ࡱ> ~y bjbj ?{{k,%,%,%,%,%Dp)p)p)/t24p)N7\H:HHHqIJ KD$8a,%!MqIqI!M!M,%,%HH _ _ _!MF,%H,%H _!M _ _γL2HНjB|gMZ0NtN 2,%@`MKLK6 _K,K&MKMKMKWMKMKMKN!M!M!M!MMKMKMKMKMKMKMKMKMK #: CHILDREN S FOSTER CAREDHS FC Worker Load #: FORMTEXT      PERMANENT WARD SERVICE PLANDHS FC Worker Name: FORMTEXT      Michigan Department of Human PAFC Agency Name: FORMTEXT      ServicesPAFC Agency Worker Name: FORMTEXT      County of Referral: FORMTEXT      Court Jurisdiction: FORMTEXT      Court Docket #: 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. Add Children Below To insert additional names, copy and paste below Native American row.NameDate of BirthLog NumberCase NumberChild GenderChild RaceHeightWeightHair ColorEye ColorReligionDated Entered CareDate of Current PlacementCurrent Placement TypeAnticipated Next PlacementDate of Anticipated Next PlacementCurrent Legal StatusFederal Permanency Plan GoalChilds Address (if not FH)Native American?If Yes, Tribal AffiliationInsert copied rows here Document in social work contacts date Native American question asked, to whom, and outcome. I.LEGAL STATUS A.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 [2] "Click Here and Type"  B.Next Court Date:  MACROBUTTON [2] "Click Here and Type"  II.REASONABLE EFFORTSNote:For children who may be Indian Children, see NAA 205, Active Efforts. A.Efforts made by the Agency to place the child in a permanent placement in a timely manner.   MACROBUTTON [b2] "Click Here and Type"  B.If services were not provided, explain the reasons why services were not provided.   MACROBUTTON [b2] "Click Here and Type"  III.SOCIAL WORK CONTACTSl List date, person(s) contacted, role/position, type of contact (telephone, in person, home visit, office visit, PPC, etc.), location of contact (Foster Home, relative home, court, etc.) for each contact, attempted contact and scheduled, but unkept appointments. l Provide a brief narrative statement of the topics covered during the contact. Limit the narrative to 2-3 sentences. l See FOM 722-9, Updated Service Plan for required face-to-face contacts.  MACROBUTTON [b2] "Click Here and Type"  IV.PROGRESS SUMMARY A.Child Reassessment 1.Child Needs and Strengths Reassessment: Indicate, for each permanent ward; Address and explain each individual item scored as a strength or need on the Child Assessment of Needs and Strengths, please attach appropriate DHS-432, 433, 434 and/or 435. l Identify and describe the priority needs of the child for service. Provide specific and concise examples to support narrative. l Identify the situational concerns, which cannot be identified in consecutive report periods. l List and describe all other strengths of the child whether identified on the assessment or not. l Document child s view of needs and strengths (as age appropriate).  MACROBUTTON [b2] "Click Here and Type"  2.Placement Information l The current placement. l Any replacements during the reporting period. Document efforts to prevent replacements. l Any change in the placement household during the review period. Include results of Central Registry and criminal record checks and assessment of investigation if applicable, if new adults are in the placement household. Identify if change of placement was planned to meet the child s permanency goal. l Child s feelings and observations about current placement. l For Indian Children, include Foster Care Placement Preference from NAA 215, Placement Priorities for Indian Children.  MACROBUTTON [2] "Click Here and Type"  Add Children Below To insert additional children, tab at the end of the row.Child nameLiving ArrangementBegin DateEnd Date  Reason for Replacement:  MACROBUTTON [b2] "Click Here and Type"  3.Child(ren)s Current Status Indicate for each child under court jurisdiction: Describe current status of child including: l Significant events since the last assessment. l A physical description including distinctive characteristics. l Emotional and physical development. l Participation in extracurricular/cultural/hobbies, likes and dislikes, etc. l Relationships with siblings, if applicable, l Behavioral and past experiences. l How the child s permanency plan was shared with the child and the child s feelings about the plan.  MACROBUTTON [2] "Click Here and Type"  4.Education Information For each child, complete the following information: l Child name. l Name of the school child is attending. l Grade. l Special education information, if applicable. l Reassessment of education needs (educational assessments, report cards and contacts with the parents, teacher(s), foster parent, child/youth and/or education liaison is used to assess the child s educational needs and strengths). l Detailed narrative of the child s academic performance. Describe all services provided to meet the child s specific identified educational needs and provide progress updates. l For foster parents receiving a Determination of Care (DOC) supplement based on providing activities for education participation, detail the specifics for school collaboration and the actual tasks involved in the daily educational interventions required for the child in the case service plan. l Statement documenting child/youth is attending elementary or secondary school as a full-time student, has completed secondary education or is incapable of attending school on a full-time basis due to medical condition. If a replacement occurred during this report period, the following additional information is required: l Name of the school child was attending prior to change in placement. l Determination of the preferred school for the child based on best interest factors and the input of the parent or legal guardian, along with the education liaison (see FOM 722-6). l School transportation plan (include role of the school and foster parent, if applicable). l Date child began attending school. Full-time school attendance is required within five days of replacement. If child did not start school within five days give explanation. l Verification from new school child s previous school record was obtained within 30 days.  MACROBUTTON [2] "Click Here and Type"  5.Provision for Medical, Dental Information and Mental Health Services MEDICAL During this report period, for each child complete the following: l Child name. l Current health status and medical needs. l List prescribed medications and regularly dispensed over-the-counter medications, including dosage, diagnosis resulting in prescribed medications and prescribing physician. l Documentation of informed consent for each psychotropic medication. l Any needed emergency medical, dental and health care provided since entry into foster care. l Date of full medical examination. l Description of any needed medical follow-up appointments. l Immunization status (refer to immunization chart in FOM 722-6). l Child s perception of their medical needs, if applicable.  MACROBUTTON [2] "Click Here and Type"  DENTAL l Child name. l Date of dental examination or date of scheduled appointment. l Description of any needed dental follow-up appointments. l Child s perception of their dental needs, if applicable.  MACROBUTTON [2] "Click Here and Type"  MENTAL HEALTH l Child name. l Date referred to mental health provider for mental health screening and/or assessment (from the physical/medical exam). l Description of any needed mental health treatment/assessment, if applicable. Include name of treatment provider, frequency of sessions and treatment goals. l Child s perception of their mental health needs, if applicable.  MACROBUTTON [2] "Click Here and Type"  6.Placement Resources a.Sibling Placement l If the child has siblings who are not placed in the same placement, describe reasonable efforts made to place siblings together and provide an explanation of the reasons for the split placement. l If placing all siblings together in one placement is contrary to the safety or well-being of any of the siblings, provide explanation of circumstances. l Describe the ongoing efforts to place the siblings within the same home. l Quarterly reassessments of sibling placement (for separated siblings), assess progress and status towards reunifying siblings within one placement. l Note: If sibling placement is split, second line supervisor approval is required. The Second Line Supervisor must sign the PWSP in the space designated at the end of the PWSP. If there are no siblings or if siblings are placed together, write N/A.  MACROBUTTON [b2] "Click Here and Type"  b.Sibling and Relative Visitation Provide a report on all siblings and relative visits. Visits between siblings are to occur at least monthly, if in separate placements. Specifically document the following: l Dates of visits or contacts. l Location of visits or contacts. l Duration of visits or contacts. l Other ongoing interactions between siblings (phone calls, letters, school activities, etc). l Worker assessment on the quality of sibling visitation, based on personal observations, each child s description of visits and any reports from others, including parent(s), relative(s) and foster parent (as applicable). l Reasonable efforts made to provide frequent visitation, if sibling visitation did not occur. l Relative visits including adult siblings and potential placements in the relative network. l Worker assessment of relative visitation. l Include a discussion of any exceptions (missed appointments, changed appointments, suspensions of appointments and changes in supervision status) to the plan during the reporting period.  MACROBUTTON [b2] "Click Here and Type"  Sibling placement/visitation is contrary to the childrens safety or well-being due to: FORMCHECKBOX N/A children placed together. FORMCHECKBOX The visit may be harmful to one or more of the siblings. FORMCHECKBOX The sibling is placed out of stat in compliance with the Interstate Compact on Placement of Children. FORMCHECKBOX The distance between the childrens placement is more than 50 miles and the child is placed with a relative. FORMCHECKBOX One of the siblings is above the age 16 and refuses such visits, include reasons for refusal. FORMCHECKBOX Other: (If other, provide explanation in summary below.)  MACROBUTTON [b2] "Click Here and Type"  c.Best Interests of Current Placement l Describe the foster parent / relative caregiver s willingness and capacity to meet the specified needs of the child. l Why this current placement is in the child s best interest. l Describe how this specific placement supports the child s permanency plan. l Document any CPS complaints regarding the caregiver since the last report period, omitting any information about the CPS referral source. l Document any foster home licensing complaint investigations regarding the caregiver since the last report period and any corrective action plans that were a result of the complaint. l Describe any safety concerns (if any) and how the concerns were addressed.   MACROBUTTON [b2] "Click Here and Type"  7.Residential Care Describe reasons for residential placement. If the youth is 10 years of age or over and is placed in a residential or institutional setting: l Document whether Wraparound, assisted care or other efforts were made to prevent the residential placement. l Identify the plan for services that will allow the youth to be placed in a less restrictive setting. OR If the youth is under age 10 and is placed in a residential or institutional setting: l Document whether Wraparound, assisted care efforts were made to prevent the residential placement. Document that a screening for Fetal Alcohol Spectrum Disorder was completed. l Identify the plan for services that will allow the youth to be placed in a less restrictive setting. l 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 [b2] "Click Here and Type"  8.Permanency Planning Goal For each child list the permanency planning goal.a.Describe the effort made to finalize the permanency plan.  MACROBUTTON [b2] "Click Here and Type"  b.Attitudes regarding termination of parental rights and adoption.  MACROBUTTON [b2] "Click Here and Type"  c.Preparation of child for adoption.  MACROBUTTON [b2] "Click Here and Type"  d.Possibility of adoption by relative network or foster parents.  MACROBUTTON [b2] "Click Here and Type"  e.Efforts made to place the child(ren) for adoption or within the relative network through guardianship. Statement of the efforts made to place the child(ren) for adoption or within the relative network through guardianship.  MACROBUTTON [b2] "Click Here and Type"  f.Compelling Reasons. Document the compelling reasons why it is not in the childs best interest to be placed for adoption or within the relative network.  MACROBUTTON [b2] "Click Here and Type"  9.Permanency Planning Conference For each child, provide a narrative of all PPCs held this reporting period including the outcomes for each meeting.  MACROBUTTON [b2] "Click Here and Type"  For each child list the permanency planning goal.B.Foster Parent/Relative Caregiver Input l Attach written input from the foster parent(s)/relative/unrelated caregiver for the child(ren). If a written statement from the foster parent(s)/relative/unrelated caregiver is not available, summarize the foster parent s feedback. l Document date Medicaid card, Medicaid number and Consent for Emergency Treatment Card (DHS-3726) was given to caregiver. l Describe the caregiver s continuing family adjustment to child s placement.   MACROBUTTON [b2] "Click Here and Type"  V.RECOMMENDATION Recommendations to Court, if applicable. l For each child, indicate whether the child should remain in placement, under the supervision of the courts, as appropriate or as State Wards. l Request any other orders from the court as appropriate.   MACROBUTTON [b2] "Click Here and Type"  Department of Human Services of MichiganPermanent Ward Treatment Plan and Service AgreementThis treatment plan is developed to assure that each child will receive safe and proper care and services by the following activities. Service Type Code:AD =Alcohol or Drug Abuse RehabilitationFR =Reunification ServicesIL =Independent Living ServicesOT =Other Program NeedsDC =Day CareFC =Family Counseling/Outreach CounselingJT =Job Training/Employment AssistancePS =Parenting Skills TrainingED =EducationHS =Homemaker Services or Parent AidesMH =Mental Health ServicesTH =Individual/Group TherapyDV =Domestic Violence ProgramMD =Medical ServiceWP=WraparoundA. SERVICE REFERRAL TABLE Using the codes above for member referred and service provider type, enter the information for all services below. l To enter additional services for following reports, place the cursor in the FIRST FIELD of the row ABOVE where you want the new row and click the Insert Svc Ref Row button to insert services between rows as needed. l To enter continued headings, click in the FIRST FIELD on the new page and click the ADD SVCREF HEADING button. To remove continued headings, click the REMOVE SVC REF HEADING.  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FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMDROPDOWN  FORMDROPDOWN  FORMTEXT       Permanent Ward Treatment Plan and Service Agreement (continued) B. Foster Parent / Relative Caregiver Activities and Discipline and Child Handling Techniques1. List each goal for foster parent/relative caregiver, specific action steps, time frame for achieving, and expected outcome. 2. Describe the discipline and child handling techniques to be used while the child is in placement. 3. Describe the plan of supervision for the child while in placement. 4. Describe the plan for acceptable activities such as baby sitting, routine household tasks, privileges etc. 5. Justify the tasks and/or additional expenses provided by the caregiver that justifies the Determination of Care (DOC) Supplement. Describe all specific activities required by the caregiver to meet the individual needs of the child. 6. Describe activities provided by the caregiver to promote educational stability and success for the child. If the youth is age 14 or older, detail the independent living preparation activities the foster parent/relative caregiver will provide to assist the youth. (See FOM 722-6 Independent Living Preparation.)   MACROBUTTON [b2] "Click Here and Type"  C. Individual Child ActivitiesDescribe all activities to achieve the permanency planning goal. List for each child, the service goals and action steps, time frame for achieving, and expected outcome. Goals should address areas prioritized on Child Needs and Strengths Assessment and activities of daily living (if applicable). Identify what the agency and the provider need to do to meet these specific needs. Address sibling visitation, if siblings are split. When separated, the relationship between siblings must be maintained by detailed plan of visits, phone calls and letters. Outline the specific sibling visitation plan including: l Dates of visits. l Location of visits. l Duration of visits. l All other ongoing sibling interactions. For each ward age 14 or older (including those wards who become 14 years of age during the report period), include a description of the programs and services which will assist the youth to prepare for transition to a state of functional independence or the ability to take care of oneself physically, socially, economically and psychologically. Identify where, how and by whom these services are to be provided. (See FOM 722-6, Independent Living Preparation).   MACROBUTTON [b2] "Click Here and Type"  D. Foster Care Worker Activities1. Identify the supports to be provided to the child and foster parents / relative caregiver by the foster care worker. 2. State proposed foster care worker contact with the family, child, caregivers, and service provider, if applicable. If the youth is age 14 or older, detail the independent living preparation activities that the worker will provide to assist the youth. (See FOM 722-6 Independent Living Preparation.) If siblings are in separate placements, identify the ongoing efforts the FC worker will make to place siblings within the same home. Identify all required FC worker actions to ensure educational stability for the child. Identify foster parent/relative caregiver needs related to caring for the child, if any, and specify plan to address the need.   MACROBUTTON [b2] "Click Here and Type"  Report Date: REF Date2 \* MERGEFORMAT  Report Period Begin Date: REF BeginDate \* MERGEFORMAT  End Date: REF EndDate \* MERGEFORMAT  The development of this plan was negotiated with: (also list those individuals who were unavailable to participate in the development and why not): Youth age 14 and older must be involved in the development of the plan and be responsible for its implementation with the assistance of identified individuals. Upon clicking in the Name and Title field below, a question box allows addition of a signature line for Youth Age 14 and Older, if applicable and/or additional Other Agency Worker Name rows. If youth is unavailable or refuses to sign PATP, worker must identify and document additional action needed to secure the youth s participation in service planning and compliance with PATP.  MACROBUTTON [b2] "Click Here and Type"  Youth Name: (Age 14 and Older) FORMTEXT        Youth Signature:  Date:  FORMTEXT       Youth Name: (Age 14 and Older) FORMTEXT        Youth Signature:  Date:  FORMTEXT       Youth Name: (Age 14 and Older) FORMTEXT        Youth Signature:  Date:  FORMTEXT       Name and Title: FORMTEXT       Signature: Date:  FORMTEXT       Name and Title: FORMTEXT       Signature: Date:  FORMTEXT       Name and Title: FORMTEXT       Signature: Date:  FORMTEXT       Name and Title: FORMTEXT       Signature: Date:  FORMTEXT       DHS Local Office Name: FORMTEXT        DHS Local Office Approval: Name and Title: FORMTEXT       Signature: Date:  FORMTEXT      Distribution of Case Plan  MACROBUTTON [b2] "Click Here and Type"  The local office shall approve, or disapprove, in writing, the PWSP for a child in placement agency foster care or residential care. The Placement Agency Foster Care (PAFC) contractor is responsible for all elements of the service plan in cases 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 PAFC agency has not accepted total case responsibility. The report from the local office should not duplicate the PAFC agency report, but should address those areas for which the PAFC agency is not responsible per the DHS-3600 contract. Signing the PWSP submitted by the PAFC agency indicates approval. The approved PWSP is to be returned to the PAFC 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 PAFC 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 PAFC 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 Urban/Field Office. If Urban/Field Office is unable to intervene successfully, then the Child Welfare Contract Compliance Unit is to be involved. (See FOM 914, Monitoring Worker Responsibilities for more information.) 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-68 (Rev. 9-11) Previous edition obsolete. MSWord  PAGE 1 DHS-68 (Rev. 5-11) Previous edition obsolete. MS Word  PAGE 2 DHS-68 (Rev. 9-11) Previous edition obsolete. 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Child DevelopmentDf AD=Alcoh/Drg Abuse RehabOT=Other Program NeedsJT=Job Trng/Empl AssistFR=Reunification Svs DC=Day CarePS=Parenting Skills TrngMH=Mental Health SvsMD=Medical SvsIL=Independent Living Svs ED=EducationTH=Individual/Group TherHS=Homemkr Svs or Par AidDV=Dom Violence ProgFC=Fam Couns/Outrch Couns WP=WraparoundjD6jDjDjDdDfD1 = Service Unavailable 2 = Continue Services 3 = Refused Services 1=Svs Unavlbl 2=Cont Svs 3=Refusd Svs4=NewDf S=Satisfact U=UnsatisfjD$$If !v h#v2 #vp#v$ #v#v*#v#v #v *:V lO952 5p5$ 55*55 5 */ /  / / / / / 4a ytN,vD6Text11PDf C1. Medical/Physical Health C2. Mental Health and Well-Being*C3. Fam and Unrel Caregiver Rel/Attachment C4. EducationC5. Substance UseC6. Sexual BehaviorC7. Life Skills#C8. Peer/Adult Social RelationshipsC9. Cultural/Comm IdentC10. Ind LivingC11. Soc/Emot DevelopC12. Cog/Intell DevelopC13. Phys/Motor DevelopC14. Lang/Comm SkillsC15. Child DevelopmentDf AD=Alcoh/Drg Abuse RehabOT=Other Program NeedsJT=Job Trng/Empl AssistFR=Reunification Svs DC=Day CarePS=Parenting Skills TrngMH=Mental Health SvsMD=Medical SvsIL=Independent Living Svs ED=EducationTH=Individual/Group TherHS=Homemkr Svs or Par AidDV=Dom Violence ProgFC=Fam Couns/Outrch Couns WP=WraparoundjD6jDjDjDdDfD1 = Service Unavailable 2 = Continue Services 3 = Refused Services 1=Svs Unavlbl 2=Cont Svs 3=Refusd Svs4=NewDf S=Satisfact U=UnsatisfjD$$If !v h#v2 #vp#v$ #v#v*#v#v #v *:V lO952 5p5$ 55*55 5 */ /  / / / / / 4a ytN,vD6Text11PDf C1. Medical/Physical Health C2. Mental Health and Well-Being*C3. Fam and Unrel Caregiver Rel/Attachment C4. EducationC5. Substance UseC6. Sexual BehaviorC7. Life Skills#C8. Peer/Adult Social RelationshipsC9. Cultural/Comm IdentC10. Ind LivingC11. Soc/Emot DevelopC12. Cog/Intell DevelopC13. Phys/Motor DevelopC14. Lang/Comm SkillsC15. Child DevelopmentDf AD=Alcoh/Drg Abuse RehabOT=Other Program NeedsJT=Job Trng/Empl AssistFR=Reunification Svs DC=Day CarePS=Parenting Skills TrngMH=Mental Health SvsMD=Medical SvsIL=Independent Living Svs ED=EducationTH=Individual/Group TherHS=Homemkr Svs or Par AidDV=Dom Violence ProgFC=Fam Couns/Outrch Couns WP=WraparoundjD6jDjDjDdDfD1 = Service Unavailable 2 = Continue Services 3 = Refused Services 1=Svs Unavlbl 2=Cont Svs 3=Refusd Svs4=NewDf S=Satisfact U=UnsatisfjD$$If !v h#v2 #vp#v$ #v#v*#v#v #v *:V lO952 5p5$ 55*55 5 */ /  / / / / / 4a ytN,vD6Text11PDf C1. Medical/Physical Health C2. Mental Health and Well-Being*C3. Fam and Unrel Caregiver Rel/Attachment C4. EducationC5. Substance UseC6. Sexual BehaviorC7. Life Skills#C8. Peer/Adult Social RelationshipsC9. Cultural/Comm IdentC10. Ind LivingC11. Soc/Emot DevelopC12. Cog/Intell DevelopC13. Phys/Motor DevelopC14. Lang/Comm SkillsC15. Child DevelopmentDf AD=Alcoh/Drg Abuse RehabOT=Other Program NeedsJT=Job Trng/Empl AssistFR=Reunification Svs DC=Day CarePS=Parenting Skills TrngMH=Mental Health SvsMD=Medical SvsIL=Independent Living Svs ED=EducationTH=Individual/Group TherHS=Homemkr Svs or Par AidDV=Dom Violence ProgFC=Fam Couns/Outrch Couns WP=WraparoundjD6jDjDjDdDfD1 = Service Unavailable 2 = Continue Services 3 = Refused Services 1=Svs Unavlbl 2=Cont Svs 3=Refusd Svs4=NewDf S=Satisfact U=UnsatisfjD$$If !v h#v2 #vp#v$ #v#v*#v#v #v *:V lO952 5p5$ 55*55 5 */ /  / / / / / 4a ytN,vD6Text11PDf C1. Medical/Physical Health C2. Mental Health and Well-Being*C3. Fam and Unrel Caregiver Rel/Attachment C4. EducationC5. Substance UseC6. Sexual BehaviorC7. Life Skills#C8. Peer/Adult Social RelationshipsC9. Cultural/Comm IdentC10. Ind LivingC11. Soc/Emot DevelopC12. Cog/Intell DevelopC13. Phys/Motor DevelopC14. Lang/Comm SkillsC15. Child DevelopmentDf AD=Alcoh/Drg Abuse RehabOT=Other Program NeedsJT=Job Trng/Empl AssistFR=Reunification Svs DC=Day CarePS=Parenting Skills TrngMH=Mental Health SvsMD=Medical SvsIL=Independent Living Svs ED=EducationTH=Individual/Group TherHS=Homemkr Svs or Par AidDV=Dom Violence ProgFC=Fam Couns/Outrch Couns WP=WraparoundjD6jDjDjDdDfD1 = Service Unavailable 2 = Continue Services 3 = Refused Services 1=Svs Unavlbl 2=Cont Svs 3=Refusd Svs4=NewDf S=Satisfact U=UnsatisfjD$$If !v h#v2 #vp#v$ #v#v*#v#v #v *:V lO952 5p5$ 55*55 5 */ /  / / / / / 4a ytN,vD6Text11PDf C1. Medical/Physical Health C2. Mental Health and Well-Being*C3. Fam and Unrel Caregiver Rel/Attachment C4. EducationC5. Substance UseC6. Sexual BehaviorC7. Life Skills#C8. Peer/Adult Social RelationshipsC9. Cultural/Comm IdentC10. Ind LivingC11. Soc/Emot DevelopC12. Cog/Intell DevelopC13. Phys/Motor DevelopC14. Lang/Comm SkillsC15. Child DevelopmentDf AD=Alcoh/Drg Abuse RehabOT=Other Program NeedsJT=Job Trng/Empl AssistFR=Reunification Svs DC=Day CarePS=Parenting Skills TrngMH=Mental Health SvsMD=Medical SvsIL=Independent Living Svs ED=EducationTH=Individual/Group TherHS=Homemkr Svs or Par AidDV=Dom Violence ProgFC=Fam Couns/Outrch Couns WP=WraparoundjD6jDjDjDdDfD1 = Service Unavailable 2 = Continue Services 3 = Refused Services 1=Svs Unavlbl 2=Cont Svs 3=Refusd Svs4=NewDf S=Satisfact U=UnsatisfjD$$If !v h#v2 #vp#v$ #v#v*#v#v #v *:V lO952 5p5$ 55*55 5 */ /  / / / / / 4a ytN,vD6Text11PDf C1. Medical/Physical Health C2. Mental Health and Well-Being*C3. Fam and Unrel Caregiver Rel/Attachment C4. EducationC5. Substance UseC6. Sexual BehaviorC7. Life Skills#C8. Peer/Adult Social RelationshipsC9. Cultural/Comm IdentC10. Ind LivingC11. Soc/Emot DevelopC12. Cog/Intell DevelopC13. Phys/Motor DevelopC14. Lang/Comm SkillsC15. Child DevelopmentDf AD=Alcoh/Drg Abuse RehabOT=Other Program NeedsJT=Job Trng/Empl AssistFR=Reunification Svs DC=Day CarePS=Parenting Skills TrngMH=Mental Health SvsMD=Medical SvsIL=Independent Living Svs ED=EducationTH=Individual/Group TherHS=Homemkr Svs or Par AidDV=Dom Violence ProgFC=Fam Couns/Outrch Couns WP=WraparoundjD6jDjDjDdDfD1 = Service Unavailable 2 = Continue Services 3 = Refused Services 1=Svs Unavlbl 2=Cont Svs 3=Refusd Svs4=NewDf S=Satisfact U=UnsatisfjD$$If !v h#v2 #vp#v$ #v#v*#v#v #v *:V lO952 5p5$ 55*55 5 */ /  / / / / / 4a ytN,vD6Text11PDf C1. Medical/Physical Health C2. Mental Health and Well-Being*C3. Fam and Unrel Caregiver Rel/Attachment C4. EducationC5. Substance UseC6. Sexual BehaviorC7. Life Skills#C8. Peer/Adult Social RelationshipsC9. Cultural/Comm IdentC10. Ind LivingC11. Soc/Emot DevelopC12. Cog/Intell DevelopC13. Phys/Motor DevelopC14. Lang/Comm SkillsC15. Child DevelopmentDf AD=Alcoh/Drg Abuse RehabOT=Other Program NeedsJT=Job Trng/Empl AssistFR=Reunification Svs DC=Day CarePS=Parenting Skills TrngMH=Mental Health SvsMD=Medical SvsIL=Independent Living Svs ED=EducationTH=Individual/Group TherHS=Homemkr Svs or Par AidDV=Dom Violence ProgFC=Fam Couns/Outrch Couns WP=WraparoundjD6jDjDjDdDfD1 = Service Unavailable 2 = Continue Services 3 = Refused Services 1=Svs Unavlbl 2=Cont Svs 3=Refusd Svs4=NewDf S=Satisfact U=UnsatisfjD$$If !v h#v2 #vp#v$ #v#v*#v#v #v *:V lO952 5p5$ 55*55 5 */ /  / / / / / 4a ytN,vD6Text11PDf C1. Medical/Physical Health C2. Mental Health and Well-Being*C3. Fam and Unrel Caregiver Rel/Attachment C4. EducationC5. Substance UseC6. Sexual BehaviorC7. Life Skills#C8. Peer/Adult Social RelationshipsC9. Cultural/Comm IdentC10. Ind LivingC11. Soc/Emot DevelopC12. Cog/Intell DevelopC13. Phys/Motor DevelopC14. Lang/Comm SkillsC15. Child DevelopmentDf AD=Alcoh/Drg Abuse RehabOT=Other Program NeedsJT=Job Trng/Empl AssistFR=Reunification Svs DC=Day CarePS=Parenting Skills TrngMH=Mental Health SvsMD=Medical SvsIL=Independent Living Svs ED=EducationTH=Individual/Group TherHS=Homemkr Svs or Par AidDV=Dom Violence ProgFC=Fam Couns/Outrch Couns WP=WraparoundjD6jDjDjDdDfD1 = Service Unavailable 2 = Continue Services 3 = Refused Services 1=Svs Unavlbl 2=Cont Svs 3=Refusd Svs4=NewDf S=Satisfact U=UnsatisfjD$$If !v h#v2 #vp#v$ #v#v*#v#v #v *:V lO952 5p5$ 55*55 5 */ /  / / / / / 4a ytN,vD6Text11PDf C1. Medical/Physical Health C2. Mental Health and Well-Being*C3. Fam and Unrel Caregiver Rel/Attachment C4. EducationC5. Substance UseC6. Sexual BehaviorC7. Life Skills#C8. Peer/Adult Social RelationshipsC9. Cultural/Comm IdentC10. Ind LivingC11. Soc/Emot DevelopC12. Cog/Intell DevelopC13. Phys/Motor DevelopC14. Lang/Comm SkillsC15. Child DevelopmentDf AD=Alcoh/Drg Abuse RehabOT=Other Program NeedsJT=Job Trng/Empl AssistFR=Reunification Svs DC=Day CarePS=Parenting Skills TrngMH=Mental Health SvsMD=Medical SvsIL=Independent Living Svs ED=EducationTH=Individual/Group TherHS=Homemkr Svs or Par AidDV=Dom Violence ProgFC=Fam Couns/Outrch Couns WP=WraparoundjD6jDjDjDdDfD1 = Service Unavailable 2 = Continue Services 3 = Refused Services 1=Svs Unavlbl 2=Cont Svs 3=Refusd Svs4=NewDf S=Satisfact U=UnsatisfjD$$If !v h#v2 #vp#v$ #v#v*#v#v #v *:V lO952 5p5$ 55*55 5 */ /  / / / / / 4a ytN,vD6Text11PDf C1. Medical/Physical Health C2. Mental Health and Well-Being*C3. Fam and Unrel Caregiver Rel/Attachment C4. EducationC5. Substance UseC6. Sexual BehaviorC7. Life Skills#C8. Peer/Adult Social RelationshipsC9. Cultural/Comm IdentC10. Ind LivingC11. Soc/Emot DevelopC12. Cog/Intell DevelopC13. Phys/Motor DevelopC14. Lang/Comm SkillsC15. Child DevelopmentDf AD=Alcoh/Drg Abuse RehabOT=Other Program NeedsJT=Job Trng/Empl AssistFR=Reunification Svs DC=Day CarePS=Parenting Skills TrngMH=Mental Health SvsMD=Medical SvsIL=Independent Living Svs ED=EducationTH=Individual/Group TherHS=Homemkr Svs or Par AidDV=Dom Violence ProgFC=Fam Couns/Outrch Couns WP=WraparoundjD6jDjDjDdDfD1 = Service Unavailable 2 = Continue Services 3 = Refused Services 1=Svs Unavlbl 2=Cont Svs 3=Refusd Svs4=NewDf S=Satisfact U=UnsatisfjD$$If !v h#v2 #vp#v$ #v#v*#v#v #v *:V lO952 5p5$ 55*55 5 */ /  / / / / / 4a ytN,vD6Text11PDf C1. Medical/Physical Health C2. Mental Health and Well-Being*C3. Fam and Unrel Caregiver Rel/Attachment C4. EducationC5. Substance UseC6. Sexual BehaviorC7. Life Skills#C8. Peer/Adult Social RelationshipsC9. Cultural/Comm IdentC10. Ind LivingC11. Soc/Emot DevelopC12. Cog/Intell DevelopC13. Phys/Motor DevelopC14. Lang/Comm SkillsC15. 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