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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 Road to Independence (18-22) 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: 11/05/2009Review 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?RequirementsYouth NameYouth's BirthdateYouth's Age at Time of ReviewDate of Youth's 18th BirthdayLast Date be<strong>for</strong>e Youth's 21st BirthdayDate that is 90 days prior to last birthday <strong>for</strong> renewalsIf the student applied <strong>for</strong> reinstatement, is the completed <strong>for</strong>m “Road toIndependence Scholarship and/or Education Training Vouchers (ETV)Funds Reinstatement Application”, CF-FSP 5297, September 2005, inthe file, and was it signed by the student, reviewing authority, andapproval authority?65C-31.006(3)(c)1., F.A.C.SourceDCF Contract Oversight Page 6 of 6

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