Independent Living Program - Florida's Center for Child Welfare
Independent Living Program - Florida's Center for Child Welfare
Independent Living Program - Florida's Center for Child Welfare
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2009-2010 Life Skills (Age 15-17) Monitoring ToolProvider Name: COU Team Member: Provider City: Site Visit Date: Contract Number: Assigned COU: Service Description: <strong>Independent</strong> <strong>Living</strong>Date of Tool Revision: 8/17/2009Review Files As Of: COMPLETE INFORMATION ON THE "PROVIDER AND SAMPLE INFO" SHEET TO POPULATE CHILD CALCULATIONS AND TOOL HEADERS.AuthorityFully Met? Fully Met? Fully Met? Fully Met? Fully Met?Requirements<strong>Child</strong> Name<strong>Child</strong>'s Birthdate<strong>Child</strong>'s Age at Time of Review<strong>Child</strong>'s Age at RemovalWas the Special Judicial Review completed on time? It is requiredwithin 90 days following the 17th birthday.Source39.701(6)(a) and D(b)and 65C-28.009(9)(a)65C-28.009(9)(b) DWas the required staffing completed prior to the Special JudicialReview?Was the required staffing completed on time? This means within the 65C-28.009(9)(b) D30 days prior to this Special Judicial Review.At the Special Judicial Review, was the court given written verificationthat the child received the following…...Current Medicaid card and in<strong>for</strong>mation regarding how to apply <strong>for</strong> 39.701(6)(a)1. Dcoverage upon reaching age 18 if appropriate?F.S.... A certified copy of the child's Birth Certificate? 39.701(6)(a)2. DF.S....A valid driver's license or a Florida identification card?39.701(6)(a)2.)2 DF.S....In<strong>for</strong>mation related to SSI benefits and a full accounting of any trust 39.701(6)(a)3. Dfunds if applicable?F.S....In<strong>for</strong>mation and training related to budgeting, interviewing, and 39.701(6)(a)4. Dparenting?F.S....All in<strong>for</strong>mation related to the Road to Independence <strong>Program</strong>? 39.701(6)(a)5. DF.S.…verification that the child has an open bank account, or has39.701(6)(a)6. Didentification necessary to open an account, and in<strong>for</strong>mation relating to F.S.essential banking skills been provided to the client?...In<strong>for</strong>mation on Public Assistance and how to apply?...A clear understanding of where they will be living on their 18Birthday, how living expenses will be paid, and what educationalprogram or school they will be enrolled in?39.701(6)(a)7.F.S.39.701(6)(a)8.F.S.DDx x x x xDCF Contract Oversight Page 3 of 4
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