CMS-07-021/023 - Los Angeles County Department of Children and ...

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PROSPECTIVE CONTRACTOR LIST OF CONTRACTS Contractor’s Name: _____________________________ REQUIRED FORMS – FORM 6 List of all public entities for which the Contractor has provided service within the last three (3) years. Use additional sheets if necessary. 1. Name of Firm Address of Firm Contact Person Telephone # Fax # ( ) ( ) Name or Contract No. # of Years / Term of Contract Type of Service Dollar Amt. 2. Name of Firm Address of Firm Contact Person Telephone # Fax # ( ) ( ) Name or Contract No. # of Years / Term of Contract Type of Service Dollar Amt. 3. Name of Firm Address of Firm Contact Person Telephone # Fax # ( ) ( ) Name or Contract No. # of Years / Term of Contract Type of Service Dollar Amt. 4. Name of Firm Address of Firm Contact Person Telephone # Fax # ( ) ( ) Name or Contract No. # of Years / Term of Contract Type of Service Dollar Amt. 5. Name of Firm Address of Firm Contact Person Telephone # Fax # ( ) ( ) Name or Contract No. # of Years / Term of Contract Type of Service Dollar Amt.
PROSPECTIVE CONTRACTOR LIST OF TERMINATED CONTRACTS Contractor’s Name: _____________________________ List all contracts that have been terminated with the past three (3) years. 1. Name of Firm Address of Firm Contact Person Telephone # Fax # ( ) ( ) Name or Contract No. Reason for Termination: 2. Name of Firm Address of Firm Contact Person Telephone # Fax # ( ) ( ) Name or Contract No. Reason for Termination: 3. Name of Firm Address of Firm Contact Person Telephone # Fax # ( ) ( ) Name or Contract No. Reason for Termination: 4. Name of Firm Address of Firm Contact Person Telephone # Fax # ( ) ( ) Name or Contract No. Reason for Termination: 5. Name of Firm Address of Firm Contact Person Telephone # Fax # ( ) ( ) Name or Contract No. Reason for Termination: REQUIRED FORMS - FORM 7
Page 1 and 2: DEPARTMENT OF CHILDREN AND FAMILY S
Page 3 and 4: REQUEST FOR STATEMENT OF QUALIFICAT
Page 5 and 6: 1.0 INTRODUCTION 1.1 Preamble For o
Page 7 and 8: COUNTY agencies and their partners
Page 9 and 10: 1.3 DCFS Mission Statement DCFS wil
Page 11 and 12: 2.0 GENERAL INFORMATION 2.0 Scope o
Page 13 and 14: 2.4.1.2 Prospective Contractor must
Page 15 and 16: old for 30 days or less; (3) provid
Page 17 and 18: Contractor protest. In all cases, t
Page 19 and 20: 2.19 Conflict of Interest No County
Page 21 and 22: submit evidence at that hearing. Af
Page 23 and 24: solicitation may result in the pros
Page 25 and 26: County’s contracting process by c
Page 27 and 28: 2.33 Contractor’s Charitable Cont
Page 29 and 30: 3.0 Instructions to Prospective Con
Page 31 and 32: The request for a Solicitation Requ
Page 33 and 34: 3.7.1 Language The SOQ and all docu
Page 35 and 36: coverage should the prospective Con
Page 37 and 38: 3.8.6 Please refer to Section 3.0 I
Page 39 and 40: 4.0 SOQ REVIEW/SELECTION/QUALIFICAT
Page 41 and 42: The Department will execute Board o
Page 43 and 44: 19 20 21 22 List of Required Forms
Page 45 and 46: CONTRACTOR’S ORGANIZATION QUESTIO
Page 47 and 48: CONTRACTOR’S ORGANIZATION QUESTIO
Page 49 and 50: VENDOR’S EEO CERTIFICATION REQUIR
Page 51: REQUIRED FORMS - FORM 5 FAMILIARITY
Page 55 and 56: REQUIRED FORMS - FORM 9 COUNTY OF L
Page 57 and 58: REQUIRED FORMS - FORM 11 OFFER TO P
Page 59 and 60: CERTIFICATION OF FISCAL COMPLIANCE
Page 61 and 62: LIST OF COMMITMENTS Legal Name of A
Page 63 and 64: REQUIRED FORMS - FORM 17 CONTRACTOR
Page 65 and 66: CERTIFIED FOSTER PARENT CONFIDENTIA
Page 67 and 68: CONTRACTOR’S EMPLOYEE ACKNOWLEDGE
Page 69 and 70: Type of program: Foster Family Agen
Page 71 and 72: CONTRACTOR’S NAME: CONTRACT NO. N
Page 73 and 74: REQUEST FOR STATEMENT OF QUALIFICAT
Page 75 and 76: TRANSMITTAL FORM TO REQUEST A RFSQ
Page 77 and 78: APPENDIX E LISTING OF CONTRACTORS D
Page 79 and 80: SAMPLE CONTRACT COUNTY OF LOS ANGEL
Page 81 and 82: LIST OF EXHIBITS SAMPLE CONTRACT Ex
Page 83 and 84: SAMPLE CONTRACT COUNTY OF LOS ANGEL
Page 85 and 86: SAMPLE CONTRACT Exhibit A-IX Requir
Page 87 and 88: as a single process. SAMPLE CONTRAC
Page 89 and 90: SAMPLE CONTRACT 2.27 “Foster Care
Page 91 and 92: SAMPLE CONTRACT written in accordan
Page 93 and 94: SAMPLE CONTRACT Such insurance shal
Page 95 and 96: SAMPLE CONTRACT 6.0 INSURANCE COVER
Page 97 and 98: SAMPLE CONTRACT partial, and supple
Page 99 and 100: SAMPLE CONTRACT 7.15 Provided that
Page 101 and 102: 10.0 COUNTY’S RESPONSIBILITY SAMP
Page 103 and 104:
SAMPLE CONTRACT 10.13 The CSWs shal
Page 105 and 106:
SAMPLE CONTRACT and/or Certified Fo
Page 107 and 108:
SAMPLE CONTRACT Investigation/Monit
Page 109 and 110:
SAMPLE CONTRACT will also invite CO
Page 111 and 112:
SAMPLE CONTRACT 18.4 The CONTRACTOR
Page 113 and 114:
SAMPLE CONTRACT management review,
Page 115 and 116:
SAMPLE CONTRACT 20.2 CONTRACTOR and
Page 117 and 118:
SAMPLE CONTRACT 22.2 CONTRACTOR her
Page 119 and 120:
SAMPLE CONTRACT notice by the CONTR
Page 121 and 122:
SAMPLE CONTRACT COUNTY’s prior wr
Page 123 and 124:
SAMPLE CONTRACT FOSTER FAMILY AGENC
Page 125 and 126:
SAMPLE CONTRACT to the Contract, wh
Page 127 and 128:
SAMPLE CONTRACT governing or impact
Page 129 and 130:
8.0 GRIEVANCES SAMPLE CONTRACT term
Page 131 and 132:
SAMPLE CONTRACT 11.1.2 For purposes
Page 133 and 134:
SAMPLE CONTRACT CONTRACTOR will int
Page 135 and 136:
SAMPLE CONTRACT conduct a hearing w
Page 137 and 138:
SAMPLE CONTRACT CONTRACTOR warrants
Page 139 and 140:
SAMPLE CONTRACT solely of CONTRACTO
Page 141 and 142:
1015, attached hereto as Exhibit L.
Page 143 and 144:
SAMPLE CONTRACT 30.1.3 CONTRACTOR m
Page 145 and 146:
SAMPLE CONTRACT not limited to, the
Page 147 and 148:
SAMPLE CONTRACT amounts COUNTY clai
Page 149 and 150:
SAMPLE CONTRACT COUNTY OF LOS ANGEL
Page 151 and 152:
COUNTY OF LOS ANGELES DEPARMENTS OF
Page 153 and 154:
PART A: INTRODUCTION 1.0 PREAMBLE E
Page 155 and 156:
EXHIBIT A COUNTY agencies and thei
Page 157 and 158:
EXHIBIT A (Health and Safety Code),
Page 159 and 160:
PART B: TARGET DEMOGRAPHICS 1.0 TAR
Page 161 and 162:
1.0 SAFETY EXHIBIT A PERFORMANCE OU
Page 163 and 164:
1.1.7 Required Services by CONTRACT
Page 165 and 166:
EXHIBIT A The CONTRACTOR shall Moni
Page 167 and 168:
PROGRAM TARGET GROUP: Placed Childr
Page 169 and 170:
EXHIBIT A the fullest extent possib
Page 171 and 172:
EXHIBIT A Monitor for Compliance th
Page 173 and 174:
3.0 WELL-BEING EXHIBIT A PERFORMANC
Page 175 and 176:
EXHIBIT A participation in treatmen
Page 177 and 178:
EXHIBIT A individuals to the extent
Page 179 and 180:
EXHIBIT A 88068.2, 88068.3, and 880
Page 181 and 182:
EXHIBIT A objectives appropriate to
Page 183 and 184:
EXHIBIT A The CONTRACTOR shall prov
Page 185 and 186:
3.7.4 Monetary Consequences EXHIBIT
Page 187 and 188:
EXHIBIT A Days. After 14 Days, the
Page 189 and 190:
EXHIBIT A The CONTRACTOR shall have
Page 191 and 192:
EXHIBIT A for the Placed Child to r
Page 193 and 194:
EXHIBIT A specified in the Needs an
Page 195 and 196:
EXHIBIT A The CONTRACTOR shall Moni
Page 197 and 198:
FOSTER YOUTH BILL OF RIGHTS EXHIBIT
Page 199 and 200:
EXHIBIT A-I 19. Residents have the
Page 201 and 202:
EXHIBIT A-I Reprise 25. Residents s
Page 203 and 204:
INTENTIONALLY LEFT BLANK EXHIBIT A-
Page 205 and 206:
EXHIBIT A-IVa STATE OF CALIFORNIA
Page 207:
FOSTER CHILD’S NEEDS AND CASE PLA
Page 225 and 226:
AGENCY - GROUP HOME AGREEMENT Child
Page 227 and 228:
EXHIBIT A-VIII SPECIAL INCIDENT REP
Page 229 and 230:
5. SERIOUS INJURY, ILLNESS OR ACCID
Page 231 and 232:
EXHIBIT A-VIII 10. SIGNIFICANT INCI
Page 233 and 234:
SCREENING REQUIREMENT PERIODICITY S
Page 235 and 236:
Anticonvulsant medications, when pr
Page 237 and 238:
Dr. faxes pages 1 & 2 of PMAF to th
Page 239 and 240:
EXHIBIT A-X 2. Contact the physicia
Page 241 and 242:
EXHIBIT A-X 1. Instruct the caregiv
Page 243 and 244:
APPROVAL LEVELS Section Level Appro
Page 245 and 246:
(CSW completes top section) Los Ang
Page 247 and 248:
D. Please attach a list of the foll
Page 249 and 250:
TO THE HEADS OF EXECUTIVE DEPARTMEN
Page 251 and 252:
implementation of individual provis
Page 253 and 254:
E. Negotiation and Approval of Indi
Page 255 and 256:
. The restraints or requirements im
Page 257 and 258:
objectives of the organization are
Page 259 and 260:
distribution base. The result of th
Page 261 and 262:
special cost studies (such as an en
Page 263 and 264:
other activity. The bases must be e
Page 265 and 266:
g. The results of each negotiation
Page 267 and 268:
49. Training costs 50. Transportati
Page 269 and 270:
e. Costs identified in subparagraph
Page 271 and 272:
compensation for employees on feder
Page 273 and 274:
(3) Excise taxes on accumulated fun
Page 275 and 276:
with certainty as to time, intensit
Page 277 and 278:
appeals, antitrust suits, or the pr
Page 279 and 280:
(1) Donated or volunteer services m
Page 281 and 282:
(1) Capital expenditures for genera
Page 283 and 284:
(2) "Idle facilities" means complet
Page 285 and 286:
enovations, alterations, equipment,
Page 287 and 288:
. For non-profit organizations subj
Page 289 and 290:
already required or maintained. Als
Page 291 and 292:
see paragraphs 37., Professional se
Page 293 and 294:
41. Recruiting costs. a. Subject to
Page 295 and 296:
continued to own the property. This
Page 297 and 298:
48. Termination costs applicable to
Page 299 and 300:
(3) Fees charges by the educational
Page 301 and 302:
e. Foreign travel. Direct charges f
Page 303 and 304:
Southern Research Institute, Birmin
Page 305 and 306:
A-C Handbook Page 1 AUDITOR-CONTROL
Page 307 and 308:
A-C Handbook Page 3 2.2 Cash Receip
Page 309 and 310:
A-C Handbook Page 5 If a Payroll Re
Page 311 and 312:
A-C Handbook Page 7 Outside Meals -
Page 313 and 314:
A-C Handbook Page 9 CONTRACTOR shal
Page 315 and 316:
A-C Handbook Page 11 2.3 Petty Cash
Page 317 and 318:
A-C Handbook Page 13 Salaried emplo
Page 319 and 320:
A-C Handbook Page 15 Indirect Cost
Page 321 and 322:
A-C Handbook Page 17 2.3 Acceptable
Page 323 and 324:
A-C Handbook Page 19 D. UNALLOWABLE
Page 325 and 326:
EXHIBIT C-II AUDITOR-CONTROLLER/DEP
Page 327 and 328:
• California Code of Regulations,
Page 329 and 330:
If CONTRACTOR and A-C/DCFS hold a p
Page 331 and 332:
XIV. Final Report to the Board of S
Page 333 and 334:
EXHIBIT D Cont. I understand that I
Page 335 and 336:
EXHIBIT D-I Cont. I understand that
Page 337 and 338:
24. Equipment Leases 25. Depreciati
Page 339 and 340:
Report all costs related to telepho
Page 341 and 342:
EXHIBIT E D. Total Un-Expended AFDC
Page 343 and 344:
EXHIBIT F (D) If the State Departme
Page 345 and 346:
EXHIBIT F (C) Individuals who are e
Page 347 and 348:
EXHIBIT F subdivision (g). The Stat
Page 349 and 350:
EXHIBIT F processing. (B) Upon requ
Page 351 and 352:
EXHIBIT F self-addressed envelope f
Page 353 and 354:
EXHIBIT F shall disclose that clien
Page 355 and 356:
EXHIBIT F state, would have been pu
Page 357 and 358:
statement, fingerprints and photogr
Page 359 and 360:
Name, Address and Telephone Number
Page 361 and 362:
EXHIBIT G If a CSW or SCSW has any
Page 363 and 364:
EXHIBIT G 10) minute orders and cou
Page 365 and 366:
0500-501.20 (Rev 12/02) EXHIBIT G 4
Page 367 and 368:
EXHIBIT G See Procedural Guide 0200
Page 369 and 370:
EXHIBIT G that the research will no
Page 371 and 372:
EXHIBIT G detrimental to the safety
Page 373 and 374:
EXHIBIT G Procedural Guide 0500-504
Page 375 and 376:
EXHIBIT H of changes to the plan. (
Page 377 and 378:
EXHIBIT I (e) The child's caretaker
Page 379 and 380:
EXHIBIT I CSW in Concurrent Plannin
Page 381 and 382:
Procedures A. WHEN: A CHILD IS DETA
Page 383 and 384:
B. WHEN: A CHILD IS IN OUT-OF-HOME
Page 385 and 386:
Dependency Investigator CSW Respons
Page 387 and 388:
EXHIBIT I For offices who have impl
Page 389 and 390:
EXHIBIT I FB1 Addendum, Family Back
Page 391 and 392:
CHILD WELFARE SERVICES PROGRAM 31-4
Page 393 and 394:
Department of the Treasury Internal
Page 395 and 396:
DCFS FOSTER FAMILY AGENCY CONTRACT
Page 397 and 398:
EXHIBIT N medication authorizations
Page 399 and 400:
EXHIBIT N 5. The DCFS Division Chie
Page 401 and 402:
EXHIBIT O 1. The lesser number is a
Page 403 and 404:
EXHIBIT O COUNTY OF LOS ANGELES CON
Page 405 and 406:
CONTRACTOR’S CERTIFICATION OF COM
Page 407 and 408:
F I F I F I F I EXHIBIT R F O R Y O
Page 409 and 410:
8. Does the child receive the sport
Page 411 and 412:
EXHIBIT R 33. Is the child given th
Page 413 and 414:
Every baby deserves a chance for a
Page 415 and 416:
Es mejor que las mujeres busquen ay
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• Llámenos para recibir informac
Page 419 and 420:
A. WHEN: A FAD INDICATES A POTENTIA
Page 421 and 422:
EXHIBIT T O/P Collection EW 4. INVA
Page 423 and 424:
EXHIBIT T NOTE: Overpayment recover
Page 425 and 426:
Reconciliation EW 3. Receive the Ba
Page 427 and 428:
Overpayment Recovery Unit ES WHO HO
Page 429 and 430:
CHARITABLE CONTRIBUTIONS CERTIFICAT
Page 431 and 432:
SERVICE DELIVERY SITES Foster Famil
Page 433 and 434:
TABLE OF CONTENTS INTRODUCTION/SUMM
Page 435 and 436:
PURPOSE/PHILOSOPHY STATEMENT These
Page 437 and 438:
TEAMING PROCESS Family-Centered Tea
Page 439 and 440:
COURT ORDERS Oftentimes, the judici
Page 441 and 442:
First 24 Hours Child removed from p
Page 443 and 444:
FAMILY VISITATION PLAN Prior to the
Page 445 and 446:
• Whether or not the parent is a
Page 447 and 448:
• Maintain objectivity, and remai
Page 449 and 450:
Judicial Officers Judicial Officers
Page 451 and 452:
Unless the FVP specifically states
Page 453 and 454:
the visitation objectives. In addit
Page 455 and 456:
Sexual Abuse Permanency Transportat
Page 457 and 458:
SUBCOMMITTEE MEMBERS The Drafting S
Page 459 and 460:
EXHIBIT Y of information, including
Page 461 and 462:
EXHIBIT Y accounting of Disclosures
Page 463 and 464:
DISCHARGE SUMMARY FOR DCFS: FOSTER
Page 465 and 466:
INTENTIONALLY LEFT BLANK EXHIBIT BB
Page 467 and 468:
SAMPLE CONTRACT COUNTY OF LOS ANGEL
Page 469 and 470:
10.0 COMPLIANCE WITH CIVIL RIGHTS L
Page 471 and 472:
Exhibit T Overpayments Exhibit U Gr
Page 473 and 474:
WHEREAS, CONTRACTOR warrants that i
Page 475 and 476:
2.0 DEFINITIONS Exhibit T Overpayme
Page 477 and 478:
2.16 “Do Not Refer Status” or
Page 479 and 480:
2.31 “Pool Rate” - means the ra
Page 481 and 482:
notify COUNTY of such change. COUNT
Page 483 and 484:
equivalent providing the CONTRACTOR
Page 485 and 486:
a bed open for a Placed Child, CONT
Page 487 and 488:
7.14 CONTRACTOR may appeal the fina
Page 489 and 490:
9.2 If CONTRACTOR’s staff qualify
Page 491 and 492:
10.11 COUNTY Workers shall provide
Page 493 and 494:
13.0 FEES 12.1 CONTRACTOR shall mai
Page 495 and 496:
Exhibit N, DCFS/Probation Group Hom
Page 497 and 498:
16.0 FINANCIAL REPORTING 16.1 CONTR
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closing summary of CONTRACTOR's rec
Page 501 and 502:
including but not limited to, the U
Page 503 and 504:
19.6 Nothing herein precludes COUNT
Page 505 and 506:
entirety; or (2) reduced in accorda
Page 507 and 508:
accounted for and that unspent fund
Page 509 and 510:
omissions, resulting from its perfo
Page 511 and 512:
County of Los Angeles - Department
Page 513 and 514:
4.0 BUDGET REDUCTIONS In the event
Page 515 and 516:
6.2.3 The assurance that all employ
Page 517 and 518:
CONTRACTOR hereby assures that it w
Page 519 and 520:
12.3 CONTRACTOR shall comply with a
Page 521 and 522:
modify, deny or adopt the proposed
Page 523 and 524:
minimum waiting time for clearance.
Page 525 and 526:
County of Los Angeles Department of
Page 527 and 528:
eject children for placement consis
Page 529 and 530:
30.0 DISCLOSURE OF INFORMATION 30.1
Page 531 and 532:
33.7 CONTRACTOR shall obtain the fo
Page 533 and 534:
35.0 TERMINATION FOR CONVENIENCE 35
Page 535 and 536:
CONTRACTOR receives, has access to,
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COUNTY OF LOS ANGELES DEPARTMENT OF
Page 539 and 540:
COUNTY OF LOS ANGELES DEPARTMENTS O
Page 541 and 542:
• Safety and Survival; • Emotio
Page 543 and 544:
Service Access Service providers wi
Page 545 and 546:
The CONTRACTOR shall request approv
Page 547 and 548:
Plan/Quarterly Reports in cooperati
Page 549 and 550:
6.4 The CONTRACTOR’S Treatment Te
Page 551 and 552:
PART C: SERVICE TASKS TO ACHIEVE PE
Page 553 and 554:
1.0: SAFETY PERFORMANCE OUTCOME GOA
Page 555 and 556:
Placed Children; and (2) abide by a
Page 557 and 558:
(b) The CONTRACTOR shall use seclus
Page 559 and 560:
PERFORMANCE OUTCOME SUMMARY 2.0 PER
Page 561 and 562:
2.0: REUNIFICATION/PERMANENCY PERFO
Page 563 and 564:
2.2 Visitation Plan: modification i
Page 565 and 566:
(a) For infants from birth to 6 mon
Page 567 and 568:
PERFORMANCE OUTCOME SUMMARY 3.0 WEL
Page 569 and 570:
3.0 WELL-BEING PERFORMANCE OUTCOME
Page 571 and 572:
(b) Two children’s rights recentl
Page 573 and 574:
their responsibilities to pupils in
Page 575 and 576:
3.2.8 Educational Assessments by th
Page 577 and 578:
information such as immunizations g
Page 579 and 580:
The CONTRACTOR shall have an emerge
Page 581 and 582:
assistance with homework; (5) daily
Page 583 and 584:
3.11.5 Clothing Fit, Appropriatenes
Page 585 and 586:
placed with a minor parent if the C
Page 587 and 588:
PART D - PERFORMANCE REQUIREMENT SU
Page 589 and 590:
FOSTER YOUTH BILL OF RIGHTS EXHIBIT
Page 591 and 592:
19. Residents have the right to con
Page 593 and 594:
not prohibited by the resident's ne
Page 595 and 596:
TABLE OF CONTENTS ii EXHIBIT A-II I
Page 597 and 598:
OUT-OF-HOME CARE EXHIBIT A-II What
Page 599 and 600:
EXHIBIT A-II What is a juvenile cou
Page 601 and 602:
EXHIBIT A-II care still exist, if y
Page 603 and 604:
EXHIBIT A-II Can I have an attorney
Page 605 and 606:
TYPES OF PLACEMENTS EXHIBIT A-II Wh
Page 607 and 608:
GUARDIANSHIP EXHIBIT A-II What is t
Page 609 and 610:
INDEPENDENT LIVING EXHIBIT A-II Wha
Page 611 and 612:
CONFIDENTIALITY AND YOUR RECORDS EX
Page 613 and 614:
WHEN RECORDS ARE DESTROYED Juvenile
Page 615 and 616:
MONEY EXHIBIT A-II Do I have a righ
Page 617 and 618:
RELIGION Can my foster parents or N
Page 619 and 620:
EXHIBIT A-II What if I can't get a
Page 621 and 622:
EMANCIPATION EXHIBIT A-II What does
Page 623 and 624:
EXHIBIT A-II What are the disadvant
Page 625 and 626:
KNOW YOUR RIGHTS EXHIBIT A-II With
Page 627 and 628:
DEFINITION INDEX The number refers
Page 629 and 630:
ENDNOTES 1. The following abbreviat
Page 631 and 632:
35. WIC 317(c) 36. WIC 317(d),(e) E
Page 633 and 634:
84. VC 12814.6 85. VC 17701 86. FC
Page 635 and 636:
PROBATION CASE PLAN FORM (PROB 1385
Page 637 and 638:
EXHIBIT A-V 1. Describe Circumstanc
Page 639 and 640:
EXHIBIT A-V Probation Officer’s R
Page 641 and 642:
EXHIBIT A-V _______________________
Page 643 and 644:
SIGNATURES: EXHIBIT A-V MINOR: THIS
Page 645:
FOSTER CHILD’S NEEDS AND CASE PLA
Page 663 and 664:
cc: to group home, child’s(ren’
Page 665 and 666:
SPECIAL INCIDENT REPORTING GUIDE FO
Page 667 and 668:
4 EXHIBIT A-VIII 5. SERIOUS INJURY,
Page 669 and 670:
6 EXHIBIT A-VIII 10. SIGNIFICANT IN
Page 671 and 672:
SCREENING REQUIREMENT PERIODICITY S
Page 673 and 674:
Anticonvulsant medications, when pr
Page 675 and 676:
Dr. faxes pages 1 & 2 of PMAF to th
Page 677 and 678:
EXHIBIT A-X 2. Contact the physicia
Page 679 and 680:
EXHIBIT A-X 1. Instruct the caregiv
Page 681 and 682:
APPROVAL LEVELS Section Level Appro
Page 683 and 684:
Group Home Organization: FORMAT FOR
Page 685 and 686:
Exhibit A-XIIIa COUNTY OF LOS ANGEL
Page 687 and 688:
Exhibit A-XIIIb COUNTY OF LOS ANGEL
Page 689 and 690:
GROUP HOME PROGRAM STATEMENT EXHIBI
Page 691 and 692:
TO THE HEADS OF EXECUTIVE DEPARTMEN
Page 693 and 694:
implementation of individual provis
Page 695 and 696:
E. Negotiation and Approval of Indi
Page 697 and 698:
. The restraints or requirements im
Page 699 and 700:
objectives of the organization are
Page 701 and 702:
distribution base. The result of th
Page 703 and 704:
special cost studies (such as an en
Page 705 and 706:
other activity. The bases must be e
Page 707 and 708:
g. The results of each negotiation
Page 709 and 710:
49. Training costs 50. Transportati
Page 711 and 712:
e. Costs identified in subparagraph
Page 713 and 714:
compensation for employees on feder
Page 715 and 716:
(3) Excise taxes on accumulated fun
Page 717 and 718:
with certainty as to time, intensit
Page 719 and 720:
appeals, antitrust suits, or the pr
Page 721 and 722:
(1) Donated or volunteer services m
Page 723 and 724:
(1) Capital expenditures for genera
Page 725 and 726:
(2) "Idle facilities" means complet
Page 727 and 728:
enovations, alterations, equipment,
Page 729 and 730:
. For non-profit organizations subj
Page 731 and 732:
already required or maintained. Als
Page 733 and 734:
see paragraphs 37., Professional se
Page 735 and 736:
41. Recruiting costs. a. Subject to
Page 737 and 738:
continued to own the property. This
Page 739 and 740:
48. Termination costs applicable to
Page 741 and 742:
(3) Fees charges by the educational
Page 743 and 744:
e. Foreign travel. Direct charges f
Page 745 and 746:
Southern Research Institute, Birmin
Page 747 and 748:
A-C Handbook Page 1 AUDITOR-CONTROL
Page 749 and 750:
A-C Handbook Page 3 2.2 Cash Receip
Page 751 and 752:
A-C Handbook Page 5 If a Payroll Re
Page 753 and 754:
A-C Handbook Page 7 Outside Meals -
Page 755 and 756:
A-C Handbook Page 9 CONTRACTOR shal
Page 757 and 758:
A-C Handbook Page 11 2.3 Petty Cash
Page 759 and 760:
A-C Handbook Page 13 Salaried emplo
Page 761 and 762:
A-C Handbook Page 15 Indirect Cost
Page 763 and 764:
A-C Handbook Page 17 2.3 Acceptable
Page 765 and 766:
A-C Handbook Page 19 D. UNALLOWABLE
Page 767 and 768:
EXHIBIT C-II AUDITOR-CONTROLLER/DEP
Page 769 and 770:
EXHIBIT C-II circumstances, the ent
Page 771 and 772:
EXHIBIT C-II At the pre-exit meetin
Page 773 and 774:
EXHIBIT C-II will be provided with
Page 775 and 776:
CONTRACTOR EMPLOYEE ACKNOWLEDGEMENT
Page 777 and 778:
Group Home Semi-Annual Expenditure
Page 779 and 780:
EXHIBIT F (D) If the State Departme
Page 781 and 782:
EXHIBIT F (C) Individuals who are e
Page 783 and 784:
EXHIBIT F subdivision (g). The Stat
Page 785 and 786:
EXHIBIT F processing. (B) Upon requ
Page 787 and 788:
EXHIBIT F self-addressed envelope f
Page 789 and 790:
EXHIBIT F shall disclose that clien
Page 791 and 792:
EXHIBIT F state, would have been pu
Page 793 and 794:
statement, fingerprints and photogr
Page 795 and 796:
Name, Address and Telephone Number
Page 797 and 798:
EXHIBIT G If a CSW or SCSW has any
Page 799 and 800:
EXHIBIT G 10) minute orders and cou
Page 801 and 802:
0500-501.20 (Rev 12/02) EXHIBIT G 4
Page 803 and 804:
EXHIBIT G See Procedural Guide 0200
Page 805 and 806:
EXHIBIT G that the research will no
Page 807 and 808:
EXHIBIT G detrimental to the safety
Page 809 and 810:
EXHIBIT G Procedural Guide 0500-504
Page 811 and 812:
EXHIBIT H of changes to the plan. (
Page 813 and 814:
EXHIBIT I (e) The child's caretaker
Page 815 and 816:
EXHIBIT I CSW in Concurrent Plannin
Page 817 and 818:
Procedures A. WHEN: A CHILD IS DETA
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B. WHEN: A CHILD IS IN OUT-OF-HOME
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Dependency Investigator CSW Respons
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EXHIBIT I For offices who have impl
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EXHIBIT I FB1 Addendum, Family Back
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Department of the Treasury Internal
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DCFS GROUP HOME CONTRACT INVESTIGAT
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EXHIBIT N c) insufficient or poor f
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EXHIBIT N 5. The Division Chief or
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EXHIBIT O 1. The lesser number is a
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EXHIBIT O COUNTY OF LOS ANGELES CON
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CONTRACTOR’S CERTIFICATION OF COM
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F I F I F I F I EXHIBIT R F O R Y O
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8. Does the child receive the sport
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EXHIBIT R 33. Is the child given th
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It is best that women seek help to
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Safely Surrendered Baby Hotline (87
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Cada recién nacido merece una opor
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DATE OF ISSUE: APPLICABLE TO: LEGAL
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TA/EW b) INVALID OVERPAYMENT EXHIBI
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WHO HOW following conditions exist:
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EXHIBIT T Deposit EW 3. Reconcile t
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O/P Collection EW b) Enter the stat
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c) FAD Exception Distribution d) Ov
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s mobility and independent function
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1180.3. (a) This section shall appl
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(A) Obesity. (B) Pregnancy. (C) Agi
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PROBATION QUARTERLY REPORT FORMAT E
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Name of School: Address of School:
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Date Type Los Angeles County Probat
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Are there any SIRS to report? Yes N
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TARGET POPULATIONS WITH CORRESPONDI
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EXHIBIT Y THE TARGET POPULATION FOR
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CONTRACT NO. COUNTY PROGRAM DIRECTO
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EXHIBIT CC LOS ANGELES COUNTY SUPER
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INTRODUCTION/SUMMARY In June, 2005,
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elatives) should reflect the unique
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Additionally, every effort should b
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DEPENDENCY CASE STAGES Stage 1: Pre
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The Pre-Disposition Family Visitati
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PRELIMINARY CONSIDERATIONS/FACTORS
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• Provide a drug/weapon/violence
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• Give parents suggestions for wh
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Visitation Objectives (reason for e
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issues specific to teen parents. Th
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Circumstance Team Response in FVP
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BIBLIOGRAPHY Casey Family Programs.
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Reporting Runaways A Guide for Care
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CONTRACTOR’S OBLIGATIONS UNDER HI
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213-974-2166 EXHIBIT EE The initial
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5.0 MISCELLANEOUS EXHIBIT EE agents
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CONTRACTOR’S NAME: CONTRACT NO. C
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BACKGROUND AND RESOURCES: CALIFORNI
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It is best that women seek help to
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Safely Surrendered Baby Hotline (87
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Cada recién nacido merece una opor
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2.203.010 Findings. Chapter 2.203,
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APPENDIX M following: 1. Has ten or
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