\@ st@| DLPpxt @`t @ d @8T @D @p`%X"<`%$@, @ @ @ @ @x @ @ @ P\G$*\Rffff*1U4cf116fd*\R0*#f*\R1*#17b*\R1*#c1*\R1*#c0*\R1*#d0*\R1*#158*\R1*#c6*\R0*#13*\R0*#1a*\R0*#19*\R0*#1*\R0*#14 "  (@H P h       "6&.".0".X". .       ( H.` 8(: 6&:&:@&:h&:&:&:$:N:0 @6: <2:8.:p.:2:2:0:@.:p  44  0 < nX nDC8 BC n n8 l :C :CX :C :C :C @CX 2 1  & h0 j D:B:P h h jh f::@::::::::@@: " b dP@?>? b8 d `6?h6?6?6?6?H<? " d fPBU>U d@ f `.Up.U.U.U.U0:U` 4  &$&(.8h8mp6 ]Dim UserFCCNo$ Dim UserFCCN$&]]Dim UserPSCNo$ Dim UserPSCN$] Dim UserCTNO$c. ]]  Dim UserHAL$ck Cle Dim UserHAF$on F]8]P]h]n-You MUST Save This Document Before Continuing $r $r Select Save In Folder and $r $r $Enter File Name in SaveAs Dialog Box ' p Define promptx9OPEN FCISP TOOLSvxz B@t FCISP Tools|~ B@tBorders| B@tDatabase| B@tDrawing| B@tForms| B@tdisplay hidden text ( 95R9qq B@save document'DEFINE DIALOG BOXI^CaseInfo B@"1 WordBasic.TextBox 150, 32, 300, 18, "YourFCWLNo" , YourFCWLNo B@/ WordBasic.TextBox 150, 56, 300, 18, "YourFCWN"8,YourFCWN B@P,YourPOSA B@&h,YourPOSW B@R,YourCOFR B@V,YourCOJ B@?7,YourCDN B@!,YourDC B@/|2k  0Enter the following information about this case. B@d: WordBasic.Text 19, 36, 130, 13, "DHS FC Worker Load No.:"$ DHS FC Worker Load No.: B@d6 WordBasic.Text 19, 59, 130, 13, "DHS FC Worker Name:"*; DHS FC Worker Name: B@dK_C9S POS Agency Name: B@d_k POS Worker Name: B@dSJ County of Referral: B@d[[[ Court Jurisdiction: B@d&I7oG Court Docket No.: B@dT Date Completed: B@d 19@*13K DHS`J&No.:_ a46,1z50}1^a$b q^8 W@$ Agencybe/vC6t3 13dCounty of Referral;OG5rt JurisdipIon7pLket _p20034V!qetedAO HLOKrM2689821U4wCancel4AN#&Res NP'QZCU XdlgA Obb: S=VCurValu8es.mGET USER INFO FROMI FILE AND PUT I NTO:_'.Z`0gW [GetPrivf StrPx$]("O P|ЃaNoc :\q.ini"pg? hCEA WN!: orV_ o!Se!er0ůCOURGp!ourPQAoo ??3W???OSW??0??>??1OJ///ЈA m30\caseinfo.ini") dlgUserIYourDC = WordBasic.[GetPrivateProfileString$]("n", "DCompleted c: 'DISPLAY DIALOG BOX AND RESPOTO USER INPUT iRet Dialog.u (If 3-1 Then 'OK BUTTON WRI@TE NEW3FO6I FILVE{S{ zFCCNoy No62ame32d kerLoad3WL4eNU4WNM@PSg?gA}"?R?KK K"C@OURTNOLCR2??ePOSA  $OSW W CofR  COJ OJ CDN >D3G::JDC u Ѡ from"f@b$@%"M@' ݤ ?r !  worɱ N_ S ` dXDEo/?'?OBOKP K߿9W1PJ KcO D-s?"OocDC  O-ɴ03 Upd Form withGN0U Exist Bookmark("рEASE@x)PResult2 , pNo$CAME"etN7   WORKE RLOAD c.~ N S B  WNONFO O.OdO7/ . LOK7OqS_<+LB$ P W?* _/RL L_?^OL2OJ/./,B"`R|DCOMPLETED") Then WordBasic.SetFormResult "DCOMPL, UserDC$ ' Update other d Fields on& Exit Macro@ Else n0d If6Here: *Sub HandleErro"r!If  = 4198'save file cancelled@MsgBox Prompt$, vbCri`ticalme 'return to point of e9 in routinZO_-E.Description1ExcPlama"or" rr.Numb& "In Case Info"F F 'Reprotect DocuLmeL esub aft&T=!EPME @x$$-View instructions for using FIA-#### buttons.vTemplateProject.ToolHelp.MAIN{jf@ ][`( en \G% " &(JPPP>@JLZ PLH 6hVHN@     <  2` " 4 08H]DEFINE DIALOG BOXF,FCISP Tool Help B@"  ,**To CHANGE Case Info WITHOUT closing form** B@d(`; 11. Click Clear Case Info Button on FCISP Toolbar B@d;" 12. Click Change CaseInfo Button on FCISP Toolbar B@dR.  to bring up new pop-up screen. B@d;: ,3. Enter new case information and click OK. B@d;H -The new information will fill in on the form. B@d \ <**To Select Appropriate ADD Buttons from the FCISP Toolbar** B@d;h 11. Use Mouse to position Cursor over any button B@d;t -2. Read the Help message line at the Bottom B@dR *of the Screen to see an exact description B@dR of the Button function. B@d; 83. When you have located the correct button, Click it. B@d  )** To Remove Entire Row from any table** B@d; 0 Click Remove Table Row Button on FCISP Toolbar B@d   B@d;  B@dN B@$ B@&]F !*!,.(6GET USER INFO FROM INI FILE AND PUT IT INTO DIALOG BOX,DISPLAY DIALOG BOX AND RESPOND TO USER INPUT ( !.%,'  OK BUTTONGet user info from INI file. Update other Form Fields on Form & Exit MacrokoNAttribute VB_Name = "ToolHelp" Public Sub MAI`N() D.rDescriptionView instruc&s for using FI(A-# tons.ePPro cData\Invoke_Funcemplate"ject..LDim iRet 'DEFINE DIALOG BOX WordBasic.BeginDialog 582, 300, "FCISP 5* Text 9, 1513**To CHANGE Case Info WITHOUT clo}Xm**Q)5)2CB)1. Ckear+Butm Vb,3(4, ,2,haxngeB++L4 61@A to brAyup n0pop-ee&nAz>58'3. EntercSiSrmaand@Tick OK7 STheB will finASthh9}Sel@ Appropri ADD Rrom jL10 k@ UMlou@XpACHursovJany W11Fk Reada] messaBline at4BoMm A@127ofScr@> Bse` n exact dB n4kD Sf. 95 5JWhen you hav`e loc 5CcXorrA8,nit @1K** `)m`1!Wire `Row f?A3tablex38>ReB T" d 3_Ŕ22J)x&23j&/OK45` e7@?30E$nd Adl gWrAs Ob: SeAH = '[Valu8es.! GET USER INFO FROM I@LE ANHD P`IT`TOALAY"RESPO  ` `G(@Ifb`-1 `n 'OK BUTTON#'GxrQCINIe (Upd!o r Form Fields& Exit Macro , If ` $+\=xMExp\Gx%Attribute VB_Name = "NewMacros" dks\= =RemoveRowg ViewtoolsxThisDocument_VBA_PROJECTxMEP 0@\G "   (8Xh B@ B@ B@l B@  o Attribute VB_Name = "RemoveRow" Public Sub MAIN() WordBasic.ToolsUnprotectDocument BableS\el<2Dt oYP W NoReset:=1, Type:=2 End dk[\==xMEP 0@\G """0Xhvxz B@tFCTools|~ B@to Attribute VB_Name = "Viewtools" Public Sub MAIN() WordBasic.TTbars ColorButtons:=1,@ Large 0, TTip:AN:="FC s", ShowQ End '\=^=#xME (SLSS<N0{00020906-0000-0000-C000-000000000046}@(%H@0\GxAttribute VB_Name = "ThisDocument" Bas0{00020P906-0C$0046} |GlobalSpacFalse dCreatablPredeclaIdTru BExposeTemplateDerivBustomizD2ay  *\G{000204EF-0000-0000-C000-000000000046}#4.0#9#C:\Program Files\Common Files\Microsoft Shared\VBA\VBA6\vbe6.dll#Visual Basic For Applications*\G{00020905-0000-0000-C000-000000000046}#8.3#0#C:\Program Files\Microsoft Office\OFFICE11\MSWORD.OLB#Microsoft Word 11.0 Object Library*\G{00020430-0000-0000-C000-000000000046}#2.0#0#C:\WINDOWS\system32\stdole2.tlb#OLE Automation*\G{0D452EE1-E08F-101A-852E-02608C4D0BB4}#2.0#0#C:\WINDOWS\system32\FM20.DLL#Microsoft Forms 2.0 Object Library *\G{22C7F56E-9DEF-4E9D-AB31-E1D78C694469}#2.0#0#C:\DOCUME~1\vallejod\LOCALS~1\Temp\VBE\MSForms.exd#Microsoft Forms 2.0 Object Library.E .`M &*\G{2DF8D04C-5BFA-101B-BDE5-00AA0044DE52}#2.3#0#C:\Program Files\Common Files\Microsoft Shared\office11\mso.dll#Microsoft Office 8.0 Object Library  \G  \=ThisDocument1G4cf116fdThisDocument^=-NewMacros1H4cf116fdNewMacrosToolHelp1I4cf116fdToolHelp<=0Q ClearCaseInfo1J4cf116fd0ClearCaseInfot=HCaseInfo1U4cf116fd\CaseInfo6=`(,RemoveRow1L4cf116fdRemoveRow =xyViewtools1M4cf116fdViewtools=aCheckSpelling1N4cf116fdCheckSpellingP AddParentRowAuto1O4cf116fd AddParentRowAutoa 5 AddIdentInfoAuto1P4cf116fd AddIdentInfoAutog Y 6AddCourtRecommendationsAuto1Q4cf116fd6AddCourtRecommendationsAutoe u &AddDHSSignatureAuto1R4cf116fd&AddDHSSignatureAutoh  AddSignatureAuto1S4cf116fd AddSignatureAuton  (AddVBRecommendations1T4cf116fd(AddVBRecommendations8 X8 `0Hxh;19OG\4 a@/OO&<uMGxH&1AB0C]@nbۓF|zB|hK^[[џ5svRCߍ( 9#%d'AfPFϲoB6?': Wordk VBAWin16~Win32MacVBA6# TemplateProjectEstdole`MSFormsCOfficeu ThisDocument< _Evaluate NewMacrosj ToolHelpThMAIN,iRet,p WordBasic BeginDialogFOKButton| EndDialogmP dlgUserInfo2" CurValuesȤ UserDialogDialogf ClearCaseInfohFileFind SearchName֡ SearchPath.SubDir+Title~AuthorKeywordsTSubjectRPOptions MatchCase PatternMatch DateSavedFromu= DateSavedTojdSavedByDateCreatedFrom DateCreatedToViewISortByoListBy+ SelectedFile\Kill CaseInfo UserFCWLNoyUserFCWNUserPOSAPUserPOSWeUserCofRUserCOJmUserCDNkUserDC HandleError;PromptmChrK~ ViewToolbars| ColorButtons} LargeButtonsSWToolTips5+Toolbar2ShowHide9z Application*DisplayStatusBar ActiveWindow+DisplayHorizontalScrollBar<ShowHiddenTextkActiveDocument\SaveTextBoxQ CancelButton YourFCWLNoGetPrivateProfileString$xYourFCWN0YourPOSA/)YourPOSWD)YourCofRYourCOJ_@YourCDN>YourDCSetPrivateProfileString=ExistingBookmark SetFormResultExitHereP$ErroMsgBoxR vbCritical+} Description  vbExclamationNumber- RemoveRow0^ToolsUnprotectDocument(TableSelectRowTableDeleteRowAToolsProtectDocument-0NoResetg Viewtools (CheckSpellingW Unprotect?Password SelectionZHomeKeyunitwdStory&EndKey5Extend?wdExtendd LanguageID wdEnglishUSCheckGrammarWithSpelling CheckGrammarProtectfwdAllowOnlyFormFields!(AddParentRowAuto#?numrowsInputBox  cmdCancel ExitHere2i`MoveDown̝wdLineCount0v SplitTable7DisplayAutoCompleteTips$+AttachedTemplateAutoTextEntriesInsertrWhere֍Range RichTextNDeletex wdCharacterWhatCwdGoToBookmarkJ( AddIdentInfoAutoH( AddCourtRecommendationsAutoY( AddDHSSignatureAutoP5 Bookmarks?n( AddSignatureAutoT( AddVBRecommendations_Documentj _B_var_Chr\; _B_str_Promptl1#&]  $ ! " % '(CheckSpellingClearCaseInfoGAddIdentInfoAuto"BAddParentRowAuto"dk\=PxMEP 0@\G"   ,0 `h   0(X h CheckSpelling Macro& Macro recorded 10/10/99 by Sandy Caincladd87 B@x  B@   B@ck Cle  (erHA B! B@hd B@-k  B@fore C cladd87 l B@oAttribute VB_Name = "CheckSpelling" Sub L() ' T Macro, record@ed 10/99 by Sandy CainP ActiveDocument.Unprotect PasswB:="cl`add871Selion.HomeKey unit:=wdS0toryV$End#, ExtendLanguageIDwdEnglishUSIf O$ptAs.GrammarWithTrue Thev[v ,Else0nd If"@PW[, NoReseVA2, Type:= _C'wdAllowOnlyFormFields \ dk\=t=xMEP 0@\G "  4c:\6 caseinfo.ini8:<>@BDdFHJLNPRTVX B@2T]c:\caseinfo.ini B@Z]oPH>Attribute VB_Name = "ClearCaseInfo" Public Sub MAIN() WordBasic.File@Find Slch:=" ",! Path c:V\$:ci.ini(ubDir:=0, Title.Autho" Keywqsject Option=MatchKex#ternDateSavedFrom3# ToByCre  View0Sort4, LisPSel\;Kill " Eub dk/ \=a xMEP dkS \=g xMEP 550@\G5"   .0 `h p  @  Xh p      >X$x   @   &(P.`86    AddIdentAuto MacroL( Macro recorded 01/11/01 by Program Arean6There is already ONE Identifying Information section. $r +How many ADDITIONAL IDENTIFYING INFORMATION $r : for Child(ren) groups are needed for this report? $r $r 4 Example: {Total children being reported = 3} $r B { Minus existing = 1} $r B { Enter additional = 2} $r $r CANCEL or ESC if none IDENTIFYING INFORMATION$'-You MUST Save This Document Before Continuing $r $r Select Save In Folder and $r $r $Enter File Name in SaveAs Dialog Box ' p Define prompt    0ed B@L cladd87 B@     B@ B@00 (  ! addidentinfo !%B@  B@   ChildName B@ kxcladd87 l B@[reprotect document|0(| n fsave file cancelled p A@ #return to point of error in routined ! Error ! In Case InfoA@+Reprotect Document and exit sub after errorkpoh`Attribute VB_Name = "AddIdentInfoAuto" Sub X()  '0V Macro* recorded 01/11/01 by Program Area* On Error GoTo @Handle numrowsInputBox("There is alCdy ONE ifying rmation sec. " + Chr(10) "How many ADDITIONAL IDENTIFYING INFOXRMA  fYChild(ren) groupJMnee{thTreport? $F(Example: {Total c..8 bek#= 3}J%{ Minus existA= 1:Enter addi[@.= 2 ;CANCEL OESC if none", "`, 0 mpt$@"You MUST S ave TAYDocum Be@^e Con7u71^SelIn Fold1ndV C:File inBAs Di`alog 'Define pdro@, ^CI;cmdCancel@0enExitH2!CElse"0."&AA!AveJ.' Un`t#Passwy :="cl`<87F8i@2Eux1 Step -1# ,q.MoAwn unit:P=wdL$, 5un13SplitTable#Apc"{.DisplayC,@leteTip=p Tru a@chedTelate.Text:ries("AXi").Insert _aW:=GRange, Rich! :=DLଁCharac@fG# '@Wha$Bookmar|k,N`1BaP1N  i: ,>k=oRese, Type7Allo wOnly@mFields 'troB dDr A Ӡɣ E2h$_@ÀM4198B_ 'sfr"cBiled Msgq@p$, vbCrcalturn to point of e`{``IoJ `.De`scripA Ex`dcor" &!.Numb&n Cas6eդ7 e" '+@,      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~660@\G6"   .0 `h p `   (8 @P X  `p   >($H p  @  & .0`8h6   AddParentRowAuto Macro( Macro recorded 01/11/01 by Program Areasn%There is already ONE parent section. $r How many ADDITIONAL PARENT $r 9 groups are needed for this report? $r $r 3 Example: {Total parents being reported = 3} $r B { Minus existing = 1} $r B { Enter additional = 2} $r $r CANCEL or ESC if none PARENT ROWS$'-You MUST Save This Document Before Continuing $r $r Select Save In Folder and $r $r $Enter File Name in SaveAs Dialog Box ' p Define prompt   0ed B@cladd87 B@    B@ B@ (  ! addPARENTROW !%B@  B@   PARENTName B@OT kXPHcladd87 l B@[reprotect document||n fsave file cancelled p A@{ #return to point of error in routinedX ! Error ! In Case InfoA@+Reprotect Document and exit sub after errorSkoAttribute VB_Name = "AddParentRowAuto" Sub X() '0 Mac ro2 recorded 01/11/01 by Progra@m Area* On Error GoTo H andle numrowsInputBox("There is alCdy ONE p section. " + C@hr(10) "How many ADDITIONAL PARENT  group8+@,>dk \=n xMEP AddSignatureAuto" AddDHSSignatureAuto(IAddVBRecommendations*AddCourtRecommendationsAuto8e440@\G4" DP X 8    ( 0  8H h"  @("H p  @  & .0`8h6  = creates message box for number response to Agency signatures[n((There is already ONE signature section. $r How many ADDITIONAL SIGNATURE $r ) rows are needed for this report? $r $r 0 Example: {Total Signatures required = 3} $r < { Minus existing = 1} $r < { Enter additional = 2} $r $r CANCEL or ESC if none AGENCY SIGNATURES$'' Prompt$ = "You MUST Save This Document Before Continuing" + Chr(10) + Chr(10) + "Select Save In Folder and" + Chr(10) + Chr(10) + "Enter File Name in SaveAs Dialog Box" Define prompt   0ed B@cladd87 B@   AddSignatures %B@H  B@ B@rd  (ate  ! AddSignatures !%B@  B@  AddSignatures %B@H k80(cladd87 l B@[reprotect document||n fsave file cancelled p A@> #return to point of error in routinerd ! Error ! In Case InfoA@+Reprotect Document and exit sub after errorukoAttribute VB_Name = "AddSignatureAuto" Sub X() ' creates message box for number response to Ag@ency ss On Err.GoTo Handle B BrowsInputBox("There is alxdy ONEQ section. " + Chr(10) "How many ADDITIONAL SIGNATURE- >a7neededkth=report?6 Example: {Total squir*= 3}@# { Minus existing14%EntajaddiAO@*= 27CANCEL @mESC if none",GENCYVS0@Prompt$)"You MUST S ave TATDocument Bee Con4u@5YSel{In Fold0 ndV C9File inBAs Dialog @'Defined pB, ]CI :umĤcmdC ancel@0enBExitH@2CElse"0"&A!AtveJ.OC U n.tAGPassword:="clw8784Fpi@2%m`p1 St ep -12 Bookmarks(᪄s").1c qMown unit:=wdL@+,;unD$SplitTablepcabzDisplay!C`IleteTipTru+$achedTep.Text@Arie _a$BIrt WA:=Range, Richa :=;DSCharaclf,Ȱe ,N` iCEnd IfcPC R:LFsF, NoRese5, TypeA9AllowOnlyHmFields '`roB ddz  ȣ2h$g@àU4198bg 's!f!zcbqledQ Msgy , vbCrcalnpoiof eҀrou$KxJ `.DescrLipSA ExlmUor" &!.N& "`CaInf!M a ! 'Re%x&`At s`af"?+Ab-!dk \=h xMEP 330@\G3" DP X 8    ( 0  8H h   B( H h x @  &.(X8`6  >creates message box for number response to add DHS signatures3 n(,There is already ONE DHS signature section. $r !How many ADDITIONAL DHS SIGNATURE $r ) rows are needed for this report? $r $r 0 Example: {Total Signatures required = 3} $r < { Minus existing = 1} $r < { Enter additional = 2} $r $r CANCEL or ESC if none DHS SIGNATURES$'-You MUST Save This Document Before Continuing $r $r Select Save In Folder and $r $r $Enter File Name in SaveAs Dialog Box ' p Define prompteAs  ' p 0ed B@cladd87 B@B@   dhssignature %B@H  B@B@ B@B@ ( (  !AddDHSSignatures !%B@  B@  dhssignature %B@H  k@80cladd87 l B@[reprotect document||n fsave file cancelled p A@ #return to point of error in routined  ! Error ! In Case InfoA@+Reprotect Document and exit sub after errorrkoAttribute VB_Name = "AddDHSSignatureAuto" Sub d() 'creates message box for number response t@o add ss On Err0GoTo Handle CrowsInputBox("There is alz@dy ONE U section. " + Chr(10) "How many ADDITIONALSIGNAThURE Ba;neededpthAreport?8 Example: {Total squir*= 3n}@#{ Minus existing14%EntmjiAP@*= 27CANCEL @oESC if none", "AyFUS@0 Prompt$'"You MUST Save TSDocument BeA@e Con@3uc4WSelzI@n Fold/ndV 8File BinBAs Dialog 'Define ^pB,YCI@9umcmdCancel@0enExitH2!CElse"0N"&! Av:eJ.OC Un.tAGPassword:="clv878F7i@2mp1 St ep -12 Bookmarks("dhsy").O1cpMown unit:=(wdL +,;un$$SplitTablepca"zDisplayC@IleteTipTru $ached,Te p@.Text Ariels _c$Irt W:=Range, Rich :=GDT`%Charac@l_,W,N i#End IfcPC R:lFs5F, N`oRese 6, Type9AllowOnlyHmFields 'roB dz  ɣ2$gU4198g 'sAfAz"cqled Ms gy Ď, vbCrcal nApoiaof eҠr|oudK!xJ `.DescripTA ExlmU  or" &.Nc& "CaInfAL a A 'ReExFt saf?"?+Ab- dk \=xMEP 440@\G4" " &0 X` h P   ( 0@ H  P`   F &@ h x @  &.(X8`6   AddVARecommendations Macro Macro recorded 01/29/01 by FIAn-There is already ONE recommendation section. $r #How many ADDITIONAL RECOMMENDATION $r + SECTIONS are needed for this report? $r $r . Example: {Total Children required = 3} $r 8 { Minus existing = 1} $r 8 { Enter additional = 2} $r $r CANCEL or ESC if none V. COURT RECOMMENDATIONS$'-You MUST Save This Document Before Continuing $r $r Select Save In Folder and $r $r $Enter File Name in SaveAs Dialog Box ' p Define prompt  e 0ed B@B@cladd87 B@    B@ B@ (rd   !AddVBRecommendations !%B@  B@ B@   NameofChild B@H  kPH@cladd87 l B@[reprotect document||n fsave file cancelled p A@ #return to point of error in routined@ ! Error ! In Case InfoA@+Reprotect Document and exit sub after errorkoŴAttribute VB_Name = "AddVBRecommendations" Sub Ah() '2A h Macro:  rrded 01/29/01 by FIA! On Error GoTo Handle numrowsInputBox("There is already O NEb sec. " + C@hr(10) "How many ADDITIONAL RECOMMENDA" SECS a=neeffZthDreport?5:! Example: { TotalLildren^quir= 3} Y{Minus existin g10#Enter addiN'= 25CANCEL @ESC if none", "V. CPOURT VS0 Prompt$@)"You MUST Save TSDocu!t BeXe hCon4u5WS el{In Fold2ndV : File BinBAs Dialog @'De@fine pB, 6 \CI;ƦcmdCancel@0 enBExitH@2CElse"0"&A!AveJ.OC) Un.tAGPassword:="cly87:F9i@2%n`q1 Step -1# #,.MoAwn unit:=wdL$, 5un26Split Table#Apc.DisplayAutoCBleteTipq!~Trua@chedTeiate.TextA:ries(3). _Ins ert W:=gRange, RichA :=DN`Chaxracgf N&AW ha%Bookmark,P2PofCh@3N@ iCEnd CANCEL @JESC if none", "COURT REHCOM[DAhS%0 mpt$@"You MUST Save T[Docu!t Be`e hCon8u8`S el@In FoldA1ndV 9 File inBAs Dialog @'Define pro@, ^CI;cmdCance2l@0enExhitH2CElse"0"&KhA cvee%.' Un`t#Password :="cl <87F8i@2Etw1 Step -1# ,`.MoAwn unit:P=wdL$, 5unSplitTableDpc•.DisplayC`,leteTip!TrukachedTemate.Text:ries("mO).Insert _c%W!:=Range, Rich :=gDM ECharacǠfBAWhaB%Bookmark,O2eMN i>End Ixf %KL:#,@m?oRe se!, Type9AllowOnlyBmFi@elds 'roB dDt A  E2h$a@ĀO4198QBa 'sftcBkled Msgs@r$, vbCrcalturn to point 0of e`}ro>u`KqJ `.DescripA tEx`fmBVor" &!.NuDmb& "@Case InfA AL e" 'Rer`t saf!"> rAPROJECTwPROJECTwmuCompObjqID="{C19A4581-C492-4EC8-BC74-7AA8F89FEAAB}" Document=ThisDocument/&H00000000 Module=ClearCaseInfo Module=Viewtools Module=RemoveRow Module=ToolHelp Module=CaseInfo Module=CheckSpelling Module=NewMacros Module=AddParentRowAuto Module=AddIdentInfoAuto Module=AddCourtRecommendationsAuto Module=AddDHSSignatureAuto Module=AddSignatureAuto Module=AddVBRecommendations Name="TemplateProject" HelpContextID="0" VersionCompatible32="393222000" CMG="27250EC112DFA5E3A5E3A5E3A5E3" DPB="B6B49F52A16E316F316F31" GC="45476CFF748F758F7570" [Host Extender Info] &H00000001={3832D640-CF90-11CF-8E43-00A0C911005A};VBE;&H00000000 [Workspace] ThisDocument=0, 0, 0, 0, C ClearCaseInfo=71, 91, 467, 450, Viewtools=150, 150, 594, 491, RemoveRow=100, 100, 544, 441, ToolHelp=125, 125, 569, 466, CaseInfo=-3, 27, 578, 386, CheckSpelling=27, 27, 566, 255, NewMacros=-4, 2, 643, 275, AddParentRowAuto=154, 154, 458, 489, AddIdentInfoAuto=0, 0, 304, 335, AddCourtRecommendationsAuto=22, 22, 326, 357, AddDHSSignatureAuto=44, 44, 348, 379, AddSignatureAuto=66, 66, 677, 445, AddVBRecommendations=44, 44, 394, 379, Z ThisDocumentThisDocumentClearCaseInfoClearCaseInfoViewtoolsViewtoolsRemoveRowRemoveRowToolHelpToolHelpCaseInfoCaseInfoCheckSpellingCheckSpellingNewMacrosNewMacrosAddParentRowAutoAddParentRowAutoAddIdentInfoAutoAddIdentInfoAutoAddCourtRecommendationsAutoAddCourtRecommendationsAutoAddDHSSignatureAutoAddDHSSignatureAutoAddSignatureAutoAddSignatureAutoAddVBRecommendationsAddVBRecommendations  FMicrosoft Office Word Document MSWordDocWord.Document.89q'` 2bjbj{P{P _:: &4&4ZZZZZ$~$Pү~/:vvvvv@bXZ\\\\\\$ihiZvvZZvvRZvZvZZZZ~vֵ :|I RF0/^RZ8^/~~~ ~~~~~~ZZZZZZ  Name and Title: FORMTEXT       Signature: Date:  FORMTEXT       NameDate of BirthLog NumberCase NumberChild GenderHeightWeightHair Color FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT      Eye ColorReligionDated Entered CareDate of Current PlacementCurrent Placement TypeAnticipated Net Placement FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMTEXT      Date of Anticipated Next PlacementCurrent Legal StatusFederal Permanency Plan Goal FORMTEXT       FORMTEXT       FORMDROPDOWN Child s Address (if not FH) FORMTEXT      Native American? FORMDROPDOWN If Yes, Tribal Affiliation FORMTEXT       NameRelationshipChildrenParticipating FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN Parent s Current Address: FORMTEXT      Date of Birth FORMTEXT      Telephone: FORMTEXT      Protective Services Risk Level: FORMDROPDOWN   FORMDROPDOWN  FORMTEXT       FORMDROPDOWN  Name and Title: FORMTEXT       Signature: Date:  FORMTEXT       Recommendation for: FORMTEXT       Enter the child s name.Check Boxes: Check only one box (1  3) and as many a  I as necessary if box 3 is checked.1. FORMCHECKBOX A mandatory petition is not required. If #1 is checked, a petition for termination for parental rights has not been filed. Write N/A in the space below.2. FORMCHECKBOX A petition for termination of parental rights has been filed and it is in the child(rens) best interest to proceed. If #2 has been checked and it is in the best interests of the child to proceed, provide the reasons why in the space below. 3. FORMCHECKBOX A petition for termination of parental rights has been filed and it is not in the child(rens) best interest to proceed. N4P4R4h4j4l4x4z44~xr5$If$If 6$IfK$IfpkdW$$Ifl\ #*f4 la44444444444444455 5"5.505D5F5H5J5^5`5b5l5n5p5r55ͽxtix[xTxt hlhy jhy UmHnHujMhy Uhy jhy Uh4+hy 5>*CJOJQJ"h4+hy 5>*@CJOJQJhy 5>*CJOJQJhlhy >*CJOJQJhlhy 5>*CJOJQJhP hlhPjhPUmHnHujhlhPUjhlhPU 44444445"505F5{{{{{{{{$pp$If]p^pa$pkdf$$Ifl\ #*f4 la F5H5kd $$IflִL r6%*X`adacaf+    4 lapPH5p5555686`66E$If555555555555555555555566 6666&6(6*6466686:6N6P6R6\6^6`6b6v6x6z6666666ӽӲӧӜӑׄhlhy CJOJQJjhy Ujhy Ujhy Ujhy Uj/hy Ujhy Uhy hlhy jhy UmHnHujhy Ujۍhy U2666E$Ifkd}$$IflִL r6%*X`adacaf+    4 lapP666667<7p7$$If]^a$ $$Ifa$9kd$$Ifl*++4 la6666666 77:7<7n7p7r7t7777777777777777777777888888808284868ŨšŨšŨšŨšušj4hy Ujʕhy Uj.hy Ujhy U hlhy jhy UmHnHujhy Uhy jhy Uhlhy >*CJOJQJ&h4+hy 5>*CJOJQJ^JaJ hy 5>*CJOJQJ^JaJ.p7r7777868^8GAAAAAAE$Ifkd$$Ifl ֈL *X`ad  +4 lap<6888L8N8P8Z8\8^8`8d88888 9999&9(9*9496989:9N9P9R9\9^9`9b9~999999999ӵwljhy Ujhy Uj0hy U&h4+hy 5>*CJOJQJ^JaJ&hhy 5>*CJOJQJ^JaJ hy 5>*CJOJQJ^JaJhlhy CJOJQJ hlhy jhy UmHnHujΗhy Uhy jhy U(^8`8b8ICE$IfkdD$$IflֈL *X`ad  +4 lap<b8d8889 $Ifgd:F $$Ifa$gd:F$$If]^a$gd:F@kd:$$Ifl*++4 lap 9989`99 E$Ifgd:Fnkd$$IflF *`  +    4 lapyt:F999999^S 4$<$Ifa$9kd$$Ifl*++4 laE$If`kd|$$IflF *`  +    4 layt:F99999::,:.:0:h:j:~:::::::::::::::::;;;;;;׳ׯ|xm|_|X hlhPjhPUmHnHujhPUhPjhPUhlhPCJOJQJhlhP>*CJOJQJhlhP5>*CJOJQJhy j!hlhy UjUhy Ujhlhy U hlhy jhy UmHnHujhy UjDhy U"99:2:h::E$If4$IfJkd$$Ifl0U * G+4 la::::^X9kd+$$IflL*++4 laE$Ifkd?$$Ifl\M *F (+4 lap(::::::::;>;f;;pjjjjE$Ifkdx$$Iflr AWQ *K b8 +4 la $$Ifa$ ;;,;.;0;:;<;>;@;T;V;X;b;d;f;h;;;;;;;;;;;;;< << <"<,<.<F<H<\<^<`<j<l<p<r<yhlhPCJjMhlhPUjhlhPUjShlhPUjhPUhPjhPUjahlhPUjhPUmHnHujhlhPU hlhPjhlhPU+;;;;;;<0<F<NHHH4$If9kd$$Ifl**+4 laE$Ifpkd{$$Ifl\ AW*K b2+4 laF<n<p<r<b\5$Ifkdy$$Iflֈi#* S+4 laE$Ifr<t<<<<<<<=,=P=nlff6$IfJkd$$Ifl09 * W+ 4 la5$If$If9kd0$$Ifl**+4 la r<t<<<<<<<<<<<<=======(=*=,=.=J=L=N=T=v=x===========ο}odjhPUjhPUmHnHujhPUjhdUjhdUmHnHuj$hdUjhdUjhdUhdj}hPUhPjhPUhlhPCJOJQJhlhP5CJOJQJhlhPOJQJ'P=R=T=V=v====zzrll$If5$IfK$If|kd$$Ifl4rD*nx4 lf4=========}w5$If$If 6$IfK$IfkkdO$$Ifl\ #*f4 la=====&>(><>>>@>J>L>N>~>>>~>{5x$IfKx$IfK$Ifkkd^$$Ifl\ #*f4 la~>>>>?.[kd$$Ifl4FD*%    4 laf4K$Ifnkda$$Ifl4\D *4 laf4>?@?B?H?l?O@P@Q@R@U@g@XAqkdŶ$$Ifl4rDb$ *nf!4 laf4L$IfK$If XAYAZA[A^ApAڂ}wwqqqL$IfK$Ifkdҷ$$Ifl4rDb$ *nf!4 laf4nAoAAAA؂ڂ܂ԃփ؃@BNPlnp؄ڄ܄؅څ vh=:hPB* phf h=:hPjWhPUjBhPUj-hPUjhPUjhPUhlhP5hq+hP<B* phfUhP<B*phhlhP<B*ph hlhPjhlhPU,      !"#$%&'()*+,-./012345679:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXIndicate why termination is not in the best interests of the child by checking as many boxes as apply below:a. FORMCHECKBOX The child is age 14 or over and refuses to consent to his/her adoption.b. FORMCHECKBOX Child in treatment services are not yet completed.c. FORMCHECKBOX The youth is age 18 or over.d. FORMCHECKBOX The supervising agency has not yet provided the services detailed in the prior service plans to make reunification possible.e. FORMCHECKBOX Other. If this is the compelling reason, there must be clear documentation within the service plan of the individual circumstances of the child that necessitates this selection. f. FORMCHECKBOX The parent suffers from a chronic illness and the child is unable to return to the home, but there continues to be a close relationship between the child and parent.g. FORMCHECKBOX There are financial benefits for the child to maintaining parental rights.h. FORMCHECKBOX There is an appropriate relative caregiver to care for the child and the relative caregiver is not willing to adopt the child.i. FORMCHECKBOX Child is an unaccompanied refugee minor.  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMTEXT       FORMDROPDOWN Child s Address (if not FH) FORMTEXT      Native American? FORMDROPDOWN If Yes, Tribal Affiliation FORMTEXT           ڂ܂ނ}wwqqqL$IfK$Ifkd߸$$Ifl4rDb$ *nf!4 laf4}wwqqqqL$IfK$Ifkdx$$Ifl4rD$ *f!4 laf4ڃ@jdd^^^^L$IfK$Ifkdw$$Ifl4ֈDb$ *n4 laf4@BDFHNrjdd^^^^L$IfK$Ifkd$$Ifl4ֈDb$ *n4 laf4ބ؅jdd^^^^L$IfK$Ifkd$$Ifl4ֈDb$ *n4 laf4؅څ܅ޅ npjdd^^^^^L$IfK$Ifkd$$Ifl4ֈDb$ *n4 laf4pr~ĉƉjlnpr렜wlj`hdUjhdUmHnHujhdUhdjhdUhPhlhPCJOJQJjhPUjhPUjhPUjlhPUjhlhPU hlhPhlhP5h=:hP<B* phf*prtvx~jdd^^^^L$IfK$Ifkd˾$$Ifl4ֈDb$ *n4 laf4 jdd^^^^L$IfK$Ifkd$$Ifl4ֈDb$ *n4 laf4ĉjdd^^^^L$IfK$Ifkd$$Ifl4ֈDb$ *n4 laf4jjdd^^^^L$IfK$Ifkd$$Ifl4ֈDb$ *n4 laf4jlnp4\jec]]]]]]]E$If$a$kd%$$Ifl4ֈDb$ *n4 laf4 ‹֋؋ڋ .0246JLNXZ\^z|~ЌҌԌތ$&(`bvxzj*hdUj^hdUjMhdUjhdUjhdUjvhdUjhdUj hdUhdjhdUmHnHujhdU6_TNE$If 4$<$Ifa$kd$$Ifl֞T &##+FFF_o4 l*`KIIfkdj$$Ifl\T +FA4 lE$If4$If@kd$$Ifl0\ + 4 lhdhI |jhI |U  3 0P P / =!@"`#$% (/ =!"#$% Enter Foster Care Worker's Name$$If!vh5f555#vf#v#v#v:V l5f555/ 4vD Text55$$If!vh5f555#vf#v#v#v:V l5f555/ / 4>$$If!vh5X5`5a5d5a5c5a5f#vX#v`#va#vd#va#vc#va#vf:V l+,5X5`5a5d5a5c5a5f4pPD0Enter Child's NameD Text32Enter Child's Date of BirthD$Text33Enter Child's Case NumbervD$Text56vD Text57vD Text58vD Text59vD Text604$$If!vh5X5`5a5d5a5c5a5f#vX#v`#va#vd#va#vc#va#vf:V l+5X5`5a5d5a5c5a5f4pPK$$If!vh5+#v+:V l+5+4$$If!vh5X5`5a5d5 5 #vX#v`#va#vd#v #v :V l +,5X5`5a5d5 5 4p<D Enter Child's NameD$Enter Child's Date of BirthD Enter Child's Case NumberjD Df Dropdown5  Parental HomeLic/Unlic RelativeLegal Guardian Adoptive HomeLic Unrelated Foster Home Ind LivingUnrelated CaregiverOthervD2Text63$$If!vh5X5`5a5d5 5 #vX#v`#va#vd#v #v :V l+5X5`5a5d5 5 4p<X$$If!vh5+#v+:V l+5+4p $$If!vh5` 5 5#v` #v #v:V l+,5` 5 54pyt:FvD Text61vDText62`Df ReunificationAdoption Guardianship1Permanent Placement with Fit and Willing Relative APPLA/APPLA-Ey$$If!vh5` 5 5#v` #v #v:V l+5` 5 54yt:FK$$If!vh5+#v+:V l+5+4DY$Child's Address (if not foster home)]$$If!vh5 5G#v #vG:V l+5 5G4Df Dropdown4Native American? Select response. To add additional child(ren) click or tab to Tribal Affiliation field and click Add Child Info button YesNoUnknownPendingDTribeUIf yes, Tribal Affiliation. To add additional child(ren) click Add Child Info button$$If!vh55F55#v#vF#v#v:V l (+55F554p(K$$If!vh5+#v+:V lL+5+4$$If!vh5K 5b5558 #vK #vb#v#v#v8 :V l+5K 5b5558 4D4Enter Parent's NameD3 RelationshipEnter Parent's RelationshipDChildren!Enter all children of this parent^Df8Make appropriate participation selection for this parent %1. Yes, participating in reunif. plan&2. No, can't locate or is unavailable.3. No, is incarcerated.4. No, has refused services.5. Parent is deceased.6. No, PFFA in place7. Parental rights terminated28. No, reunification services not needed/per courtorder9. No, unwilling10. Not an assessment household$$If!vh5K 5b552#vK #vb#v#v2:V l+5K 5b5524K$$If!vh5*#v*:V l+5*4DText38Enter Parent's Current AddressHDText39iEnter Parent's Date of Birth. To add Parent, click or tab to next field and click Add Parent Row button.,DPPNEnter Parent's Telephone Number. To add Parent, click Add Parent Row button.PopUpPrompt3.MAIN$$If!vh55 555S5#v#v #v#v#vS#v:V l+55 555S54K$$If!vh5*#v*:V l+5*4Df Dropdown1%Select Protective Services Risk Level LowModerateHigh Intensivek$$If!vh5 5W#v #vW:V l+ 5 5W/ 4,Df0Select appropriate number for child to be added.C1C2C3C4C5C6C7C8C9C10C11C12C13C14D. CourtName Child's NameVDfCA&Enter Case Action for Child for PeriodPopUpPrompt5.MAIN Continued PlacementReturn Home and MonitoringClosure$$If!vh5555n5x#v#vn#vx:V l455n5x/ 4af4D2Enter Foster Care Worker's Name$$If!vh5f555#vf#v#v#v:V l5f555/ 4vD Text55$$If!vh5f555#vf#v#v#v:V l5f555/ 4jD$$If!vh5555#v#v#v:V l45554f4k$$If!vh555%#v#v%:V l455%4f4tDeCheck1$$If!vh555n55f!#v#vn#v#vf!:V l455n55f!4f4tDeCheck2$$If!vh555n55f!#v#vn#v#vf!:V l455n55f!4f4tDeCheck3$$If!vh555n55f!#v#vn#v#vf!:V l455n55f!4f4$$If!vh55555f!#v#v#vf!:V l4555f!4f4tDeCheck4$$If!vh555n555#v#vn#v#v:V l455n554f4tDeCheck5$$If!vh555n555#v#vn#v#v:V l455n554f4tDeCheck6$$If!vh555n555#v#vn#v#v:V l455n554f4tDeCheck7$$If!vh555n555#v#vn#v#v:V l455n554f4tDeCheck8$$If!vh555n555#v#vn#v#v:V l455n554f4tDeCheck9$$If!vh555n555#v#vn#v#v:V l455n554f4vDeCheck10$$If!vh555n555#v#vn#v#v:V l455n554f4vDeCheck11$$If!vh555n555#v#vn#v#v:V l455n554f4vDeCheck12$$If!vh555n555#v#vn#v#v:V l455n554f4D(Text31Enter Child's NameDText32Enter Child's Date of BirthD#Text33Enter Child's Case NumberD Text34 M/dd/yyyyEnter Date Child Entered CareZDf)Select Child's Current Placement and Type Foster Home Ind. LivingRelative Residential Adoptive HomeOwn HomeOtherD Text35 M/dd/yyyy'Enter Date of Child's Current PlacementDf Dropdown3'Select Child's Permanent Plan Goal Code  6 = Indp. Living7 = Plcmt. Relatives8 = Return Home9 = Custodial Care 10 = Adoption11 =Term. Parent Rts.12 = Perm. FFA13 = Maint. Own Home$$If!vh55F5F5F55_5o#v#vF#v#v_#vo:V l55F55_5o4aDb$Child's Address (if not foster home)]$$If!vh5 5#v #v:V l5 54aDf Dropdown4Native American? Select response. To add additional child(ren) click or tab to Tribal Affiliation field and click Add Child Info button YesNoUnknownPending@DTribeUIf yes, Tribal Affiliation. To add additional child(ren) click Add Child Info buttonPopUpPrompt1.MAIN$$If!vh55F55A#v#vF#v#vA:V l55F55A/ 4aL@LNormal#CJ OJQJ_HmHnHsH tH uDAD Default Paragraph FontVi@V  Table Normal :V 44 la (k(No List VV Address1d8(OJQJ_HkHmH sH tH RR CareOfd8(OJQJ_HkHmH sH tH ZZ CaseNumberd8(OJQJ_HkHmH sH tH Z"Z ClientCityd8(OJQJ_HkHmH sH tH \2\ ClientStated8(OJQJ_HkHmH sH tH XBX ClientZipd8(OJQJ_HkHmH sH tH XRX CoAddressd8(OJQJ_HkHmH sH tH ZbZ CoAreaCoded8(OJQJ_HkHmH sH tH RrR CoCityd8(OJQJ_HkHmH sH tH \\ CoExtensiond8(OJQJ_HkHmH sH tH `` CoPhoneNumberd8(OJQJ_HkHmH sH tH TT CoStated8(OJQJ_HkHmH sH tH `` CoSuppaddressd8(OJQJ_HkHmH sH tH ZZ CountyNamed8(OJQJ_HkHmH sH tH \\ CountyNumber'CJ OJQJ_HkHmHnHsH tH uPP CoZipd8(OJQJ_HkHmH sH tH PP Date1d8(OJQJ_HkHmH sH tH VV District d8(OJQJ_HkHmH sH tH XX FirstName!d8(OJQJ_HkHmH sH tH Z"Z FirstName2"d8(OJQJ_HkHmH sH tH 2 GranteeFirstName3#$ p@ P ^a$CJ_HmH sH tH dBd GranteeLastName$d8(OJQJ_HkHmH sH tH VRV LastName%d8(OJQJ_HkHmH sH tH XbX LastName2&d8(OJQJ_HkHmH sH tH TrT OtherID'd8(OJQJ_HkHmH sH tH TT Section(d8(OJQJ_HkHmH sH tH `` SuperAreaCode)d8(OJQJ_HkHmH sH tH bb SuperExtension*d8(OJQJ_HkHmH sH tH ff SuperPhoneNumber+d8(OJQJ_HkHmH sH tH bb SupervisorName,d8(OJQJ_HkHmH sH tH NN Unit-d8(OJQJ_HkHmH sH tH RR Worker.d8(OJQJ_HkHmH sH tH bb WorkerAreaCode/d8(OJQJ_HkHmH sH tH dd WorkerExtension0d8(OJQJ_HkHmH sH tH ZZ WorkerName1d8(OJQJ_HkHmH sH tH \"\ WorkerPhone2d8(OJQJ_HkHmH sH tH f2f Captions 8pt Nbox 3d`PCJOJQJkHmH sH u\OB\ Captions 8pt Bold 4d`5CJOJQJuZORZ User Input 11pt5$d8(a$CJOJQJuXObX User Input 10pt6d8(CJOJQJu^r^ Identinfo17d8(5OJQJ_HkHmH sH tH ^^ IdentInfo28d8(5OJQJ_HkHmH sH tH ^^ IdentInfo39d8(5OJQJ_HkHmH sH tH ^^ IdentInfo4:d8(5OJQJ_HkHmH sH tH ^^ IdentInfo5;d8(5OJQJ_HkHmH sH tH ^^ IdentInfo6<d8(5OJQJ_HkHmH sH tH ^^ IdentInfo7=d8(5OJQJ_HkHmH sH tH `` Identinfo11>d8(5OJQJ_HkHmH sH tH `` IdentInfo21?d8(5OJQJ_HkHmH sH tH `` IdentInfo31@d8(5OJQJ_HkHmH sH tH `` IdentInfo41Ad8(5OJQJ_HkHmH sH tH `"` IdentInfo51Bd8(5OJQJ_HkHmH sH tH `2` IdentInfo61Cd8(5OJQJ_HkHmH sH tH `B` IdentInfo71Dd8(5OJQJ_HkHmH sH tH NOaRN User Input 09ptE]^CJ\b\ IdentInfo74Fd8(OJQJ_HkHmH sH tH \r\ IdentInfo72Gd8(OJQJ_HkHmH sH tH \\ IdentInfo73Hd8(OJQJ_HkHmH sH tH XX Captions 8pt Id`CJOJQJmH sH uFAF Captions 8pt box J<JOAJ Captions 9pt BoldKdLCJPOP Captions 9pt LdLCJOJQJu 5'(QRDEFG/012HIJKvw789:lm?@OPXYUV[\ > ? _ ` [ \ ( ) Y Z 0n0,0n0,0$n0,0\n0,0 n0,0  0,0  p0,0\m0,0m0,0p0,0q0,0?P0,0@A0,0BC0,0DE0,0FGXgf0,0HIgf0,0JKgf0,0LMhf0,0NO8hf0,0PQphf0,0,@00@00@00@000@AddDHSSignatures addidentinfo7 addPARENTROWAddRecommendations AddSignaturesAddVBRecommendationsChildIdentInfoUser Input 09ptUser Input 10ptNormalCaptions 9pt BoldSLn    "H! #&)*,3-.3@:f;<=8?{ATCXEGOIJL*OPQT*XlYZ\>`dMgilVL456689;r<=nA8<BDHKNQVZ]ahmqtw|  "&)+048;@MSV D x 6NR8&HTX !!""8#^#$$%s&\''( )\)**/+B,, -Q-s---3.a.,/11U22f33T4.5568748839G: ;; <p===,>>2?(@~@@|AA|B5DuDDFEEE0FpFFGHGGGGBHHHIvJKLMNOIPP QQ0RYTUVmVXX?YYB\\=]y]~_A`^abcd/f8g5h;hhhiij?kk;l}lloj\bZN44F5H566p7^8b8999::;F<r<P===~>>?XAڂ@؅pj9;=>?@ACEFGIJLMOPRSTUWXY[\^_`bcdefgijklnoprsuvxyz{}~  !#$%'(*,-./1235679:<=>?GHIJKLNOPQRTUW:#=IO(.0<B '-4@Fw#/5Zjp%Ue^nbr  E U f v b r     & E Q W k { FFFFFFFFFFFFFFS$FFFS FS$FFFFS FtF4F4S S FtS FFFG$G$G$G$G$G$G$G$G$G$G$G$FTFTFTFTS$FTS$FtS F4Text32Text33Text56Text57Text58Text59Text60 Dropdown5Text63 Dropdown1 CourtNameCAText55Text31Text32Text33Text34Text35 Dropdown3 Dropdown4Tribe 1 [   l  /C.k  ' |    y :F[-KJ1hI |Pd%&'(45<QRSXfq}0DEFGQZm /012Uj4HIJKLQ^guvw#789:Zlmnop?@ABOPQRUgXYZ[^pUVWXYZ[\]^_bt  ! > ? @ A B E W _ ` a b c f x [ \ ] ^ _ b t   ( ) E Y Z k } @v{tvvd `4`6`8`:`<`>`@`Unknown Gz Times New Roman5Symbol3& z Arial?5 : Courier NewURITC Zapf Dingbats (D1)C MS Sans Serif5& zaTahoma;Wingdings7Tms Rmn"h0@P?d2