synergy family foster care, inc.

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synergy family foster care, inc.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: GENERAL REQUIREMENTS TO BE CERTIFIED AS A FOSTER CAREGIVER
POLICY NUMBER: 01
ORC REFERENCE: 5101:2-7-02, 2-5-20
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 1/1/03, 1/30/09, 4/22/10, 5/1/12
A
A foster caregiver shall be at least 21 years of age.
B
At least one foster caregiver in the home shall be able to read, write, and speak in English or be able to
effectively communicate with any child placed in their home and with the recommending agency.
C
A foster caregiver may be a legally married couple, a single person or co-parent(s).
D
A foster caregiver shall have an income sufficient to meet the basic needs of the household and to make
timely payment of shelter costs, utility bills, and other debts. To show the household has an income
sufficient to meet the basic needs of the household and makes timely payment of shelter costs, utility bills,
and other debts, a foster caregiver or applicant shall provide at a minimum:
1. For a foster care applicant:
a
A completed JFS 01681 "Applicant Financial Statement" (rev. 10/2000).
b
Proof of income for the household for the most recent tax year prior to the date of application.
c
Proof of income for the household for a two month period. The verification of income shall
not be dated more than six months prior to the agency's recommendation for initial certification.
d
At least one utility bill for each utility necessary to maintain the household. The bill or bills
shall not be dated more than six months prior to the agency's recommendation for initial
certification.
2. For a certified foster caregiver a completed JFS 01681 "Applicant Financial Statement" (rev. 10/2000) if
there are any substantial changes to a caregiver's financial situation.
E
A foster caregiver and all members of the household shall be free of any physical, emotional, mental
condition, which could endanger a child or seriously impair the ability of the foster caregiver to care for a
foster child.
F
An applicant shall have a JFS 01653, “Medical Statement for Foster Care/Adoptive Applicant and
Household Members”, completed by a licensed physician within six months prior to the agency’s initial
recommendation for certification.
G
An applicant may be required to secure and provide a report in addition to the JFS 01653, “Medical
Statement for Foster Care/Adoptive Applicant and Household Members”, of an examination of any
member of the household by a licensed physician, psychologist, or other certified licensed professional if:
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
1
An applicant or any person residing within the household has suffered a serious illness or injury
within the past year; or
2
The recommending agency determines it to be necessary to ensure the safety, health, or care of
any foster child who may be placed in the home.
H
Except as provided in paragraph (I) of this rule, a foster caregiver and all other persons eighteen years of
age or older who reside with the foster caregiver shall not have been convicted or pleaded guilty to any of
the offenses listed in paragraph (J) of this rule.
I
No person who has been convicted of or pleaded guilty to an offense listed in paragraph (J) of this rule
shall be certified as a foster caregiver on or after October 29, 1993, unless the recommending agency
finishes and documents that person has met all of the following conditions:
J
1
Except as provided in paragraph (I)(3) of this rule, where the offense was a misdemeanor, or
would have been a misdemeanor if conviction occurred under the current criminal code, at least
three years have elapsed from the date the person was fully discharged from any imprisonment or
probation arising from the conviction. A person who has had his record of misdemeanor
conviction sealed by a court pursuant to section 2953 of the Revised Code shall be considered to
have met this condition.
2
Except as provided in paragraph (I)(3) of this rule, where the offense was a felony, at least ten
years have elapsed since the person was finally discharged from imprisonment or probation.
3
Where an offense was committed by a foster child under the age of twenty-one who remains in the
custody of a PCSA or PCPA, the recommending agency may determine the person need not meet
the elapsed time period requirements of paragraphs (I)(1) and (I)(2) of this rule.
Except as provided in paragraph (I) of this rule, a foster caregiver shall not have been convicted of or
pleaded guilty to, any of the following offenses:
1
A violation of section 959.13, 2903.01, 2903.02, 2903.03, 2903.04, 2903.11, 2903.12, 2903.13,
2903.15, 2903.16, 2903.21, 2903.211, 2903.22, 2903.34, 2905.01, 2905.02, 2905.05, 2907.02,
2907.03, 2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09, 2907.21, 2907.22, 2907.23,
2907.25, 2907.31, 2907.32, 2907.321 (2907.32.1), 2907.322 (2907.32.2), 2907.323 (2907.32.3),
2909.02, 2909.22, 2909.23, 2909.24, 2909.03, 2911.01, 2911.02, 2911.11, 2911.12, 2919.12,
2913.49, 2917.01, 2917.02, 2919.22, 2919.24, 2919.25, 2923.12, 2923.13, 2923.161 (2923.16.1),
2925.02, 2925.03, 2925.04, 2925.05, 2925.06, 2927.12, or 3716.11 of the Revised Code, a
violation of section 2905.04 of the Revised Code as it existed prior to July 1, 1996, a violation of
section 2919.23 of the Revised Code that would have been a violation of section 2905.04 of the
Revised Code as it existed prior to July 1, 1996, had the violation been committed prior to that
date, a violation of section 2925.11 of the Revised Code that is not a minor drug possession
offense, two or more violations of section 4511.19 of the Revised Code or the equivalent violation
from any other state committed within the three years immediately preceding the submission of
the application or petition that is the basis of the request, or felonious sexual penetration in
violation of former section 2907.12 of the Revised Code as listed in appendix A to this rule.
2
A violation of an existing or former law of this state, any other state, or the United States that is
substantially equivalent to any of the offenses listed in paragraphs (J)(1) and (J)(2) of this rule.
3
The victim of the offense was not one of the following:
a
A person under the age of eighteen.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
4
5
b
A functionally impaired person as defined in division (A) of section 2901.10 of the
Revised Code.
c
A mentally retarded person as defined in division (K) of section5123.01 of the Revised
Code.
d
A developmentally disabled person as defined in division (Q) of section 5123.01 of the
Revised Code.
e
A person with a mental illness as defined in division (A) of section 5122.01 of the
Revised Code.
f
A person sixty years of age or older.
The person’s certification as a foster caregiver will not jeopardize in any way the health, safety or
welfare of the children the agency serves. The following factors shall be considered in
determining the person’s certification as a foster caregiver.
a
The person’s age at the time of the offense.
b
The nature and seriousness of the offense.
c
The circumstances under which the offense was committed.
d
The degree in which the person participated in the offense.
e
The time elapsed since the person was fully discharged from imprisonment or probation.
f
The likelihood that the circumstances leading to the offense will recur.
g
Whether the person is a repeat offender.
h
The person’s employment record.
i
The person’s efforts at rehabilitation and the results of those efforts.
j
Whether any criminal proceedings are pending against the person.
k
Whether the person has been convicted of or pleaded guilty to a felony contained in the
Revised Code that is not listed in paragraph (J) of this rule, if the felony bears a direct
and substantial relationship to being a foster caregiver or adult member of the caregiver’s
household.
l
Any other factors the agency considers relevant.
If any of the following have a felony conviction for spousal abuse, rape, sexual assault, or
homicide, the foster home shall not be certified and no rehabilitation standards exist for:
a
An adult resident in the household of a foster caregiver or applicant.
b
A foster caregiver.
c
A foster care applicant.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
K
It is the prospective foster caregiver’s duty to provide verification to the recommending agency that the
conditions specified in paragraph (I) of this rule are met for that person and if requested for all adult
members of the household. If the prospective foster caregiver fails to provide such proof or if the agency
determines that the proof offered by the person is inconclusive or insufficient, the person shall be denied
certification pursuant to rule 5101:2-5-22 of the Administrative Code.
L
To determine whether a prospective foster caregiver is qualified to be certified as a foster caregiver
pursuant to paragraph (J) of this rule, a BCII and FBI criminal records check shall be conducted for the
prospective foster caregiver and will be conducted for each adult member of the household (18 years and
older)pursuant to rule 5101:2-5-09.1of the Administrative Code. In accordance with rule 5101:2-5-09.1 of
the Administrative Code, a criminal records check shall be requested:
1
For the foster care applicant and each adult who resides with the foster care applicant in accordance
with paragraph (J) of this rule. The results shall be reviewed prior to the agency's recommendation for
certification to ODJFS.
2
For a certified foster caregiver and each adult who resides with the foster caregiver every four years
within six months prior to the upcoming recertification of the caregiver.
M
An agency shall not approve a prospective foster caregiver on a conditional basis awaiting the results of the
criminal record check required by paragraph (I) of this rule. The required criminal records check must be
completed prior to an agency recommending a prospective foster caregiver for certification.
N
The provisions of paragraph (I) of this rule must be considered for any prospective foster caregiver and all
other persons eighteen years of age or older who reside with the foster caregiver who has been convicted
of, or pleaded guilty to, one or more of the offenses listed in paragraph (J) of this rule, even if the person’s
record has been sealed by a court pursuant to section 2953.32 of the Revised Code because the information
contained in the sealed record bears a direct and substantial relationship to the care to be provided to any
foster child who may be placed in the home.
O
A conviction of, or plea of guilty to, an offense listed in paragraph (J) of this rule shall not prevent a
person’s certification as a foster caregiver or being an adult household member of the home if the person
has been granted an unconditional pardon for the offense pursuant to Chapter 2967. of the Revised Code or
the conviction or guilty plea has been set aside pursuant to law. “Unconditional pardon” includes a
conditional pardon with respect to which all conditions have been performed or transpired.
P
A foster caregiver or prospective foster caregiver shall notify the recommending agency in writing if a
person at least twelve years of age, but less than eighteen years of age, residing with the foster caregiver or
prospective foster caregiver has been convicted of or pleaded guilty of any of the offenses listed in
Appendix A of this rule, or has been adjudicated to be a delinquent child for committing an act that if
committed by an adult would have constituted such a violation.
ODJFS shall deny a foster home certificate on the grounds that a person at least twelve years of age but less
than eighteen years of age residing with the foster caregiver or prospective foster caregiver has been
convicted of or pleaded guilty to an offence listed in Appendix A of this rule or has been adjudicated to be
a delinquent child for committing an act that if committed by an adult would have constituted such an
offense, unless the agency establishes that the delinquent child meets the rehabilitation provisions of
paragraph (I)(3) and (4) of this rule. In considering the provisions of paragraphs (I)(3) and (4) of this rule,
the agency shall view these provisions considering the age of the delinquent child involved and the age and
sex of children that are or would be placed in the foster home.
Q
A foster caregiver shall not operate the home as an adult boarding or rooming house.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
R
A foster caregiver shall obtain written approval from the recommending agency prior to conducting any
business, or allowing any business to operate, including babysitting services, in the home.
S
A foster caregiver shall not provide or allow babysitting services in a foster home such that more than ten
children, including foster, natural or adoptive children are present and under the supervision of a caregiver
at any one time. Any caregiver that is an approved or certified type B family day care home provider shall
follow the requirements for approval or certification as a type B family day care home.
T
A foster caregiver shall obtain an inspection of the foster home by a state certified fire safety inspector or
the state fire marshal’s office using the JFS 01200 “Fire Inspection Report for Homes” (rev. 10/2000) or
other form used for a local or state fire inspection, certifying that the foster home is free from conditions
hazardous to the safety of foster children. The inspection/certification must have occurred not more than
twelve months prior to the initial recommendation for certification of the foster home by the agency or
within thirty days of any change of address of the foster home.
U
If a state certified fire safety inspector or the state fire marshal’s office is unavailable within twelve months
prior to the agency’s recommendation for initial certification, the fire inspection required by paragraph (T)
of this rule must still be completed as soon as a state certified fire safety inspector or the state fire marshal’s
office is available.
V
A foster caregiver shall complete all preplacement and continuing training as required by rule 5101:2-5-33
of the Administrative Code and any additional hours of training required by the recommending agency’s
written training plan.
W
A foster caregiver or applicant shall comply with all agency policies or instructions.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: ADDITIONAL REQUIREMENTS FOR A TREATMENT FOSTER CAREGIVER AND A
TREATMENT FOSTER HOME
POLICY NUMBER: 01.2
ORC REFERENCE: 5101:2-7-16, 5101:2-5-13(A)(15), (17)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 10/1/02
DATE REVISED: 1/30/09
A
Effective 4/1/05 all special and exceptional needs children shall be placed in homes certified as treatment
foster homes.
B
In Addition to the requirements found in rules 5101:2-7-02 to 5101:2-7-15 of the Administrative Code, a
treatment foster home shall meet the following requirements:
C
A treatment foster caregiver initially certified after the effective date of this rule shall meet at least one of
the following requirements. This requirement shall not apply to a foster caregiver certified prior to the
effective date of this rule.
D
1
A minimum of three hundred sixty-five days of caring for a foster child in placement as a certified
foster caregiver.
2
A minimum of sixty hours of training in a classroom setting that complies with the following. For
an applicant the training shall be completed within twenty-four months prior to the date of
application for initial certification as a specialized caregiver. For a certified caregiver the training
shall be completed within twenty-four months of the certified caregiver’s written intent to upgrade
their certification if the caregiver does not meet the requirement in paragraph (c)(1) of this policy.
The training shall relate to children with special or exceptional needs as defined in rule 5101:2-4718 of the Administrative Code.
3
A minimum of five years cumulative experience caring for a child in the home of the foster
caregiver or applicant on a daily basis.
4
A minimum of one year of cumulative experience caring for a child who has special or exceptional
needs as defined in rule 5101:2-47-18 of the Administrative Code in the home of the foster
caregiver or applicant on a daily basis.
Each treatment foster caregiver shall successfully complete the number of hours of preplacement and
annual continuing training specified by Synergy Family Foster Care, Inc. training policy required pursuant
to rule 5101:2-5-13 of the Administrative Code. No fewer than thirty-six hours of preplacement training
and no fewer than thirty hours of continuing annual training is required for each treatment foster caregiver.
All preplacement and annual continuing training received by a treatment foster caregiver shall be subject to
the requirements specified in paragraphs (C)(7) and (C) (8) of rule 5101:2-5-33 of the Administrative Code.
1
Prior to receiving a child in placement, each treatment foster caregiver shall successfully complete
an American Red Cross, First Aid and Adult and Child Cardiopulmonary Resuscitation (CPR)
certification training program or its equivalent. If foster children under the age of three will be
placed in the treatment foster home, infant CPR shall be included in the CPR certification. This
training may be counted towards the training required by paragraphs (C)(7) and (C)(8) of rule
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
5101:2-5-33 of the Administrative Code. First Aid and CPR certification shall be kept current at
all times.
E
Each treatment foster caregiver is a member of the treatment team and shall implement the service plan for
each child as prescribed by the recommending agency.
F
With the exception of the provisions of paragraph (D)(2) of this rule, a treatment foster caregiver may
provide foster care for not more than five foster children, two of whom may have exceptional needs
requiring their placement in a treatment foster home. Any exceptions to the number of children with
exceptional needs to be served, must have specific justification in accordance with Synergy Family Foster
Care, Inc. policy for matching foster children and treatment foster caregivers pursuant to rule 5101:2-5-13
of the Administrative Code. Such justification, which may include the need to place a sibling group, or the
abilities of a particular family in relation to the special or exceptional needs of a particular child, shall be
documented in the child’s case record and in the treatment foster home record. If more than two children
with exceptional needs are placed in a treatment foster home, all agencies holding custody of any other
children placed in the home shall be notified by the treatment foster care program within seventy-two hours
of placement.
1
A treatment foster caregiver who is also an appropriately trained and licensed professional such as
a social worker, professional counselor, psychologist or teacher, or who has a minimum of a
bachelor’s degree in a child development or social services field and five years of child care
experience and training related to serving children in foster care, and whose primary means of
support is from reimbursement as a treatment foster caregiver may provide care for not more than
five children with special or exceptional needs placed in the caregiver’s home.
2
Children placed in a foster home on the effective date of this rule shall not be moved to another
placement solely to meet this requirement.
G
A treatment foster caregiver or at least one member of a treatment foster caregiver couple or co-parent shall
have weekly consultation and face-to-face contact at least every two weeks with Synergy Family Foster
Cares professional treatment staff. At least one of the face-to-face contacts each month shall be in the
treatment foster home.
H
A treatment foster caregiver shall prepare, and keep current, a written record of the behavior and progress
of the child towards achieving the treatment goals as identified in the service plan of each foster child
placed in the home as required by the agency.
1
A treatment team leader shall be responsible for not more than 10 treatment or medically fragile
foster children and not more than 30 total foster children when providing case management
services.
2
The treatment team supervisor will be responsible for not more than five treatment team leaders
for supervision.
I
Under the direction of the treatment team leader, a treatment foster caregiver shall assume primary
responsibility for implementing the in-home treatment strategies specified in the child’s service plan and
any revisions thereto.
J
A treatment foster caregiver shall work cooperatively with the family of the child according to the child’s
service plan and case plan.
K
A treatment foster caregiver shall perform all other required duties as established by Synergy Family Foster
Care, Inc.
L
A treatment foster caregiver shall attend and participate in the treatment team meetings for each child
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
placed in his home. If the treatment foster home certificate is in the name of a couple or co-parents, only
one caregiver is required to attend the treatment team meetings unless otherwise specified by the
recommending agency.
M
Synergy Family Foster Care, Inc. shall conduct an annual evaluation of the specialized foster care program
by specialized foster caregivers, children in care, as appropriate to their age and understanding, and the
families of children in care, if applicable. The information gathered from the evaluation may be shared
with the employees of the agency, the board members and recommending agencies that make a written
request to the Executive Director of Synergy Family Foster Care, Inc.
N
Synergy Family Foster Care, Inc. shall provide access to crisis counseling to children in specialized foster
care and all specialized foster caregivers and their families affiliated with the program for any issues or
problems caused by a specific incident related to a child receiving treatment within the caregiver’s home
including the death or hospitalization of a child.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: ADDITIONAL REQUIREMENTS FOR A MEDICALLY FRAGILE FOSTER CAREGIVER AND
A MEDICALLY FRAGILE FOSTER HOME
POLICY NUMBER: 01.4
ORC REFERENCE: 5101:2-7-17
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 10/1/02
DATE REVISED: 1/30/09
A
Effective 4/1/05 all medically fragile children shall be placed in homes certified as treatment foster homes.
B
In Addition to the requirements found in rules 5101:2-7-02 to 5101:2-7-15 of the Administrative Code, a
medically fragile foster home shall meet the following requirements:
C
A medically fragile foster caregiver initially certified after the effective date of this rule shall have at least
two years of experience caring for medically fragile children or the equivalent child care experience,
education or training as determined by the recommending agency. This requirement shall not apply to a
foster caregiver certified prior to the effective date of this rule.
D
1
The following experience may qualify for two years experience or the equivalence to as
determined by Synergy Family Foster Care, Inc.: previous foster care experience, working in the
special and/or regular education field, certification or degree in child care and development,
working with special needs children through community services either through employment or
volunteer, and medical training or background (nurse, doctor, medical assistant or therapist).
2
Experience or equivalence must be equal to at least two years time in any one or more field of the
above mentioned.
3
Experience or equivalence shall not include successful parenting of one’s own children who do not
have special, exceptional or intensive needs as the sole criteria for determining the equivalent
experience required.
Each medically fragile foster caregiver shall successfully complete the number of hours of preplacement
and annual continuing training specified by Synergy Family Foster Care, Inc. training policy required
pursuant to rule 5101:2-5-13 of the Administrative Code. No fewer than thirty-six hours of preplacement
training and no fewer than thirty hours of continuing annual training is required for each medically fragile
foster caregiver. All preplacement and annual continuing training received by a medically fragile foster
caregiver shall be subject to the requirements specified in paragraphs (C)(7) and (C) (8) of rule 5101:2-5-33
of the Administrative Code.
1
E
Prior to receiving a child in placement, each medically fragile foster caregiver shall successfully
complete an American Red Cross, First Aid and Adult and Child Cardiopulmonary Resuscitation
(CPR) certification training program or its equivalent. If foster children under the age of three will
be placed in the medically fragile foster home, infant CPR shall be included in the CPR
certification. This training may be counted towards the training required by paragraphs (C)(7) and
(C)(8) of rule 5101:2-5-33 of the Administrative Code. First Aid and CPR certification shall be
kept current at all times.
Each medically fragile foster caregiver is a member of the medically fragile team and shall implement the
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
service plan for each child as prescribed by the recommending agency.
F
With the exception of the provisions of paragraph (E)(2) of this rule, a medically fragile foster caregiver
may provide foster care for not more than five foster children, two of whom may have intensive needs
requiring their placement in a medically fragile foster home. Any exceptions to the number of children
with exceptional needs to be served, must have specific justification in accordance with Synergy Family
Foster Care, Inc. policy for matching foster children and medically fragile foster caregivers pursuant to rule
5101:2-5-13 of the Administrative Code. Such justification, which may include the need to place a sibling
group, or the abilities of a particular family in relation to the special or exceptional needs of a particular
child, shall be documented in the child’s case record and in the medically fragile foster home record. If
more than two medically fragile foster children are placed in a medically fragile foster home, all agencies
holding custody of any other children placed in the home shall be notified by the foster care program within
seventy-two hours of placement.
1
A medically fragile foster caregiver who is also an appropriately trained and licensed professional
such as a registered nurse, social worker, professional counselor, psychologist or teacher, or who
has a minimum of a bachelor’s degree in a child development or social services field and five
years of child care experience and training related to serving children in foster care, and whose
primary means of support is from reimbursement as a medically fragile foster caregiver may
provide care for not more than five medically fragile foster children placed in the caregiver’s
home.
2
Children placed in a foster home on the effective date of this rule shall not be moved to another
placement solely to meet this requirement.
G
A medically fragile foster caregiver or at least one member of a medically fragile foster caregiver couple or
co-parent shall have weekly consultation and face-to-face contact at least every two weeks with Synergy
Family Foster Cares professional medically fragile staff. At least one of the face-to-face contacts each
month shall be in the medically fragile foster home.
H
A medically fragile foster caregiver shall prepare, and keep current, a written record of the behavior and
progress of the child towards achieving the medically fragile goals as identified in the child’s service plan.
The written record shall include signed documents of treatment provided by any health care professional, as
well as records of any hospitalizations and hospital emergency room or urgent medical care visits. All
documentation shall be maintained current and turned in to Synergy Family Foster Care, Inc. on a monthly
basis during the face-to-face contact in the home.
I
Under the direction of the medically fragile team leader, a medically fragile foster caregiver shall assume
primary responsibility for implementing the in-home medically fragile strategies specified in the child’s
service plan and any revisions thereto.
1
A treatment team leader shall be responsible for not more than 10 treatment or medically fragile
foster children and not more than 30 total foster children when providing case management
services.
2
The treatment team supervisor will be responsible for not more than five treatment team leaders
for supervision.
J
A medically fragile foster caregiver shall work cooperatively with the family of the child according to the
child’s service plan and case plan.
K
A medically fragile foster caregiver shall perform all other required duties as established by Synergy
Family Foster Care, Inc.
L
A medically fragile foster caregiver shall attend and participate in the medically fragile team meetings for
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
each child placed in his home. If the medically fragile foster home certificate is in the name of a couple or
co-parents, only one caregiver is required to attend the medically fragile team meetings unless otherwise
specified by the recommending agency.
M
Synergy Family Foster Care, Inc. shall conduct an annual evaluation of the specialized foster care program
by specialized foster caregivers, children in care, as appropriate to their age and understanding, and the
families of children in care, if applicable. The information gathered from the evaluation may be shared
with the employees of the agency, the board members and recommending agencies that make a written
request to the Executive Director of Synergy Family Foster Care, Inc.
N
Synergy Family Foster Care, Inc. shall provide access to crisis counseling to children in specialized foster
care and all specialized foster caregivers and their families affiliated with the program for any issues or
problems caused by a specific incident related to a child receiving treatment within the caregiver’s home
including the death or hospitalization of a child.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: CARE AND TREATMENT PLANNING
POLICY NUMBER: 02
ORC REFERENCE: 5101:2-7-03
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 9/17/14
A
Care and treatment planning for a child will begin at the time the child is referred to the Agency. The case
manager or case aide will contact the recommending agency and obtain preliminary data on the child. A
list of required data will be faxed to the recommending agency by the office manager. This information
will be given to the case manager or case aide assigned to the case. When further information is obtained
on a child, there is a possibility that the child may be moved to enhance placement adjustment.
B
A foster caregiver shall work cooperatively with Synergy Family Foster Care, Inc. case manager as a
member of a care and treatment team responsible for planning, providing, and discussing the care and
services provided to a foster child and shall fully disclose all information related to a foster child’s
problems or progress to agency representatives.
D
As a member of the care and treatment team, a foster caregiver shall participate in an annual review with
the recommending agency to evaluate the strengths and growth areas of the foster home and of the support
services of Synergy Family Foster Care, Inc. representatives to the foster caregiver. A foster caregiver
shall work cooperatively with Synergy Family Foster Care, Inc. in conducting an independent living skills
assessment on an age appropriate foster child, and, as requested, provide instruction to a foster child on
independent living skills. A foster caregiver shall not prohibit the foster child from participating in
independent living services. It is the responsibility of the Synergy Family Foster Care, Inc. caseworker to
invite significant persons to attend. As a member of the care and treatment team, it is mandated that the
foster caregiver attend and participate in the treatment and care plan for the child placed in their home.
This invitation should be given well in advance of the care plan meeting to ensure attendance. The
invitation will be in the form of an official Synergy Family Foster Care, Inc. invitation form mailed to all
parties concerned in the care and treatment of the child. The case manager supervisor, case manager or the
designee will chair the care and treatment plan meeting.
E
The care and treatment plan will include, but not limited to the following:
1
A description of the specific need/problem of the person served, based on diagnostic assessment
and referral information;
2
A description of strengths or assets of the person served and how they will be utilized in achieving
care and treatment plan goals;
3
A list of care and treatment goals and intermediate steps toward those goals, described in
measurable terms: a foster caregiver will work cooperatively with agency representatives
in the conduct of an independent living skills assessment on an age appropriate foster child, and,
as requested, provide instruction to a foster child on independent living skills;
4
Target dates or time frames for achievement of goals and intermediate steps;
5
The specific services provided and the frequency of service delivery;
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
F
G
6
The name(s) of the agency staff member(s) responsible for providing services;
7
The names of any other agencies or systems that are providing services to the person, a description
of the services provided, identification by name and title of the staff persons of those agencies or
systems responsible for providing such services, and evidence of inter agency service
coordination;
8
The signature(s) of the agency staff member;
9
Evidence that the person served, and , as appropriate, family, parent, guardian, or significant other
who was involved in plan;
10
Evidence of plan review and approval documented by signature of a provider qualified according
to Chapter 5122-23 of the Administrative Code;
11
Evidence of collaboration with the person served and the person’s family or significant other,
parent, or guardian as appropriate.
Each staff member providing services shall participate in developing the care and treatment plan. For
children receiving services, the care plan shall reflect attention to the needs of children including, but not
limited to the following:
1
Developmental;
2
Family;
3
School;
4
Social-recreational issues: and
5
Interagency coordination.
For children with severe mental illness, the care plan shall reflect consideration of the entire range of
issues related to the person’s life circumstances that directly affect the person’s ability to respond to
treatment. These issues shall include, but not limited to, those listed in Rule 5122-29-04 of the
Administrative Code. All changes will be documented.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: RECORDS AND CONFIDENTIALITY
POLICY NUMBER 03
ORC REFERENCE: 5101:2-7-04
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED: 8-1-12
A foster caregiver shall maintain a record on each foster child which shall include, but not limited to:
1
A copy of the current child care agreement between the agency and the foster home and any
written case plan provided by the agency;
2
Reports of scholastic performance, including current IEP/MFE, report cards, diplomas, and
certificates of achievement or merit;
3
Medical information provided by a foster youth’s physician and by the placing agency, and
current instructions regarding a foster child’s health care;
4
Psychological evaluations provided by a foster youth’s counseling center;
5
The name and telephone number of the recommending agency contact person or the custody
holding person or agency as applicable;
6
Data which is pertinent to the foster child’s life book.
B
A foster caregiver shall give the foster child’s record and all other official documents regarding the foster
child to Synergy Family Foster Care, Inc. when the foster child leaves the home.
C
A foster caregiver shall not disclose or knowingly allow the disclosure of any information regarding a
foster child or the foster child’s family to persons not directly involved in the foster child’s care and
treatment on an official basis.
D
I the event of the death of a foster child, Synergy Family Foster Care Inc. will comply with the custodial
agency and all information needed will be forwarded to the Child Fatality Review Board as needed.
E
Breeches in confidentiality includes but is not limited to: Statement or photographs on an social networking
web site (Facebook, MySpace, etc.) The placing of photos on these sites is considered a breech in
confidentiality.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: SLEEPING ARRANGEMENTS
POLICY NUMBER: 04
ORC REFERENCE: 5101:2-7-05
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 10/1/02, 1/1/03
A
The presence of a foster child in a foster home shall not cause any other resident of the home to be deprived
of a bed or bedroom.
B
A bedroom for foster children shall:
1
Have at least one outside wall window. The window should be screened and capable of opening
and closing, unless the room is provided with a ventilation system which provides fresh air;
2
Accommodate no more than four children;
3
Include storage space for personal belongings and closet or dresser space for clothing;
4
Provide a safe and comfortable sleeping area ensuring reasonable privacy and access to adult
supervision, as appropriate to the age and functioning level of each foster child. A foster home
recommended for initial certification after July 1, 2000 shall not have the entry to a foster child’s
bedroom located so as to require the foster child to pass through another bedroom or a bathroom in
order to enter his bedroom or to require another person to pass through the foster child’s bedroom
to enter another room.
5
Have floor to ceiling walls and a standard door;
6
Be provided with reasonable access to an emergency exit;
7
Not be on a floor higher than the second floor or in a basement unless approved in writing, by a
fire safety inspector, which shall be placed in the family foster file. In addition, all bedrooms for
foster children shall be comparable in appearance in terms of wall coverings, floor coverings, and
general decor to other bedrooms used by other children residing in the family foster home;
8
Approved by the agency prior to placement.
C
A foster child shall not share a bedroom with a child of the opposite sex, except when all children sharing
the room are under the age of five years, or when a foster child who is also a parent is sharing a bedroom
with her own child.
D
A foster child over one year of age shall not share a sleeping room with an adult without prior approval of
the recommending agency.
E
Each foster child shall be provided with a clean, comfortable, permanent bed and mattress of his own. A
permanent bed is one that cannot be converted to any other form other than a futon bed. Bed must have
sheets, pillow/case and blankets as needed.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
F
A bunk bed in use shall be equipped with safety rails on the upper tier for a child under the age of ten or
for any child whose physical, mental, or emotional condition indicates the need for such protection. A bed
shall not be bunked higher than two tiers.
G
A foster caregiver shall provide each foster child with clean bed linen at least once per week or more
frequently if needed. A foster child shall not be required to sleep on a bed soiled by urine or excrement.
H
Permission must be obtained from the recommending agency anytime a foster youth wishes to spend the
night somewhere other than the approved family foster home. Synergy Family Foster Care, Inc. must be
given ample time to contact the recommending agency to receive approval or the over night can not occur.
This would include spending the night with friends or family. Nights spent at friends homes may need to
be physically approved by the recommending agency.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: MEALS
POLICY NUMBER: 05
ORC REFERENCE: 5101:2-7-06
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 9/17/14
A
Each foster child shall be provided with three meals a day served at regular intervals, plus a nutritious
snack served between meals, and conforming to any religious dietary restrictions or other special
instructions imposed by the foster child’s physician. Food provided to a foster child shall be nutritious,
well-balanced, and available in sufficient quantity.
B
A foster child shall eat with other members of the foster home. A foster child will eat the same food as
other family members.
C
Each foster home shall use milk that meets the requirements of state laws and local ordinances or
regulations for pasteurized or certified milk.
D
Children with diabetic dietary needs must meet prescribed dietary needs as ordered by child’s physician.
E
Foster children will have free access to fluids (beverages), and snacks as indicated by family custom.
F
Refrigerators used for every day food storage may not be locked. Children must have access to food and
drink. They must learn to manage their diet as a task of independent living.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: HEALTH SERVICES
POLICY NUMBER: 06
ORC REFERENCE: 5101:2-7-07
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 4/22/10, 9/17/14
A
Foster caregiver shall be responsible for the following instructions of the agency, which placed the child
for providing health care services to each foster child.
B
A foster caregiver shall administer or supervise the administration of prescription drugs to a foster child
only for whom the medication was prescribed and according to the prescribing physician’s instruction.
C
1
Prescription drugs in a foster home shall be kept in the original container, labeled with the foster
child’s name, correct dosage and relevant instructions. All prescription drugs and over the counter
drugs must be stored in a locked cabinet or storage area except that an inhaler or medication may
be available to a person with a special health condition, who may need these for an emergency.
2
Prescribed drugs shall be disposed of in a safe manner when the prescription is no longer current.
3
Any side effects of prescription drugs shall be discussed with the foster caregiver as well as
documented that the foster caregiver understands the side effects, and reported immediately to the
prescribing physician and the recommending agency.
4
Medication administration is to be documented daily using the medication record. The medication
record is to be turned in with monthly paperwork to the case manager.
The following types of medications may be given to foster children:
1
Oral medications, pills, capsules, powders, liquids;
2
Ointments, salves;
3
Rectal and vaginal suppositories may be administrated as prescribed by a medical doctor and only
by the foster parent of the same sex, unless the child is under 5 years of age; or
4
Insulin may be self-administered or by foster parent, after approved by Medical Doctor.
D
Medications prescribed for one child may not be substituted for another child even if it is in the same
type and dosage of medication.
E
Medication prescriptions are the responsibility of the foster caregiver to order. If a physician prescribes a
new drug or renews a prescription it is the foster caregivers responsibility to fill the prescription. The
child’s medication is not to be allowed to “run out”. Continuation of medication is very crucial especially
with drugs that address affect, behavior and seizures. The recommending agency will be notified
immediately by the medication change form if dosage is changed or a medication is added or deleted.
Attachment: Medication Record
Medication Change Form
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
F
Vitamins, herbal supplements, dietary supplements, body building supplements, homeopathic remedies, or
any similar products may not be administered to children without the approval of the child’s physician.
G
Over the counter drugs may be administered as noted on the child‘s physical health assessment form.
Aspirin may NEVER be administered to any child. Adult Tylenol may never be administered to any child
who is younger than the age noted on the bottle. Over the counter medications, when utilized are to be
followed exactly per bottle or physician instructions.
H
Sunscreen is to be used on children who are exposed to the sun. Children may not be exposed to the sun
for long periods of time without protection. A sunscreen of at least #25 is preferred.
Attachment: Medication Record
Medication Change Form
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: PSYCHIATRIC MEDICATION
POLICY NUMBER: 07
ORC REFERENCE: 5101:2-7-07
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 9/19/2014
A
Record of psychiatric medication will be recorded utilizing the medication record at the time a child begins
taking any psychiatric medication.
B
A foster caregiver shall administer or supervise the administration of psychiatric medication to a foster
child only for whom the medication was prescribed and according to the prescribing physician’s
instruction.
1
Psychiatric medication shall be kept in a locked cabinet or completely out of the reach of any
children or adolescents, labeled with the foster child’s name the correct dosage and relevant
instructions.
2
Psychiatric medication shall be disposed of in a safe manner when the prescription is no longer
current.
3
Any side effects of psychiatric medication shall be discussed with the foster caregiver as well as
documented that the foster caregiver understands the side effects, and reported immediately to the
prescribing physician and the recommending agency.
4
Medication administration is to be documented daily using the medication log. The medication
record is to be turned in with monthly paperwork to the case manager.
C
Medications prescribed for one child may not be substituted for another child even if it is the same type and
dosage of medication.
D
Medication prescriptions are the responsibility of the foster caregiver to order. If a physician prescribes a
new drug or renews a prescription it is the foster caregiver’s responsibility to fill the prescription. The
child’s medication is not to be allowed to “run out”. Continuation of medication is very crucial especially
with drugs that address affect, behavior and seizures. The recommending agency will be notified
immediately for approval anytime a psychiatric medication dosage may change or when a psychiatric
medication is added or deleted.
E
Synergy FFC staff along with foster parents need to monitor the appropriate use of psychotropic
medications once children are placed within the agency. Synergy FFC will be working with ISAO
(Integrated Serves of Appalachian Ohio) in providing screening, assessment, and treatment planning when
it comes to providing mental health services for the children we serve.
1.
Initial diagnostic assessment with be scheduled and or provided within 3 business days of placement
for age appropriate children. During this this assessment it will be determined if a referral for
psychotropic medications is needed and if so a referral will be made to an ISAO child psychiatrist.
This is specifically for children that are not currently on any medication and not receiving current
mental health services. During this assessment process a treatment plan will also be developed.
Attachment: Medication Record
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
2.
For children being served through ISAO, Synergy FFC workers will be in ongoing contact with the
mental health provider and monthly reports on the child’s mental health services will be provided to
the agency which can in turn be provided to the custodial agency. The custodial agency will be made
aware of any initial medication prescribed along with being informed of any medication changes. This
information will be documented in SACWIS and then provided to the custodial agency at the time of
the change and within our monthly reports sent to the custodial agency.
3.
Synergy FFC in not exclusively involved with ISAO thus children working with other mental health
agencies can maintain their current services. Initial assessments will be done however to all new
placements (age appropriate) either provided or scheduled during the first three business day window.
4.
Synergy FFC staff will monitor medication usage by contacting the prescribing office, attending
appointments, or talking with foster parent after appointments. All of this contact is documented in
SACWIS.
Attachment: Medication Record
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: ALTERNATE CARE ARRANGEMENTS
POLICY NUMBER: 08
ORC REFERENCE: 5101:2-7-08
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 12/1/07, 4/1/12
A
A foster caregiver shall be responsible for the full-time care of a foster child. This does not prohibit both
foster caregivers in the case of a couple, co-parents, or a single foster caregiver from working outside the
home.
B
Alternative arrangements for the care of a foster child by someone other than the foster caregiver shall be
approved by the recommending agency.
C
A foster caregiver shall have prior written approval by the recommending agency of a plan for the care of
a foster child in emergency situations.
D
A foster caregiver shall have prior written approval by the recommending agency of a statement for each
foster child specifying whether or not the foster child may be left unattended and, if so, for what period of
time.
E
If a foster caregiver arranges for a foster child to be cared for in a child care center or by a type A or type B
child care provider, the foster care giver shall:
1
Ensure the child care center, Type A or Type B child care provided is licensed or certified in
accordance with Chapter 5101:2-12, 5101:2-13 or 5101:2-14 of the Administrative Code.
2
Provide documentation to the recommending agency that the child care center, type A or type B
child care provider is currently licensed or certified.
F
When a foster caregiver of a specialized foster home requests respite care, it shall be provided in
accordance with paragraph (A)(11) of rule 5101:2-5-13 of the Administrative Code.
G
Synergy Family Foster Care, Inc. is to be notified in advance of all child care arrangements other than
placement in assigned family foster home.
H
Alternative placements for a sexual offender must be approved by Synergy Family Foster Care, Inc. prior
to arrangement implementation. Very explicit explanations of risks must be discussed with the alternative
caregiver.
Attachment: Supervision Form
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: CARE, SUPERVISION AND DISCIPLINE
POLICY NUMBER: 09
ORC REFERENCE: 5101:2-7-09, 5101:2-5-13(A)(1)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 6/1/03, 3/1/07
A
A foster caregiver shall treat each foster child with kindness, consistency, and respect.
B
A foster caregiver shall not discriminate in providing care and supervision to the child on the basis of
race, sex, religion, color or national origin.
C
A foster caregiver shall provide humane, instructive discipline appropriate to the age and functioning level
of a foster child.
1
Disciplinary methods shall stress praise and encouragement for desired behavior rather than
punishment;
2
All rules and expectations made by a foster caregiver shall be explained to a foster child in a
manner appropriate to the child’s age and understanding during the child’s initial orientation and
prior to any disciplinary action for violations of such rules;
3
A child shall not be punished for actions over which the child has no control;
4
A child shall not be punished for bedwetting or in the course of toilet training activities;
D
A foster caregiver shall not subject a child to verbal abuse or swearing; to derogatory remarks about
foster children, their families, their races, their sex, their religion, their color or their national origin; or to
threats of physical violence or removal from the foster home.
E
A foster caregiver shall not use any of the following practices for a child:
1
Physical hitting or any type of physical punishment inflicted in any manner upon the body such as
spanking, paddling, punching, shaking, biting, hair pulling, pinching, or rough handling;
2
Use any form of chemical or mechanical restraint on a foster child:
3
Physically strenuous work or exercises, when used as a means of punishment;
4
Requiring or forcing a foster child to take an uncomfortable position, such as squatting or
bending, or requiring a foster child to repeat physical movements when used as a means of
punishment;
5
Denial of social or recreational activities for excessive or prolonged periods of time, no longer
than one week as defined by the agency;
6
Denial of social or casework services, medical treatment, educational services or counseling
services;
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
7
Deprivation of meals;
8
Denial of visitation or communication rights with the family of the child as a means of
punishment;
9
Denial of shelter, clothing, sleep, bedding or restroom facilities.
F
Any act of omission or commission by a foster caregiver or other member of the household which results
in the death, injury, illness, abuse, neglect or exploitation of a foster child shall be grounds for the denial
or revocation of a foster home certificate. This may be a recommendation of the agency supervising
a foster home or ODJFS.
G
A foster caregiver shall ensure that each child placed in the foster home who is not capable of meeting their
own personal hygiene needs is cleaned and groomed daily. Clothing and footwear shall be clean, well
fitting, seasonal and appropriate to the child’s age and sex. A child capable of meeting their own personal
hygiene needs shall be provided with adequate personal toiletry supplies appropriate to the child’s age, sex,
race and national origin. A foster caregiver shall provide each child instruction on good habits of personal
care, hygiene, and grooming appropriate to the child’s age, sex, race, national origin and need for training.
Synergy Family Foster Care, Inc. will respond to any violations noted in this policy with a one
time written memorandum to the Family Foster Home file. All repeat behavior will result in
removal of child and no other children will be placed in the home.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: CARE OF A FOSTER CHILD UNDER AGE TWO
POLICY NUMBER: 10
ORC REFERENCE: 5101:2-7-10
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED: 9/17/14
A foster child who is under two years of age or under thirty-five inches in height shall be provided with a
full-sized crib (by Synergy as needed) which meets the requirements of the “Consumer Product Safety
Commission”, as follows:
1
Crib slats shall be no more than two and three eighths inches apart.
2
Decorative cutout areas on crib end panels, which could entrap the head of a child, shall not be
permitted.
3
Only cribs that are compliant with the U.S. consumer product safety commission shall be used.
4
Each crib shall have a firm mattress which is at least one and one-half inches thick and covered
with a waterproof material not dangerous to a child. The mattress shall fit close enough in the
frame so that there is no more than one inch between the mattress and the sides of the crib.
5
A bassinet may be used only for infants under three months of age or less than fifteen pounds in
weight.
B
A foster child under two years of age shall be given regular opportunities for individual attention and
physical contact with a caring adult. A foster child under two years of age shall be given consistent and
regular opportunities for safe and comfortable participation in developmental activities such as sitting,
crawling, walking and playing as appropriate to his age and developmental ability.
C
A foster child under two years of age shall be supplied with safe play items appropriate to his age and
developmental ability.
D
A foster child under two years of age shall be fed according to instructions from his physician or the
agency as required by the child care agreement. For feeding, a foster child under two years of age shall
either be placed in a highchair, infant seat, or held, as appropriate to age. No foster child shall be placed in
a crib or bassinet for feeding. At no time shall a bottle be propped for feeding.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: SITE AND SAFETY REQUIREMENTS FOR A FOSTER HOME
POLICY NUMBER: 11
ORC REFERENCE: 5101:2-7-12
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 9/17/14, 6/3/15
A
A foster home and all structures associated with the home shall be maintained in a clean, safe, and sanitary
condition and in a reasonable state of repair.
B
Outdoor recreation equipment on the grounds of a foster home shall be maintained in a safe manner.
C
Outdoor areas on the grounds of or immediately adjacent to a foster home which are potentially
hazardous to a foster child placed in the home shall be reasonably safeguarded, considering the age and
functioning level of the foster child. Such areas include, but are not limited to:
1
Water areas, including lakes, ponds, rivers, quarries and swimming pools;
2
Open pits and wells;
3
Cliffs and caves;
4
High-speed or heavily traveled roads.
D
A foster home shall be adequately heated, lighted, and ventilated.
E
Bleach, cleaning materials, other poisonous or corrosive household chemicals, flammable and combustible
materials, potentially dangerous tools or utensils, and electrical equipment or machinery in or on the
grounds of a foster home shall be stored in a safe manner.
F.
Any firearm, air rifle, hunting slingshot or other projectile weapon kept on the grounds of or in a foster
home shall be stored in an inoperative condition in a locked area inaccessible to children. All ammunition,
arrows or projectiles for such weapons shall be stored in a separate locked space. There are to be none of
the above mentioned weapons in the presence of any foster child. Any foster caregiver that is also a law
enforcement official and can document that their jurisdiction requires them to have ready and immediate
access to their weapon shall be exempt from the requirements of this paragraph.
G
A foster home shall have a working telephone or be able to demonstrate to the recommending agency
reasonable access to a working telephone for emergency situations.
H
Appropriate emergency telephone numbers including fire, police, ambulance, poison control, the
recommending agency, and each agency with a foster child placed in the home shall be posted in a
prominent place in a foster home.
I
All locking doors inside a foster home shall be able to be unlocked from either side. Locking of the
children’s bedroom doors while children are sleeping is prohibited. Locking of outside doors is permitted.
Fencing around a yard or outside play area is permitted and must be locked around a pool.
Attachment: Authorization Form
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
J
A foster home shall have a continuous supply of safe drinking water. Well water used for drinking
and cooking shall be tested and approved by the health department prior to initial certification and
annually.
K
A foster home shall have working bathroom and toilet facilities located within the home and
connected to an indoor plumbing system.
L
Garbage shall be disposed of on a regular basis. Garbage stored outside shall be in covered containers or
closed bags.
M
A foster home shall have a working smoke alarm approved by “Underwriter’s Laboratory” on each
level of occupancy of the home.
N
A foster caregiver shall have a written evacuation plan for evacuating the home or seeking shelter in the
event of fire, tornado or other disaster. This evacuation plan shall contain a primary and alternate escape
route for each floor. A foster caregiver shall provide initial orientation and ongoing instruction on the
contents of this plan to each foster child in accordance with the foster child’s age and functioning level.
O
All escape routes shall be kept free of clutter and other obstruction.
P
Household heating equipment used in a foster home shall be equipped with appropriate safeguards
in accordance with the age and functioning level of any foster child in the home.
Q
Unvented heaters that burn kerosene or oil shall not be used. All heaters must be approved by
“Underwriter’s Laboratory”, and not prohibited by any local zoning ordinances.
R
A foster home shall have an “Underwriter’s Laboratory” approved portable fire extinguisher in working
order in or near the cooking area of the home and near the furnace.
S
Pets or domestic animals in or on the premises of a foster home shall be kept in a safe and sanitary
manner in accordance with state and local laws.
T
A foster child shall be protected from animals potentially dangerous to his health and safety in or on the
premises of a foster home.
U
Interior and exterior stairways accessible to children shall be protected child safety gates or doors
according to the child’s age and functioning level.
V
Trampolines, family swimming pools, and etc. may be used by children in foster care only with the
approval of the recommending agency.
W
A foster home shall provide a smoke free environment for foster children.
1.
2.
No smoking shall be permitted in the living area of a foster home or in a vehicle used to transport a
foster child when a foster child is present.
Smoking may be permitted in the home or vehicles used for transporting foster children only when no
foster child is present
Attachment: Authorization Form
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: FOSTER HOME CERTIFICATE
POLICY NUMBER: 12
ORC REFERENCE: 5101:2-7-13, 5101 :2-5-22
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED:
A
An agency shall not recommend for certification any applicant whose residence or person is licensed,
regulated, approved, or operated under the direction of, or otherwise certified as a facility to provide
overnight substitute care for unrelated persons, by the department of youth services, the department of
mental health, the department of alcohol and drug addiction services, a community alcohol, drug addiction
and mental health board, the department of developmental disabilities, a county board of mental retardation
and developmental disabilities, the department of health or a juvenile court.
B
A family foster home shall be recommended for certification by only one recommending agency at a time.
Each initial application for certification of a foster home shall be approved through an assessor's assessment
of the residence, prospective foster caregiver, and household members.
C
To submit a recommendation for certification of a foster home: A private child placing agency (PCPA) or
private noncustodial agency (PNA) shall submit to the Ohio department of job and family services
(ODJFS) a JFS 01317 "Recommendation for Certification/Recertification of a Foster Home" (rev. 1/2003).
D
Upon receipt of a JFS 01317, ODJFS will determine the effective and expiration dates of the certificate.
E
The effective date of an initial foster home certificate shall be no earlier than the day the JFS 01317 is
received by ODJFS as evidenced by the receipt date stamp or the date the recommendation is routed to
ODJFS in SACWIS. The JFS 01673 "Assessment of Child Placement" (rev. 8/2005) shall be used to
initiate all foster home homestudies.
F
The determination of the specific number, age, and sex of children to be placed in a particular foster
home is a joint responsibility of the foster caregiver and the recommending agency based on the agency’s
assessment of the foster caregiver’s capability and physical facilities as required by this chapter.
G
Nothing in the Ohio Revised Code shall be construed as requiring an agency to make or to continue the
placement of any child with any foster caregiver solely because of the presence of a current certificate.
H
A foster home shall not accept a child into care directly from a parent, another certified agency or other
legally approved placement source without the participation and agreement of the recommending agency.
I
If the applicants are married to each other, the foster home certificate shall be in the names of both
spouses residing in the home.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: REQUIRED NOTIFICATION
POLICY NUMBER: 13
ORC REFERENCE: 5101:2-7-14
DEVELOPED BY: Tom Stetzer
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 10/1/02, 1/1/03, 3/1/07
A
A foster caregiver shall notify the recommending agency in writing prior to allowing any person to reside for
more than two weeks in the foster home.
B
A foster caregiver shall notify the recommending agency immediately in any of the following circumstances
involving a foster child:
1
A serious injury or illness involving medical treatment of a foster child;
2
The death of a foster child;
3
Unauthorized absence of a foster child from the home;
4
Removal of a foster child from the home by any person or agency other than the placing agency, or
attempts at such removal;
5
Any involvement of a foster child with law enforcement authorities.
C
A foster caregiver shall notify the recommending agency immediately or the next working day when any fire
requiring the services of a fire department occurs within the home.
D
A foster caregiver shall notify the recommending agency and any agency which has placed a foster child in the
foster home immediately when the foster home becomes uninhabitable for any reason.
E
A foster caregiver shall notify the recommending agency within twenty-four hours or the next working day of
any of the other following circumstances:
1
Any impending change in the marital status of the foster caregiver or in the household occupancy of
the home;
2
Any serious illness or death in the household.
F
A foster caregiver shall inform the recommending agency at least four weeks prior to a planned move of the
foster caregiver.
G
A foster caregiver shall notify the recommending agency within twenty-four hours of any charge of any criminal
offense brought against the caregiver or any resident of his home. If the charges result in a conviction, the foster
caregiver shall notify the recommending agency within twenty-four hours of the conviction. Failure to notify the
agency in either of these circumstances shall result in ODJFS seeking an order to revoke the caregiver’s
certification to operate a foster home.
Pursuant to section 5103.0319 of the Revised Code, a foster caregiver or prospective foster caregiver shall also
notify the recommending agency in writing within twenty-four hours if a resident of the foster caregiver’s home
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
is at least twelve years of age, but less than eighteen years of age, and has been convicted of or pleaded guilty to
any of the offenses listed in Appendix A of Rule 5101:2-7-14 of the Administrative Code, or has been
adjudicated to be a delinquent child for committing an act that if committed by an adult would have constituted
such a violation. The notification is also required for any conviction or adjudication of delinquency resulting
from a violation of an existing or former law of this state, any other state, or the United States that is substantially
equivalent to any of the offenses listed in Appendix A of this rule.
If the recommending agency learns that a foster caregiver has failed to comply with this paragraph, it shall notify
ODJFS and ODJFS shall revoke the foster caregiver’s certification to operate a foster home.
H
Prior to the expiration date of a family foster home certificate a caregiver shall submit JFS 01331, “Notice of
Expiration and Reapplication for a Foster Home Certificate”, to the recommending agency.
I
Failure of a foster caregiver to submit the reapplication form prior to the expiration date of the current foster
home certificate shall cause the foster home certificate to expire.
J
A foster caregiver may voluntarily terminate a foster home certificate for any reason by providing written
notice of intent to terminate and the effective date of termination to the recommending agency.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: TRANSPORTATION
POLICY NUMBER: 14
ORC REFERENCE: 5101:2-7-15
DEVELOPED BY: Tom Stetzer
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 12/1/07, 3/1/10
A
Any vehicle owned or leased by a foster caregiver and used to transport a foster child shall be maintained
in a safe condition and in compliance with all motor vehicle laws. Such vehicles shall be covered by
liability insurance in accordance with current state laws.
B
A foster caregiver shall ensure that any person transporting a foster child in a motor vehicle shall be
licensed to drive that class of vehicle and that such vehicle is maintained in a safe condition according to
state laws.
C
A foster caregiver shall ensure that a foster child transported in a motor vehicle shall at all times be
restrained by a seat belt including both a lap belt and a shoulder belt in vehicles that are so equipped.
D
When the foster child is less than four years old or forty pounds in weight, a child restraint seat secured by
a seat belt or the lower anchors and tethers for children (LATCH) system shall be used. The child restraint
seat shall be placed in the back seat of any motor vehicle that has a back seat.
1
An infant less than one year of age or twenty pounds in weight shall be restrained only in a rearfacing position and whenever possible shall not be placed in the front seat of a motor vehicle
equipped with passenger air bags.
2
Children at least one year old and between twenty pounds and forty pounds in weight shall be
restrained in a forward-facing position.
E
If the foster child is less than eight years of age and less than four feet nine inches in height, the child shall
be properly restrained in a booster seat if paragraph (D) of this rule does not apply. The booster seat shall
be placed in the back of any motor vehicle that has a back seat.
F
If paragraph (D) of this rule does not apply and When the foster child is at least four eight years old of age
but not older than fifteen years of age and forty pounds in weight and less than eighty pounds or shorter
than four feet, nine inches in height, the child shall be restrained in a belt positioning booster seat in a
forward-facing position or in a seat belt including both a lap belt and a shoulder belt in vehicles that are so
equipped. The booster seat shall be placed in the back seat of any motor vehicle that has a back seat.
G
All children age twelve and under shall ride in the back seat of a motor vehicle that has a back seat and
shall not ride in the front seat of the vehicle unless the vehicle does not have a back seat. If a foster child
rides in the front seat of a vehicle as allowed by this rule, the foster caregiver must disable the passenger
side airbag if the vehicle is so equipped.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
H
Paragraphs (C), (D), (E), and (F) of this rule do not apply to the foster caregiver who has a signed affidavit
by a licensed physician in Ohio or a licensed chiropractor in Ohio. The affidavit shall state that the child
who otherwise would be required to be restrained, has a physical impairment that makes use of a child
restraint system, booster seat, or an occupant restraining device impossible or impractical, provided the
person operating the vehicle has safely and appropriately restrained the child in accordance with any
recommendation of the physician or chiropractor as noted on the affidavit.
I
Synergy Family Foster Care, Inc. will provide child restraint seats as needed.
J
Each foster caregiver shall ensure the recall and safety information issued by the consumer product safety
commission (CPSC) relat4ed to child safety seats or booster seats are reviewed. Any safety
recommendation made by the CPSC in regard to child safety seats or booster seats shall be implemented by
the caregiver.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: AGENCY GOVERNANCE AND ADMINISTRATION
POLICY NUMBER: 15
ORC REFERENCE: 5101:2-5-08, 5101:2-47-26.1 (G)(1)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 1/1/10
A
The governing body of the agency shall identify the names and current addresses of all board members,
current officers of the board, and any association, partnership or other arrangements under which the board
has been established or operates, and the names and current addresses of all partners or principle owners of
such association.
B
Synergy Family Foster Care, Inc. shall submit a copy of any proposed articles of incorporation or
amendments thereto to ODJFS prior to filing them with the secretary of state pursuant to section 5103.04 of
the Revised Code.
C
The agency shall have an office located within the state.
D
The minutes of all governing body meetings shall be maintained at the agency in an organized,
permanent and current manner and shall include, at a minimum:
1
Dates of meetings;
2
Names of those governing body members present; and
3
Issues discussed and actions taken.
E
The agency shall compile and maintain a current written table of organizations.
F
The agency shall not permit public funds to be paid or committed to be paid to any corporation, firm,
association or business in which any of the members of the governing body of the agency, the executive
personnel or their immediate families have any direct or indirect financial interest, or in which any of these
persons serve as an officer or employee, unless the services or goods involved are provided at a competitive
cost or under terms favorable to the agency. The agency shall make a written disclosure, in the minutes of
the board, of any financial transaction of the agency in which a member of the board or his/her immediate
family is involved.
G
A person who is employed by a agency certified under this chapter or any person who is a member of the
governing body shall not be eligible to vote on or participate in the decision making process with respect to
any matter or issue in which he/she could benefit financially or materially.
H
The agency shall have a written mission statement and a description of its programs.
I
The governing body of the agency shall evaluate the performance of the agencies administrator in writing
on an annual basis to be completed on or before January 1st of each proceeding year.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
J
The governing body of the agency shall review, approve and monitor a written annual budget for the
agency. Such budget shall ensure funding to provide services relevant to all certified functions and detail
anticipated income and expenditures.
K
The agency shall have an independent certified or registered public accountant authorize and review a
written annual audit.
L
The governing body of the agency shall develop an annual review of the agency written policies relevant to
the agencies certified functions.
M
No members of the board shall be made up by executive staff, family members, or foster parents employed
by Synergy Family Foster Care, Inc.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: CHILD RECORDS
POLICY NUMBER: 16
ORC REFERENCE: 5101:2-7-10
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED:
A
Synergy Family Foster Care, Inc. will maintain a separate file for each child placed in the agencies care.
B
Synergy Family Foster Care, Inc. requires the recommending agency to provide the following within
fifteen days:
1
medical records;
2
social history;
3
educational information (IEP, last school attended & previous school records);
4
birth certificate;
5
copy of social security card;
6
results of psychological and/or psychiatric tests;
7
legal data;
8
any other data pertaining to the care of the youth.
C
Synergy Family Foster Care, Inc.’s records must indicate that all information was requested from the
recommending agency. Any information still pending will be indicated on the monthly report as a
reminder.
D
All child records must be locked with access only to Synergy Family Foster Care, Inc. staff and the
recommending agency.
E
Information in the child’s file may only be released with the proper document (release of information)
signed by the recommending agency.
F
Records will be kept for a period of five years after the discharge date of the child. Records will then be
shredded or transferred to agency who may be assuming the responsibilities of Synergy Family Foster
Care, Inc.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: COMPLAINT HANDLING
POLICY NUMBER: 17
ORC REFERENCE: 5101:2-5-11, 5101:2-33-03
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 7/1/05
A
Whenever the Ohio Department of Job and Family Services (ODJFS) receives a complaint alleging that an
agency is in violation of any of the requirements of Chapters 5101:2-5, 5101:2-7, 5101:2-9, 5101:2-33,
5101:2-39, 5101:2-42, 5101:2-44, 5101:2-47 or 5101:2-48 of the Administrative Code (OAC) relative to
Synergy Family Foster Care, Inc. functions performed by the agency, ODJFS shall commence an
investigation of the allegations within three working days.
B
Whenever ODJFS receives any report concerning the operation of a certified agency which alleges that
child abuse or neglect has occurred or is occurring, ODJFS shall immediately refer the report to the
appropriate PCSA.
C
At the commencement of a site investigation by ODJFS of a complaint, other than an abuse or neglect
investigation, ODJFS shall contact the administrator or designee of the agency and explain the nature of the
complaint.
D
Synergy Family Foster Care, Inc. shall cooperate with ODJFS in the investigation of any complaint and
with the implementation of any required corrective action plans whenever an investigation finds a violation
of the requirements of Chapter 5101:2-5, 5101:2-7, 5101:2-9, 5101:2-33, 5101:2-39, 5101:2-42, 5101:2-44
or 5101:2-48 of the Administrative Code as applicable to the functions performed by the agency.
E
Upon completion of the investigation of a complaint ODJFS shall conduct an exit interview with the
administrator or designee. The purpose of the exit interview is to inform the administrator of the findings
of the investigation. Any areas of noncompliance will be presented in writing on JFS 01391 “Summary of
Findings of Noncompliance” and explained to the administrator or designee during the exit interview. The
signature of the administrator or designee on the JFS 01391 shall signify only that the administrator or
designee have received the JFS 01391.
F
Synergy Family Foster Care, Inc. shall not recommend denial or revocation of a foster home certificate or
discharge, demote, suspend, reduce board payments to a foster home, or threaten to recommend denial or
revocation of a foster home certificate, discharge, demote, suspend, or in any manner discriminate against
any foster caregiver or employee based on the foster caregiver or employee taking any of the following
actions:
1
Making any good-faith oral or written complaint to ODJFS regarding a violation of any OAC rules
applicable to the functions performed by the agency;
2
Instituting or causing to be instituted any proceeding against Synergy Family Foster Care, Inc.
under this chapter;
3
Acting as a witness in any proceeding under this chapter; or
4
Refusing to perform work that constitutes a violation of any OAC rule applicable to Synergy
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
Family Foster Care, Inc. certified functions.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: DISCIPLINE AND RESTRAINT
POLICY NUMBER: 18
ORC REFERENCE: 5101:2-5-13(A)(1)
DEVELOPED BY: Tom Stetzer
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 6/1/07, 4/22/10
A
Synergy Family Foster Care, Inc. does not allow for the use of any type of physical restraint to be used on a
foster child. Verbal de-escalation and support are preferred to physical contact.
B
In situations where a child is becoming violent or destructive and the foster parent has concerns for their
own protection, the protection of the child, protection of another person or child in the home or property
they need to contact law enforcement immediately. The parent should try to de-escalate the child and
remove the child from the area to somewhere less dangerous such as outside.
C
The foster parent must contact Synergy Family Foster Care Inc. immediately following these types of
situations. A detailed written report (incident report) of the incident shall be faxed by the case manager to
the custodial agency within twenty-four hours following this type of situation. A copy of the written report
(incident report) shall be placed in the foster child’s file and in the foster caregiver’s file.
D
Synergy Family Foster Care, Inc. does not provide services, which utilize therapeutic seclusion.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: RELIGIOUS PARTICIPATION, SOCIALIZATION, EDUCATION, CULTURE, AND ETHNIC
HERITAGE
POLICY NUMBER: 19
ORC REFERENCE: 5101:2-5-13(A)(2), 5101:2-5-16, 5101:2-7-11
DEVELOPED BY: Tom Stetzer
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 6/1/03, 4/1/12
A
A foster caregiver shall allow privileges and assign responsibilities to a foster child similar to those which
would be assigned to a family member of the foster caregiver who is of similar age and functioning level.
B
A foster caregiver shall make arrangements with the recommending agency for each school-age foster child
to attend a school which complies with the minimum standards as prescribed by the state board of
education and shall ensure that the foster child attends school in accordance with the child care agreement.
A foster caregiver who provides home schooling for a foster child shall do so only with the approval of the
child’s custodial agency. Any home schooling program used by a foster caregiver shall be approved by the
public school district in which the caregiver resides.
C
A foster caregiver shall encourage a foster child to participate in the following activities as appropriate to
the child’s age and functioning level:
1
Community;
2
School;
3
Recreation;
4
Cultural Heritage.
D
A foster caregiver shall, as is necessary and reasonable, arrange appropriate transportation for the child to
and from the activities listed in paragraph (C) of this rule.
E
Synergy Family Foster Care, Inc. follows state ODJFS regulations and believes every child has the right to
enjoy freedom of thought, conscience, and religion. A foster caregiver shall encourage and as well as
permit a foster child to practice the chosen religious faith of the foster child or his parents and shall not
subject a foster child to any form of religious coercion.
F
A foster child shall not be baptized or submitted to any religious procedures without prior consent of the
child according to their age and functioning level and prior approval of the foster child’s parent, guardian
or custodian. Whenever possible religious preference will be considered when matching for placement.
The foster caregiver shall permit a child may practice their chosen religious faith of the child or his parents,
unless it is determined and documented in the child’s case plan by the custodial agency that practicing the
child’s or family’s chosen beliefs and faith is not in the child’s best interest.
G
A foster caregiver shall, as appropriate, teach a foster child tasks and skills required for life in the
community.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
J
Synergy Family Foster Care, Inc. shall not require a child in foster care to receive non-emergency medical
treatment which conflicts with the religious tenets or practices of the religion of the child or parent without
the specific written consent of the parent, guardian or recommending agency.
K
When a child in foster care requires emergency medical treatment and such treatment conflicts with the
religious tenets or practices of the child, parent, guardian or custodian, Synergy Family Foster Care, Inc.
will immediately transport or arrange for the transportation of the child to a medical facility and contact the
custodial agency or the individual who placed the child. The case manager will follow-up with an incident
report which must be faxed within twenty-four hours.
L
Every child has the right to enjoy freedom of thought, conscience, and religion. Synergy Family Foster
Care, Inc. shall, in consultation with the parent or guardian and legal custodian, make available to a child in
foster care, cultural or ethnic activities appropriate to the child’s cultural or ethnic background.
M
Opportunity shall be provided each child in foster care for practicing in religious beliefs and faith. A
child may be encouraged to participate in religious activities, but shall not be coerced to do so.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: FOSTER CAREGIVER RECRUITMENT STRATEGIES
POLICY NUMBER: 20
ORC REFERENCE: 5101:2-5-13(A)(3), 5101:2-48-05
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED: 1/1/03, 6/1/03, 1/1/05, 7/1/05,
6/1/07, 12/1/08, 4/16/10
RECRUITMENT OVERVIEW:
Synergy Family Foster Care, Inc. will recruit a variety of individuals from the communities that they serve.
Synergy Family Foster Care, Inc. will not deny or delay licensure to any individuals based solely on sexual
orientation, cultural orientation, religion, national origin, ethnicity, age, color, race, or handicaps. Synergy
Family Foster Care, Inc. shall initiate a program that will recruit individuals from a wide variety of
backgrounds and experience that will coincide with the background and needs of the child being served.
All applicants will have in their home an operating phone prior to certification. The licensing specialist of
Synergy Family Foster Care, Inc. will conduct a face-to-face visit with all members of the home. Synergy
Family Foster Care, Inc. will schedule home studies and training’s to meet the needs of the applicant(s).
The initial face-to-face visit will include information describing the application process, explaining the
necessary forms, policy & procedures and training requirements. All forms needed will be given to the
applicant at the time of the initial visit. Individuals will be screened as to the appropriate level of care, age,
and gender so a child is placed in a home that will best meet the needs of that child. This will be
documented in the home study. Individuals interested in obtaining a license must possess a willingness to
work with youth from ages 0 to 21 years of age, from a variety of backgrounds and levels of care ranging
from but not inclusive to sexual, physical and verbal abuse, neglect, substance abuse, sexual perpetrators,
emotional difficulties, physical handicaps, learning disabilities, and juvenile delinquency. Methods of
recruitment will include but not be inclusive to; posters, newspaper ads, displays at community functions
and by word of mouth. Individuals interested in becoming foster parents must be able to attend a series of
pre-service training’s as well as attending the required on-going yearly training required by the ODJFS
Administrative Code. Training will be offered per the training schedule that has been approved by ODJFS.
The prospective family foster home must also complete a home study process as defined by ODJFS. The
caregiver(s) must also display both good physical and mental health and a safe environment for the youth.
The prospective foster parent(s) must be able to complete a series of background checks, be willing to
attend meetings concerning the youth, work cooperatively with both the recommending agency and
Synergy Family Foster Care, Inc. and be willing to strive to implement the care plan to maintain the well
being of the child placed in the family foster home.
B
AGES:
Synergy Family Foster Care, Inc. will accept youth from the ages of 0-21.
C
EMOTIONAL /DEVELOPMENTAL NEEDS:
Children in foster care will need nurturance support and development of emotional needs. The foster
caregiver will be helped to recognize normal and abnormal developmental needs, time lines, and behaviors.
Children placed in foster care may have experienced abuse, neglect, and major emotional losses. Such
children may exhibit signs and symptoms of such abuse and neglect in forms of heightened anxiety,
depression (with suicidal behavior), poor self-esteem, acting out and delinquent behavior.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
D
PHYSICAL NEEDS:
The child’s physical needs will need to be met by the family foster home. The child will need food, shelter,
clothing, and separate beds, dressers for their possessions, personal space, and choice of belongings. It is
required that all medical needs are immediately addressed and preventive optical and dental exams are
provided.
E
RACE, COLOR AND NATIONAL ORIGIN BACKGROUNDS:
Children will be accepted into foster care from a variety of race, color and national origin backgrounds.
The issues and practices held by a foster child will be discussed with the foster caregiver. The ethical,
religious, racial and cultural needs of the children must be understood, appreciated, and met by the family
foster home. Synergy Family Foster Care, Inc. will not delay or prohibit the placement of a youth because
of the agency’s inability to locate a home of the same race or ethnic placement.
F
LEVELS OF CARE:
Foster caregivers will receive children who need various levels of care that will fall into but not be limited
to one of four categories being served through Synergy Family Foster Care, Inc.;
Regular Care includes but is not limited to youth that have been identified by the recommending agency
as having been physically or verbally abused and/or neglected and may also have been found dependent.
Youth classified as Moderate Degree of Difficulty includes but is not limited to sexually abused, unruly,
learning disabled, physically disabled, returning to the community from the Department of Youth Services
or has a history of minor drug usage. Exceptional Degree of Difficulty is the third category. This includes
but is not limited to sexual perpetrators, moderate to severe drug dependency and those youth having a
history of in patient psychiatric treatment, which includes suicidal ideation. Extreme Degree of Difficulty
includes but is not limited to high risk, difficult to place youth due to behavior disorders, sexual
perpetrators and medically fragile youth who require continuous medical attention. Synergy Family Foster
Care, Inc. will also accept sibling groups and pregnant teens. Synergy Family Foster Care, Inc. will
provide ongoing training to the foster parents, as well as the case managers to work with all the above
levels of intensive care.
G
RECRUITMENT PROCEDURE:
1
Once the prospective individual contacts Synergy Family Foster Care, Inc. ,the licensing specialist
must respond within 72 hours.
2
A brief description of the program and any questions will be discussed during the initial phone
conversation.
3
An initial face-to-face visit will be scheduled within one week of the initial contact.
4
All necessary paperwork including all ODJFS required forms will be completed within a timely
manner. It is Synergy Family Foster Care, Inc. policy that all individuals in the home over 18
years of age must complete a set of fingerprints, a background check and a medical examination.
Family foster homes are licensed with ODJFS and registered through SACWIS.
5
Thirty-six hours of pre-service training will be offered with times, dates and locations to try and to
accommodate the individual needs of the prospective family foster home.
6
Reimbursement for the care of the youth will be discussed during the pre-service training. The
rates are established through Synergy Family Foster Care, Inc. pre-established rates as well as any
special agency contract rates.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
7
Synergy Family Foster Care, Inc. will notify the foster home in which the child lives should the
child become available for adoption. This notification will be done in writing by certified mail
and a copy put in the child’s file as well as the family foster home file.
8
Foster care recruitment will be conducted in a timely manner. Placements will be made according
to level of experience and bed availability as well as geographic location to the primary family
although placement of youth cannot be delayed or denied based on geographic boundaries, race,
color, creed, religion, ethnicity, national origin, handicap, or age. Placements will be made for the
betterment of the youth, not to accommodate a foster parent. All placements must be approved
through the Licensing Specialist.
9
Synergy Family Foster Care, Inc. views the Central Southern Region of Ohio as its community
although placement of youth cannot be delayed or denied based on geographic boundaries. Ads
will be placed in county newspapers on a rotational basis. The frequency of ads will be defined
by the agency’s need for county specific homes. In cases where a larger number of homes are
required, targeted marketing will be utilized (i.e. signs in stores, churches, etc.).
10
Synergy Family Foster Care, Inc. staff will be equipped to deal with diverse cultural, racial, ethnic
and economic communities. The Synergy Family Foster Care, Inc. stall will be trained by
attending accredited workshops, area conferences, and trainings. In order to provide proof of
attendance copies of all certificates will be maintained in the employees file.
11
Synergy Family Foster Care, Inc. will provide services on an as needed basis to families with
language barriers or hearing impairment. For those clients with language barriers we will utilize a
telephone interpreting service from the company thebigword. When needing to work with client
with hearing impairments we will utilize services by Community Services for the Deaf in
Portsmouth, Ohio 740-356-7200 and Personal Interpreting Services in Lancaster, Ohio 614-8374040.
12
All foster caregiver recruitment activities and materials shall be in compliance with the “Indian
Child Welfare Act of 1978” (5101:2-42-48 to 5101:2-42-58 of the Administrative Code), 25
U.S.C.A. 1901, as amended, and the “Adoption and Safe Families Act of 1997”, the Multiethnic
Placement Act of 1994 as amended by Section 1808 of the Small Business Job Protection Act of
1996, 42 U.S.C. 622(b)(9), 671(a) (18), 674(d) and 1996(b) (hereinafter “MEPA”) and Title VI of
the Civil Rights Act of 1964, 42 U.S.C. 2000d, et seq., as they apply to the Adoption process
(hereinafter “Title VI”), do not supercede the provisions of the Indian Child Welfare Act of 1978.
13
Methods for disseminating general information regarding the children served by the agency will
be discussed during family orientation meeting with the perspective foster family along with any
recruitment activities that the agency conducts. The agency will also discuss general information
during initial phone contact and throughout the initial pre-service training process.
14
Synergy Family Foster Care shall submit a copy of the agency recruitment plan to ODJFS by May
first of each even numbered year, addressing the upcoming two state fiscal years. This is from 71-10 to 6-30-11 and 7-1-11 to 6-30-12. If Synergy Family Foster Care amends its recruitment
plan at any other time then the required due date, the agency shall be responsible for submitting
the amended recruitment plan to ODJFS within ten days following a plan change. If
noncompliance is identified, ODJFS shall notify Synergy Family Foster Care of noncompliance
within sixty days of the department’s receipt of the plan.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: SIMULTANEOUSLY APPROVING APPLICANTS FOR FOSTER CARE AND ADOPTION
POLICY NUMBER: 21
ORC REFERENCE: 5101:2-5-13(A)(4)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED: 3/1/07, 1/1/10
Synergy Family Foster Care, Inc. has been certified to act as a representative of ODJFS in recommending
foster homes to place children in foster care and will be responsible for:
1
Informing all individuals applying for an initial family foster home certificate that they can also be
studied for approval for adoptive placement.
B
Upon request Synergy Family Foster Care, Inc. will provide an ODJFS 1691 “Application for Child
Placement” to any person who resides in the state of Ohio and meets the specifications of the Synergy
Family Foster Care, Inc. recruitment plan pursuant to rule 5101:2-5-13 of the Administrative Code. As
prohibited by the Multiethnic Placement Act, 42 U.S.C.A. 1996 (B), as amended, MEPA, agencies may not
deny any person the opportunity to become a foster caregiver on the basis of race, color, or national origin
of the person, or of any foster child or children involved. Along with the ODJFS 01691 “Application for
Child Placement”, Synergy Family Foster Care, Inc. will provide an applicant a copy of Chapters 5101:2-5
and 5101:2-7 of the Administrative Code.
C
Synergy Family Foster Care, Inc. will use JFS 01691, “Application for Child Placement”, for all initial
family foster home and adoption.
1
Synergy Family Foster Care, Inc. shall not accept a JFS 01691 which does not contain complete
information. Incomplete applications shall not be processed by the agency and do not afford the
applicant an opportunity for a hearing pursuant to Chapter 119 of the Revised Code. Applications
found to contain inaccurate or wrong information shall be denied pursuant to rule 5101:2-5-26 of
the Administrative Code.
2
Synergy Family Foster Care, Inc. will require that an application be made in the full name of each
adult member of a couple, a single person or each co-parent.
3
Synergy Family Foster Care, Inc. will not accept more than one application per household.
4
Except as provided in paragraph (1) of rule 5101:2-7-02 of the Administrative Code, Synergy
Family Foster Care, Inc. will not recommend a person to be certified as a foster caregiver if the
person has been convicted of any crime listed in paragraph (J) of rule 5101:2-7-02 of the
Administrative Code.
5
Synergy Family Foster Care, Inc. will not approve a prospective foster caregiver on a conditional
basis awaiting the results of the criminal records check required by paragraph (L) of rule 5101:27-02 of the Administrative Code. The required criminal records checks must be completed prior
to Synergy Family Foster Care, Inc. recommending a prospective foster caregiver for certification.
Synergy Family Foster Care, Inc. requires all household members over the age of 18 to be finger
printed, not applicable to biological child turning 18 years old, who continues to live in the home.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
Synergy Family Foster Care, Inc. requires that any person subject to a criminal records check
successfully complete the criminal records check before the person may participate in any
preplacement training required by rule 5101:2-5-33 of the Administrative Code.
D
The applicant must be a legal resident of the United States and reside in the State of Ohio.
1
Synergy Family Foster Care will conduct a search on the SACWIS System or through Central
Registry on each adult household member to determine suitability.
E
Synergy Family Foster Care, Inc. will require that the applicant provide a medical statement for all
members of the household on the ODJFS 1653 “Medical Statement for Foster Care/Adoptive Applicant and
All Household Members”, completed by a licensed physician within six months prior to an initial
recommendation by Synergy Family Foster Care, Inc. for certification. Such statement shall document that
the caregiver and all members of the household are free from any physical, emotional, or mental condition,
which would endanger children or seriously impair the ability of the household to care for a foster child.
F
Synergy Family Foster Care, Inc. may require an applicant to secure and provide to the agency a report of
additional examination by a licensed physician, or psychologist, or other certified or licensed professional
if:
1
An applicant or any person residing within the household has suffered a serious illness or injury
within the past year; or
2
It is determined to be necessary by Synergy Family Foster Care, Inc. to ensure the safety, health,
or care of any foster child who may be placed in the family foster home.
3
Synergy Family Foster Care, Inc. may require the person to provide the report of an additional
examination before the applicant may participate in any preplacement training required by rule
5101:2-5-33 of the Administrative Code.
G
Prior to recommending initial certification Synergy Family Foster Care, Inc. will require and assure that
each applicant successfully completed the required twenty-four hours of pre-service training as required by
rule 5101:2-5-33 of the Administrative Code.
H
Synergy Family Foster Care, Inc. will require that each applicant provide to the agency the names of four
individuals who are unrelated to the applicant who can be contacted by the licensing specialist as
references. In addition Synergy Family Foster Care, Inc. will require that each applicant provide the name
of any other agency or organization which the applicant has been previously certified as a foster caregiver,
or has provided care and supervision of children, as well as a written signed release of information
statement in order that any such reference may be contacted.
I
Prior to making an initial recommendation for certification for a foster home, Synergy Family Foster Care,
Inc. will contact all references given by the applicant, including any other agency or organization with
which the applicant has been previously certified as a foster caregiver, or has provided care and supervision
of children. All contacts with references shall be documented in the narrative section of either the JFS
01349 “Foster Home Homestudy” or the JFS 01673, “Assessment for Child Placement (Homestudy),” as
appropriate.
J
Synergy Family Foster Care, Inc. will require each foster caregiver to obtain an inspection of the foster
home by a State Certified Fire Safety Inspector or the State Fire Marshal’s Office, not more than six
months prior to Synergy Family Foster Care, Inc.’s recommendation for initial certification, certifying that
the foster home is free from conditions hazardous to the safety of foster children. If a prospective foster
caregiver is unable to obtain such an inspection due to the unavailability of a State Certified Fire Safety
Inspector or the State Fire Marshal’s Office and the agency can document in writing when the request was
made and the response from the Certified Fire Safety Inspector or the State Fire Marshal’s Office that such
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
an inspection cannot be completed within six months of the request, then Synergy Family Foster Care, Inc.
may conduct an alternative safety audit.
K
If an alternative safety audit is conducted, such audit shall be completed using JFS 01348 “Safety Audit
of a Foster Home” and shall document that the residence has met all safety standards required by rules
5101:2-7-05, 5101:2-7-10, 5101:2-7-12 and 5101:2-7-15 of the Administrative Code.
L
No recommendation for certification will be made to ODJFS prior to the completion of all requirements of
Chapters 5101:2-5 and 5101:2-7 of the Administrative Code which are applicable to initial certification and
documentation that the applicant is in compliance with the requirements of Chapter 5101:2-7 of the
Administrative Code.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: FOSTER CAREGIVER ASSESSMENT ACTIVITIES
POLICY NUMBER: 22
ORC REFERENCE: 5101:2-5-13(A)(5)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED:
Synergy Family Foster Care, Inc. requires a foster caregiver applicant to complete or participate in only
those materials or activities specifically required by Chapter 5101:2-7 of the Administrative Code. Synergy
Family Foster Care, Inc. does not require any extra materials or documentation to complete a family foster
home applicant’s home study.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: PAYMENT TO FOSTER CAREGIVER
POLICY NUMBER: 23
ORC REFERENCE: 5101:2-5-13(A)(7)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED: 8/8/02, 6/1/04, 1/1/08
REIMBURSEMENT:
Synergy Family Foster Care, Inc. has developed a reimbursement scale based on the level of care of the
child; Traditional, Degree of Difficulty, Special Needs, and Intensive Care. The level of care is derived
from a contractual agreement established between Synergy Family Foster Care, Inc. and the recommending
agency which specifies a plan for services that will best fit the child’s needs at the time of placement. The
services will include but not limited to; food, shelter, clothing, supervision, transportation, community
activities, family activities, school activities, allowance, personal care items, independent living skill
training and other services as identified by the care plan. The reimbursement may range from $13.00 $40.00 dollars a day. Synergy Family Foster Care, Inc. will reimburse the foster family every 14 days.
The pay-period will be every other Friday. The first 14 days will be held back. The amount will be set and
discussed prior to the placement of the child in the home. A financial section in the care agreement will
specify the amount to be paid out to the foster parent, which will be signed by the foster parents and the
Business Administrator of Synergy Family Foster Care, Inc. A copy will be placed in the Business
Administrator’s file. Changes made in the per-diem rate from the recommending agency will be made
effective in accordance with the contract from the recommending agency. Pay to the foster parents will be
adjusted the next pay day covering the billing dates. New contracts shall be signed by the foster parents
and the Business Administrator within 14 days of the rate change.
1
2
3
4
Regular Care: $13.00 to 25.00 a day
Moderate Degree of Difficulty: $32.50 a day
Exceptional Degree of Difficulty: $40.00
Extreme Degree of Difficulty: $47.50
** Reimbursement Rates may vary due to other contractual agreements derived at the time of intake
or due to a County Contract that has been set in advance. In some cases an agency may ask that a
child be re-evaluated and the reimbursement lowered. In such cases the situation will include a
meeting that includes the placing agency, foster parent(s) and Synergy Family Foster Care, Inc. In
such a case, children are to remain in the foster home. Children will not be transferred due to a
decrease in the rate of pay. Such incidents may result in a rules violation as well as a loss of
consideration for any new placements in the family foster home.
B
RESPITE:
Synergy Family Foster Care, Inc. will provide funds at $30.00 a day that will pay for two days of respite
per month per child. The money will be held in escrow for the foster parent. The respite days may be
carried over from month to month but not calendar year to calendar year. Each new year begins a new
respite fund. The foster caregiver and the respite foster caregiver must each transport the youth one way or
meet half way in between the foster homes. The foster caregiver must have the respite approved through
the agency. If a child is sent to respite but does not return to the original foster home then no respite will be
paid to that family. Foster child needs to return to the foster home in order for respite payments to be made
to the family.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
C
TRAININGS:
All licensed foster caregiver will be reimbursed $10.00 per parent, per hour, per training for up to the
required training needs per year as long as the training has been provided or funded by Synergy Family
Foster Care, Inc.
D
EXTRAORDINARY EXPENSES:
There are no regularly paid expenses beyond the regular reimbursement. Special reimbursement will be
considered on an individual basis and must be approved in advance through the Business Administrator.
Once the foster parent notifies the case manager the first step will be to explore other options such as
community resources, then the recommending agency will be asked to help with the extra expenses in part
or in full. Once all other options have been exhausted, than Synergy Family Foster Care, Inc. will consider
the request.
E
CLOTHING VOUCHERS
1.
All gift cards must be picked up from the Synergy office or distributed by the case manager.
2.
All receipts must be turned in within 30 days in the self addressed envelope provide or dropped off
at the Synergy office. No receipts are to be given to the case manager to be returned to the office.
3.
If receipts are not submitted then no further clothing vouchers will be distributed to the foster
family until records are up to date.
a.
If the child leaves the home before the receipts are submitted then the cost of the clothing voucher
will be deducted from the foster family’s per-diem payment.
4.
If a foster family chooses to purchase items at another store they may submit the receipts at the
time the clothing voucher would be distributed and receive reimbursement on their next per-diem
payment.
5.
Clothing vouchers are distributed on the following dates: April 30th, August 31st and December
31st.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: FOSTER CAREGIVER PREPLACEMENT AND CONTINUING TRAINING
POLICY NUMBER: 24
OAC REFERENCE: 5101:2-5-13(A)(8), 5101:2-5-40(G)(4)(a-g)) and 5101:2-5-33
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 4/1/03, 1/2/07, 11/15/10, 12/4/14,
8/1/16
A
Synergy Family Foster Care, Inc. shall assure that each person seeking certification successfully completes
all preplacement training required by this policy according to the type of foster home for which
certification is sought. The projected outcome of the parents completing the preplacement training would
be they have more knowledge of the issues that plague children in the child welfare system, understanding
of the thoughts and feelings of the biological family, an understanding of the guidelines in which child
welfare agencies work, a game plan on how to help and deal with issues that could arise in the foster home
and be prepared to provide quality foster care services to children placed in their home
B
Synergy Family Foster Care, Inc. shall assure that each foster caregiver for whom recertification is
recommended successfully completes all continuing training required by this policy for Family, Treatment
or Medically Foster homes, unless a waiver is approved by Synergy Family Foster Care, Inc. pursuant to
paragraph (L) of this policy and appropriately documented according to paragraph (M) of this policy.
C
Synergy Family Foster Care provides pre service training to individuals wanting to become Family Foster
caregivers or Treatment Foster caregivers along with families wanting an approved adoption home study.
The curriculum utilized was developed by Ohio Child Welfare Training Program and consists of twelve 3
hour sessions. Completion of this of the thirty-six hours of preplacement training will be provided along
with the home study process prior to the placement of any youth in the home. The pre-service trainer will
be someone whom has completed their adoption assessor training or in the process of doing so. Courses
provided during the pre- service training are the following:
1
2
3
4
5
6
7
8
9
10
11
12
ORIENTATION TO FOSTER CARE, ADOPTION, AND KINSHIP CARE (includes Synergy
specific policies and procedures regarding foster caregivers.
THE CHILD PROTECTION TEAM (includes information on the legal rights and responsibilities
of foster caregivers along with educational advocacy for children and Community Health and
Social Services available to children ).
THE EFFECTS OF CHILD ABUSE OR NEGLECT ON CHILD DEVELOPMENT
ATTACHMENT, SEPARATION, AND PLACEMENT
MANAGING BEHAVIOR (includes appropriate behavior management techniques)
PREVENTING AND DE-ESCALATING CRISIS
CULTURAL ISSUES IN PLACEMENT
UNDERSTANDING PRIMARY FAMILIES
CHILDREN WHO HAVE BEEN SEXUALLY ABUSED
THE EFFECTS OF CAREGIVING ON THE CAREGIVER FAMILY (includes information on
the legal rights and responsibilities of foster caregivers and information required to be shared with
a foster caregiver as stated in Section 2152.72 of Revised code. Also includes information
regarding community health and social services available to families and children).
PERMANENCY FOR CHILDREN
PERMANENCY FOR FAMILIES
Attachment: Training Sign in Sheet
Training Tracking Sheet
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
D
In addition to the preplacement training requirements of paragraph (C) of this policy, all licensed foster
parents by Synergy Family Foster Care are required to have current first aid and CPR certification (which
will count for 8 hours towards their continuing training hours). A prospective family foster caregiver who
will be providing care for a youth expected to remain in foster care until the youth’s eighteenth birthday
shall be prepared adequately with the appropriate knowledge and skills to understand and address the issues
confronting adolescents preparing for Independent Living, and provide, under the instruction of the
recommending agency, such services to the youth as are needed and appropriate and, to the extent possible,
coordinate such services with the life skill services required to be provided by rules 5101:2-42-19 of the
Administrative Code. The substance of section 2151.62 of the Revised Code which deals with the
information required to be shared with a foster caregiver when a child who has been adjudicated a
delinquent child for the commission of certain violent crimes is placed in a foster home; a course
addressing section 2151.62 of the Revised Code shall be not less than one hour long. Families will also be
provided courses specific to the types of children placed in a treatment foster home and courses specific to
the types of children to be placed in a medically fragile foster home. These courses will be offered as part
of the continuing training program. New foster parents that have been trained using CWTP pre service
training revised June 2015 will be receiving Normalcy and the reasonable and prudent parent standard
within the pre-service training. Parents that were licensed prior to that date will receive training either at
Synergy Family Foster Care Inc. or at another venue in order to receive the Normalcy and the reasonable
and prudent parent standard training. Synergy Family Foster Care in utilizing the curriculum designed by
the CWTP dated September of 2015. This training is placed in all recertifying foster parents Training plan
and needs completed prior to their next certification.
E
Foster caregiver certified to operate a family foster home shall complete a minimum of forty hours of
continuing training during each certification period. Foster caregivers certified to operate a treatment or
medically fragile will need sixty hours of continuing training during each certification period. A
continuing training program shall consist of courses that a foster caregiver must complete in accordance
with the caregiver’s written needs assessment and continuing training plan. Along with the training
provided by Synergy we also utilize the regional training centers and also allow for parents to receive
training online through www.fosterparents.com . Topics provided through the regional training center are
placed in our monthly newsletter and the online courses are listed on the www.fosterparents.com website.
Synergy takes care of all costs in regards to these online trainings. The following topics are provided by the
agency twice a year and are as follows.
1
Parents and foster caregivers as part of child protection teams;
2
The dynamics of child abuse and neglect and recognizing and preventing child abuse and neglect;
3
The effect of child abuse and neglect on child development;
4
How foster caregivers should work with children and their families regarding placement,
separation, and attachment issues;
5
Behavior management techniques;
6
Foster caregivers’ working with children’s families;
7
Effects of caregiving on children’s families;
8
Caring for children who have been sexually abused;
9
Cultural competency;
10
Substance abuse and dependency;
11
Symptoms of mental illness and learning disorders; and
Attachment: Training Sign in Sheet
Training Tracking Sheet
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
12
Developmentally appropriate activities for children.
13
Maintain First Aid and Child Adult CPR
14
Preparing adolescents for independent living
15
Preparing parents for youth transitioning into adulthood.
F
No preplacement training received under paragraph (C) of this policy shall be counted towards the
completion of annual continuing training required by paragraph (E).
G
The continuing training plan will follow closely with each foster caregivers ITNA (Individual Training
Needs Assessment). The outcomes of the continuing training program is to build on the parents strengths
along with providing them additional focus and training on areas that are agreed upon need more
information and mastery. Overall the goal of the ongoing training program is to help in the placement of
children and restrict the need for moving a child to a new home. Give the parents the training and
information needed to help them deal with the children placed in their home.
H
In addition to the continuing training requirements of paragraph (E) of this policy, a family foster or
treatment foster caregiver who will be providing care for a youth expected to remain in foster care until the
youth’s eighteenth birthday shall be prepared adequately with the appropriate knowledge and skills to
understand and address the issues confronting adolescents preparing for Independent Living, and provide,
under the instruction of the recommending agency, such services to the youth as are needed and appropriate
and, to the extent possible, coordinate such services with the life skill services required to be provided by
rules 5101:2-42-19 of the Administrative Code.
I
Video presentations and training completed outside of a classroom shall be accepted only pursuant to the
following:
1
Video presentations may be used as a tool to meet preplacement or continuing foster caregiver
training requirements provided that a qualified trainer is present during the training session to
respond to questions or if the video presentation is part of a self-directed learning program
approved by ODJFS if it is not otherwise approved as part of an agency’s training proposal as ser
forth in rule 5101:2-5-40 of the Administrative Code.
2
Video presentations prepared for entertainment purposes shall not be considered as meeting
training requirements unless transfer of learning components are included prior to or following the
video presentation. Transfer of learning components may include a pretest, a posttest, or a
discussion following the video presentation. Video presentations prepared for entertainment
purposes shall not be used for preplacement training or to meet more than one-third of the training
requirements.
3
The acceptance of continuing training for Family Foster Homes, Treatment Foster Homes or
Medically Fragile Foster Homes that is completed outside a classroom where a trainer is not
present, shall be considered by Synergy Family Foster Care on an individual basis. Such
trainings, which may include training offered through video presentations, computer programs,
internet sites, interactive video presentations, books or magazines, shall not be used for
preplacement training or to meet more than one-third of a foster caregiver’s continuing training
requirements. To be accepted by Synergy Family Foster Care to meet a foster caregiver’s
continuing training requirements, the training must include a transfer of learning component prior
to or following the training. Transfer of learning components may include a pretest, a posttest, or
Attachment: Training Sign in Sheet
Training Tracking Sheet
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
a discussion following the training. Such training shall be consistent with Synergy Family Foster
Care’s written needs assessment and continuing training plan developed for the foster caregiver
pursuant to paragraph (K) of this policy.
4
J
Pursuant to rule 5101:2-5-38 of the Administrative Code, neither a foster caregiver training
stipend nor an agency training allowance payment shall be made for training completed outside a
classroom where a person in the role of a trainer is not present.
Synergy Family Foster Care, Inc. shall develop and implement a written needs assessment and continuing
training plan for each foster caregiver within 30 days of initial or recertification of an foster care license.
Each needs assessment and continuing training plan shall satisfy all of the following requirements:
1
Be effective for the two-year period the foster caregiver’s certificate is in effect;
2
Be appropriate for the type of foster home the foster caregiver operates;
3
Require the foster caregiver to successfully complete the courses the agency considers appropriate;
4
Include criteria Synergy Family Foster Care, Inc. is to use to determine whether the foster
caregiver has successfully completed the courses;
a
K
L
Synergy Family Foster Care, Inc. will have a pre-test and post-test to demonstrate the
foster caregivers level of competency on the subject being presented during
preplacement, as well as, continuing trainings.
5
Synergy Family Foster Care, Inc. will offer courses that are required to be completed based on
outcomes of the families continuing training plan to the foster caregiver at reasonable times and
places. Also linking up families with trainings provided by the ORTC (Ohio Regional Training
Centers).
6
For a family foster caregiver or a specialized foster caregiver, specify whether the agency will
waive any of the hours of continuing training the foster caregiver is required by paragraph (E) and
(H) and of this policy to complete during each certification period if the foster caregiver satisfies
the conditions for the agency to issue a waiver. If Synergy Family Foster Care will issue a waiver,
Synergy Family Foster Care shall state in the needs assessment and continuing training plan the
number of hours of continuing training, not to exceed eight during each certification period.
Synergy Family Foster Care, Inc. shall maintain a record for each foster caregiver showing the date,
location, course name and length of each preplacement and continuing training course each foster caregiver
attended, and the name of the trainer.
1
Perspective foster caregivers and foster caregivers will be required to sign-in on the training log
which identifies the date, training topic, and presenter and hours trained.
2
Upon completion of the training a certificate will be placed in the perspective foster caregiver and
foster caregiver file noting the topic of the training, the foster parent name, name of the instructor,
date of the training, length of the training and the location of the training.
3
All training will be entered on the ODJFS web-base SACWIS system with the course offering and
attendance to the stated training.
At the beginning, of a foster caregiver’s second certification period or a subsequent certification period,
Synergy Family Foster Care may include within the foster caregiver’s written needs assessment and
Attachment: Training Sign in Sheet
Training Tracking Sheet
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
continuing training plan, a waiver of up to eight hours of continuing training that a foster caregiver holding
a certificate for a family foster home or specialized foster home is otherwise required by paragraph (E) of
this policy to complete during the certification period, if all of the following apply:
M
1
The foster caregiver has held a foster home certificate for at least two years;
2
The foster caregiver has provided foster care for at least ninety days of the twelve months
preceding the date that Synergy Family Foster Care, Inc. issues the waiver;
3
The foster caregiver has not violated any requirements governing certification of foster homes
during the twelve months preceding the date Synergy Family Foster Care, Inc. issues the waiver:
4
The foster caregiver has complied in full with the needs assessment and continuing training plan
developed for the foster caregiver under paragraph (J) of this policy; and
5
The waiver is in compliance with Synergy Family Foster Care, Inc. policy that has been
established pursuant to rule 5101:2-5-13 of the Administrative Code regarding good cause for a
foster caregiver’s failure to complete the continuing training requirements of paragraph (B) of this
policy.
For each continuing training waiver approved by Synergy Family Foster Care, Inc. for a foster home the
following shall be maintained in the foster caregiver’s record:
1
The date of the waiver,
2
The number of hours of training waiver,
3
A statement that each of the requirements of paragraph (L) of this policy have been met, and
4
The name and signature of the authorized agency representative who approved the waiver.
N
Pursuant to Section 3 of Substitute House Bill 332 as enacted by the 123rd Ohio General Assembly, the
provisions of paragraph (C), (D) and (E) of this policy shall not apply to a foster caregiver holding a valid
certificate to operate a family foster home on January 1, 2001.
O
Synergy Family Foster Care, Inc. will not be held responsible for any damage done to a family foster home
by a child. Synergy Family Foster Care, Inc. recommends that all family foster homes obtain their own
liability insurance.
P
Synergy Family Foster Care, Inc. will not pay for any legal representation, legal fees, counseling, or legal
advocacy for foster caregivers for matters directly related to the proper performance of their roles as foster
caregivers.
Q
Upon notification of allegations of abuse and /or neglect involving a child living in a Synergy foster home.
Synergy Family Foster Care, Inc. shall notify the appropriate law enforcement department as well as the
recommending agency of the child involved in the allegations. Synergy Family Foster Care, Inc. will also
notify all recommending agencies of children placed within the family foster home. Synergy Family Foster
Care, Inc. will follow-up with the appropriate recommendations based on the findings of the investigation.
R
Qualified trainers shall possess knowledge of the training material and be able to communicate the
information to the caregiver in a way that a posttest will show the level of knowledge the caregiver gained
from the training. Adoption assessors will be utilized for pre-services and other on-going trainings provided
Attachment: Training Sign in Sheet
Training Tracking Sheet
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
by the agency.
S
Caregivers will be notified of the training program courses and the schedule by a yearly newsletter
distributed by January 31 of each year. In addition, reminders will be noted in the monthly newsletters
distributed by Synergy Family Foster care, Inc. Synergy Family Foster Care will make the training
schedule available to outside agencies upon request.
T
Synergy Family Foster Care, Inc. who operates a preplacement training program or continuing training
program approved by ODJFS shall make the program available to foster caregivers without regard to the
type of recommending agency from which a foster caregiver seeks a recommendation and without charge
to the foster caregiver. Synergy Family Foster Care shall make stipend payments according to the
following:
1
For pre-placement training, the agency that provides the training shall record the preplacement
training in the statewide automated child welfare information system (SACWIS) and shall be
responsible for paying the stipend to the caregiver upon certification.
2
For continuing training, the caregiver's recommending agency shall be responsible for paying all
stipends to the caregiver and shall enter all of the training sessions into SACWIS.
3
If the training is provided by a regional training center of the Ohio child welfare training program
(OCWTP), the agency that enrolled the participant is responsible for paying the stipend to the
participant.
Synergy Family Foster Care, Inc. will accept applications for training courses and schedule training for
caregivers outside the agency. The acceptance will be on a first come, first serve basis. The training will
be limited to twenty participants per training course. The recommending agency Synergy Family Foster
Care, Inc. will be responsible for providing the recommending agency with a training certificate and the
evaluation through mail, email or fax. .
U
Synergy Family Foster Care, Inc. will conduct a written evaluation of the effectiveness of the courses
offered and the overall effectiveness of the training programs every two years when submitting a new
training program to ODJFS. The evaluation will review the testing of the participants and gather input
from the caregivers concerning the training program and its effectiveness.
Attachment: Training Sign in Sheet
Training Tracking Sheet
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: HANDLING FOSTER CAREGIVER GRIEVANCES
POLICY NUMBER: 25
ORC REFERENCE: 5101:2-5-13(A)(9)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED: 3/1/07, 3/21/14
PURPOSE:
To provide a systematic process for all foster caregivers to use as an outlet to resolve differences that
appear to be interfering with the treatment process or any other programmatic issue so as to assure that all
individuals in need do not have to register the complaint with the party that may be the source of the
perceived concern. In addition this reporting process is to assure that any threat of retaliation is removed.
B
GRIEVANCE:
A written complaint initiated either verbally or in writing by a client or by any other individual or agency
on behalf of the client regarding denial or abuse of any of the client’s rights.
C
PROCEDURE:
Disagreements and misunderstandings can occur during case management due to the fact that change is
difficult and often emotional. It is preferred that disagreements be resolved quickly so that preservation of
casework relationship is maintained. The preferred practice is for the foster caregiver to discuss issues that
may arise with the supervisor that is responsible for the supervision of agency professionals who are being
perceived as the source of concern. The aggrieved party is encouraged to file a grievance in writing or by
telephone as soon as possible from the date, which the grievance occurred with any Synergy Family Foster
Care, Inc. staff member. The staff member receiving the grievance must document the information and
report it to the case manager supervisor within twenty-four hours. The aggrieved party must be notified by
the staff member within seventy-two hours of the receipt of the grievance in an attempt to resolve the
grievance.
The following is the procedure for filing a grievance:
1
Grievances must be filed within fourteen (14) calendar days (two weeks) of the date of the
incident and a reason for the grievance to the case manager supervisor. Grievance against the case
manager supervisor should be filed with the executive administrator.
2
All grievances will be registered through the case manager supervisor or executive administrator
in writing.
3
The following lists the proper steps to follow in filing a grievance.
a
In the case where the grievance is against the agency professional(s):
Case Managers/Social Workers
Case Aids
Student Interns
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
The grievance will be registered with the following person:
Case Manager Supervisor
b
In the case where the grievance is against the agency professional(s) and includes):
Case Manager Supervisor
Licensing Specialist
Administrative Assistant
The grievance will be registered with the following:
NAME:
TITLE:
LOCATION:
Tom Stetzer, LSW
Executive Administrator
769 E. Main St.
Chillicothe, Ohio 45601
HOURS OF AVAILABILITY:
TELEPHONE NUMBER:
c
Monday - Friday, 9:00am - 4:00pm
(740) 779-6636
In the case where the grievance is against the agency professional:
Executive Administrator
The grievances may be registered with:
Ohio Department of Job and Family Services
50 West Town Street
6th Floor
Columbus, OH 43215
(614) 752-0035
Attn: Chris Tesi
Ohio Department of Mental Health
30 E. Broad Street
Columbus, OH 43266-0414
(614) 466-2596
Ohio Legal Rights Service
50 West Broad Street
Suite 1400
Columbus, OH 43215
(614) 466-7264
4
All grievances will be resolved and the written notification and explanation of the resolution will
be given to the griever within thirty (30) calendar days of the date the grievance is filed.
The following must be completed:
a
Provide the party a complete opportunity to be heard;
b
Conduct an investigation into the circumstances leading up to the grievance when
necessary;
c
Inform the foster caregiver of the resolution in writing;
d
Inform the foster caregiver of the right to appeal;
e
After all steps are completed documentation of the grievance, the resolution, and whether
or not the caregiver wishes to appeal shall be filed in the family foster home file.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
5
If the griever is not satisfied with the resolution at the level the grievance was filed, the griever has
the right to file another grievance at the next higher level within the agency. If the griever
proceeds through all levels and remains unsatisfied with the resolution, the griever may call any of
the resources listed above. Any relevant information regarding the grievance will be provided
upon request to any outside agency with which the griever has initiated a grievance.
6
Foster caregiver grievance procedures will be developed and posted in the administrative office
and in each family foster home manual. Employees will receive a copy and discuss the policy at
the time of orientation. The foster caregiver grievance policy will be presented and explained
during the family foster home pre-service training.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: SHARING A FAMILY FOSTER HOME WITH ANOTHER AGENCY
POLICY NUMBER: 26
ORC REFERENCE: 5101:2-5-13(A)(10) and 5101:2-5-31
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 1/1/03, 6/1/07
A
It is Synergy Family Foster Care, Inc.’s policy that the agency will not share foster homes with any other
foster care agency, but will have shared home agreements with county foster homes. In an agency to
agency basis Synergy, Inc. will only do shared home agreements for homes that are licensed with Synergy
Family Foster Care, Inc.
B
All requests to do so will be addressed by the executive administrator in order to work out a plan that is in
the best interest of the child.
C
Prior to Synergy Family Foster Care, Inc. sharing use of a foster home which has been recommended for
certification by another agency, the agency wishing to use the home shall obtain a written agreement signed
by Synergy Family Foster Care, Inc. stating how the home is to be used and that all parties affected by the
agreement approve of it. Synergy Family Foster Care, Inc. shall also provide written notification to any
other agencies currently using the home.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: TRANSFER OF FAMILY FOSTER HOME
POLICY NUMBER: 27
ORC REFERENCE: 5101:2-5-13(A)(11) and 5101:2-5-31
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED: 8/8/02, 1/1/03, 6/1/03, 3/1/07
Although it is preferred that a family foster home stay with Synergy Family Foster Care, Inc. it will not be
Synergy Family Foster Care, Inc.’s intention to retain a family foster home that is not content with Synergy
Family Foster Care, Inc. Synergy Family Foster Care, Inc. will transfer a currently licensed family foster
caregiver to a PCSA, PCPA, or PNA certified to recommend foster homes of the same type as the foster
home proposed to be transferred for certification, and which has agreed to accept the transfer if the family
foster home meets the criteria stated in section B of this policy. A foster caregiver certified to operate a
specialized foster home may transfer to an agency that does not operate a specialized foster home program
if the caregiver agrees that upon execution of the transfer, the foster home designation will be identified as
a family foster home. Synergy Family Foster Care, Inc. wishes to license family foster homes that show
evidence of absolute dedication to the well being of the child. This goal must be the driving idea for a
home to be incorporated into the Synergy Family Foster Care, Inc. Program. Synergy Family Foster Care,
Inc.’s goal is geared towards the betterment of the child and it is Synergy Family Foster Care, Inc.’s belief
that if the family foster home is not content it will negatively effect the child(ren). Therefore Synergy
Family Foster Care, Inc. will make an attempt to rectify the problem if possible, if not, as long as the family
foster home file is up to date the license may be transferred. The following criteria must be present before
the transfer may be completed:
1
Synergy Family Foster Care, Inc. may transfer a currently certified foster home to a PCSA, or to a
PCPA or PNA which is certified by ODJFS to recommend foster homes of the same type as the
foster home proposed to be transferred for certification, and which has agreed to accept the
transfer.
2
A foster caregiver certified to operate a specialized foster home may transfer to an agency that
does not operate a specialized foster home program, if the caregiver agrees that upon execution of
the transfer, the foster home designation will be identified as a family foster home.
3
Prior to the recommendation of a transfer of a foster home from one agency to another, the
agency initiating the transfer shall obtain a written agreement signed by both agencies and the
foster caregiver indicating that all parties agree to the transfer.
4
The foster caregiver must discuss their reason(s) with the Synergy Family Foster Care, Inc.
executive administrator as well as the licensing specialist.
5
The sending agency shall make a recommendation to ODJFS to transfer the foster home to the
receiving agency by submitting the JFS 01334 “Notification of Transfer of a Foster Home”, which
must be completed and contain the following information:
a
The foster caregiver’s full name.
b
The foster caregiver’s present address.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
4
c
The effective dates of the current certificate.
d
The names and addresses of both agencies involved in the transfer.
e
The effective date of the transfer.
f
A statement that copies of the home study or the most recent re-certification study and
the current certificate has been sent to the receiving agency.
g
The authorized signature of the sending agency representative, the authorized signature of
the receiving agency representative and the signature of the foster caregiver(s); and
h
The current and proposed new FACSIS resource identification numbers.
The transfer of the foster home must occur prior to the expiration of the current license:
a
If the effective date of the transfer occurs within 90 days of the expiration date of the
foster home license the sending agency shall be responsible for the completion of
the re-certification assessment.
b
If the effective date of the transfer occurs more than 90 days prior to the expiration of a
foster home license, the receiving agency shall be responsible for the completion
of the re-certification assessment.
5
Following receipt of a JFS 01334 “Notification of Transfer of a Foster Home” by the
Children’s Services Licensing Section, ODJFS will issue a temporary foster home
certificate, the receiving agency identification number indicated as the recommending agency.
6
Following receipt of an JFS 01334 “Notification of Transfer of a Foster Home“, but
prior to submitting to the Children’s Services Licensing Section, the receiving agency shall enter
the necessary data into FACSIS to register the home as a resource.
7
Synergy Family Foster Care, Inc. must have written communication from the recommending
agency for each child in the home. This communication must specify the recommending agency’s
desired plan for the child placed in the home. A meeting will be arranged with all parties
concerned to discuss the change with the child.
B
Licensed family foster homes that have been initially licensed by Synergy Family Foster Care, Inc. for less
than six months and wishing to change agencies will be required to withdraw their license from Synergy
Family Foster Care, Inc. Any home wishing to transfer between six months and twelve months of being
licensed may do so if the foster family agrees to pay Synergy Family Foster Care, Inc. $250 for the transfer.
After twelve months Synergy Family Foster Care, Inc. will transfer the family foster home license with no
stipulations as outlined in section A of this policy.
C
Any home transferring into Synergy Family Foster Care, Inc. will remain with Synergy Family Foster Care,
Inc. for at least six months before allowing a family foster home to transfer to another agency.
D
Upon receipt of a signed release of information form, Synergy Family Foster Care, Inc. shall release a copy
of a foster care homestudy to an adoption agency when the foster caregiver is being considered as an
adoptive parent.
E
Procedures to be considered prior to accepting a transfer of a foster caregiver:
1
Synergy Family Foster Care shall accept a transfer of a foster home from another agency only if
the foster caregiver has been certified with the sending agency for a minimum of one year.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
a
2
An exception shall be made in the case of a foster caregiver who has relocated to another
county not served by the foster caregiver’s recommending agency or if the foster
caregiver’s recommending agency ceases to recommend foster homes for certification to
ODJFS.
Upon receipt of a written request from a foster caregiver expressing the desire to transfer from the
caregiver’s current recommending agency, the receiving agency shall consider the request and
make a decision whether it wishes to proceed further with an assessment to determine whether to
accept the transfer.
a
A foster caregiver shall not initiate more than one transfer request during a certification
period and only to one agency at a time.
3
Before accepting the transfer of a foster home, the receiving agency shall contact the sending
agency in writing to notify the sending agency that such a request has been received and to request
a complete copy of the caregiver’s foster home records (excluding personal references and
criminal records checks).
4
Upon receipt of the transfer request from the receiving agency, the sending agency shall inform
the receiving agency of any decision to not place any more children in the foster caregiver’s home,
including the reasons why this decision was made.
5
a
If the receiving agency still wishes to proceed with exploring the transfer request, the
receiving agency shall notify the sending agency in writing.
b
Prior to sending the records to the receiving agency, the sending agency shall obtain a
signed release of information authorization from the foster caregiver authorizing the
release of information to the receiving agency. The release of information may be
obtained by, either agency or the foster caregiver.
c
While the transfer request is pending the sending agency shall continue to work with the
foster caregiver as it does with all other foster caregivers associated with the agency and
shall continue to provide the caregiver with notification of training events needed
according to the foster caregiver’s written needs assessment and continuing training plan.
d
The sending agency shall allow the foster caregiver to attend any such events and shall
continue to meet with the caregiver regarding the care of any child placed in the home.
e
The agency shall not remove a child(ren) from a foster caregiver’s home solely because
the caregiver has requested a transfer.
Within fifteen (15) working days of receipt of the signed release of information and any applicable
copying fees, the sending agency shall send a complete copy of the foster home records (excluding
references and criminal records checks) to the receiving agency. The records shall be sent by
certified mail, return receipt requested or hand delivered by Synergy Family Foster Care staff. If
the records are hand delivered, Synergy Family Foster Care shall be provided with a receipt
showing the date the records were delivered to the receiving agency. The receiving agency shall
document the date of receipt of the records.
a
The record information to be transferred includes: the most recent homestudy, homestudy
updates, training records, fire inspection reports, safety audits and medical reports, all
complaint or rule noncompliance investigations and any applicable corrective action
plans.
b
Synergy Family Foster Care shall notify the receiving agency of the nature of any
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
outstanding complaint or rule noncompliance investigations and any corrective action
plans that have not been fully implemented.
c
Synergy Family Foster Care shall charge the receiving agency ten cents per page for
copying the records, not to exceed twenty-five cents per page. No additional fee may be
charged to any party. The records shall not be sent until the fee is paid.
6
Synergy Family Foster Care shall accept the copy of the foster caregiver’s records only from the
sending agency. Synergy Family Foster Care shall not accept a copy of the records from the foster
caregiver.
7
Upon receipt of the foster caregiver’s records, Synergy Family Foster Care shall assign an assessor
to review the information received and conduct an assessment of the transfer request.
8
The assessor shall review the foster caregiver’s foster home records and any other information
received from the sending agency to make an informed decision whether Synergy Family Foster
Care wishes to proceed with the transfer request.
9
a
The assessor shall complete the review and make a recommendation to the receiving
agency regarding the transfer within sixty (60) days after the receipt of the records. If the
transfer review cannot be completed within sixty (60) days, the assessor shall document
in the foster home records the reasons why the review cannot be completed within sixty
(60) days.
b
The assessor shall contact staff from the sending agency and the foster caregiver(s) to
ascertain the reasons why the request is being made, to determine if there are foster
children in the home and to identify the agency with custody of the child(ren).
c
The assessor shall make at least one visit to the foster home and conduct a face-to-face
meeting with each foster caregiver and all household members.
d
The assessor shall not recommend acceptance of the transfer unless the assessor is
satisfied that any outstanding complaints or rule noncompliance investigations are not
material to the request to transfer the home and the safety of any children who are or may
be placed in the home.
e
All transfer review activities shall be documented in the receiving agency’s foster home
records.
The receiving agency shall not approve the transfer request until the following information has
been received and approved by the agency:
a
Three new personal references for the foster caregivers from three persons who are
unrelated to the caregiver and who do not live with the caregiver;
b
A new criminal records check has been obtained, reviewed and approved by the assessor
for all persons subject to a criminal records check residing in the home;
c
A new safety audit of the foster home has been conducted to verify that the home meets
all current safety requirements for foster homes;
d
Documentation of the assessor’s decision to recommend the approval of the transfer
request, and the reasons for the decision. Synergy Family Foster Care shall send written
notification to the sending agency and foster caregiver of Synergy Family Foster Care’s
decision within five working days of the decision.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
10
Synergy Family Foster Care who approves the transfer request shall maintain all information sent
by the original recommending agency as well as any information gathered in the transfer review
process and the assessor’s written recommendation as a part of Synergy Family Foster Care’s
foster caregiver records.
11
Synergy Family Foster Care who does not approves the transfer request shall maintain a copy of
the records received from the sending agency and the assessor’s written recommendation to reject
the transfer request shall be maintained by Synergy Family Foster Care for at least two years.
12
The approval or rejection of a transfer request rests solely with Synergy Family Foster Care
subject to the approval of ODJFS and creates no right to appeal pursuant to Chapter 119 of the
Revised Code for any party to the transfer request.
13
Prior to accepting a transfer, Synergy Family Foster Care shall ensure that the custodial agency of
any child currently placed in the home agrees to the transfer.
a
If the custodial agency does not agree to the transfer while a child in its custody is placed
in the home, the transfer shall not take place until the child is no longer placed in the
home.
b
A child shall not be removed from a caregiver’s home solely because the caregiver seeks
to transfer his/her foster home certificate to another agency.
14
Synergy Family Foster Care is not required to accept a transfer of a foster home from another
agency.
15
Synergy Family Foster Care shall provide an orientation to the foster caregiver of Synergy Family
Foster Care’s policies and procedures for foster caregivers prior to or not later than thirty calendar
days after a transfer request has been processed by ODJFS.
16
Synergy Family Foster Care when deciding to accept the transfer shall make a recommendation to
ODJFS to transfer the foster home to the agency by submitting a JFS 01334 “Notification of
Transfer of a Foster Home”
17
Synergy Family Foster Care may seek an agreement to determine which agency (sending or
receiving) will conduct the recertification review, if a transfer of a foster home is pending within
the ninety days immediately prior to the expiration of the certificate.
a
18
The foster home’s recommending agency shall be responsible for conducting the
recertification review and recommendation, if there is no agreement between the sending
and receiving agencies.
Upon receipt of a signed release of information form, the agency shall release a copy of a foster
care homestudy to an adoption agency when the foster caregiver is being considered as an
adoptive parent.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: NOTIFYING FAMILY FOSTER HOME THAT CHILD IS AVAILABLE FOR ADOPTION
POLICY NUMBER: 28
ORC REFERENCE: 5101:2-5-13(A)(12)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 6/1/07
A
Synergy Family Foster Care, Inc. will notify the foster caregiver in writing by certified mail of the adoption
process when a foster child placed with the foster caregiver becomes available for adoption. The letter will
include that the foster caregiver will have priority for adoption of the child in their home unless an adult
relative has expressed an interest in adopting the child, a prospective adoptive parent has been identified
prior to placing the child temporarily with the foster caregiver or if the agency determines that such
placement is not in the best interest of the child. The notification will be consistent with the requirements
contained in Rules 5101:2-48-11, 5101:2-48-11.1 and 5101:2-48-16 of the Ohio Administrative Code.
B
Synergy Family Foster Care, Inc.’s licensing specialist and/or the recommending agency will complete the
following steps when permanent custody of a child has been obtained through the court and a prior
arrangements were not made for an adoptive placement.
C
1
During a conference with written documentation in the foster caregiver file and the child’s file it
will be determined if the foster caregiver is interested in adopting the youth.
2
Unless prior arrangements have been made or the placement has been determined that it is not in
the best interest of the child the foster caregiver must be notified that they will be given priority
consideration in adopting the child placed in their home. This must also be documented in the
foster caregiver file.
3
Make the following information available to the foster caregiver:
a
Adoption Process;
b
If the child is considered “special needs” the family must be made aware of the different
forms of assistance once the adoption becomes final such as Title IV-E Adoption
Assistance.
Once the child has been declared permanent custody and the foster caregiver expresses an interest in
adoption the following procedures must be followed:
1
If the foster home has not had prior approval for adoption of a child then an ODJFS 1691 form
must be completed;
2
Review information listed in Rule 5101:2-48-09 to determine if the foster caregiver is appropriate
for an adoptive placement;
3
The licensing specialist will complete a home visit(s) to obtain information listed in Rule
5101:2-48-09;
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
4
Complete an addendum to the ODJFS 1349. It must contain an assessment of the ongoing
appropriateness of the placement and also the adjustment of both the child and the family from
foster care to adoption; and
5
Documentation in the file must acknowledge the capabilities of the foster caregiver to provide
long-term needs and how they will meet those needs.
D
Synergy Family Foster Care, Inc. will document the decision to either approve or deny the foster caregiver
for the adoptive placement of the child. The foster caregiver must also receive written notification of the
decision. In cases of dispute or acute subjectivity, the foster caregiver has the right to ask Synergy Family
Foster Care, Inc. to sub-contract with another agency to obtain a non-biased opinion.
E
All ODJFS Rules will be provided once the foster caregiver has been approved for adoption.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: DISCHARGE PLAN
POLICY NUMBER: 28.5
ORC REFERENCE: 5101:2-5-13(A)(28) and 5101:2-5-17
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED:
A
In the event a youth is removed or leaves the foster care placement, such as: AWOL, placing of a more
restrictive environment (psychiatric hospital or treatment center, etc.), incarceration, medical emergency,
death of the youth, change in youth care plan, or lack of appropriate foster care placement, Synergy Family
Foster Care, Inc. will immediately notify the recommending agency or appropriate guardian.
B
Synergy Family Foster Care, Inc. will complete and submit a discharge summery, in accordance with
policy number 29 of the Synergy Family Foster Care, Inc. policy and procedure manual, to the
recommending agency within 30 days of discharge.
C
In the event the recommending agency wishes to return and maintain the youth in Synergy Family Foster
Care, Inc., Synergy staff will maintain on-going contact with the youth and assist the recommending
agency with the criteria needed to return the youth to a family foster home.
D
In the event of an unplanned discharge Synergy Family Foster Care, Inc. will assist the recommending
agency and/or biological parents with any needed services.
Attachment: Discharge Summary
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: DISCHARGE SUMMARY REPORT
POLICY NUMBER: 29
ORC REFERENCE: 5101:2-5-13(A)(28) and 5101:2-5-17
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 1/1/03
A
The discharge summary report will be completed on all youth who are in care, this includes emergency
discharges as well as planned discharges. A discharge constitutes what is stated in the youth’s case plan
which would be considered a planned discharge. The conditions for an emergency discharge may include
but not limited to AWOL, disruption from a placement and no other appropriate placements in the agency.
B
The discharge summary report must be completed within thirty days of the youths discharge and forwarded
to the recommending county.
C
A copy of the discharge summary shall be provided to the recommending agency, the primary family and
any other person that is specified by the recommending agency.
D
The discharge summary must contain the following information:
1
List of current medication(s)
2
List of most recent medical, psychiatric and counseling appointments including upcoming
appointments.
3
A list of current goals including progress or lack of progress.
4
A list of any recommendations that need to be followed up on after youth is discharged.
5
A list of any information pertaining to Education (including current IEP & report card).
6
Admission and discharge dates.
7
Current foster home and case manager.
8
The reason for discharge.
9
A summary of the child’s adjustment and results of the placement.
10
The name and official title or relationship of the person to whom the child was released.
11
The new location of the child.
E
It is the responsibility of the case manager who has the supervision of the youth at the time of discharge to
complete the report.
F
When a child is placed from a foster home into a respite care setting, a discharge summary is not required,
provided the child is expected to return to the foster home when the period of respite care has ended.
Attachment: Discharge Summary
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: ACCESSIBILITY OF THE ADMINISTRATOR
POLICY NUMBER: 30
ORC REFERENCE: 5101:2-5-13(A)(29)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED:
A
The executive administrator for Synergy Family Foster Care, Inc. whereabouts when absent from the office
must be posted on a schedule that is provided to the clerical staff. The schedule must include a phone
number or other means in which to contact the executive administrator. Any persons wishing to make an
appointment with the executive administrator may do so by contacting the executive administrator to
schedule an appointment.
B
The executive administrator for Synergy Family Foster Care, Inc. must provide a daytime as well as
nighttime phone number for the Ohio Department of Job and Family Services. Any phone number changes
must be reported within 24 hours.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: FOSTER HOME RECORDS
POLICY NUMBER: 31
ORC REFERENCE: 5101:2-5-13(A)(30)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 1/1/03
A
Upon being licensed with Synergy Family Foster Care, Inc. a new and separate file shall be developed for
each foster home. Upon admission to a Synergy Family Foster Care, Inc. foster home a new and separate
file shall be developed for each child.
B
Synergy Family Foster Care, Inc will maintain all closed records for Foster Homes, Adoptive Homes,
Children’s files for a period of five years following the date of closing or leaving the agency.
C
Foster and adoptive home files and child files shall be maintained in a locked file.
D
Absolute confidentiality shall be maintained unless a release of information is signed by the foster family
home or a release of information is signed by the child’s recommending agency.
E
Present in the family foster home file will be a log that contains, at a minimum:
F
1
The name of the foster child;
2
The child’s date of birth;
3
The date of placement in the family foster home;
4
The date of discharge/removal form the family foster home; and
5
The new location of the child.
6
When the foster home is a specialized foster home, the use of any planned or crisis respite care for
children placed in the home shall be documented in the log. At a minimum, the documentation
shall show the starting and ending dates of any respite care services received by the child and
where the respite care was provided. When the approved respite care provided is a certified foster
caregiver, the name of the child and the starting and ending dates of any respite care services
provided by the foster caregiver shall also be documented in the log for that foster home.
The family foster home has the right to review and/or copy any material in their file. The Synergy Family
Foster Care, Inc. licensing specialist will assist the process.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: CONFIDENTIALITY OF INFORMATION
POLICY NUMBER: 32
ORC REFERENCE: 5101:2-5-13(A)(31), 5101:2-42-89
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 5/1/03, 1/1/10
A
Synergy Family Foster Care, Inc. will hold all information regarding a child in care and the child’s primary
family in confidence by all concerned.
B
All information pertaining to the child that Synergy Family Foster Care, Inc. receives will be shared with
the prospective family foster home prior to the placement of the child. This material is shared to better
enable the family foster home to make a decision regarding whether or not the family is able to meet the
therapeutic needs of the child.
C
Synergy Family Foster Care, Inc. will share information such as but not limited to:
D
1
Strengths;
2
Potential Problems;
3
Needs;
4
Educational Information; and
5
Intervention Strategies.
Synergy Family Foster Care, Inc. will address the importance of confidentiality with the family foster
home.
1
The family foster home will not disclose any information regarding a child or the child’s family.
2
Information may be shared with the following, after the recommending agency has signed a
release of information:
3
a
Counselors;
b
Medical Providers;
c
School Personnel; and
d
Others that will allow for the betterment of the child
In situations when the family foster home is unsure about whether or not a person fits into these
categories they should contact the Synergy Family Foster Care, Inc. licensing specialist for any
clarification.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
E
Synergy Family Foster Care, Inc. expects the family foster home to keep the following information in the
child’s records but not inclusive to:
1
A copy of the care plan; both Synergy Family Foster Care, Inc.’s and the recommending agencies;
2
A phone number for the Synergy Family Foster Care, Inc. case manager and also one for the
county worker;
3
Medical information and a list of numbers for the child’s medical team; and
4
Information and records regarding school.
** All records will be returned in to Synergy Family Foster Care, Inc. upon the discharge of the child from
the family foster home.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: PARTICIPATION IN HUMAN RESEARCH PROJECTS, FUND RAISING, AND PUBLICITY
ACTIVITIES
POLICY NUMBER: 33
ORC REFERENCE: 5101:2-5-13(A)(32)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED:
A
Synergy Family Foster Care, Inc. will not involve a child in any Human Research Projects, Fund Raising or
Public Activities without the prior informed written consent of the primary family, guardian or legal
custodian and the child, according to the child’s age and functioning level. Such written consent must be
contained in the child’s file.
B
Synergy Family Foster Care, Inc. prohibits the use of a child’s pictures, quotations, or art work to be used
in any type of advertisements without the prior written consent of the primary family, guardian or legal
custodian and the child, according to the child’s age and functioning level. Such written consent must be
contained in the child’s file.
C
Under no circumstances shall Synergy Family Foster Care, Inc. involve a child in any form of research
project.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: PERSONNEL POLICIES AND PROCEDURES
POLICY NUMBER: 34
ORC REFERENCE: 5101:2-5-13(A)(33)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED: 8/8/02, 6/1/03. 6/1/07
Employee Hire
1
Synergy Family Foster Care, Inc. will have written descriptions specific for each position or group
of positions within the agency’s certified function for all foster caregivers, college interns,
volunteers, and employees.
2
Synergy Family Foster Care, Inc. will post all available employment positions in area newspapers
specifying the availability of open positions within the agency. Synergy Family Foster Care, Inc.
will obtain and review a variety of inquires form the communities that the agency serves. Synergy
Family Foster Care, Inc. will not deny or delay employment to any individual based solely on
sexual orientation, cultural orientation, religion, national origin, age, color, race, or handicaps.
Synergy Family Foster Care, Inc. will initiate a program that will recruit individuals from a wide
variety of backgrounds and experience that will coincide with the background and needs of the
child being served.
3
Synergy Family Foster Care, Inc. will obtain at least three written references, or written notes on
verbal references, from non-relatives regarding a prospective family foster home, a college intern,
a volunteer, or an employee who will have direct contact with children. Separate files will be
maintained on each individual.
4
Synergy Family Foster Care, Inc. will hire qualified employees to provide the services, which it is
certified to provide. Clinical staff will be appropriately licensed.
5
a
The person employed as the executive administrator of the agency after the effective date
of this chapter shall posses at least a bachelor’s degree and other qualifications and
experience as determined by the governing body in writing.
b
An agency shall assure that all the staff hired or who are under any personal service
contract who are required by law to possess any professional licensure or certification are
so licensed or certified. A copy of licensure or certification will be made for the
employee’s file.
c
Individuals employed in positions responsible for the daily direct or supervision of
children shall be at least twenty-one years of age, possess a high school diploma or
equivalency certificate, or have at least one year of full-time equivalent paid or volunteer
experience in the direct provision of care to children. Foster parents do not have to meet
educational criteria.
In those instances when an employee is responsible for varied job responsibilities and, as such,
falls within more than one job description, such employee shall meet those qualifications, which
are the most rigorous among the competing criteria.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
6
Synergy Family Foster Care, Inc. will require an employee or prospective employee to provide
reports if the individual exhibits signs of a physical or mental health, from a qualified professional,
which might impair the individual’s ability to ensure the health and safety of a child.
7
Synergy Family Foster Care, Inc. will document that staff have not been convicted of or pleaded
guilty to any of the offenses listed in paragraph (K) in ORC 5101:2-5-09
8
a
Synergy Family Foster Care, Inc. requires any staff who are charged or convicted with
any criminal offense listed in rule 5101:2-5-09 report the charge to the executive
administrator within twenty-four hours by submitting a copy of the charge. Failure to do
so will result in immediate termination of the staff.
b
If a conviction of any of the crimes listed in rule 5101:2-5-09 while in the employment of
Synergy Family Foster Care, Inc. shall result in immediate dismissal from employment
with the agency.
An employee of Synergy Family Foster Care, Inc. who is convicted of or who has pleaded guilty
to an offense listed in paragraph (K) of 5101:2-5-09 and who is hired by Synergy Family Foster
Care, Inc. as an administrator, child care staff, case manager, or in any other position responsible
for a child’s care only if the following conditions have been met:
a
Where the offense was a misdemeanor, or would have been a misdemeanor if conviction
had occurred under the current criminal code, at least three years have elapsed from the
date the prospective employee was fully discharged from any imprisonment or probation
arising from the conviction. A prospective employee who has had a misdemeanor record
of conviction sealed by a court pursuant to section 2953.32 of the Revised Code shall be
considered to have met this condition; or
b
Where the offense was a felony, at least ten years has elapsed since the person was fully
discharged from imprisonment or probation; or
c
The victim of the offense was not one of the following:
d
1
A person under the age of eighteen;
2
A functionally impaired person as defined in division (A) of section 2901.10 of
the Revised Code;
3
A mentally retarded person as defined in division (K) of section 5123.01 if the
Revised Code;
4
A developmentally disabled person as defined in division (Q) of section 5123.01
of the Revised Code;
5
A person with a mental illness as defined in division (A) of section 5122.01 of
the Revised Code; or
6
A person sixty years of age or older.
Before Synergy Family Foster Care, Inc. will hire the prospective employee, Synergy
Family Foster Care, Inc. will conclude that the hire will not jeopardize in any way the
health, safety, or welfare of the child. The following factors must be considered:
1
The applicant’s age at the time of the offense;
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
e
2
The nature and seriousness of the offense;
3
The circumstances under which the offense was committed;
4
The degree to which the person participated in the offense;
5
The time elapsed since the person were fully discharged from imprisonment or
probation;
6
The likelihood that the circumstances leading to the offense will recur;
7
Whether the applicant is a repeat offender;
8
The applicant’s employment record;
9
The applicant’s efforts at rehabilitation and the results of those efforts;
10
Whether any criminal proceedings are pending against the applicant;
11
Whether the applicant has been convicted of or pleaded guilty to a felony
contained in the Revised Code that is not listed in paragraph (K)(1) of this rule,
if the felony bears a direct and substantial relationship to the duties and
responsibilities of the position being filled; and
12
Any other factors that Synergy Family Foster Care, Inc. considers important.
Except as provided in paragraph (J) of 5101-2-5 Synergy Family Foster Care, Inc. shall
not, as of October 29, 1993, hire a prospective employee as administrator, child care
staff, case manager, or in any other position responsible for a child’s care in out-ofhome-care if the person has been convicted of or pleaded guilty to any of the following
offenses:
1
A violation of section 2903.01, 2903.02, 2903.03, 2903.04, 2903.11, 2903.12,
2903.13, 2903.16, 2903.21, 2903.34, 2905.01, 2905.02, 2905.04, 2905.05,
2907.02, 2907.03, 2907.04, 2907.05, 2907.06, 2907.07, 2907.08, 2907.09,
2907.12, 2907.21, 2907.22, 2907.23, 2907.25, 2907.31, 2907.32, 2907.321,
2907.322, 2907.323, 2911.01, 2911.02, 2911.11, 2911.12, 2919.12, 2919.22,
2919.24, 2919.25, 2923.12, 2923.13, 2923.161, 2925.02, 2925.03, 2925.04,
2925.05, 2925.06, 2925.11 that is not a minor drug possession offense, or
3716.11 of the Revised Code as listed in appendix A of this rule; or
2
A violation of an existing or former law of this state that is substantially
equivalent to any of the offenses listed in paragraph (K)(1) of 5101-2-5-09
f
It is the prospective employee’s duty to provide written verification that the conditions
specified in paragraph (J) of 5101-2-5-09 are met. If the prospective employee fails to
provide such proof or determines that the proof offered by the prospective employee is
inconclusive or insufficient, the person shall not be hired. Any doubt shall be resolved
in favor of protecting the children the agency serves;
g
Synergy Family Foster Care, Inc. will complete a criminal records check, pursuant to rule
5101:2-5-091 of the Administrative Code; and
h
Synergy Family Foster Care, Inc. may conditionally hire a prospective employee until the
criminal records check required by rule 5101:2-5-091 of the Administrative Code is
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
completed and the agency receives the results of the criminal record check, if the
prospective employee has not been convicted of or pleaded guilty to any offense listed in
paragraph (K) of 5101:2-5-091. If the results of the criminal record check indicate that
the person does not qualify for employment, Synergy Family Foster Care, Inc, will
immediately release the person from employment.
9
Employees and Board Members shall conduct themselves in a manner that is appropriate to the
social services field. Synergy Family Foster Care, Inc. will not tolerate any employee or board
member who conducts any illegal activity weather during business or personal time that will
reflect negatively on Synergy Family Foster Care, Inc. An employee will not engage in any
discriminatory acts, policies, or practices involving race, color, or national origin in the foster care
or adoption process.
10
Employees and Board Members shall conduct themselves in a manner that is appropriate to the
social services field. Synergy Family Foster Care will not tolerate any employee or board member
who conducts any illegal activity weather during business or personal time that will reflect
negatively on Synergy Family Foster Care. Employees and board members shall perform in a
manner that complies with the Multiethnic Placement Act of 1994 as amended by Section 1808 of
the Small Business Job Protection Act of 1996, 42 U.S.C. 622(b)(9), 671(a)(18), 674(d) and
1996(b)(MEPA) and Title VI of the Civil rights Act of 1964, 42 U.S.C. 20000d, et seq, as they
apply to the foster care and adoption process (Title VI). The written standards of conduct shall:
a
Prohibit denying any person the opportunity to become a foster caregiver or an adoptive
parent on the basis of race, color or national origin of that person, or of the child
involved; or delaying or denying any placement of a child in foster care or for adoption
on the basis of the race, color or national origin of the foster caregiver(s), of the adoptive
parent(s) or of the child involved.
11
Synergy Family Foster Care shall provide a copy of the written standards of conduct (Code of
Ethics of the National Association of Social Workers) to each employee or contractor who is
engaged in the placement of children into foster care or for adoption, or engaged in the
recruitment, assessment, approval, or selection of a foster caregiver(s) or adoptive family.
Employees or contractors within thirty days of the effective date of this rule and within thirty days
of the completion of any revisions to the standards of conduct. New employees or contractors
shall receive a copy of the written standards of conduct within thirty days of their hire date or the
effective date of their contract.
12
Synergy Family Foster Care shall not require an ongoing, foster care or adoption worker to justify
a proposed placement for the reason that the race, color or national origin of the child is different
from that of the family whom the worker is proposing as the child’s foster caregiver or adoptive
parent.
13
If a Synergy Family Foster Care employee or contractor engages in discriminatory acts, policies,
or practices involving race, color or national origin in the foster care or adoption process as
determined by the Ohio Department of Job and Family Services upon completion of the
investigation conducted pursuant to rule 5101:2-33-03 of the Administrative Code the process will
be handled in the following manner:
a
14
The standards of conduct will be enforced by the Executive Director and/or the Board
Members of Synergy Family Foster Care.
Synergy Family Foster Care shall conduct an investigation that shall include, but is not limited to:
a
Face-to-face interviews with the complainant, the respondent and all relevant witnesses.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
b
Issuance of a final investigation report to the complainant and the subject of the
complaint. The report shall include the allegations, background information, analysis,
determination and recommendation and shall be issued within ninety days of the receipt
of the initial complaint.
15
Upon completion of the final investigation report, the executive director or board president shall
determine if any action against the employee or contractor is warranted.
16
Employee or contractor found to be in violation of the code of conduct will be disciplined in the
following manner and as deemed necessary by the severity of the violation.
17
a
The employee will be notified of the complaint within three days of receipt of Synergy
Family Foster Care being made aware of a discriminatory acts, policies, or practices
involving race, color or national origin in the foster care or adoption process.
b
The employee or contractor will be written up for the first time offense and filed in the
employee or contractors file.
c
The employee or contractor will be suspended from work without pay for a period of five
days for the second time offense and a report filed in the employee or contractors file.
Any employees or contractors found to have an offense occur within a twelve month
period may immediately be terminated at that time.
d
The employee or contractor that commits a third offence will be immediately terminated,
this is in accordance with the Ohio employment law.
If a Synergy Family Foster Care employee or contractor is found to have engaged in a
discriminatory act, policy or practice involving race, color, or national origin by the Ohio
Department of Job and Family Services then a submission of a corrective action plan will
completed within thirty days of notification of the findings of the investigation by the Ohio
Department of Job and Family Services.
a
The corrective action plan will be required to address how the agency will prevent future
violations by the employee or contractor.
18
Personnel records will be kept in the Executive Directors office in a locked filing cabinet.
Absolute confidentiality shall be maintained of all personnel files. Any employee does have
access to their own file and may review it at any given time. Synergy Family Foster Care, Inc will
maintain all records for personnel who have either left the agency on their own, retired or were
terminated for a period of five years following the date they left the agency. After five years the
files will be shredded.
19
All administrative records e.g. financial statements, board minutes, financial audits will be
maintained in filing cabinets and only administrative personnel have access to those files. These
files will be disposed of once they are five year old. At this time the files will be shredded.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: VOLUNTEERS AND COLLEGE INTERNS
POLICY NUMBER: 35
ORC REFERENCE: 5101:2-5-13(A)(34) and 5101:2-5-15
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED: 6/1/03, 12/1/07
RECRUITMENT PROCESS:
Anyone interested in becoming a volunteer/intern must be at least 18 years of age and complete an
application. Volunteers and interns will receive an initial orientation on the agency policies and
procedures in which they must comply. An intern must be attending college at least part time to become a
Licensed Social Worker. Failure to do so will result in termination of paid interns. If the intern position is
to obtain credits for their college classes the College must be notified in writing of the salary. They must
sign a confidentiality form. Fingerprints as well as a background check must be completed. Three
references by non-relatives must also be submitted. The above items must be completed prior to beginning
the position. Specific background information that will be assessed from the application includes prior
volunteer experience, training, education, employment history, and experience with those having
characteristics similar to potential clients, motivation for volunteering and preferences for assignment. The
executive administrative, as well as the case manager supervisor, is responsible for recruitment, selection,
assignment, training, supervision and evaluation of the volunteer/intern.
B
STUDENT’S ROLE, RESPONSIBILITIES, MINIMUM QUALIFICATIONS & TRAINING:
1
Volunteers or college interns shall be given a specific written job description (made available on a
person to person basis written in conjunction of the specific requirements made by their college
professor and also based on the number of hours available) delineating the functions to be
performed, minimum qualifications the student must possess and a statement outlining the
respective supervisory and evaluation responsibilities of the agency and the placing school.
2
Synergy Family Foster Care, Inc. shall not use volunteers or college interns as a replacement for
paid staff. Volunteers or college interns shall not be counted to meet required staff ratios as
required by rule 5101:2-9-02 of the Administrative Code.
3
Synergy Family Foster Care, Inc. will work cooperatively with Degree Programs and the
community to utilize volunteers and interns. Synergy Family Foster Care, Inc. agrees to provide
supervision, at least monthly as well as evaluations as requested by the school. The supervision
and evaluations will be documented and placed in the personnel file of the volunteer/intern.
4
Orientation will be provided prior to beginning duties to the agency administrative structure,
policies and procedures, affiliated programs, treatment foster care, overall program goals, the
responsibilities of the volunteer/intern to the agency, clients and foster parents, the responsibilities
of the agency to the volunteer/intern, and information about clients served. Additional training
will be provided as appropriate to their skill level, demonstrated competence, and requirements of
assigned tasks and responsibilities.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
5
C
It will be the Volunteer/Intern’s responsibility to report any charge or conviction of any criminal
offense listed in rule 5101:2-5-09 by turning in a copy of the charge or conviction to the executive
administrator within twenty-four hours. Failure to do so will result in immediate termination.
SUPERVISION AND EVALUATION:
The Licensed Social Worker or working supervisor as deemed appropriate will include but not be limited
to provide supervision and evaluations:
D
1
Regular face-to-face supervisory conferences as specified in the original agreement;
2
Assistance with practical problems;
3
Suggestions regarding behavior or future activity;
4
Reassurance or recognition of the value of the individuals efforts;
5
Supervision in compliance with their respective school requirements; and
6
At least a midterm and a final evaluation from the supervisor as well as a self-evaluation.
WRITTEN AGREEMENT:
Volunteers/interns will be required to sign a written agreement prior to participating with Synergy Family
Foster Care, Inc. The original agreement will be kept in the personnel file of the volunteer/intern file. A
copy will be given to the volunteer/intern.
E
F
SELF EVALUATION:
1
Interns will be asked to complete a self-evaluation at the end of the rotation. This self-evaluation
will be sent to the University/College. A copy of the self-evaluation will be given to the intern
and a copy placed in the personnel file of the intern.
2
Volunteers will be asked to complete a self-evaluation at the end of the volunteer experience. The
original remains in the volunteer’s personnel file and a copy will be given to the volunteer.
Synergy Family Foster Care, Inc. will document that volunteers and college interns have not been
convicted of or pleaded guilty to any of the offenses listed in paragraph (K) in ORC 5101:2-5-09
a
Synergy Family Foster Care, Inc. requires any staff who are charged or convicted with
any criminal offense listed in rule 5101:2-5-09 report the charge to the executive
administrator within twenty-four hours by submitting a copy of the charge. Failure to do
so will result in immediate termination of the staff.
b
If a conviction of any of the crimes listed in rule 5101:2-5-09 while serving as a volunteer
or college intern for Synergy Family Foster Care, Inc. shall result in immediate dismissal
from employment with the agency.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: ASSURANCE OF CIVIL RIGHTS
POLICY NUMBER: 36
ORC REFERENCE: 5101:2-5-13(A)(35)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED:
Synergy Family Foster Care, Inc. will not discriminate against any child or teenage mother because of race,
color, gender, religion, national origin, disability, age, or other factors as specified in the Civil Rights Act
of 1964, Rehabilitation Act of 1973, and subsequent amendments. Synergy Family Foster Care, Inc. will
comply with all appropriate Federal and State Laws regarding such regulations. The child or teenage
mother will be made aware of as well as receive a copy of the Child’s Rights and Grievance Policy during
the initial contact after admission to Synergy Family Foster Care, Inc.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: ADOPTION SERVICES
POLICY NUMBER: 37
ORC REFERENCE: 5101:2-5-13(A)(29), 5101:2-48-09(J)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 6/1/03, 6/1/07, 4/20/09
A
Synergy Family Foster Care, Inc. will be licensed in the state of Ohio to provide Adoption Services.
Synergy Family Foster Care, Inc. will develop an Adoption Service Program that’s sole purpose is to
provide the guidance and therapeutic support necessary that enables the child and the parent(s) to develop a
mutually beneficial relationship that allows for a successful adoption.
B
Synergy Family Foster Care, Inc. will also coordinate an individual set of services that will meet the needs
of the child, the primary family, and the adoptive family with the main goal always being “what is in the
child’s best interest.” Synergy Family Foster Care, Inc. will not use race, color, national origin, or
geographic location as the basis for denying or delaying placement of available children. Synergy Family
Foster Care, Inc. will encourage open adoptions between the birth parent and the adoptive parent within the
agency when it is in the best interest of the child.
C
All adoption assessments will be provided by a staff member who has successfully completed the assessor
training and are certified by ODJFS. Post-adoption services will be provided for 90 days after the adoption
is final unless otherwise specified.
D
All adoptive applicants must meet the following criteria:
1
Must be at least 18 years old;
2
Must reside in Ohio; and
3
Must submit a completed application.
E
Individuals shall be willing to adopt youth up to 18 years of age, any race, national origin, handicap and or
youths that have a variety of special needs.
F
Synergy Family Foster Care, Inc. will facilitate services that include the matching of children to adoptive
homes with preference to special needs children as well as recruitment and on-going training of adoptive
applicants, family assessments and referral follow-up.
G
Synergy Family Foster Care, Inc. will provide pre-service training targeted toward adoption issues that may
arise above and beyond the regular pre-service training requirements for foster caregivers. The additional
pre-service training will include the following topics: the adoption process (agency policy and procedures,
role of the agency, pre-service training, home assessment, matching placement, post-placement services,
adoption subsidies, legalization, openness of adoption), child development (normal child development,
predictable stages of development in an adoptive child, the impact of earlier separations, the impact of
abuse and neglect, identity and control issues in adolescence), attachment and separation (techniques for
supporting the grieving child, developing empathy for the child’s past, promoting attachment and dealing
with the unattached child), dealing with behavioral challenges (why behaviors occur, typical behaviors to
be expected, creative parenting/discipline), cultural issues(defining culture, understanding how ones own
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
culture impacts parenting in general, understanding ones own culture impacts ;the adopted child, impact of
cultural issues on adoptive issues arising post placement, how adoptive parents can use their knowledge of
the child’s culture to stimulate attachment, stimulate developmental growth and assist that child in identity
formation, impact of cross cultural placement on triad and extended family, diversity issues, issues of
racism and overview of MEPA of 1994 and title IV of civil rights act 1964); minimum of three hours
require and cannot be waived, caring for children who have been sexually abused (dynamics of sexual
abuse, impact of sexual abuse on children, therapeutic parenting methods), adoption related issues
(permanency issues for children, permanency issues for families, talking about adoption with the adoptee,
the child’s birth family and ongoing contact with significant others, adoption and the extended family,
adoption issues at school and in the community, using community resources and advocating for the
adoptive family and child).
H
I
Synergy Family Foster Care will maintain approved homestudies received from any other agency in the
same manner that other adoptive homestudies that were approved by the receiving agency pursuant to rule
5101:2-48-19 of the Administrative Code.
1
Synergy Family Foster Care shall only consider approved homestudies that have been forwarded
by a PCSA, PCPA, or PNA or comparable agency of another state.
2
Synergy Family Foster Care shall not require additional documentation for the homestudy beyond
that which is required by Chapter 5101:2-48 of the Administrative Code.
3
When approved homestudies are forwarded for a specific child Synergy Family Foster Care must
consider those homestudies in the same manner in which the agency considers its own
homestudies approved within the agency.
4
Homestudies from other agencies shall be regularly considered for potential adoption matches
until the family is no longer available for adoption, a child has been matched with the family or
the homestudy has expired.
5
Synergy Family Foster Care shall not solicit homestudies from other agencies for the purpose of
locating a family of a specific race, color or national origin.
6
Synergy Family Foster Care shall integrate all homestudy materials and related documents
received from other agencies into the receiving agency’s files of approved homestudies.
Synergy Family Foster Care will adapt the review procedures pursuant to Rule 5101:2-48-24 of the
Administrative Code.
1
The procedures address complaints from adoptive applicants, prospective adoptive families and
adoptive families.
2
Synergy Family Foster Care shall occur within thirty days of the receipt of a request for an agency
review and shall include face-to-face meeting with the adoptive applicant, prospective adoptive
families and adoptive families requesting an agency review, the adoptive family caseworker and
the administrator of Synergy Family Foster Care or his designee.
3
A written decision, including the reason for the decision, shall be rendered by the administrator of
Synergy Family Foster Care or his designee. The decision shall be based upon the evidence
presented at the review. A copy of the decision shall be provided to all parties to the agency
review within fifteen days of the review.
4
All documentation related to notification regarding rights to an agency review and written
decisions of the agency review required by this rule shall be maintained in the child and family
case record.
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POLICY AND PROCEDURES
J
5
When an approved adoptive family requests an agency review because the family believes an
adoptive placement was denied or will be denied solely on the basis of geographic location,
Synergy Family Foster Care shall provide the family with notices and copies of all materials
related to requesting a state hearing.
6
For complaints involving alleged discriminatory acts, policies, or practices pertaining to the foster
care and adoption process that involve race, color or national origin, the procedures contained in
rule 5101:2-33-03 of the Administrative Code supersede the requirements of this rule.
7
Synergy Family Foster Care shall follow procedures as outlined in rule 5101:2-33-13 of the
Administrative Code when an agency determines there may knowingly be falsification on an
adoptive application or homestudy.
Synergy Family Foster Care will notify the public children services agency in the county in which the
prospective adoptive parent resides within ten days after the initiation of a homestudy according to section
3107.013 of the Revised Code, which shall include:
1
2
H
The PCSA, if different from the PCSA in the county in which the adoptive applicant(s) resides,
Synergy Family Foster Care shall provide a letter containing relevant information about the
adoptive applicant(s) to the PCSA in the county in which the adoptive applicant resides when the
adoptive homestudy is initiated. The written information to the PCSA shall include the following:
a
The applicant’s name;
b
The applicant’s address;
c
The applicant’s telephone number; and
d
The names and dates of birth of all household members at the time of the application.
Relevant information includes, but is not limited to all of the following:
a
Past or present functioning of the prospective adoptive parent,
b
Rule violations involving foster and pre-adoptive child,
c
Third party investigations,
d
Information relating to previous adoption applications and/or placements, or
e
Information on events leading to a removal of any child from the prospective adoptive
home.
f
Confirmation of household members as determined by a review of the agency records.
Synergy Family Foster Care will notify the public children services agency in the county in which the
prospective parent resides of an impending adoptive placement no later than ten days prior to the placement
of the child in the adoptive home.
1
If a PCSA intends to place a child for adoption with an adoptive family from another county, it
shall notify the PCSA in the county in which the applicant resides or if a PCSA or Synergy Family
Foster Care or attorney arranging an adoption intends to place a child for adoption with an
adoptive family, it shall notify the PCSA in the county in which the applicant resides.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
2
In the case of an infant placement, the notification may be made prior to the birth of the child.
3
The written notification shall include the following information:
a
The prospective adoptive child’s age;
b
A description of the prospective adoptive child’s special needs;
c
The name(s) of the prospective adoptive parent,
d
The number of children that will reside in the prospective adoptive home when the
prospective adoptive child is placed in the prospective adoptive home,
e
This does not apply to stepparent adoption.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: ADOPTION POLICY
POLICY NUMBER: 38
ORC REFERENCE: 5101:2-5-13(A)(38), 5101:2-48-19, 5101:2-48-05(B)(1)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 7/1/05, 3/1/07, 4/20/09, 1/1/10
A
Synergy Family Foster Care, Inc. is a private non-profit agency that serves family foster homes in but not
limited to the following counties: Athens, Ross, Franklin, Pickaway, Fairfield, Fayette, Highland, Pike,
Scioto, Morgan, Madison, and Jackson. We will provide adoption services to any foster caregiver within
the agency that displays interest. There could be special circumstances where we could provide our
services to other individuals or agencies. This would be done on a situational basis.
B
Prior to placing a child in a family foster home Synergy Family Foster Care, Inc. will take into
consideration any special needs that the child may have. The child will then be placed in a home that can
best suit those needs. The goal of Synergy Family Foster Care, Inc. is to place children in a pre-adoptive
home when the situation is warranted. The children in our agency are considered adoptable once the
county has received permanent custody and the county has decided that the best interest for the child is to
be adopted. The current foster caregiver will be given the opportunity to adopt the child through contact
from Synergy Family Foster Care, Inc. and the recommending agency. If the foster caregiver is not
interested in adoption, Synergy Family Foster Care, Inc. will try to place the child in a home that is
interested in adoption.
C
Synergy Family Foster Care, Inc. shall make our adoption services available to everyone in the State of
Ohio. Our primary work however will be done with the foster caregiver within our agency. If someone
outside our network is interested in our adoption services an initial meeting will be set up with the family.
At that time it will be assessed if Synergy Family Foster Care, Inc., Inc. would be able to meet the family’s
needs. If it were found that the family would be better-suited working with another agency then Synergy
Family Foster Care, Inc. would make the appropriate referrals for the family.
D
Synergy Family Foster Care, Inc. shall not use geographic location as the basis for denying or delaying any
services or placements to the family. Synergy Family Foster Care Inc. defines their geographic area for
conducting adoption homestudy assessments to the southern part of Ohio. We however would work with
any family within the state if it appears that we may be some assistance to them. For those that inquire that
live outside our geographic area of services we will assist them in finding services locally to them.
E
Synergy Family Foster Care, Inc. shall not be involved with any open adoptions. If a family is interested in
the availability of open adoptions Synergy Family Foster Care, Inc. will refer them to the proper agency.
F
Synergy Family Foster Care, Inc. shall make inquiries to all foster caregiver prior to initial family foster
home certification on their desire to become adoptive parents. If a family is interested the, ODJFS 1673
“Home Study Application” will be used. Any licensed family foster home with Synergy Family Foster
Care, Inc. can ask that an ODJFS 1673 “Home Study Application” be done on their home.
G
Synergy Family Foster Care, Inc. shall request that BCII include information from the federal bureau of
investigation (FBI) in the criminal records check for each person subject to a criminal records check in
accordance with section 109.572(A)(8) of the Revised Code. Other adults living in the home (not
applicants) are subject to the same criteria as described above. Synergy Family Foster Care, Inc. will
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
provide the applicant with all information on obtaining their fingerprints and forward it to the appropriate
agency. Synergy Family Foster Care, Inc. will assume all fees related to the record check. Local law
enforcement checks will also be conducted on the applicants and all other adults living in the home.
Synergy Family Foster Care, Inc. will not proceed with the application process if it is found through the
background check that the applicant or another adult member in the home has been convicted of or pleaded
guilty to the following offenses:
1
Aggravated murder, murder, voluntary manslaughter, involuntary manslaughter, felonious
assault, aggravated assault, assault, aggravated menacing, failing to provide for a
functioning impaired person, offenses against residents or parties of a care facility,
kidnapping, abduction, child corruption of a minor, gross sexual imposition, sexual
imposition, importuning, voyeurism, public indecency, felonious sexual penetration,
compelling prostitution, promoting prostitution, prostitution, disseminating matter harmful to
juveniles, pandering obscenity, illegal use of a minor, pandering obscenity of a minor, aggravated
robbery, robbery, aggravated burglary, burglary, endangering children, contributing to the
delinquency of children, domestic violence, carry a concealed weapon, corrupting another with
drugs, trafficking offenses, illegal manufacturing of drugs or cultivation, or possession of drugs or
marijuana.
Any applicant or other adult household member convicted of an offense or offenses listed in the previous
paragraph may be considered as an adoptive family if all the following conditions are met:
1
The offense was a misdemeanor and at least three years has passed since the applicant was fully
discharged from imprisonment or probation or the record of conviction is sealed according to
ORC 2953.32.
2
The offense was a felony and at least ten years have elapsed since the applicant was fully
discharged from imprisonment or probation.
3
The victim of the offense was one of the following: a person under the age of eighteen, a
functionally impaired person (see ORC 2901.10), a mentally retarded person (ORC 5123.01), a
developmentally disabled person (ORC 5123.01), a mentally ill person ( ORC 5122.0), a person
sixty years of age or older.
The applicant’s approval must not jeopardize in any way the health, safety or welfare of the child.
H
Synergy Family Foster Care, Inc. will not put any restrictions regarding the length of time between
adoptive placements. The PCSA will decide if any restriction needs to be made.
I
Synergy Family Foster Care, Inc. will not be involved in any relative adoptions. If any family comes to our
agency interested in relative adoptions they will be referred to the appropriate agency.
J
Synergy Family Foster Care, Inc. will provide an adoption assessor to complete the home study process.
The family will complete and return to the agency the ODJFS 1691 application. Upon receipt of the
completed application, Synergy Family Foster Care, Inc. will request the following information that will
include, but not limited to: documentation of current marital status (marriage certificate, divorce decree, or
other verification as applicable), financial statement (ODJFS 1681- income, assets, liabilities), completed
criminal records check for the applicant and all adult household members, and proof of residence in Ohio
for a minimum of five years. All home assessments will be documented on ODJFS 01673.
“Home Study Application” will be completed by an adoption assessor. The additional documentation
required for the home assessment is as follows:
1
ODJFS 1653 (Medical Statement for Foster Care/Adoptive Applicant and All Household
Members) signed by a licensed physician.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
2
Three personal references (non-relatives) regarding the applicant’s suitability to parent.
3
ODJFS 1348 (Safety Audit).
4
A fire inspection.
Synergy Family Foster Care, Inc. has 180 days to complete the home assessment.
K
Complaints of an adoptive applicant, prospective adoptive families and adoptive families will be reviewed
within thirty days of the receipt of a written request for review. The agency review shall occur within thirty
days of the receipt of a request for an agency review and shall include a face-to-face meeting with the
adoptive applicant, prospective adoptive families and adoptive families requesting an agency review, the
adoptive family case manager/assessor and the executive administrator. The executive administrator will
make a written decision, including the reason for the decision. The decision shall be based upon the
evidence presented during the review. A copy of the decision will be given to all parties within fifteen days
of the review. All documentation related to the review will be maintained in the child and adoptive
applicant’s case record.
L
Synergy Family Foster Care, Inc. will provide adoptive families with the orientation training that is needed
to become foster/adoptive parents. The adoption coordinator will use the thirty-six hour curriculum
developed by the Institute for Human Services for ODJFS. The following components will be addressed:
the adoption process (agency policy and procedures, role of the agency, pre-service training, home
assessment, matching placement, post-placement services, adoption subsidies, legalization, openness of
adoption), child development (normal child development, predictable stages of development in an adoptive
child, the impact of earlier separations, the impact of abuse and neglect, identity and control issues in
adolescence), attachment and separation (techniques for supporting the grieving child, developing empathy
for the child’s past, promoting attachment and dealing with the unattached child), dealing with behavioral
challenges (why behaviors occur, typical behaviors to be expected, creative parenting/discipline), cultural
issues(defining culture, understanding how ones own culture impacts parenting in general, understanding
ones own culture impacts ;the adopted child, impact of cultural issues on adoptive issues arising post
placement, how adoptive parents can use their knowledge of the child’s culture to stimulate attachment,
stimulate developmental growth and assist that child in identity formation, impact of cross cultural
placement on triad and extended family, diversity issues, issues of racism and overview of MEPA of 1994
and title IV of civil rights act 1964); minimum of three hours require and cannot be waived, caring for
children who have been sexually abused (dynamics of sexual abuse, impact of sexual abuse on children,
therapeutic parenting methods), adoption related issues (permanency issues for children, permanency issues
for families, talking about adoption with the adoptee, the child’s birth family and ongoing contact with
significant others, adoption and the extended family, adoption issues at school and in the community, using
community resources and advocating for the adoptive family and child).
1
This training will be conducted on an as needed basis. Components of the training may
be waived if the county the child resides will allow. Along with our agency providing
training we will also provide the foster caregiver with information about training
available in other counties.
M
The adoption assessor will provide application requirements and/or Adoption Subsidy Guide
Provided/Attached, eligibility criteria, consultation services etc. to applicants related to all available state
and federal subsidy and assistance programs. Information will be provided during inquiry, training, at
placement, prior to finalization and post finalization, as applicable. Information will include, but not be
limited to, Federal Adoption Subsidy (AA); Non Recurring Adoption Expenses Subsidy; State Adoption
Maintenance Subsidy (SAMS) and Post Adoption Special Services Subsidy (PASSS) as applicable.
N
The agency will update the home assessment if the applicant is requesting a subsequent adoptive placement
and finalized an adoption of a child within the previous two years and had an approved adoptive home
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
assessment. Synergy Family Foster Care, Inc. will also update the home assessment if it is older than two
years and the applicant expresses a desire in continuing to wait for an adoptive placement. The assessment
shall not be updated more than two times. After the second update, the agency must complete a new
assessment.
O
The payment for services will be determined based per county contract and based on if multiple births
occur. If a fee is imposed it will range from $250 to $1000.
P
Synergy Family Foster Care, Inc. does not have any requirement of religious affiliation related to
application or service provision. The agency does not discriminate on the basis of religious affiliation or
preference.
Q
The goal of pre-finalization services is to provide ongoing support and education to facilitate a healthy and
happy placement and to monitor and address areas of concern. Synergy Family Foster Care, Inc. will
provide to the adoptive family all information regarding the child. This information will be made available
to Synergy Family Foster Care, Inc. by the PCSA. Synergy Family Foster Care, Inc. will provide ongoing
case management to the adoptive family up until the time of finalization. Synergy Family Foster Care, Inc.
will also provide post-finalization services to the child and families. This will be accomplished through
monthly home visits for six month after finalization. Adoptive families are always welcome to call
Synergy Family Foster Care, Inc. at any point if any problems arise. Synergy Family Foster Care, Inc. will
make sure that they are put in contact with the proper agency.
R
Synergy Family Foster Care, Inc. will comply with all parts of the “Indian Child Welfare Act of 1978”, 25
U.S.C.A. 1901, “The Multiethnic Placement Act of 1994” as amended by Section 1808 of the “Small
Business and Job Protection Act of 1996”, 42 U.S.C. 622(b)(9), 671 (a)(18), 674(d) and 1996(b), and “Title
VI of the Civil Rights Act of 1964”, 42 U.S.C. 2000d as they apply to the adoption process “Adoption
Promotion and Stability Act of 1996”, “Adoptions SAFE Families Act of 1997”, and 25 U.S.C.A 1901et
seq.
S
Synergy Family Foster Care shall adhere and be in compliance with MEPA and Title VI, ICWA and ASFA
in all recruitment activities and materials.
T
Synergy Family Foster Care, Inc. will inform adoptive families of the availability of a state hearing if the
family foster home believes that an adoptive placement was denied, or will be denied, solely for the reasons
of geographic location of the family.
U
Synergy Family Foster Care, Inc. will at no time delay or deny an applicant or the placement of children
based on geographic location, race, color, creed, religion, ethnicity, national origin, handicap or age.
V
Synergy Family Foster Care, Inc. is offering the services of providing needed adoptive home studies to
families within our network. Due to the amount of home studies needed we have found that in many cases
the counties we work with do not have the time or people needed to provide this service. In response to
this need we feel that it is eminent that Synergy Family Foster Care, Inc. helps out by providing all work in
completing the home study. We feel that our foster caregiver(s) and the counties with which we work need
this service.
W
For complaints involving alleged discriminatory acts, polices, or practices pertaining to the foster care and
adoption process that involve race, color, or national origin, the procedures contained in the rule 5101:2-3303 of the Administrative Code will be administered.
X
Synergy Family Foster Care shall follow as outlined in rule 5101:2-33-13 of the Administrative Code when
an agency determines there may knowingly be falsification of an adoptive application or homestudy.
Y
Synergy Family Foster Care will provide access to approved home studies , as well as related documents to
another PCSA or PCPA which requests a copy of the home study for matching purposes of a special needs
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
child pursuant to rule 5101:2-48-19.
Z
1
Synergy Family Foster Care shall make its home studies of all approved families, who have signed
the authorization for release of information form, available to any other agency which requests a
copy of the home study.
2
Synergy Family Foster Care Inc.shall release the homestudy and related materials (including the
JFS 01530) within fifteen days after a request has been made as long as the authorization for such
releases has been submitted to the agency and agency policy requirements have been met.
3
Synergy Family Foster Care shall not release or accept a home study when it is determined that
the application or the home study contains a false statement knowingly made be the applicant(s)
and included in the written report of the homestudy.
The assessor shall complete the JFS 01530 “Multiple Children/Large Family Assessment” when an
applicant seeking to adopt a minor or foster child will have at least five children residing in the prospective
adoptive home after the minor or foster child to be adopted is placed in the home for adoption.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: POST FINALIZATION SERVICES
POLICY NUMBER: 39
ORC REFERENCE: 5101:2-5-13(A)(30)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 3/1/07, 4/20/09
A
Synergy Family Foster Care, Inc. staff will maintain contact with the adoptive family on a monthly basis
for 90 days after the adoption has been finalized. The contacts will continue to be documented and placed
in the child’s file and the family foster home’s file.
B
Synergy Family Foster Care, Inc. will also continue to participate with the child’s team by continuing to
attend the team meetings and actively giving advice.
C
Synergy Family Foster Care, Inc. will arrange a final family meeting after the 90 days. A 90 day adoption
report will be developed and sent to all parties concerned as well as placing one in the child’s file and the
family foster home’s file.
D
If requested by the recommending agency, Synergy Family Foster Care, Inc. will arrange as well as
participate in the child’s good-bye visit to their primary family.
E
Post finalization adoption services shall be made available upon the request of the adoptive parent or the
adoptee and may be provided directly or by referral.
1
In the case Synergy Family Foster Care does not provide the specific post-finalization adoption
services requested then Synergy Family Foster Care shall refer each person who requests post
finalization adoption services to an agency that provides such services and;
2
Upon written request of a parent, legal custodian, or guardian, provide consultation on adoptionrelated issues to non agency professionals who are working with the family.
3
Synergy Family Foster Care shall provide information regarding the procedures for releasing
identifying information pursuant to rules 5101:2-4-48-20 of the Ohio Administrative Code.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: WAIVERS
POLICY NUMBER: 40
ORC REFERENCE: 5101:2-5-18
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 1/1/03
A
The granting of a waiver of any requirement imposed by Chapter 5101:2-5, 5101:2-7, 5101:2-9, 5101:2-39,
5101:2-42, and 5101:2-47 of the Administrative Code is a discretionary act of ODJFS based upon
documentation as to why Synergy Family Foster Care, Inc. or the foster caregiver is not in compliance.
The refusal of ODJFS to grant a waiver, in whole or in part shall be final and shall not be construed as
creating any rights to a hearing under Chapter 119. of the Revised Code.
B
A request for a waiver shall be written and time limited. ODJFS shall deny any waiver request that does
not contain sufficient information, including the time period for which the waiver is requested, to allow
ODJFS to make an informed decision on the request. The time limit of a waiver shall not exceed the
expiration date of the current certificate. Upon the written request of an agency a waiver may be renewed
once, at the discretion of ODJFS, contingent upon documentation to ODJFS of the efforts of the agency or
foster caregiver to come into compliance and the reasons they have not come into compliance.
C
A request for a waiver of the requirements or prohibitions imposed by Chapter 5101:2-5, 5101:2-9, 5101:239, 5101:2-42, and 5101:2-47 of the Administrative Code on an agency’s administration shall be written
using JFS 01276 “Waiver Request for Agency Rules” and submitted to the appropriate ODJFS district
office.
D
A request for a waiver of the requirements or prohibitions imposed upon a foster home or a foster caregiver
by Chapters 5101:2-7, 5101:2-39, 5101:2-42, and 5101:2-47 of the Administrative Code and related
provisions of Chapter 5101:2-5 of the Administrative Code shall be written using JFS 01317
“Recommendation for Certification/Recertification of a Family Foster Home” and submitted to ODJFS,
bureau of accountability and regulation.
E
The granting of a waiver by ODJFS shall not be construed as constituting precedence for the granting of
any other waiver or the subsequent renewal of an existing waiver. All waiver requests shall be considered
on a case-by-case basis.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: VARIANCE
POLICY NUMBER: 41
ORC REFERENCE: 5101:2-5-18
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED:
A
The granting of a variance of any requirement imposed by Chapter 5101:2-5, 5101:2-7, and 5101:2-9 of the
Administrative Code is a discretionary act of ODJFS based upon documentation as to why Synergy Family
Foster Care, Inc. or foster caregiver is not in compliance. The refusal of ODJFS to grant a variance, in
whole or in part, shall be final and shall not be construed as creating any rights to a hearing under Chapter
119. of the Revised Code.
B
A request for a variance of the requirements or prohibitions imposed by Chapter 5101:2-9 of the
Administrative Code and related requirements or prohibitions imposed by Chapter 5101:2-5 of the
Administrative Code shall be in writing and shall submitted to the appropriate ODJFS licensing specialist.
C
A request for a variance of the requirements or prohibitions imposed by Chapter 5101:2-5 of the
Administrative Code on Synergy Family Foster Care, Inc.’s administration shall be in writing and shall be
submitted to the appropriate ODJFS licensing specialist.
D
A request for a variance of the requirements or prohibitions imposed by Chapter 5101:2-5 of the
Administrative Code and related requirements or prohibitions imposed by Chapter 5101:2-5 of the
Administrative Code shall be in writing and shall be submitted to ODJFS, Bureau of Resource
Management.
E
All pertinent information necessary to document justification for the permanent suspension of all or part of
an Administrative Code rule shall be included with the variance request. The absence of information
needed to make an informed decision shall result in a denial of the request.
F
The granting of a variance by ODJFS shall not be construed as constituting precedence for the granting of
any other variance. All variance requests shall be considered on a case-by-case basis.
G
Should the terms or conditions of a variance be violated or otherwise become nullified by situation or
Administrative Code rule, the variance may be rescinded. ODJFS has sole discretion in the rescission of a
variance. The rescission of a variance shall not be construed as creating any rights to a hearing under
Chapter 119. of the Revised Code.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: AGENCY ASSESSMENT OF AN INITIAL APPLICATION FOR FOSTER HOME
CERTIFICATE
POLICY NUMBER: 42
ORC REFERENCE: 5101:2-5-21
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 1/1/05
A
Synergy Family Foster Care, Inc. shall not discriminate in recommending foster caregivers on the basis of
age, color, race, sex, religion, national origin, cultural heritage, marital status or disabilities in violation of
Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. 794 and of Title II of the Americans with
Disabilities Act of 1990, 42 U.S.C., 1201 et seq. Synergy Family Foster Care, Inc. may selectively recruit
on the basis of the need for family foster homes for specific types of children as specified in the Synergy
Family Foster Care, Inc. recruitment plan as required by rule 5101:2-5-13 of the Administrative Code.
B
Synergy Family Foster Care shall consider the race, color or national origin of a foster caregiver applicant
to determine whether that person shall be certified as a foster caregiver. Synergy Family Foster Care shall
not consider the race, color, or national origin of a child, for whom a prospective foster caregiver or a
certified foster caregiver has indicated an interest in providing foster care, in determining whether the
applicant should be certified or the child placed with the foster caregiver. Only in those cases where it is
determined pursuant to rule 5101:2-42-18.1 of the Administrative Code that a child’s race, color or national
origin should be considered, shall the agency consider those factors in the placement of the child with a
foster caregiver.
C
Synergy Family Foster Care, Inc. shall document in the record of each applicant that the applicant has been
evaluated by the Synergy Family Foster Care, Inc. licensing specialist to determine the applicant’s
compliance with Chapter 5101:2-7 of the Administrative Code. The documentation shall be a completed
JFS 01673 “Assessment for Child Placement” or JFS 01349 “Foster Home Homestudy” as applicable. In
completing these forms, a written narrative shall also be compiled and signed by the assessor, indicating the
assessor’s approval or denial of the application, and attached to either the JFS 01673 or the JFS 01349. An
agency participating in the Adopt Ohio program shall use the JFS 01673.
D
In addition to the criteria on either the JFS 01673 or the JFS 01349 “Family Foster Home Homestudy” and
Synergy Family Foster Care, Inc. may establish a written policy, applicable to all applicants, which requires
applicants to submit additional materials or documents and to participate in additional assessment activities.
E
The assessment required by paragraph (C) of this rule and as documented through the completion of the
JFS 01673 or the JFS 01349, shall be commenced within thirty days of the date the agency receives the JFS
01691, “Application for Child Placement”. The assessment shall be completed within one hundred eighty
days of the date it is started. An agency that fails to commence an assessment within thirty days or
complete the assessment within one hundred eighty days shall document the reasons why it was unable to
meet one or both of these requirements in the foster caregiver’s record. Commencement of a homestudy
means, at a minimum, scheduling an appointment to interview the applicant or assuring that the applicant
has been informed of the necessary materials required for the assessor to complete the homestudy. The
assessment shall include at least one visit by an assessor to the applicant’s home to ensure that the physical
facilities of the home are in compliance with the requirements set forth in Chapter 5101:2-7 of the
Administrative Code and to determine any placement limitations which the physical environment or space
availability of the home may necessitate.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
F
In order to complete the JFS 01673 or the JFS 01349 “Foster Home Homestudy” an assessor shall
interview all members of the household over the age of four years. The interview may be conducted in
conjunction with the visit to the prospective foster home as required by paragraph (D) of this rule, or may
be conducted during a separate visit to the home or held elsewhere. The interview with all members of the
household over the age of four years may be a joint interview or separate individual interviews.
G
Prior to recommending initial certification of a foster home an agency shall ensure that the applicant has
completed all of the preplacement training required for the type of foster home for which the applicant is
seeking certification; the agency has received a signed and fully completed JFS 01691; a criminal records
check has been conducted and successfully completed for the applicant(s) and all other adult members of
the home; personal references have been received and verified; a JFS 01653 “Medical Statement for Foster
Care/Adoptive Applicant and All Household Members” has been received indicating that the applicant and
all household members are free from any physical, emotional, or mental condition that would endanger
children or impair the ability of the household to care for a foster child; if determined necessary by the
agency, an additional report of an examination by a physician, psychologist or other certified or licensed
professional; a fire safety inspection of the applicant’s home has been conducted by a state certified fire
safety inspector certifying that the applicant’s home is free from conditions hazardous to the safety of foster
children; and , an assessor has completed a JFS 01673 or JFS 01349, including a written narrative,
indicating the assessor’s approval of the application.
H
Synergy Family Foster Care, Inc. shall not place a child or cause a child to be placed in a family foster
home until:
1
The initial assessment of the foster home and the JFS 01673 or the JFS 01349 “Foster Home
Homestudy” has been completed by an assessor and the assessor has recommended that the
applicant(s) be certified as foster caregiver(s);
2
The foster caregiver has completed the preplacement training required by rule 5101:2-5-33 of the
Administrative Code for the type of foster home certification the caregiver is seeking;
3
An original JFS 01317 “Recommendation for Certification/Recertification of a Foster
Home” recommending certification has been submitted to the Ohio Department of Human
Services ODJFS; and
4
The effective date of a foster home certificate that has been issued by ODJFS.
I
The determination of the specific number, age, and sex of children to be placed in a foster home is the joint
responsibility of the foster caregiver and the recommending agency based on the assessor’s evaluation of
the caregiver’s capabilities and physical facilities as required by Chapter 5101:2-7 of the Administrative
Code.
J
All placements in a foster home shall conform with provisions of paragraph (i) of this rule and with the
provisions of rule 5101:2-5-32 of the Administrative Code.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: RECOMMENDATIONS FOR INITIAL FAMILY FOSTER HOME CERTIFICATION OR
DENIAL OF INITIAL FAMILY FOSTER HOME CERTIFICATION
POLICY NUMBER: 43
ORC REFERENCE: 5101:2-5-22
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED:
A
Synergy Family Foster Care, Inc. shall not recommend for certification any applicant whose residence is
licensed, regulated, approved, or operated under the direction of, or otherwise certified as a facility to
provide overnight substitute care for unrelated persons, by the department of youth services, the department
of mental health, a community mental health board, the department of mental retardation and development
disabilities, a county board of mental retardation and development disabilities, the department of health or a
juvenile court.
B
For each application for a family foster home certificate submitted to Synergy Family Foster Care, Inc. and
assessed through the agency’s completion of the ODJFS 1349 “Family Foster Home Homestudy”, Synergy
Family Foster Care, Inc. shall submit to ODJFS an ODJFS 1348 “Family Foster Home Safety Audit” and
an ODJFS 1317 “Recommendation for Certification/Recertification of a Family Foster Home” which shall
make one of the following recommendations:
1
Recommend certification; or
2
Recommend denial of certification based on specific rule noncompliance.
C
Synergy Family Foster Care, Inc.’s recommendation for certification shall be on an ODJFS 1317
“Recommendation for Certification/Recertification of a Family Foster Home” and forward to ODJFS
Children’s Services Licensing Section, after submitting data to ODJFS by way of the FACSIS reporting
mechanism.
D
Upon receipt of an ODJFS 1317”Recommendation for Certification/Recertification of a Family Foster
Home” and accompanying ODJFS 1348 “Family Foster Home Safety Audit”, as applicable, ODJFS will
determine the effective and expiration dates of he certificate, and enter the necessary data into the ODJFS
FACSIS system to generate the family foster home certificate.
E
The effective date of an initial family foster home certificate shall be no earlier than the day the ODJFS
1317 “Recommendation for Certification/Recertification of a Family Foster Home” is received by ODJFS
as evidenced by the receipt date stamp.
F
If Synergy Family Foster Care, Inc. decides to recommend denial of initial certification; it may contact the
Children’s Services Licensing Section’s rules coordinator for consultation regarding required evidence,
correct procedures and advise prior to notifying the applicant.
G
If Synergy Family Foster Care, Inc. recommends denial of initial certification; it shall provide written
notification to the applicant on ODJFS 1315 “Notification of Denial of Initial Certification, Recertification
or Revocation of a Family Foster Home Certificate” of:
1
The reason for the recommendation;
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
2
The specific law and rule allegedly violated; and
3
The agency’s grievance policy as required by rule 5101:2-5-13 of the Administrative Code.
H
Following notification of denial pursuant to paragraph (G) of this rule, and following the local agency
grievance meeting if requested by the applicant, Synergy Family Foster Care, Inc. shall submit its
recommendation for denial to ODJFS, unless the applicant has voluntarily withdrawn the application in
writing. The recommendation for denial shall be submitted to ODJFS on ODJFS 1317 “Recommendation
for Certification/Recertification of a Family Foster Home” and shall identify and document the rules found
to be out of compliance and specific evidence supporting the recommendation for denial.
I
The decision to approve or deny a family foster home application for initial certification rests solely with
ODJFS in its exercise of discretion. ODJFS shall provide written notification of this action to the applicant
and the recommending agency.
J
All actions of ODJFS with respect to denial of an initial family foster home certificate shall be subject to
the requirements of Chapter 119. of the Revised Code and Chapter 5101:3-50 of the Administrative Code.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: FORM AND DURATION OF A FOSTER HOME CERTIFICATE
POLICY NUMBER: 44
ORC REFERENCE: 5101:2-5-23
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED: 1/1/03
The form and appearance of a foster home certificate shall be prescribed by the department ODJFS
Children’s Services Licensing Section. At a minimum, the certificate shall include:
1
The name an address of the foster caregiver;
2
The effective date of the certificate;
3
The expiration date of the certificate; and
4
A designation of the type of foster home.
B
The duration of foster home certificate shall not be longer than two years.
C
A foster home certificate shall be valid only for the address listed on the certificate.
D
The certificate for a family foster home shall include all of the requirements in paragraph (A) to (C) of this
rule and, in addition, shall be identified by a family and children services information system FACSIS
resource identification number assigned to the home.
E
The certificate for a treatment foster home shall include all of the requirements in paragraphs (A) to (C) of
this rule and, in addition, shall be identified by a FACSIS resource identification number assigned to the
home.
F
The certificate for a medically fragile foster home shall include all of the requirements in paragraphs (A) to
(C) of this rule and, in addition, shall be identified by a FACSIS resource identification number assigned to
the home.
G
The certificate for a pre-adoptive infant foster home shall include all of the requirements in paragraph (A)
to (C) of this rule and, in addition, shall be identified by a FACSIS resource identification number assigned
to the home.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: FOSTER HOME RECERTIFICATION PROCEDURE
POLICY NUMBER: 45
ORC REFERENCE: 5101:2-5-24
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 1/1/03, 4/22/10
A
Not less than ninety or more than one hundred twenty calendar days prior to the expiration of a foster home
certificate, Synergy Family Foster Care, Inc. shall notify a foster caregiver of the date for expiration of the
certificate. The notification shall identify any information or documentation which a foster caregiver is
required to submit for recertification. The notification shall be on JFS 01331, “Notice of Expiration and
Reapplication for a Family Foster Home Certificate.”
B
Following the Synergy Family Foster Care, Inc. notification to the foster caregiver as required by paragraph
(A) of this rule, if the caregiver fails to either reapply or voluntarily terminate prior to the expiration date of
the certificate, the foster home certificate shall expire.
C
If a foster home certificate expires because a caregiver has failed to comply with paragraph (H) of rule
5101:2-7-14 of the Administrative Code there are no rights to appeal pursuant to Chapter 119. of the
Revised Code.
D
Following the expiration of a foster home certificate, Synergy Family Foster Care, Inc. shall submit a JFS
01317 “Recommendation for Certification/Recertification of a Foster Home” to ODJFS after entering the
appropriate data into the agency’s SACWIS system to close the home.
E
Prior to the recommendation for and expiration of a current certificate, an assessor shall complete JFS
01385, “ODJFS Assessment for Child Placement Update”, to ensure that the foster caregiver remains in
compliance with the requirements set forth in Chapter 5101:2-7 of the Administrative Code.
F
An assessor’s reassessment of a foster home shall include at least one interview with each member of the
household (except foster children) over the age of four years currently residing in the home. This may be a
joint interview or individual interviews.
G
Prior to recommending a foster home for recertification and prior to or within ten working days after any
relocation of a foster home Synergy Family Foster Care, Inc. shall conduct a safety audit of the foster
caregiver’s residence and document that the residence has met all safety standards required by rules
5101:2-7-05, 5101:2-7-10, 5101:2-7-12, and 5101:2-7-15 of the Administrative Code by completing JFS
01348 “Safety Audit of a Foster Home.”
H
In addition to completion of the JFS 01348 “Safety Audit of a Family Foster Home”, Synergy Family
Foster Care, Inc. may require a foster caregiver to have the foster home inspected by a certified fire safety
inspector prior to recommending the home for recertification if the agency deems it necessary to ensure that
the home is free from conditions which may be hazardous to the safety of a foster child.
I
In order to ensure the safety, health or care of a foster child, Synergy Family Foster Care, Inc. may require
a report of a physical, psychiatric or psychological examination or treatment of the caregiver or any foster
home resident. Such examination shall be conducted by a licensed physician, psychologist, or other
certified or licensed professional.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
J
Prior to the expiration date of a foster home certificate Synergy Family Foster Care, Inc. shall submit an
original JFS 01317 to ODJFS recommending:
1
Recertification;
2
Denial of recertification; or
3
Closure, based on receipt of a voluntary withdrawal or failure of the caregiver(s) to submit a
reapplication as required by rule 5101:2-7-14 of the Administrative Code.
K
Upon receipt and approval of the JFS 01317, “Recommendation for Certification/Recertification of a
Foster Home”, ODJFS will determine the effective and expiration dates of the certificate, and enter
the necessary date into the SACWIS system to generate a foster home certificate.
L
The effective date of the foster home certificate shall be the day of expiration of the previous certificate or
the date of receipt of the original JFS 01317, “Recommendation for Certification/Recertification of a
Family Foster Home”, as evidenced by the ODJFS date stamp, if received after the expiration date of the
previous certificate provided that the family foster home reapplied prior to expiration as evidenced by a
copy of the JFS 01331. If the family foster home fails to reapply prior to the date of expiration of the
previous certificate, the family foster home must re-apply for initial certification pursuant to rule 5101:2-520 of the Administrative Code.
M
The Synergy Family Foster Care Inc. shall request the conducting of a criminal records check for a certified
foster caregiver and each adult who resides with the foster caregiver every four years within six months
prior to the upcoming recertification of the caregiver. Synergy Family Foster Care Inc. shall evaluate
whether the foster home should continue to be recommended for certification or be recommended for
denial or revocation of certification when a person who is certified as a foster caregiver is convicted of any
offense listed in paragraph (J) of rule 5101:2-7-02 of the Administrative Code.
(1) The evaluation shall begin within five days of the agency's knowledge of the person's conviction, be
completed within thirty days, and be documented in the foster home's record.
(2)
At a minimum, the provisions of paragraph (R)(S) of this rule shall be considered in the evaluation.
(3) This requirement shall also be applicable for any adult who resides with a foster caregiver upon
conviction of any offense listed in paragraph (J) of rule 5101:2-7-02 of the Administrative Code.
N
The evaluation of this rule shall include, at a minimum:
(1)
Whether there are children currently placed in the foster home and the impact of disruption on the
children if moved.
(2)
Whether rehabilitation of the individual had to be considered for initial certification.
(3)
The length of time of certification prior to this conviction.
(4) The factors outlined in paragraphs (I)(1), (I)(2), (I)(3), and (I)(4) and (I)(5) of rule 5101:2-7-02 of
the Administrative Code.
Upon receipt of notification of an adult who resides with a foster caregiver who has pleaded guilty to or been
convicted of a foster caregiver disqualifying offense, the recommending agency shall assess the foster home for
safety concerns and forward any recommendations to ODJFS for revocation if applicable. As used in this rule,
"foster caregiver disqualifying offense" means any offense or violation listed or described in division (C)(1) of
section 2151.86 of the Revised Code.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: DENIAL OF RECERTIFICATION OF A FAMILY FOSTER HOME CERTIFICATE
POLICY NUMBER: 46
ORC REFERENCE: 5101:2-5-25
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 1/1/03
A
If Synergy Family Foster Care, Inc. intends to recommend denial of recertification, it may contact the
ODJFS children services licensing coordinator prior to notifying the caregiver of the agency’s intent, for
consultation regarding required evidence, procedures and advise.
B
If Synergy Family Foster Care, Inc. decides to recommend denial of recertification, it shall provide written
notification by certified mail, return receipt requested, to the caregiver of:
1
The reason for the decision to recommend denial of recertification;
2
The specific law and rules directly involved and allegedly violated;
3
The method of and time limits for requesting a local agency grievance meeting;
4
The caregiver may voluntarily withdraw from the recertification process in writing at any time. A
written withdrawal shall result in no further certification of the home and no further action by the
licensing specialist or ODJFS to deny the recertification. A withdrawal shall waive the caregiver’s
right to any hearing pursuant to Chapter 119. of the Revised Code; and
5
The final decision to deny recertification will be made by ODJFS at which time the caregiver shall
be afforded the opportunity to request a hearing conducted pursuant to Chapter 119. of the
Revised Code.
C
Notification as required by paragraph (B) of this rule shall be on JFS 01315 “Notification of Denial of
Initial Certification, Recertification, or Revocation of a Foster Home Certificate.”
D
Following the completion of the requirements of paragraph (B) of this rule, Synergy Family Foster Care,
Inc. shall notify ODJFS of the recommendation to deny recertification on a JFS 01317 “Recommendation
for Certification/Recertification of a Foster Home” and shall submit:
1
A summary of the grievance meeting, if one was held;
2
Identification of rules with which the foster caregiver is allegedly not in compliance;
3
Specific documentation and evidence supporting the recommendation for denial of recertification;
4
A copy of the JFS 01315 “Notification of Denial or Initial Certification, Recertification or
Revocation of a Foster Home Certificate” sent to the caregiver;
5
A copy of the reapplication pursuant to paragraph (G) of rule 5101:2-7-14 of the Administrative
Code; and
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
6
E
A copy of the completed JFS 01385 “Foster Home Recertification Assessment.”
Upon receipt of the JFS 01317, “Recommendation for Certification/Recertification of a Foster Home”,
required by paragraph (D) of this rule, ODJFS shall evaluate the evidence submitted by Synergy Family
Foster Care, Inc. and take one of the following actions:
1
Return the JFS 01317, “Recommendation for Certification/Recertification of a Foster Home”, and
evidence to Synergy Family Foster Care, Inc. due to insufficient or inappropriate documentation
with a written explanation of the deficiency;
2
Reject Synergy Family Foster Care, Inc. recommendation in writing specifying the reasons for the
rejection; or
3
Proceed with the denial process.
F
At the time ODJFS proceeds with Synergy Family Foster Care, Inc. recommendation to deny
recertification, ODJFS shall send a notice to the foster caregiver pursuant to paragraph (J) of rule 5101:350-07 of the Administrative Code. A copy of the notice shall be sent Synergy Family Foster Care, Inc.
which shall immediately notify any other agency which may have a child placed in the family foster home.
G
The decision to proceed or not proceed with a recommendation for denial of recertification rests solely with
ODJFS in its exercise of discretion.
H
Any action by ODJFS to deny the recertification of a family foster home shall be subject to the
requirements of Chapter 119. of the Revised Code and Chapter 5101:3-50 of the Administrative Code.
I
If the foster home application or certificate has been denied pursuant to Chapter 119. of the revised Code,
the applicant or person to whom the certificate was issued shall not be eligible for any ODJFS children
services license or certification for two years from the date of denial or the exhaustion of all appeals,
whichever is later.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: REVOCATION OF A FOSTER HOME CERTIFICATE
POLICY NUMBER: 47
ORC REFERENCE: 5101:2-5-26
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 1/1/03
A
At the time of Synergy Family Foster Care, Inc.’s decision to recommend revocation of a family foster
home certificate, Synergy Family Foster Care, Inc. may contact the ODJFS licensing enforcement
coordinator prior to notifying the caregiver of the agency’s intent for consultation regarding required
evidence, procedures and advise.
B
If Synergy Family Foster Care, Inc. decides to recommend revocation, it shall provide written notification
by certified mail, return receipt requested, to the caregiver of the following:
1
The reason for the decision to recommend revocation;
2
The specific law and rule(s) allegedly violated;
3
The method of and time limits for requesting a local agency grievance meeting; and
4
That the final decision to revoke certification will be made by ODJFS at which time the caregiver
shall be afforded the opportunity to request a hearing conducted pursuant to Chapter 119. of the
Revised Code.
C
Notification required by paragraph (B) of this rule shall be on JFS 01315 “Notification of Denial of Initial
Certification, Recertification or Revocation of a Foster Home Certificate”.
D
Following the completion of the requirements of paragraph (B) of this rule, Synergy Family Foster Care,
Inc. shall notify ODJFS of its recommendation to revoke the certificate on a JFS 01317 “Recommendation
for Certification/Recertification of a Foster Home” and shall submit documentation of:
E
1
A summary of the grievance meeting, if one was held;
2
Identification of rules with which the foster caregiver is allegedly not in compliance;
3
Specific documentation and evidence supporting the recommendation for revocation; and
4
A copy of the JFS 01315, “Notification of Denial of Initial Certification, Recertification or
Revocation of a Foster Home Certificate”, sent to the caregiver.
Upon receipt of the JFS 01317, “Recommendation for Certification/Recertification of a Foster Home”,
required in paragraph (D) of this rule, ODJFS shall evaluate the evidence and documentation submitted by
Synergy Family Foster Care, Inc. and take one of the following actions:
1
Return ODJFS 1317, “Recommendation for Certification/Recertification of a Family Foster
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
Home”, and evidence to Synergy Family Foster Care, Inc. due to insufficient or inappropriate
evidence and documentation with a written explanation of the deficiency;
2
Reject Synergy Family Foster Care, Inc. recommendation in writing specifying the reasons for
rejection; or
3
Proceed with the revocation process.
F
At the time ODJFS proceeds with the Synergy Family Foster Care, Inc. recommendation to revoke a family
foster home certificate, ODJFS shall notify the foster caregiver pursuant to paragraph (J) of rule 5101:3-5007 of the Administrative Code. A copy of the notice shall be sent to Synergy Family Foster Care, Inc.
which shall immediately notify any other agency which may have a child placed in the family foster home.
G
The decision to proceed or not to proceed with a recommendation for revocation rests solely with ODJFS in
its exercise of discretion.
H
Any action by ODJFS to revoke a family foster home certificate shall be subject to the requirements of
Chapter 119. of the Revised Code and Chapter 5101:3-50 of the Administrative Code.
I
If a foster home certificate has been revoked pursuant to Chapter 119. of the Revised Code, the caregiver
shall not be eligible for certification through any public children services agency, private child placing
agency or private non-custodial agency for two years from the date of revocation or the exhaustion of all
appeals, whichever is later.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: CAUSE FOR DENIAL OF INITIAL CERTIFICATION, DENIAL OF RECERTIFICATION OR
REVOCATION OF A FOSTER HOME CERTIFICATE
POLICY NUMBER: 48
ORC REFERENCE: 5101:2-5-28
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
B
DATE REVISED: 1/1/03
Any one or any combination of the following circumstances may be considered valid cause for denial of
initial foster home certification, denial of recertification, or revocation of a foster home certificate either
upon the recommendation of Synergy Family Foster Care, Inc. or through unilateral action by ODJFS:
1
A foster caregiver fails or refuses to comply with any requirements of Chapter 5101:2-7 of the
Administrative Code;
2
A foster caregiver furnishes false or misleading statements or reports to Synergy Family Foster
Care, Inc.;
3
A foster caregiver falsifies, refuses or fails to submit any report required by Chapter 5101:2-7 of
the Administrative Code.
4
A foster caregiver refuses or fails to make available any record required by or necessary to the
administration of Chapter 5101:2-7 of the Administrative Code;
5
A foster caregiver refuses to admit into the residence any person performing duties required by
Chapter 5101:2-5, 5101:2-7 or 5101:2-34 of the Administrative Code or any laws of the state or
any subdivision therein;
6
A foster caregiver fails or refuses to comply with agency instructions regarding care of a child an
agency has placed within the home;
7
A foster caregiver interferes or acts in conflict with the Synergy Family Foster Care, Inc. plan for
a child’s care;
8
Any resident of a foster caregiver’s home, other than the foster children who are placed there, is
found guilty of any crime perpetrated against a child; or
9
A foster caregiver, any adult resident of a foster, or any minor resident of a foster home at last
twelve years of age, but less than eighteen years of age, residing with the foster caregiver has been
convicted of or pleaded guilty to, or been adjudicated delinquent for commission of any offence
listed in paragraphs (J) and (P) of rule 5101:2-7-02 of the Administrative Code; or
10
A foster caregiver or any other resident of a foster home who is a person subject to a criminal
records check refuses to obtain a criminal records check.
When Synergy Family Foster Care, Inc. has knowledge that one or more of the circumstances listed in
paragraph (A) of this rule apply to a resident of a foster caregiver’s or prospective foster caregiver’s home,
the agency shall do all of the following:
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
1
Review the foster home certificate, if applicable, and if appropriate, recommend that ODJFS
revoke or deny the certificate.
2
If the Synergy Family Foster Care, Inc. does not have temporary, legal, or permanent custody of a
foster child residing in the foster home, notify the entity that has custody of the child that is has
received a notice under paragraph (P) of rule 5101:2-7-02 or paragraph (G) of rule 2-7-14 of the
Administrative Code.
3
Assess the foster caregiver’s need for training because of the conviction, plea of guilty, or
adjudication described in paragraph (A) and provide any necessary training unless Synergy Family
Foster Care, Inc. action is to recommend revocation of the certificate.
C
If Synergy Family Foster Care, Inc. learns that a foster caregiver has failed to comply with the provisions
of paragraph (P) of rule 5101:2-7-02 and paragraph (G) of rule 5101:2-7-14 of the Administrative Code, it
shall immediately notify ODJFS and ODJFS shall revoke the foster home certificate.
D
If Synergy Family Foster Care, Inc. determines that any of the conditions listed in paragraph (A) of this
rule presents or creates a threat to the life, health, or safety of a foster child, it shall immediately remove the
foster child from the foster home and notify the recommending agency within two hours. Synergy Family
Foster Care Inc.’s determination of threat to a foster child’s safety shall be considered sufficient basis for
any such action, and shall not require any additional justification.
E
For all currently certified foster homes, the recommending agency shall begin an investigation of all
allegations of violations of Chapter 5101:2-7 of the Administrative Code within three calendar days of
receipt of an allegation of a rule violation. Synergy Family Foster Care, Inc. shall complete the
investigation within thirty calendar days of beginning the investigation unless the investigation of rules
violation conflicts with any other third party or law enforcement investigation. The results of
investigations conducted pursuant to this paragraph and the development and implementation of corrective
action plans as required by Synergy Family Foster Care, Inc. shall be documented and maintained in the
foster caregiver file.
F
Any act of omission or commission by a foster caregiver or other member of the household which results in
the death, injury, illness, abuse, neglect or exploitation of a foster child shall be grounds for the denial of
recertification or revocation of a foster home certificate. This may be a recommendation from the agency
supervising a foster home or ODJFS.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: CHANGE IN HOUSEHOLD OCCUPANCY; CHANGE IN MARITAL STATUS;
CHANGE IN ADDRESS
POLICY NUMBER: 49
ORC REFERENCE: 5101:2-5-30
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 1/1/03
A
Upon notification of any change in household occupancy of a foster home, or change in marital status of a
foster caregiver, Synergy Family Foster Care, Inc. shall evaluate the change within thirty days of the
Synergy Family Foster Care, Inc.’s receipt of notification to determine if the foster caregiver is capable of
providing continued care for the foster children, to determine that new household occupants meet any
applicable requirements of Chapter 5101:2-5 or Chapter 5101:2-7 of the Administrative Code. If the
change is a new resident in the foster home, a JFS 01653, “Medical Statement for Foster Care/Adoptive
Applicant and All Household Members” shall be completed for that individual within thirty days of the
date the individual became a household member. If a new occupant of a foster home is a person subject to
a criminal records check, a criminal records check shall be initiated within ten working days. Whenever
there is a new occupant in a foster home, Synergy Family Foster Care, Inc. shall review the new
circumstances and, if necessary, redetermine the specific number, age, and sex of children to be placed with
the foster caregiver taking into consideration the new occupant(s) of the foster home. The review and
redetermination shall be documented in the caregiver’s record.
B
Upon notification of a change of address of a foster home, Synergy Family Foster Care, Inc. shall, within
ten working days after the notification or the change of address, conduct a safety audit or use the JFS 01348
“Safety Audit of a Foster Home.” Synergy Family Foster Care, Inc. shall also require the foster caregiver
to obtain a fire safety inspection certifying that the foster caregiver’s new residence is free from conditions
hazardous to the safety of foster children. The fire safety inspection shall be conducted within ninety days
of the change of address by a state certified fire safety inspector or the state fire marshal’s office. Synergy
Family Foster Care, Inc. shall review the foster caregiver’s new living situation and, if necessary,
redetermine the specific number, age, and sex of children to be placed with the foster caregiver taking into
consideration the physical facilities of the foster caregiver’s new residence. The review and
redetermination shall be documented in the caregiver’s record.
C
Synergy Family Foster Care, Inc. shall submit a JFS 01317 “Recommendation for
Certificate/Recertification of a Foster Home” to ODJFS to recommend any change which would cause a
change on the face of the certificate. Such recommendation shall be made within thirty calendar days of
the Synergy Family Foster Care, Inc.’s receipt of notification, or in case of a change of address, within
thirty calendar days after either the notification or the change of address.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: OCCUPANCY LIMITATIONS AND ACCESSIBILITY
POLICY NUMBER: 50
ORC REFERENCE: 5101:2-5-32
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 1/1/03
A
Synergy Family Foster Care, Inc. shall place a child in a foster home only when Synergy Family Foster
Care, Inc. and the foster caregiver are on compliance with the provisions of Chapter 5101:2-5 and 5101:2-7
of the Administrative Code.
B
Not more than five foster children and not more than a total of ten children, including the children of the
foster caregiver, shall reside in a foster home at any one time, except:
1
When a foster caregiver has been certified for less than two years to operate a foster home,
or has less than two years of professional child care experience as documented by Synergy Family
Foster Care, Inc., not more than three foster children shall be placed in the home at any one time
except sibling groups.
2
Not more than two children under the age of two years, except sibling groups, including the
children of a foster caregiver, shall reside in a foster home at any one time.
3
Not more than four children under the age of five years, except sibling groups, including the
children of a foster caregiver, shall reside in a foster home at any one time.
4
If the foster home is a specialized foster home, the additional placement limitations of rules
5101:2-5-36 and 5101:2-5-37 of the Administrative Code, as applicable, shall apply.
C
Placement of a physically handicapped child in foster home shall be made only after Synergy Family Foster
Care, Inc. has assured that any necessary special arrangements to meet the child’s needs have been made.
D
Pursuant to section 5103.0317 of the Revised Code, a foster home shall not receive more than five foster
children except in any of the following circumstances:
E
(1)
To accommodate a sibling group or the remaining members of a sibling group.
(2)
When the additional child or children are related to the foster caregiver by blood or marriage.
(3)
When the additional child or children are foster children who previously resided in the foster home.
(4)
When the additional child or children are the children of a foster child who resides in the foster
home.
If a foster home has less than five foster children placed, the home may accept one additional sibling group
that causes the foster home to exceed the limit of five foster children. The foster home that accepts a sibling
placement in this circumstance shall not exceed a total of ten children in the home as specified in paragraph
(F) of this rule.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
F
Not more than a total of ten children, including the children of a foster caregiver, children being cared for
by a type B child care provider and children receiving any private child care services, shall reside or receive
child care services in a foster home at any one time.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: ADOPTION RECRUITMENT PLAN
POLICY NUMBER: 51
ORC REFERENCE: 5101:2-48-03(D), 5101:2-48-05
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED: 1/1/05, 7/1/05, 3/1/07, 7/24/07
12/1/08, 3/25/09, 4-16-10
RECRUITMENT OVERVIEW:
Synergy Family Foster Care, Inc. will recruit not only therapeutic homes, but homes that are looking to
“foster to adopt”. Synergy Family Foster Care, Inc. will not deny or delay a perspective adoptive family or
individual from licensure due to sexual orientation, cultural orientation, national origin, ethnicity, religion,
color, race, age or handicaps. Synergy Family Foster Care, Inc. provides a community based program that
will recruit persons from a wide variety of backgrounds and experience that will coincide with the
background and needs of the youth looking to be adopted. Synergy Family Foster Care, Inc. will make
these services available to families all across Ohio. All “foster to adopt” applicants receive a phone call
and face-to-face visit. The majority of these visits will be done during the regular working hours of 8:00am
to 5:00pm. If the family can not be seen during the regular working day evening appointments can be
scheduled. Synergy Family Foster Care, Inc. will schedule an initial home study and training’s to meet the
needs of the applicants. The initial face to face visit will include information describing the application
process, explain the necessary forms, policy & procedures, and training requirements. All forms needed
will be given to the applicant at time of the initial visit. Individuals will be screened as to the appropriate
level of care, age, gender, as well as race, so a youth is placed in a home that will best suit his or her needs.
This will be incorporated into the home study. Persons interested in obtaining a license must possess a
willingness to work with youth from ages 0 to 21 years of age, from a variety of backgrounds/levels of care
ranging from but not inclusive to sexual, physical and verbal abuse, neglect, substance abuse, sexual
perpetrators, emotional difficulties, physical handicaps, learning disabilities, and juvenile delinquency.
Before an adoptable youth is placed in a home, the family will be notified that the youth is adoptable or that
the county agency is looking to take permanency, in which the youth will be adoptable at a later date. After
the youth has been placed in the “foster to adopt” home for an appropriate amount of time to ensure that
both parties are still willing to adopt, an adoptive home study will be done by the licensing specialist.
Synergy Family Foster Care, Inc. will work with the agency’s case manager to ensure that the adoption
process is completed in an accurate and timely manner. Methods of recruitment will include but not be
inclusive to; newspaper ads, and guest speaking to specific organizations, displays at community functions
and by word of mouth. Individuals interested in becoming adoptive foster parents must be able to attend a
series of pre-service training’s. Synergy Family Foster Care, Inc. and county agency trainings will be
offered during different times as well as various days to ensure the families have access to obtain all
aspects of the adoption process. A special phone system will be placed within the agency to accommodate
the hearing impaired clients. The adoptive foster parents must complete an adoptive home study process
defined by ODJFS. They must also display both good physical and mental health, to ensure that a safe
environment is provided for the child. They must also complete a series of background checks. Throughout
the course of being a adoptive foster parent the individual must be willing to attend meetings concerning
the child, work cooperatively with both the recommending agency worker and their Synergy Family Foster
Care, Inc. case manager and also be willing to strive to implement the care plan to maintain the well being
of the child(ren) placed in their care.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
B
AGES:
Synergy Family Foster Care, Inc. will try to place youth from the ages of 0-18 in adoptive foster homes.
The placement of children will not be delayed or denied based on race, color, creed, religion, ethnicity,
national origin, handicap or age.
C
EMOTIONAL /DEVELOPMENTAL NEEDS:
Children in an adoptive family foster home will need nurturance support and development of emotional
needs. Adoptive foster parents will be helped to recognize normal and abnormal developmental needs,
time lines, and behaviors. Children may have experienced abuse, neglect, and major emotional losses.
Such children may exhibit signs and symptoms of such abuse and neglect in forms of heightened anxiety,
depression (with suicidal behavior), poor self-esteem, acting out and delinquent behavior.
D
PHYSICAL NEEDS:
Children have physical needs, which need to be met. They need food, shelter, clothing, and separate beds,
dressers for their possessions, personal space, and choice of belongings. It is required that all medical
needs are immediately addressed and preventive optical and dental exams are provided.
E
RACE, COLOR AND NATIONAL ORIGIN BACKGROUNDS:
Children will be accepted into adoptive foster care from a variety of race, color and national origin
backgrounds. The issues and practices held by a child will be discussed with the adoptive foster parents.
The ethical, religious, and cultural needs of the children must be understood, appreciated, and met by the
family foster home. Synergy Family Foster Care, Inc. will not delay or prohibit the placement of a child
because of the agency’s inability to locate a home of the same background.
F
LEVELS OF CARE:
Adoptive foster parents will receive children who need various levels of care that will fall into but not be
limited to one of three categories being served through Synergy Family Foster Care, Inc.;
Regular Care includes but is not limited to youth that have been identified by the recommending agency
as having been physically or verbally abused and/or neglected and may also have been found dependent.
Youth classified as Moderate Degree of Difficulty includes but is not limited to sexually abused, unruly,
learning disabled, physically disabled, returning to the community from the Department of Youth Services
or has a history of minor drug usage. Exceptional Degree of Difficulty is the third category. This includes
but is not limited to sexual perpetrators, moderate to severe drug dependency and those youth having a
history of in patient psychiatric treatment, which includes suicidal ideation. Extreme Degree of Difficulty
includes but is not limited to high risk, difficult to place youth due to behavior disorders, sexual
perpetrators and medically fragile youth who require continuous medical attention. Synergy Family Foster
Care, Inc. will also accept sibling groups and pregnant teens. Synergy Family Foster Care, Inc. will
provide ongoing training to the foster parents, as well as the case managers to work with all the above
levels of intensive care.
G
RECRUITMENT PROCEDURE:
1
Once the prospective person contacts Synergy Family Foster Care, Inc. the licensing specialist
must respond within seventy-two hours.
2
A brief description of the program and any questions will be discussed during the initial phone
conversation.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
3
4
An initial home visit will be scheduled. The visit must occur within 7 working days of the initial
contact. If the visit cannot be scheduled the adoption information will be mailed to the family or
individual within 7 working days.
At the time of the initial contact Synergy Family Foster Care Inc. will provide the family a copy of
the JFS 01675 “Ohio Adoption Guide”, a description of Title IV-E adoption assistance and state
adoption subsidy programs including requirements and the application process, A description of
children in the state available for adoption may be accessed on the website at
http://jfs.ohio.gov/oapl , information on how to obtain an application for adoption, and a copy of
the adoption/foster care policy. Families will be made aware it is Synergy Family Foster Care,
Inc.’s policy that all individuals in the home 18 years and older complete a background check.
The family will also be made aware of the foster care/adoption homestudy process MEPA
complaint procedures and will go over JFS 01611. Family foster homes are licensed with ODJFS
and registered through SACWIS.
5
Thirty-six hours of pre-service training will be offered with times, dates and locations varying to
try and accommodate the individual needs of the prospective family foster home.
6
Reimbursement for the care of the youth will be discussed and expenditures itemized during the
pre-service training. The rates are established through Synergy Family Foster Care, Inc. preestablished rates as well as any special agency contract rates.
7
Synergy Family Foster Care, Inc. will notify the family foster home in which the child lives
should the child become available for adoption. This notification will be done in writing and a
copy put in the child’s file as well as the family foster home file. The written notification will be
completed by certified mail. Synergy Family Foster Care, Inc.’s certified social worker will
contact the foster home in order to begin an adoptive home study.
8
Adoptive foster care recruitment will be conducted in a timely manner. Placements will be made
according to level of experience and bed availability as well as geographic location to the primary
family, although placement of youth cannot be delayed or denied based on geographic boundaries,
race, color, religion, ethnicity, national origin, handicap, or age. Placements will be made for the
betterment of the child not to accommodate a family foster home. All placements must be
approved through the executive administrator or the licensing specialist.
9
Synergy Family Foster Care, Inc. views the Central Southern Region of Ohio as its community.
Newspaper ads will be placed in counties on a rotational basis. The frequency of ads will be
defined by Synergy Family Foster Care, Inc’s need for county specific homes. In cases where a
larger number of homes are required, targeted marketing will be utilized (i.e. signs in stores,
churches, etc.).
10
Synergy Family Foster Care, Inc. will provide services on an as needed basis to families with
language barriers or hearing impairment. For those clients with language barriers we will utilize a
telephone interpreting service from the company thebigword. When needing to work with client
with hearing impairments we will utilize services by Community Services for the Deaf in
Portsmouth, Ohio 740-356-7200 and Personal Interpreting Services in Lancaster, Ohio 614-8374040.
11
Synergy Family Foster Care, Inc. will comply with all parts of the “Indian Child Welfare Act of
1978”, “Adoption Promotion and Stability Act of 1996”, “Small Business and Job Protection Act
of 1996”, and “Adoptions SAFE Families Act of 1997”, the Multiethnic Placement Act of 1994 as
amended by Section 1808 of the Small Business Job Protection Act of 1996, 42 U.S.C. 622(b)(9),
671(a) (18), 674(d) and 1996(b) (hereinafter “MEPA”) and Title VI of the Civil Rights Act of
1964, 42 U.S.C. 2000d, et seq., as they apply to the Adoption process (hereinafter “Title VI”), do
not supercede the provisions of the Indian Child Welfare Act of 1978.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
H
12
Synergy Family Foster Care, Inc. staff will be equipped to deal with diverse cultural, racial, ethnic
and economic communities. The Synergy Family Foster Care, Inc. staff will be trained by
attending accredited workshops, area conferences, and trainings. In order to provide proof of
attendance copies of all certificates will be maintained in the employees file.
13
Synergy Family Foster Care shall submit a copy of the agency adoption recruitment plan for the
upcoming fiscal year, signed by the agency director, to ODJFS by May first of each year, and shall
address the upcoming state fiscal year. If Synergy Family Foster Care amends its recruitment plan
at any other time then the required due date, the agency shall be responsible for submitting the
amended recruitment plan to ODJFS within ten days following a plan change. If noncompliance
is identified, ODJFS shall notify Synergy Family Foster Care of noncompliance within sixty days
of the department’s receipt of the plan.
14
Synergy Family Foster Care will provide a timely search for prospective parents and assist them in
locating available children in permanent custody by utilizing the following. A description of
children in the state available for adoption may be accessed on the website at
http://ifs.ohio.gov/oapl. The site gives a description that includes the children’s age, gender, race,
and ethnicity of the children; their developmental, emotional, and physical needs; the number and
race of the children awaiting adoptive placement for one to twelve months, as well as more than
twelve months, from the date the court order granting permanent custody became final and nonappealable; and the average time over the previous five years from the date on which the court
order granting permanent custody of each child, broken down by race, became final and nonappealable and was placed for adoption. A search of the statewide automated child welfare
information system provides a listing of available adoptive families as it becomes available to the
agency when there are no families to be presented at any matching conference scheduled for a
child.
15
Synergy Family Foster Care will complete a comparison of the characteristics specified in 5101:248-05(D)(1)(D)(2), with the racial and ethnic diversity of the adoptive applicants approved by the
agency who are waiting to adopt. If there is an identification of any racial or ethnic category of
families that are under represented; then Synergy Family Foster Care will target the racial or
ethnic category of families that are under represented by recruiting adoptive applicants.
16
Synergy Family Foster Care will not charge a fee to any family in completing an adoptive home
study or in approving a family for adoption.
Synergy Family Foster Care will provide access to approved home studies , as well as related documents to
another PCSA or PCPA which requests a copy of the home study for matching purposes of a special needs
child pursuant to rule 5101:2-48-19.
1
Synergy Family Foster Care shall make its home studies of all approved families, who have signed
the authorization for release of information form, available to any other agency which requests a
copy of the home study.
2
The home study shall be released within fifteen days after a request has been made as long as the
authorization for such releases has been submitted to the agency and agency policy requirements
have been met.
3
Synergy Family Foster Care shall not release a home study when it is determined that the
application or the home study contains a false statement.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: ADMISSION POLICY AND PROCEDURE
POLICY NUMBER: 52
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED:
All children will be referred to the licensing specialist. At the time of admission to Synergy Family Foster
Care, Inc. the intake assessment form will be completed on each child. The following areas should be
reviewed with the recommending agency:
1
Psychiatric treatment (within the past five years);
2
Psychiatric medication (within the past year);
3
Counseling from a mental health agency;
4
Adjudication for sex offense;
5
Current sex offense charges pending;
6
History of abuse from adults or another child;
7
Medically frail child;
8
Current medical diagnosis; and
9
Child’s need for foster care.
B
All Children will be discussed with the administrative supervisor, who will determine the level of care.
C
Children arriving for emergency placement during the night or on the weekend will be admitted as an
emergency, by the on-call worker, and then referred to the licensing specialist or executive administrator
on the next working day. At this time the licensing specialist will do the intake assessment form. All
children will be discussed with the licensing specialist of executive administrator who may make
adjustments in the placement of the child.
D
The office manager will ensure that an intake packet is faxed to the recommending agency. The intake
packet will include but not be limited to the following:
1
Request form;
2
Release of school record form;
3
Release of information form;
4
Supervision form;
Attachment: Intake Form
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
F
G
5
Authorization form;
6
Drug screen form;
7
School of record form; and
8
Per-diem contract.
The office manager will be responsible for sending the following forms to the family foster home.
1
Per-diem contract;
2
Respite information form; and
3
Placement letter.
The office manager will also be responsible for the following:
1
A letter of notification of a child in foster care, being placed out of county, to the new residing
county juvenile court (except for Franklin County placements).
2
A letter to the Board of Education of the school district of the family foster home with information
of the school responsible for payment.
Attachment: Intake Form
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: ADMISSION TO FOSTER CARE
POLICY NUMBER: 53
ORC REFERENCE: 5101:2-7-17
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
B
DATE REVISED:
Within five working days of admission to foster care the assigned case manager or case aide will:
1
Meet with the child individually;
2
Meet with child and foster parent together; and
3
Sign and discuss foster parent agreement.
4
Give the foster parents the admission packet which may include but not be limited to:
a
Copy of child’s birth certificate;
b
Copy of child’s social security card;
c
Copy of child’s medical card;
d
Copy of child’s immunization records;
e
Copy of recommending agency’s case plan;
f
Copy of child’s IEP, if applicable;
h
Copy of child’s MFE, if applicable; and
i
Copy of Synergy Family Foster Care, Inc.’s case plan when complete.
At the time of this first visit the following issues must be completed:
1
Welcome child to home;
2
Review with child his/her adjustment to foster care and the foster home;
3
Physically inspect child’s living quarters and complete a clothing inventory;
4
Explore child’s physical and medical conditions by observing child and discussion with foster
parents. Observe for the following: bruises, cuts, burns, underweight, overweight, acne, dental
problems, lumps, seizures, hearing deficits, vision deficits, curvature of the spine, allergies, etc.;
5
Explore child’s emotional and mental condition by observing child and discussion with child and
foster parent. Observe for: nail biting, crying, withdrawal, acting out, threatening behavior, bed
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
wetting, fire setting, cruelty to animals, suicidal and run away behavior. Refer any emotional
issues to case manager supervisor.
6
Explain rules of foster care and discuss the child’s response to these rules;
7
Complete a clothing inventory to assess clothing needs; and
8
Discuss expectations of agency with child in regard to:
a
Home;
b
School; and
c
Visitation.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: CHILD’S RIGHTS AND GRIEVANCE POLICY
POLICY NUMBER: 54
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 3/10/07, 3/21/14
PROCEDURE:
Disagreements and misunderstandings can occur during case management due to the fact that changing is difficult
and often emotional. It is preferred that disagreements be resolved quickly so that preservation of the case manager
relationship is maintained. The preferred practice is for the child or the child’s family foster home to discuss issues
that may arise with the case manager supervisor that is responsible for the supervision of the case manager or case
aide who may be perceived as the source of concern.
“Grievance” means a written complaint initiated either verbally or in writing by a child or by any other person or
agency on behalf of a child regarding denial or abuse of any child’s rights.
The following is the procedure for filling a grievance:
A
Grievances must be filed within fourteen (14) calendar days (two weeks) of the date of the
incident or reason for the grievance, with the exception of abuse allegations, to the case manager
supervisor. A grievance against the case manager supervisor should be filed with the executive
administrator.
B
All grievances will be registered through the case manager supervisor or executive administrator.
The Child’s Right Advocate will direct the child’s foster caregiver through the proper steps in
filing the grievance and offer assistance until the grievance is resolved.
C
The following lists the proper steps to follow in filing a grievance.
1. In the case where the agency professional(s):
Case Managers/Social Workers
Case Aides
Student Interns
A grievance will be registered with the case manager supervisor.
2. In the case where the agency professional(s) include(s):
Case Manager Supervisor
Licensing Specialist
Administrative Assistant
Grievance will be registered with the following:
NAME:
Tom Stetzer, LSW
TITLE:
Executive Administrator
LOCATION:
769 E. Main St.
Chillicothe, Ohio 45601
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
HOURS OF AVAILABILITY:
TELEPHONE NUMBER:
Monday - Friday, 9:00am - 4:00pm
(740) 779-6636
3. In case where the agency professional is:
Executive Administrator
Business Administrator
A grievances may be registered with:
Ohio Department of Job and Family Services
50 West Town Street
6th Floor
Columbus, OH 43215
(614) 752-0035
Attn: Chris Tesi
Ohio Legal Rights Service
50 West Broad Street
Suite 1400
Columbus, OH 43215
(614) 466-7264
D
All grievances will be resolved and the written notification and explanation of the resolution will
be given to the griever within twenty (20) working days of the date the grievance is filed.
E
If the griever is not satisfied with the resolution at the level the grievance was filed, the griever
has the right to file another grievance at the next higher level within the agency. If the griever
proceeds through all levels and remains unsatisfied with the resolution, the griever may call any of
the resources listed above. Any relevant information regarding the grievance will be provided
upon request to any outside agency with which the griever has initiated a grievance.
Children’s Rights and Grievance Policy will be posted in the administrative office. Employees will receive a copy
and discuss the policy at the time of orientation. Each child will receive a personal copy at the time of admission to
Synergy Family Foster Care, Inc.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
CHILD’S RIGHTS
Synergy Family Foster Care, Inc. believes that each child in our family foster homes shall have:
1.
The Right to enjoy freedom of thought, conscience and religion and ability to abstain from the practice
of religion. .
2.
The Right to reasonable enjoyment of privacy.
3.
The Right to have his or her opinions heard and be included, to the greatest extent possible, when any
decisions are being made affecting his or her life.
4.
The Right to receive appropriate and reasonable adult guidance, support, and supervision from foster
caregivers.
5.
The Right to be free from physical abuse and inhumane treatment.
6.
The Right to be protected from all forms of sexual exploitation.
7.
The Right to receive adequate and appropriate medical care.
8.
The Right to receive adequate and appropriate food, clothing, and housing.
9.
The Right to his/her own money and personal property in accordance with the child's service or case
plan.
10. The Right to live in clean, sage surroundings.
11. The Right to participate in an appropriate educational program.
12. The Right to communicate with family, friends and "significant others" from whom he or she is living
apart, in accordance with the child's service or case plan.
13. The right to be taught to fulfill appropriate responsibilities to himself or herself and to others.
14. The Right to a current, written, individualized care plan that addresses mental health, physical health,
social needs, and appropriate and adequate services. The right to information about the reason for their
placement and help in developing an explanation of their situation to others without unnecessary
erosion of self-esteem.
15. The Right to know about and to actively participate in the development and review of the service or
case plan.
16. The Right to participate in any appropriate and available activities offered in foster home, including but
not limited to education, training, social development, recreation, and religious observance.
17. The Right upon admission to a family foster home to receive written and verbal explanations of the
policies so those acceptable and unacceptable behaviors and the consequences are clear.
18. The Right to have a case manager and have regularly scheduled visits by the case manager. The right
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
to have a confidential time with the case manager at the time of the review.
19. The Right to send and receive mail without censorship. If individual exception is necessary, children
have the right to have a reason recorded in the treatment plan and shared with the recommending
agency and the family foster home.
20. The Right to help in dealing with effects of separation.
21. The Right not to be discriminated against based on religion, race, color, creed, sex, national origin,
lifestyle, physical or mental disability, developmental disability, inability to pay, HIV infection, AIDSrelated complications or AIDS.
22. The Right to file a grievance and to have verbal and written instructions for filing a grievance.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: FOSTER PARENT WEEKLY CALENDAR
POLICY NUMBER: 55
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED:
A
Foster parent weekly calendars are part of the documentation which Synergy Family Foster Care, Inc.
collects and maintains on each child.
B
Foster parent weekly calendars are required as part of the contractual responsibilities between the family
foster home and Synergy Family Foster Care, Inc.
C
Synergy Family Foster Care, Inc. require that the foster caregiver complete the calendar in a timely fashion
in order for the case manager to collect the next week. The calendars will be maintained as a permanent
part of the child’s file.
D
The original calendar will be placed within the context of the monthly report submitted to the
recommending agency. A copy will be placed in the child’s file.
E
At the time of discharge or transfer all paperwork regarding the child shall be returned to Synergy Family
Foster Care, Inc. for the child’s file.
Attachment: Foster Parent Weekly Calendar
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: INCIDENT REPORTS
POLICY NUMBER: 56
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED:
A
The foster caregivers are required to notify Synergy Family Foster Care, Inc. immediately when a crucial
incident occurs involving the foster child. At any time that an incident occurs involving the child the case
manager or case manager supervisor that handles the situation is required to document the incident on an
incident report form and fax it to the recommending agency the date that the incident occurred or if it is
after hours then at the beginning of the next business day. The original incident report will be filed in the
child’s file and noted on the following monthly report sent to the recommending agency.
B
The following situations are to be considered but not limited to crucial incidents in which the on-call or
daytime staff would need to verbally contact the appropriate recommending agency and/or any emergency
services required. Follow up with a written incident report within twenty-four hours will be submitted by
fax to the recommending agency.
C
The following situations are required to be reported to the recommending agency:
1
Hospitalization;
2
Emergency room;
3
Any illegal substance or medication not prescribed for the youth;
4
Suicidal ideation;
5
Police involvement;
6
AWOL; or
7
Abuse, sexual or physical.
Attachment: Incident Report
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: INVESTIGATIONS OF ALLEGATIONS OF ABUSE, NEGLECT, OR LACK OF QUALITY
CARE OF A FAMILY FOSTER HOME
POLICY NUMBER: 57
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
All allegations received will be immediately dated, signed and recorded on the family foster home progress
note by the first person identifying the problem.
1
B
DATE REVISED:
Documentation should be noted by any of the following: licensing specialist, executive
administrator, case manager supervisor, case manager, or case aide.
The family foster home progress note will be given to or phoned to the licensing specialist who will:
1
Discuss initial referral with the executive administrator, the case manager supervisor, and gather
any data from other staff as needed and make documentation.
C
The licensing specialist will review the family foster home file.
D
The licensing specialist will arrange a face-to-face interview with the family foster home. Allegations shall
be discussed in person. Only when foster parents refuse to a face-to-face interview shall phone discussion
be allowed. The refusal of a face-to-face interview needs to be documented.
E
The licensing specialist shall prepare a Deposition which shall include but not be limited to:
F
G
1
Discussion of concern; and
2
Preparation of JFS 01921 and a written plan of action.
If concern appears substantiated:
1
Discuss with recommending agency;
2
Discuss with executive administrator;
3
Discuss with case manager supervisor; and
4
Discuss with assigned case manager or case side.
Remove children from home if concern is:
1
Sexual abuse, inappropriate sexual behavior, sexual allegations, or the existence of pornographic
materials;
2
Physical abuse;
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
H
3
Verbal abuse/ridicule; or
4
Physical neglect of an infant, child with physical illness or pregnancy.
May leave children in home if situation can be corrected immediately, within twenty-four hours.
1
I
A written plan of corrective action must be signed by the foster caregiver and the licensing
specialist. Required changes must be listed separately with specific outcome goals and time
frames. The licensing specialist must revisit the home on each date that an item is due. The plan
of action will be filed in the family foster home file.
If child is to be removed:
1
Work with agency case manager to arrange most appropriate placement;
2
Notify recommending agency verbally (before move) and follow up with written notice of move,
investigation and plan of action if necessary;
3
Notify children’s services in the county of events verbally and in writing;
4
Notify custodial agency whose children were removed of final investigation results in writing
within thirty days.
J
Review final disposition with executive administrator and case manager supervisor .
K
Complete JFS 01921 and file in family foster home file.
L
Obtain mandatory agency signatures on 28D and plan of action.
M
File all appropriate data in family foster home file within thirty days. All documents are to be dated and
signed. A narrative log with specific dates and times of interactions should be recorded in the family foster
home file.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: OBTAINING PHYSICAL, EYE AND DENTAL
POLICY NUMBER: 58
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED:
A
The physical health assessment is the responsibility of the foster caregiver to both schedule and transport.
Initial physicals are to be completed within the first 30 days unless scheduling or lack of medical card
creates a problem. In this case once the medical card is obtained the first available appointment will be
sufficient. If this should occur it must be documented in the child’s file. Synergy Family Foster Care, Inc.
physical health assessment form will be utilized. Documentation of the appointment must be turned in to
the case manager during the first home visit following the actual appointment. Routine physicals must be
scheduled annually. Ongoing medical appointments are the responsibility of the foster caregiver to both
schedule and transport. Case managers will provide assistance and referrals as needed.
B
The optical and dental assessments are the responsibility of the foster caregiver to both schedule and
transport. Appointments must be scheduled within the first week after placement with the actual
appointment occurring within the first 90 days of placement. Synergy Family Foster Care, Inc. forms must
be utilized. Documentation of the appointments must be turned in to the case manager during the first
scheduled home visit following the actual appointment. Eye Exams must be scheduled annually. Once the
initial dental work is completed routine cleaning must occur every 6 months.
Attachment: Physical Health Assessment Form
Standard Optical Form
Appointment Report Form
Standard Dental Form
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: PROGRESS NOTES
POLICY NUMBER: 59
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED:
Progress notes shall reflect implementation of the care/treatment plan, including documentation of the
choices and perceptions of the child served regarding the service(s) received and shall:
1
Contain descriptions of changes in the child’s condition and needs, and of the child’s responses
to services provided;
2
Be dated, signed, and legible and include the professional qualifications of the individual making
the entry;
3
Include notes from staff member(s) providing each service; and
4
Be recorded upon each service contact.
B
Specialized counseling group notes may be substituted with approval from executive administrator or case
manager supervisor.
C
If a child is terminated involuntary from a service or from the agency, the reasons shall be documented
and reviewed as part of the agency quality assurance activities. Documentation shall also include
alternative services or interagency referrals that were provided prior to the involuntary termination.
Attachments: Progress Note
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: SEARCH AND SEIZURE
POLICY NUMBER: 60
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 3/21/14
A
The dignity of each child in care of Synergy Family Foster, Inc. as to regards to their personal property and
their person must be respected at all times by the network staff and the family foster home. For reasonable
cause, it may, at times, be necessary to conduct a search for missing or stolen property or for control of
contraband. Just and reasonable cause to believe that the child involved is in possession of such materials
will be the test before the decision to search a child’s person or property is permitted. When such a search
takes place, the foster caregiver and, if possible, at least one staff member must be present. In addition,
whenever possible, the child should be present.
B
With a spirit of courtesy, on the degree of orderly search necessary to ascertain the presence or absence of
missing or stolen articles or contraband and the removal of such articles is permitted. The decision to or
the method of search is not to be used as discipline of the child in question. If contraband (ie. material, the
mere possession of which is unqualifiedly illegal) is found Synergy Family Foster, Inc.’s executive
administrator or case manager supervisor is to be immediately contacted and absolutely no further action,
except as instructed, is to be taken. If missing or stolen articles are found and their legal owner can be
identified, they are to be promptly returned and a receipt obtained. If the owner cannot be identified, such
articles are to be tendered to the executive administrator or appropriately disposed
C
Any searches motivated by information from individuals other than Synergy Family Foster, Inc.’s staff or
foster caregivers must be first referred to the executive administrator or case manager supervisor before
any action is to be taken. Searches requested by licensure agency, recommending agency, or other outside
agency staff is to be conducted if said request is made directly to the Synergy Family Foster, Inc. executive
administrator or case manager supervisor. The executive administrator or case manager supervisor may at
times consult with legal counsel to protect the rights of Synergy Family Foster, Inc.’s staff, foster caregiver,
and of the child involved.
THERE ARE TO BE NO EXCEPTIONS TO THIS POLICY
A written report covering the circumstances surrounding a specific search must be made to the
executive administrator or case manager supervisor, and faxed to the recommending agency within twentyfour hours of the search with the results.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: SERVING CHILDREN WITH HUMAN IMMUNODEFICIENCY VIRUS AND AIDS RELATED
CONDITIONS
POLICY NUMBER: 61
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED:
A
Synergy Family Foster Care, Inc. will not discriminate against any child who has been exposed to or tested
positive for HIV, or Aids related conditions.
B
Confidentiality of medical/clinical information is to be treated with the same safeguards, as is all client
information. The confidentiality policy is addressed in the medical records and confidentiality policy.
All health care conditions of the child are reviewed with the foster parents who are held accountable to the
same level of confidentiality.
C
Children who request an HIV test for a known or suspected exposure will be referred to Children’s Hospital
Infectious Disease Clinic. The child will be accompanied be a Synergy Family Foster Care, Inc. case
manager and a parent of the family foster home. Children’s Hospital provides education regarding the
testing procedure and the results.
D
A minor may consent to an HIV test and the concurrence of the minors parents(s) or guardian(s) is not
required.
E
Synergy Family Foster Care, Inc. will make every possible effort to assist the child with concerns in this
area; encouraging the child to work with the foster caregiver and/or legal guardian. Synergy Family Foster
Care, Inc. will work with Children’s Hospital to ensure the following information is given to the child:
F
1
An oral or written explanation that the test is voluntary and that the individual may elect
to have an anonymous test;
2
An oral or written explanation that consent to be tested may be withdrawn:
a
(outpatient) at any time before the individual leaves the premises where blood
is taken for the test;
b
(inpatient) consent may be withdrawn within one hour after a blood sample is
taken for testing.
3
An oral or written explanation of the test and testing procedures, including the purposes
and limitations of the test and the meaning of its results; and
4
An oral or written explanation of behaviors known to pose risks for transmission of HIV
infection.
Synergy Family Foster Care, Inc. will fully document the discussion with the child and a record of
obtaining permission by the administering health care professional.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
G
When the child receives the results, the Synergy Family Foster Care, Inc. case manager must accompany
the child and arrange an immediate time to process the events and the information. If required Synergy
Family Foster Care, Inc. will be responsible to set up counseling and/or education where available.
H
The foster caregiver will receive training in Infectious Diseases and legal issues related to discrimination of
children with infectious diseases. They will receive training in Universal Precautions by a Synergy Family
Foster Care, Inc. trained staff member. Current information brochures will be available to the foster
caregiver.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: SUBMISSION OF POLICIES TO ODJFS
POLICY NUMBER: 62
ORC REFERENCE: 5101:2-7-13(B)(C)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED:
A
All policies by Synergy Family Foster Care, Inc. shall be submitted to ODJFS at the time of application for
initial certification or re-certification, or within ten days of a policy change.
B
Synergy Family Foster Care, Inc. shall provide all policies required by chapter 5101:2-5-13 to any person
affected by the policy. Any policy required by chapter 5101:2-5-13 shall be provided by Synergy Family
Foster Care, Inc. to any person upon request at no cost to the individual.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: SUICIDAL LETHALITY ASSESSMENT POLICY
POLICY NUMBER: 63
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED:
A
The family foster home should immediately contact Synergy Family Foster Care, Inc. at any talk or
behavior of suicidal tendency.
B
The Suicidal Lethality Assessment will be completed on a routine/emergency basis by a licensed mental
health agency or hospital emergency room in the following circumstances:
C
1
Child is talking about suicide; or
2
Child’s behavior may reflect suicidal thinking/rumination.
Notification to the recommending agency must be immediate with written notification utilizing the incident
report within twenty-four hours of incident or assessment.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: SUPERVISION OF FAMILY FOSTER HOME AND OR PLACEMENT
POLICY NUMBER: 64
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
A
DATE REVISED:
The case manager or case aide member assigned to monitor a home is responsible for:
1
Weekly contact with home. This must be at least two times a month (based on the needs of the
child: more severe child will require four times a month) face-to-face individually with child. The
visit to the home will include a review of each child’s progress in an interview with the foster
caregiver and a joint interview to review successes and problems.
2
The weekly contact should be planned, directed towards the goal specific treatment plan and
documented on progress notes. It should be positive. The child and foster parent should view the
visit as positive and goal directed. The contact should cover the goals that pertain to the progress
or lack of progress.
3
There should be at least one phone contact weekly with the foster parent, child or both. The
phone conversation should be documented on a conversation log, which will be filed in the child’s
file weekly after being reviewed by the case manager supervisor.
4
The professional staff is also responsible for addressing the following issues at the time of the
visit:
5
a
Observe child’s living/sleeping space;
b
Ensure child is physically and sexually safe;
c
Ensure child’s physical, nutrition, hygiene, and medical needs are being met;
d
Ensure child’s emotional needs are being met;
e
Review child’s academic progress and establish a routine to see school reports etc.; and
f
Complete clothing inventories at admission to care, each time a clothing voucher is
received, and at time of discharge from agency.
The case manager is responsible for collecting the prior months foster parent documentation
and submitting it with the monthly report. The original documents are to be sent to the
recommending agency within the monthly report, and the office manager is to put copies of the
reports in the child’s file.
Attachment: Conversation Log
Weekly Contact Sheet
Progress Notes
Home visitation form
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: TREATMENT OR DIAGNOSTIC SERVICES
POLICY NUMBER: 65
ORC REFERENCE: 5101:2-5-14)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 12/1/07
A
When a child in foster care has, in addition to routine medical, dental, or vision care, an assessed need for
treatment or diagnostic services which are not included in the current case plan. Synergy Family Foster
Care, Inc. shall inform the recommending agency, of the child, of the need for assessment with verbal
notification prior to receiving services followed by written verification within seventy-two hours. The
services will also be documented on the child’s monthly report as well as the case file required pursuant to
rule 5101:2-5-10 of the Administrative Code
B
If the recommending agency does not directly employ or contract with a vendor for treatment or diagnostic
services, Synergy Family Foster Care, Inc. shall arrange with the recommending agency for the provision
of such services.
C
Any treatment or diagnostic services provided to any child pursuant to this rule shall be documented in the
child’s case record required pursuant to rule 5101:2-5-10 of the Administrative Code.
D
It is the responsibility of the case manager to ensure that the case manager supervisor is made aware of
the need for treatment/diagnostic services. Once aware it is the case manager supervisor’s responsibility
to ensure that the case manager complies with 5101:2-5-14.
Attachment: Treatment or Diagnostic Service
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: SCHOOL ENROLLMENT
POLICY NUMBER: 66
ORC REFERENCE: 5101:2-5-14
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED:
A
The foster caregiver will be responsible for enrolling any youth placed in their family foster home by
Synergy Family Foster Care, Inc. within forty-eight hours of placement when the necessary paperwork is
obtained.
B
The foster caregiver shall need the following documents for school enrollment;
1
Copy of Birth Certificate;
2
Copy of Social Security Card;
3
Copy of immunization records;
4
Copy of prior school transcript;
5
Copy of current journal entry;
6
Copy of current IEP, if applicable;
7
Copy of current MFE, if applicable; and
8
Copy of foster caregiver placement letter.
C
If any of the mentioned documents should not be available then the school of enrollment should request the
necessary documentation from the previous school of enrollment. The previous school of record should be
obtained from the assigned Synergy Family Foster Care, Inc. case manager.
D
Synergy Family Foster Care, Inc. understands the need to expedite the school enrollment process. If the
foster caregiver should have any difficulties in the school enrollment process then the foster caregiver
should notify the appointed family foster home case manager. The case manager shall at that time work
with the recommending agency case worker to acquire the required documentation for the school
enrollment process.
Attachment: Treatment or Diagnostic Service
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: MAINTENANCE OF RECORDS
POLICY NUMBER: 67
ORC REFERENCE: 5101:2-5-13(A)(30)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 9/1/02, 3/1/07
A
All records for Synergy Family Foster Care, Inc. will be maintained in separate files for each client, foster
home, adoption, personnel and administrative records in the agency.
B
All records will be locked with access only to Synergy Family Foster Care, Inc. staff or administration.
C
Information in the records may only be released with the proper document (release of information) signed
by the appropriate individual for whom the information is on.
D
Records will be kept for a period of five years after the date of discharge, termination of licensure or
termination of employment. After five years the records will be disposed of by shredding.
E
No records are permitted to leave the offices of Synergy Family Foster Care, Inc. by employees. Unless
attending a scheduled case plan meeting, treatment team meeting, Semi-annual review, mental health intake
appointment and any court hearings. The file must be returned to the office the same day or if not returning
to the office then at the beginning of the next business day. If the employee has the next business day
scheduled off then arrangements need to be made for the return of the file(s). All files must be signed out
be the individual removing the file from the office through the Business Administrator.
F
Foster parents wanting to view files of a child to be placed or placed in their home may do so at the office
location. The case worker for the child must document the date the family reviewed the file and have the
family sign that they viewed the file.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: RESPITE PLACEMENT
POLICY NUMBER: 68
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/01
DATE REVISED: 11/1/14
A
Each case manager will fill out a respite data sheet that gives the respite caregiver vital information
regarding the youth that is being placed in respite. The respite data sheet will need to be on file at the
office before any respite will be arranged for the selected youth.
B
The foster caregiver will be required to give a five (5) day notice prior to requesting respite for a youth
placed in their family foster home, except in incidents where the youth may pose a danger to someone in
the family foster home. Utilization of respite care shall be only with the approval of the Executive
Director.
C
The foster caregiver shall be required to notify the respite placement person to request respite for a youth.
The respite placement person will then make every possible attempt to place the requested youth into
respite. After the respite placement person finds an appropriate respite home for the youth they will pass
along the information to the foster caregiver for them to make drop-off and pick-up arrangements with the
respite caregiver. It will be the responsibility of the foster caregiver and respite caregiver to provide all
transportation, usually settling on a midway destination for each caregiver. Only approved respite care
providers shall be utilized. This would include a licensed foster parent. An approved respite care provider
who is not certified as a foster caregiver or specialized foster caregiver shall receive at least twelve hours of
orientation and training relevant to the children served by the specialized foster care program and have a
criminal record check conducted as for a foster caregiver pursuant to rule 5101:2-5-091 of the
Administrative Code prior to providing respite care.
D
It is the responsibility of the foster caregiver to be sure that enough clothes are sent with the youth that the
respite caregiver will not have to do daily washing. The foster caregiver will also be responsible to make
sure that the proper amount of medication is given to the respite caregiver with instructions for
administration. It will be the foster caregiver’s responsibility to take care of all necessary prescription
refills prior to sending youth on respite. In failing to do so the foster caregiver will be liable to remedy the
situation.
E
If any incidents occur during respite the respite caregiver shall notify the appropriate case manager for the
youth with details.
F
The respite caregiver should never discuss or imply that the youth is welcome to remain in the home as a
permanent placement. This decision can only be made and discussed by the ongoing case manager.
Failure to comply could jeopardize future placements for respite.
G
A respite care provider shall not provide respite care for children for more than two consecutive weeks
unless the provider is certified as a specialized foster caregiver.
H
Prior to each occasion of respite care, the recommending agency shall provide the respite care provider
with a copy of the JFS 01443, “Child’s Education and Health Information” or the form the agency uses in
lieu of the JFS 01433 completed for the child pursuant to rule 5101:2-39-092 of the Administrative Code as
Attachment: Respite form
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
part of his case plan and at least a written summary of the child’s service plan. In addition, for a medically
fragile child, any nursing treatment plan containing physician orders shall be provided. The information
required by this paragraph shall be provided to the respite care provider by the agency that has approved
the respite care provider. Documentation that this has been done shall be maintained in the child’s case
record by the agency that approved the respite care provider.
1
2
I.
For each occasion of respite care, a respite care provider shall provide a written report of the
child’s stay in respite care to the specialized foster caregiver.
A respite care provider for a medically fragile child shall be certified as a foster caregiver for
medically fragile children or be a licensed medical professional.
Synergy FFC will recommend families to provide respite only to children remaining in the custody of their
family. (Not in agency Custody) These placements will be called Direct placements. These parents will
not be licensed foster parents thus will not be able to provide services to children in the custody of a court
or county. Only children not placed into the SACWIS system will be placed in these respite only homes.
In order to be used as a respite only home parents need the following.
1.
2.
3.
4.
5.
12 hours of training prior to children being placed in the home. This training centering on
agency policy, working with behavior issues, physical abuse, sexual abuse, neglect, working
with biological families, etc.
CPR/First Aide certification. (cost is reimbursed by Synergy)
FBI and BCII background check (cost is reimbursed by Synergy)
Fire inspection. (cost is reimbursed by Synergy)
Completion of JFS01691 Application for Child Placement and JFS01348 safety audit.
Once Synergy FFC has these items the family can provide respite for children. We will follow same rules
as licensing a foster parent in regards to results of background check and completion of fire inspection.
Attachment: Respite form
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: LIFE BOOK
POLICY NUMBER: 69
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 9/26/01
DATE REVISED:
A
Each family foster home shall encourage the youth to collect items to added to their life book. The family
foster home shall also maintain a collection of information to include in the youths life book. The family
foster caregiver shall collect items such as: photos, school certificates, activity awards or recognition,
personal items, etc.
B
Information to be contained in the life book should give the youth a collection of information to document
their past life accomplishments. Knowledge regarding birthparents can only be placed in the book if the
child has the information and places it in the book themselves.
C
Upon placement of a youth in a family foster home the caregiver(s) will begin collecting items for the Life
Book at that time.
D
Upon exit of the youth from the agency the Life Book will follow the child.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: REQUESTED REMOVAL OF YOUTH
POLICY NUMBER: 70
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 9/26/01
DATE REVISED:
A
When a family foster home is requesting a youth to be removed from their home a written notice giving
their reason why will need to be submitted to the Synergy Family Foster Care, Inc. case manager. The
notice will give the agency a 30-day notice unless the family foster home feels that a member of the home
or the youth is in physical or psychological danger while remaining in the home.
B
The 30-day notice allows Synergy Family Foster Care, Inc. adequate time to notify the recommending
agency of the plan to move the youth to another family foster home. This also allows the staff of Synergy
Family Foster Care, Inc. adequate time in finding a suitable placement for the youth.
C
During this time if the family foster home feels the need to place the youth in respite they will be advised
that their respite days will be utilized for the planned respite, unless other arrangements have been made
through the recommending agency.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: PIERCING AND TATTOOS
POLICY NUMBER: 71
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 9/26/01
DATE REVISED:
A
Synergy Family Foster Care, Inc. shall not encourage foster youths to have piercing or tattoos done while
placed in a Synergy Family Foster Care, Inc. family foster home. Only if the recommending agency or
biological parent consents in writing for the youth to have a piercing or tattoo may the family foster
caregiver be permitted to accompany or transport the youth to have a piercing or tattoo done while placed
in the family foster home.
B
If the youth has a piercing or tattoo done while on a biological parent or relative visit Synergy Family
Foster Care, Inc. will not be held responsible if the piercing or tattoo is not properly taken care of. Synergy
Family Foster Care, Inc. case manager should immediately be notified so that the recommending agency
can be notified of the piercing or tattoo.
C
If the youth has a piercing or tattoo done while placed in the family foster home either by themselves or
another individual then the recommending agency will be notified by the Synergy Family Foster Care, Inc.
case manager. The recommending agency shall give their recommendation as to how the incident will be
handled or resolved.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: WEAPONS
POLICY NUMBER: 72
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 9/26/01
DATE REVISED:
A
Synergy Family Foster Care, Inc. shall not permit youths placed in family foster homes to acquire or
possess any type of object that can be used as a weapon toward themselves or another individual. This
would include but not be limited to any type of ninja weapons (such as throwing stars), pocket knives,
switch blades, guns, BB guns, air guns, paint guns and archery equipment.
B
Permission to use any of the items mentioned above needs to be given in writing by the recommending
agency prior to use and only under foster caregiver’s supervision. When the weapon is not in use it will be
secured in accordance with policy #11.
C
Any youth wishing to hunt during hunting season must receive written approval from their recommending
agency and complete a Hunter’s Safety Course and only hunt with an approved adult as stated by the
recommending agency.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: ADOPTION INQUIRY
POLICY NUMBER: 73
ORC REFERENCE: 5101:2-48-08
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 2/1/02
A
B
DATE REVISED:
Synergy Family Foster Care, Inc. shall respond to inquires concerning adoption within seven working days
and shall provide the following information to the inquirer:
1
A copy of JFS 01675, “Ohio Adoption Guide.”
2
A description of the characteristics and approximate number of children available for adoption in
Ohio.
3
Information concerning:
a
A description of Title IV-E adoption assistance and state adoption subsidy programs
including eligibility requirements and the application process;
b
The availability, for review, of a copy of the “Ohio Adoption Photo Listing” (OAPL),
and the address of the AdoptOhio photo listing web page; and the JFS 01675, “Ohio
Adoption Guide”;
c
How to obtain an application for adoption and a copy of the agency adoption policy, or
summary of the policy, prepared pursuant to Rule 5101:2-48-05 of the Administrative
Code;
d
The requirements that all adoptive applicants shall provide a set of impressions of their
fingerprints and that a criminal records check must be conducted and satisfactorily
completed in accordance with section 109-572 of the Revised Code if they wish to be
considered for adoptive placement of a child. In addition, adoptive applicants may be
responsible for paying the required fee for the criminal records check; and
e
The foster care/adoption homestudy assessment process.
Synergy Family Foster Care, Inc. shall refer an inquiry from an Ohio resident, who does not meet
requirements for adoption services as identified in the Synergy Family Foster Care, Inc. adoption policy, to
another agency for adoption services. If the inquirer is from an Ohio county, other than Ross County then a
referral shall include, at a minimum, the name, address, and telephone number of the PCSA in the county
of the inquirer’s residence.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: ADOPTION OF A FOSTER CHILD WHO HAS RESIDED WITH THE CAREGIVER FOR AT
LEAST TWELVE MONTHS
POLICY NUMBER: 74
ORC REFERENCE: 5101:2-48-11.1, 5101:2-48-19
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 2/1/02
DATE REVISED: 1/1/05
A
When a foster caregiver expresses the desire to adopt a foster child who is and has been residing with the
foster caregiver for at least twelve months, Synergy Family Foster Care, Inc. shall provide the foster
caregiver a JFS 01692, “Application for Adoption of a Foster Child.”
B
Synergy Family Foster Care, Inc. shall inform the foster caregiver that consideration will be given to their
application provided that the placement is in the best interest of the child pursuant to rule 5101:2-48-16 of
the Administrative Code.
C
Upon receipt of a completed JFS 01692, Synergy Family Foster Care, Inc. shall review the application with
the foster caregiver. Synergy Family Foster Care, Inc. shall require the foster caregiver to undergo a BCII
and FBI check as a condition of acceptance or approval of the application for adoption of a foster child;
however, the agency shall inform the foster caregiver that a criminal records check is required before a
court may issue a final decree of adoption or an interlocutory order of adoption.
D
When Synergy Family Foster Care, Inc. receives a completed JFS 01692, “Application to Adopt a Foster
Child in the Home Twelve Months or More” shall provide the foster caregiver with both of the following:
1
Information about the requirement for adoption training as outlined in Rule 5101:2-48-09 of the
Administrative Code; and
2
Information about the application process and eligibility requirements of Title IV-E Adoption
Assistance, state adoption maintenance, post adoption special services subsidy, and non-recurring
adoption expenses.
E
Synergy Family Foster Care, Inc. shall process the completed JFS 01692 and follow the approval or denial
procedures found in paragraphs (G) to (I) of Rule 5101:2-48-12 of the Administrative Code.
F
Prior to the approval of the adoption homestudy Synergy Family Foster Care shall document in the case file
that the foster caregiver has fulfilled the required adoption training as outlined in rule 5101:2-48-09 of the
Administrative Code.
G
The JFS 01692 shall only be used as an approval for the adoptive placement for the child(ren) for whom the
homestudy was conducted. A separate JFS 01692 or JFS 01673, as applicable, shall be used for any other
child(ren) that the family is interested in adopting.
H
Upon approval of the foster caregiver for the adoptive placement, the agency shall follow the adoptive
placement procedures as outlined in Rule 5101:2-48-16 of the Administrative Code.
I
Synergy Family Foster Care is not involved in the approval or denial process of any adoptive child(ren) in
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POLICY AND PROCEDURES
an adoptive placement. Synergy Family Foster Care solely provides the homestudy data, training, case
management of the adoptive family and meets the licensing and recertification requirements of ODJFS.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: COMPLETION OF THE HOMESTUDY REPORT FOR AN ADOPTIVE HOME
POLICY NUMBER: 75
ORC REFERENCE: 5101:2-48-12
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 2/1/02
DATE REVISED: 1/1/05
Update adoption home study
(A)
For the purpose of this rule, "commencement of a homestudy" means, at minimum, scheduling an
appointment to interview the applicant or assuring the applicant is informed of the necessary materials required for
the assessor to complete the homestudy. In order to complete the JFS 01673 "Assessment for Child Placement
(Homestudy)"(rev. 8/2005) an assessor shall conduct a face to face interview with all members of the household
over the age of four years. The interview with all members of the household over the age of four years may be a
joint interview or separate individual interviews.
(B)
Homestudies shall be conducted by an adoption assessor meeting the requirements contained in rules 5101:21-01 and 5101:2-48-06 of the Administrative Code and is employed or under contract with one of the following:
(1)
A public children services agency (PCSA) acting as a representative of the Ohio department of job and family
services (ODJFS) to:
(a)
Place children for adoption.
(b)
Participate in the placement of children for adoption.
(2)
A private child placing agency (PCPA) or private non-custodial agency (PNA) certified to act as a
representative of ODJFS to:
(a)
Place children for adoption.
(b)
Participate in the placement of children for adoption.
(C)
The assessment required by paragraph (B) of this rule shall commence within thirty days of the date the
agency receives a fully completed JFS 01691 "Application for Child Placement" (rev. 12/2006) (rev. 6/2009) signed
by the adoptive applicant. An agency failing to commence a homestudy within thirty days of receiving the
application shall document in the applicant's record the reason(s) the agency is unable to meet this requirement.
(D)
The assessment for applicants seeking to adopt a child with special needs shall be completed within one
hundred eighty days of the date the agency received the application. An agency failing to complete a homestudy
within one hundred eighty days shall document in the applicant's record the reason(s) the agency is unable to meet
this requirement.
(E)
For an applicant(s) not seeking a child with special needs, the timeframes for completion of a written
homestudy report, approval or denial of the adoptive homestudy, and written notification to the applicant(s) of the
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approval or denial shall be consistent with the agency's adoption and foster care policy prepared pursuant to rule
5101:2-48-05 of the Administrative Code.
(F)
The PCSA, PCPA or PNA shall search the statewide automated child welfare information system (SACWIS),
or the central registry of abuse and neglect if SACWIS is not fully implemented, for each applicant and adult
members of the applicant's household in accordance with rule 5101:2-48-09 of the Administrative Code.
(G)
The PCSA, PCPA or PNA shall request a check of the child abuse and neglect registry of any other state a
prospective applicant or other adult residing with the prospective adoptive parent has resided in the five years
immediately prior to the application.
(H)
If a PCSA initiates an adoptive homestudy with an applicant from another county, it the PCSA shall notify
the PCSA in the county the applicant resides. This requirement does not apply to an adoption by a step-parent whose
spouse is a biological or adoptive parent of the minor to be adopted.
(I)
If a PCPA, PNA or attorney arranging an adoption initiates an adoptive homestudy with an applicant,
notifying they shall notify the PCSA in the county the applicant resides. This requirement does not apply to:
(1)
An adoption by a step-parent whose spouse is a biological or adoptive parent of the minor to be adopted.
(2)
An adoption where the PCSA in the county the adoptive applicant resides is contracted with the PCPA or
PNA to complete the adoptive applicant's homestudy.
(J)
The written notification to the PCSA, required in paragraphs (H) and (I) of this rule, shall be sent within ten
days of the initiation of the homestudy.
(K)
The written notification required in paragraphs (H) and (I) of this rule shall include the following
information:
(1)
The applicant's name.
(2)
The applicant's address.
(3)
The applicant's telephone number.
(4)
The names and dates of birth of all household members at the time of the application.
(5)
A request for any relevant information, if known, including, at a minimum:
(a)
Past or present functioning of the prospective adoptive parent.
(b)
Rule violations involving any foster or pre-adoptive child.
(c)
Any third party investigations.
(d)
Information relating to any previous adoption applications and/or placements.
(e)
Information on the events leading to a removal of any child from the prospective adoptive family home.
(f)
Confirmation of household members as determined by a review of agency records.
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POLICY AND PROCEDURES
(L)
If the PCSA in the county the adoptive applicant resides receives the notification letter, the PCSA shall
provide, in writing, any relevant information listed in paragraph (K) of this rule to the requesting agency within
fifteen days.
(M) The PCSA in the county the adoptive applicant resides shall maintain written documentation on each family
they receive a notification letter. If the family is known to the agency and a record exists, the information shall be
merged with the existing file.
(N)
A multiple children/large family assessment shall be completed for any person seeking to adopt a child when
a family has a total of five or more children residing in the home, including foster children and children in kinship
care; or if the family will have a total of five or more children residing in the home upon the adoptive placement of a
child. The large family assessment shall be completed on the JFS 01530 "Multiple Children/Large Family
Assessment" (12/2006) (rev. 12/2006) form and attached to the JFS 01673, if applicable.
(O)
Agencies shall respect the right of the applicant(s) to select an agency for the purpose of completing the
homestudy assessment. Once the homestudy is initiated, the PCSA, PCPA or PNA shall maintain involvement with
the applicant(s) through completion of the homestudy assessment, unless the applicant requests a transfer or fails to
follow through with timely submission of homestudy documents.
(P)
No PCSA, PCPA or PNA shall consider race, color, or national origin of a family for whom that agency is
conducting a homestudy in determining whether a homestudy is approved or disapproved. No PCSA, PCPA, or
PNA shall consider the race, color or national origin of the child in whom a family indicates an interest in adopting
in determining whether to approve or disapprove the family's homestudy.
(Q)
The race, color or national origin of a child being considered for adoption shall not be a consideration by a
PCSA, PCPA, or PNA in determining whether to approve the family's homestudy.
(Q)(R) No PCSA, PCPA or PNA shall discriminate in approving or disapproving a homestudy on the basis of
disability in violation of Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. 794 (1/2/2006) and of Title II of
the Americans with Disabilities Act of 1990, 42 U.S.C. 1201 (1/2/2006).
(R) (S) If a PCSA, PCPA or PNA determines any statement in a homestudy is false, the PCSA, PCPA or PNA shall
follow the procedures outlined in rule 5101:2-33-13 of the Administrative Code.
(S)(T) No PCSA, PCPA or PNA shall release a homestudy to any other agency or probate court if it is determined
the application or homestudy contains a false statement knowingly made by the applicant(s), included in the written
report of the homestudy.
(T)(U) All homestudies conducted by PCSAs, PCPAs and PNAs shall be documented on the JFS 01673, or the JFS
01692 "Application for Adoption of a Foster Child" (rev. 6/2009), as applicable. Step-parent and international
homestudies are exempt from this requirement. The JFS 01698 "Step-parent Homestudy Report" (rev. 10/2006) may
be used when the court requests a PCSA, PCPA, or PNA to conduct a homestudy involving a step-parent adoption.
(U)(V) Prior to the end of the assessment process, applicants shall complete and sign the JFS 01673-A "Child
Characteristics Checklist for Foster Care and/or Adoption" (rev. 12/2006) indicating the acceptable characteristics of
the child the applicant is requesting to adopt. Upon completion of the assessment process, the JFS 01673-A shall be
attached to the JFS 01673. International and step-parent adoptions are exempt from this requirement.
(V)(W) Upon completion of the homestudy, the PCSA, PCPA and PNA shall document the results of the homestudy
on the JFS 01609 "Family Permanency Planning Data Summary" (2/2005) (rev. 2/2005).
(W)(X) The agency shall require the following for the homestudy:
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(1)
JFS 01673-A signed by the adoptive/foster parent(s), assessor and assessor's supervisor.
(2)
The JFS 01530, if applicable.
(3) The JFS 01653 "Medical Statement for Foster Care/Adoptive Applicant and All Household Members" (rev.
6/2009) completed by a licensed physician, physician assistant, clinical nurse specialist, certified nurse practitioner
or certified nurse-midwife not more than six months prior to an initial recommendation by the agency for approval.
(a)
The form shall document that the applicant and all members of the household are free from any physical,
emotional or mental condition which would endanger children or seriously impair the ability of the household
members to care for the child being adopted.
(b) The agency may require the medical statements(s) be provided before the person may participate in any
preservice training required by rule 5101:2-48-09 of the Administrative Code.
(4) The names of three people unrelated to the applicant, that do not reside with the applicant and can be
contacted by the agency as references.
(a)
The agency may require the person to provide the names of the references and any signed release of
information statements before the person participates in any preservice training required by rule 5101:2-48-09 of the
Administrative Code.
(b) The applicant shall provide the name of any other agency or organization the applicant has had a homestudy
approved as well as a written and signed release of information statement so any such reference may be contacted.
(c)
Prior to approving the homestudy, the agency shall contact all references given by the applicant, including
any other agency or organization the applicant has been previously approved as an adoptive parent.
(d)
All contacts with references shall be documented in the narrative section of the JFS 01673.
(5) The JFS 01200 "Fire Inspection Report for Residential Facilities Certified by ODJFS" (rev. 10/2000) fire
safety approval or other form used for a local or state fire inspection. The report shall not be dated more than six
months prior to the agency's recommendation for approval.
(6) The JFS 01348 "Safety Audit of a Foster Home" (rev. 1/2003), also used for adoptive homes, and
documentation the residence satisfactorily meets all safety standards.
(7)
The JFS 01681 "Applicant Financial Statement" (rev. 10/2000).
(8) The bureau of criminal identification and investigation (BCII) and federal bureau of investigation (FBI)
reports as outlined in rule 5101:2-48-10 of the Administrative Code.
(9)
A completed water test by an approved Ohio water testing laboratory, if deemed necessary by the agency.
(X)(Y) The assessor shall provide written notification to the applicant(s) of approval or denial of the adoption
homestudy. The written notification shall be provided within ten days after the homestudy is approved or
disapproved.
(Y)(Z) The assessor shall make one or more of the following recommendations at the completion of the homestudy:
(1)
Approve the applicant(s) as adoptive parent(s) only.
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(2)
Recommend the applicant(s) for certification as a foster caregiver(s) only.
(3)
Approve the applicant(s) as adoptive parents and recommend the applicant(s) for certification as a foster
caregiver(s) simultaneously.
(4)
Deny the adoption application.
(5)
Recommend that the applicant(s) certification as a foster caregiver(s) not be approved.
(6)
Deny the adoption application and recommend the applicant's certification as a foster caregiver(s) not be
approved.
(Z)(AA)
If the decision of the assessor is to approve the applicant(s) as an adoptive parent(s), the written
notification required in paragraph (X) (Y) of this rule shall include, at minimum, the following information:
(1)
Date of approval of the adoptive homestudy with the date the approved homestudy or update expires.
(2)
A description of the characteristics of the child or children for whom the applicant is being approved.
(AA)(BB)
If the decision of the assessor is to deny the applicant for adoption, the written notification required in
paragraph (X) (Y) of this rule shall contain both of the following:
(1)
A detailed explanation of the reason for the denial setting forth all of the reasons for the denial.
(2)
A description of procedures for an agency review pursuant to rule 5101:2-48-24 of the Administrative Code.
(BB) (CC)
The PCSA, PCPA or PNA shall follow procedures contained in rules 5101:2-5-22 and 5101:2-5-26
of the Administrative Code for approval or denial of an applicant(s) for certification as a foster home.
(CC) (DD)
The homestudy shall be updated every two years from the date of approval of the initial homestudy
in accordance with rule 5101:2-48-12.1 of the Administrative Code.
(DD) (EE)
The homestudy shall be amended, if applicable, in accordance with rule 5101:2-48-12.2 of the
Administrative Code.
(EE)(FF)
If a child has been placed in an approved adoptive home, the PCSA, PCPA or PNA shall assure that
the home continues to be in an approved status until the adoption is finalized by updating and amending the
homestudy in accordance with rules 5101:2-48-12.1 and 5101:2-48-12.2 of the Administrative Code.
A
The homestudy shall be a joint decision making assessment and process involving the applicant and
Synergy Family Foster Care, Inc., which is designed to determine whether adoption and/or foster care is a
viable option for the applicant and the characteristics of children the applicant can best parent.
B
The agency will respect the right of the applicant to select an agency for the purpose of completing the
homestudy assessment. Once the homestudy has been initiated, Synergy Family Foster Care shall maintain
involvement with the applicant through to completion of the homestudy assessment, unless the applicant
requests a transfer or fails to follow through with timely submission of homestudy documents. The agency
shall cooperate with a family who has requested a transfer to another agency pursuant to Rule 5101:2-48-19
of the Administrative Code.
C
Synergy Family Foster Care shall not consider race, color, or national origin of a family for whom that
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POLICY AND PROCEDURES
agency is conducting a homestudy in determining whether a homestudy is approved or disapproved.
Synergy Family Foster Care shall not consider the race, color or national origin of the child in whom a
family has indicated an interest in adopting in determining whether to approve or disapprove the family’s
homestudy.
D
Synergy Family Foster Care shall not discriminate in approving or disapproving a homestudy on the basis
of disability in violation of Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. 794 and of Title II of
the Americans with Disabilities Act of 1990, 42 U.S.C. 1201.
E
All homestudies shall be documented on the JFS 01693, Assessment for Child Placement (Homestudy),” or
the JFS 01692 “Application for Adoption of a Foster Child”, as applicable. Stepparent, grandparent and
international homestudies are exempt from this requirement. The JFS 01698, “Step-parent/Adoption
Homestudy Report” may be used when the court requests Synergy Family Foster Care, Inc. to conduct a
homestudy involving a stepparent adoption.
F
Synergy Family Foster Care shall document information regarding the homestudy process on the JFS
01609 “Family Permanency Planning Data Summary.”
G
The assessment required by paragraph (E) of this rule and as documented through the completion of the
JFS 01673 shall be commenced within thirty days of the date the agency receives the JFS 01691(rev. 6/09)
“Application for Child Placement”. The assessment shall be completed within one hundred eighty days of
the date that the agency received the application. If Synergy Family Foster Care fails to commence a
homestudy within thirty days of receiving the application or fails to complete a homestudy within one
hundred eighty days shall document in the applicant’s record the reason(s)the agency was unable to meet
one or both of these requirements. Commencement of a homestudy means, at a minimum, scheduling an
appointment to interview the applicant or assuring that the applicant has been informed of the necessary
materials required for the assessor to complete the homestudy.
H
Homestudies completed by Synergy Family Foster Care, Inc. shall be conducted by an adoption assessor
who meets the requirements contained in rule 5101:2-1-01 of the Administrative Code and is employed by
or under contract with the following:
1
I
Synergy Family Foster Care, Inc. that has been certified to act as a representative of ODJFS to
recommend foster homes for certification and/or to place children for adoption or to participate in
the placement of children in foster homes or adoption.
In addition to completion of the JFS 01673, the following documents shall be completed and attached to the
homestudy document:
1
The JFS 01693 “Medical Statement for Foster Care/Adoptive Applicant and All Household
Members” signed by a licensed physician;
2
Four personal reference statements (three from non-relatives) for each applicant to determine the
applicant’s suitability to parent a child;
3
A fire inspection by a state certified fire safety inspector or the state fire marshal’s office or the
JFS 01348, “Safety Audit of a Foster Home”;
4
The JFS 01348 “Safety Audit of a Foster Home”, also used for an adoptive home.
5
JFS 01681. “Applicant Financial Statement.” This form determines the family’s ability to provide
for the child and to determine the need for an adoption subsidy.
6
The Bureau of Identification and Investigation (BCII) and, if applicable, Federal Bureau of
Investigation (FBI) reports; and
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7
Completed water test, if required.
J
The assessor shall provide written notification to the applicant for approval or denial of the adoption
homestudy. The written notification shall be provided within ten days after the homestudy has been
approved or disapproved. for any applicant seeking a special needs child. For an applicant who was not
seeking a child with special needs, the time frames for completion of a written homestudy report, approval
or denial of the adoptive homestudy, and written notification to the applicant of the approval or denial shall
be consistent with the agency’s adoption and foster care policy prepared pursuant to Rule 5101:2-48-05 of
the Administrative Code.
K
The assessor shall arrive at one or more of the following recommendations at the completion of the
homestudy:
L
M
1
Approve the applicants as adoptive parents only;
2
Recommend the certification of the applicants as foster caregivers if the agency in which the
assessor is employed or contracted by is certified to act as a representative of ODJFS to
recommend foster homes for certification;
3
Approve the applicants as adoptive parents and recommend the certification of the applicants as
foster caregivers simultaneously if the caregivers of the agency in which the assessor is employed
or contracted by is certified to act as a representative of ODJFS to recommend foster homes for
certification and place children for adoption or to participate in the placement of children in foster
homes and for adoption;
4
Deny the adoption application;
5
Recommend that the certification for foster care not be approved; or
6
Deny the adoption application and recommend that the certification for foster care not be
approved.
If the decision of the assessor is to approve the applicant as an adoptive parent or to renew the approval of
an adoptive parent through an updated study, the written notification shall include, but not be limited to, the
following information:
1
Date of approval of the adoptive homestudy or updated adoptive homestudy;
2
A description of the characteristics of the child or children for whom the applicant is being
approved.
If the decision of the assessor is to deny the applicant for adoption or updated adoptive homestudy, the
written notification shall contain both of the following:
1
A detailed explanation of the reason for the denial which sets forth all of the reasons upon which
the denial was based; and
2
A description of procedures for an agency review pursuant to Rule 5101:2-48-24 of the
Administrative Code.
N
Synergy Family Foster Care, Inc. shall follow procedures contained in Rule 5101:2-5-22 of the
Administrative Code for approval or denial of an applicant for certification as a foster home.
O
The expiration date of an initial homestudy is six years from the date of the initial approval of the
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POLICY AND PROCEDURES
applicant(s) as adoptive parent(s). No homestudy shall be valid after a six year period. Synergy Family
Foster Care, Inc. shall update an approved adoptive homestudy at least once every two years. Synergy
Family Foster Care shall complete an additional update is one of the following changes occurs in the
family’s composition or life circumstance that alters the validity of information contained in the original
homestudy or subsequent updates that have been completed, and the family is being considered for a
placement of a child:
1
A change in the marital status of an approved adoptive applicant;
2
A significant change in the health status of an approved adoptive applicant;
3
The finalization of an adoption of a child;
4
The birth of a child;
5
The death of a child or household member;
6
A criminal conviction of an approved adoptive applicant;
7
A change in the number of adult household members; or
8
A family’s relocation.
P
Once a homestudy has been updated, the expiration date is calculated from the date of approval of the
update, not to exceed six years from the date of the initial approval. After the expiration of the homestudy,
the family shall submit a new JFS 01691, “Application for Child Placement” and a new JFS 01673,
“Assessment for Child Placement” shall be completed.
Q
The Synergy Family Foster Care, Inc. assessor shall notify the family in writing, not less than ninety or
more than one hundred twenty calendar days prior to the expiration of the homestudy that their homestudy
is due to expire. The notification shall include all of the following:
R
1
The date of expiration of their homestudy;
2
A directive to the family to contact the assessor in writing regarding completion of the homestudy
process;
3
Notification that the homestudy update must be completed prior to the date of expiration; and
4
Notification that should the homestudy expire, the family would have to reapply for approval for
adoptive placement as outlined in Rule 5101:2-48-09 of the Administrative Code.
When updating the adoptive homestudy report the assessor shall complete the JFS 01385, “Ohio
Department of Job and Family Services Assessment for Child Placement Update” and conduct face-to-face
interviews with the applicant, one of which shall take place in the home of the applicant.
Home Study process for adoption
(A)
All homestudies approved on or after December 11, 2006, shall be updated every two years from the date of
approval of the initial homestudy.
(B)
Homestudies approved prior to December 11, 2006, shall be updated at every two years. The date of approval
of the most current update will becomes the new date to determine when the next two-year update is due. When a
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homestudy that was approved prior to December 11, 2006 expires, any new homestudy completed will be subject to
paragraph (A) of this rule.
(C)
If an approved adoptive home is certified for foster care by the same agency that approved the home for
adoption, the adoptive home shall be updated at the same time the home is initially certified for foster care.
(D)
If a certified foster home is approved for adoption by the same agency that certified the home for foster care,
the next adoption update shall be completed when the current foster care certificate is recertified.
(C)(E) When updating the JFS 01673 "Assessment for Child Placement (Homestudy)" (rev. 8/2005), the assessor
shall complete the JFS 01385 "Ohio Department of Job and Family Services Assessment for Child Placement
Update" (rev. 12/2006). International-only adoptions are exempt from using the JFS 01385. If a homestudy is solely
for an international adoption, the update is not required to be on the JFS 01385.
(D) (F) Updates to adoption homestudies shall be completed by an assessor employed or under contract with a
public children services agency (PCSA), private child placing agency, (PCPA) or private noncustodial agency
(PNA) who meets meeting the definition of who can be an assessor contained in rule 5101:2-1-01 of the
Administrative Code.
(E)(G) The PCSA, PCPA or PNA shall not consider race, color, or national origin of a family for whom that agency
is conducting an update to a homestudy in determining whether a homestudy is approved or disapproved.
The PCSA, PCPA, or PNA shall not consider the race, color or national origin of the child in whom a family has
indicated an interest in adopting in determining whether to approve or disapprove the update to the adoptive family's
homestudy.
(F)(H) The PCSA, PCPA or PNA shall not discriminate in approving or disapproving an update to a homestudy on
the basis of disability in violation of Section 504 of the Rehabilitation Act of 1973,29 U.S.C. 794 (1/2/2006) and
Title II of the Americans with Disabilities Act of 1990, 42 U.S.C. 1201 (1/2/2006).
(G)(I) Not less than ninety or more than one hundred twenty days prior to the expiration of an adoption homestudy
or two year update. The recommending agency shall notify the adoptive parent(s) of the date of expiration of the
homestudy not fewer than ninety days or more than one hundred twenty days prior to the expiration date. The
notification shall: identify any information or documentation that the adoptive parent(s) is required to submit for the
homestudy update or procedure for a new homestudy according to rule 5101:2-48-12 of the Administrative Code.
The notification shall be on the JFS 01331 "Notice of Expiration and Reapplication for a Foster Home Certification
or Adoption Homestudy Update/Amendment." (rev. 12/2006).
(1) Identify any information or documentation the adoptive parent(s) is required to submit for the homestudy
update.
(2) Be completed on the JFS 01331 "Notice of Expiration and Reapplication for a Foster Home Certification or
Adoption Homestudy Update/Amendment." (rev. 12/2006).
(H)(J) If the prospective adoptive parent(s) fails to apply for renewal on the JFS 01331 for renewal of the adoption
homestudy within thirty days of the date on the notification letter, the homestudy will lapse upon the expiration date.
Following agency notification to the prospective adoptive parent as required
by paragraph (I) of this rule, if the prospective adoptive parent fails to either reapply or voluntarily terminate prior to
the expiration date of the homestudy, the prospective adoptive family record shall be closed close and the
applicant(s) must shall reapply through the initial homestudy application process pursuant to rule 5101:2-48-09 of
the Administrative Code.
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(I)(K) Prior to the recommendation for and expiration of a current homestudy, if an adoptive applicant has reapplied to update a current homestudy, an assessor shall complete a JFS 01385. The agency shall attach the
following documents to the JFS 01385:
(1) A new most recent JFS 01653 "Medical Statement for Foster Care/Adoptive Applicant and All Household
Members" (rev. 02/2003)(rev. 6/2009) completed for the applicant and all household members by a licensed
physician, physician assistant, clinical nurse specialist, certified nurse practitioner or certified nurse-midwife. The
agency may require a new JFS 01653 if the agency deems it necessary.
(2)
A minimum of one written reference from a professional who is knowledgeable of the prospective adoptive
parent(s) family dynamics, or if a reference is not available from a professional, one personal reference from
someone who is aware of the prospective adoptive parent(s) family's functioning. The personal reference shall not
be completed by a relative.
(3)
A report of a physical, psychiatric or psychological examination or treatment of the caregiver or prospective
adoptive parent(s) or other household member(s) if required by the agency to ensure the safety, health or care of an
adoptive child. The examination shall be conducted by a licensed physician, psychologist, or other certified or
licensed professional.
(4)
A fire inspection by a state certified fire safety inspector or the state fire marshal's office using the JFS
01200 "Fire Inspection Report for Residential Facilities Certified by ODJFS" (rev. 10/2000), fire safety approval or
other form used for a local or state fire inspection, if the agency deems it necessary to ensure that the home is free
from conditions that may be hazardous to the safety of an adoptive child.
(5) The JFS 01348 "Safety Audit of a Family Foster Home," (rev. 01/2003), also used for adoptive homes; if
there is a reason for concern relative to the home's continued safety. The JFS 01348 must document the residence
satisfactorily meets all safety standards.
(6) The JFS 01681 "Applicant Financial Statement." (rev. 10/2000), if there has been any substantial changes to
the prospective adoptive parent(s) financial situation occurred.
(7)
A completed water test by an approved Ohio water testing laboratory, if deemed necessary by the agency.
(L)
If the recommending agency has access to the statewide automated child welfare information system
(SACWIS), the agency shall conduct a search of abuse and neglect report history in the system. The recommending
agency shall also request a search of the central registry of abuse and neglect from the Ohio department of job and
family services for each adoptive applicant and each adult who resides with the adoptive applicant. This search is to
be used to determine the suitability of the adoptive applicant as an adoptive parent.
(M) Preparation of summary report of involvement of an applicant and other adult household members in reports
of child abuse and neglect contained in SACWIS.
(1) A summary report shall be placed in each adoptive home record. Prior to the placement of each child in the
applicant's home, the summary report shall be considered as a tool to help determine the appropriateness of the
placement.
(2) One summary report shall be prepared for each applicant's home. The summary report shall include, for each
applicant and each adult member of the household, a chronological list of abuse and neglect determinations or
allegations in which the person was involved where a PCSA has done one of the following:
(a)
Determined that abuse or neglect occurred.
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(b)
Initiated an investigation, and the investigation is ongoing.
(c)
Initiated an investigation, and the agency was unable to determine whether abuse or neglect occurred. This
provision is limited to report dispositions the PCSA determined to be unable to locate.
(3)
The summary report shall not contain any of the following:
(a)
Any information concerning a report of abuse or neglect where the PCSA determined that abuse or neglect
did not occur or was unsubstantiated.
(b) The name of the person who or entity that made, or participated in the making of, the report of abuse or
neglect. This includes any additional collateral contact who made, or participated in, the report of abuse or neglect.
(c)
Any information the release of which is prohibited by state or federal law.
(d)
The name of or other identifying information regarding a child.
(4) If the search indicates there are no allegations or reports of involvement in child abuse or neglect
investigations for any applicant or adult household member, the summary report shall indicate that there is no record
involving any applicant or adult household member in an allegation or report of involvement in a child abuse or
neglect investigation reported to SACWIS or the central registry.
(J) (N) Once a homestudy is approved, a new criminal records check pursuant to rule 5101:2-48-10 of the
Administrative Code shall be conducted for the adoptive parent(s) and each adult member of the household shall be
conducted; every four years at the time of the update.
(1)
The fourth year of the homestudy at the time of the update.
(2) When the homestudy has expired due to the six year timeframe and the adoptive parent requests a new
homestudy be completed.
(K)(O) For all homestudies that were approved prior to the effective date of this rule. The agency shall conduct a
criminal records check on each adult residing in the household within sixty days of the effective date of this rule if
the last criminal records check was completed more than four years ago.
(1) The agency shall conduct a criminal records check on each adult residing in the household within sixty days
of the effective date of this rule if the last criminal records check was completed more than four years ago.
(2) After the criminal records check has been completed the agency shall conduct continued criminal records
checks pursuant to paragraph (J) of this rule.
(P) After the criminal records check is completed, the agency shall conduct continued criminal records checks
pursuant to paragraph (N) of this rule.
(L)(Q) An assessor's reassessment update of the adoptive parent(s)homestudy shall include a minimum of one face
to face home visit with each member of the household who is currently residing in the home. The interview with
other household member(s) may or may not be a joint visits.
(M)(R) The assessor shall provide written notification to the applicant(s) of approval or denial of the update to the
adoption homestudy. The written notification shall be provided to the adoptive family within ten days of completion
of the homestudy update.
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(N)(S) If the decision of the assessor is to recommend the approval of an adoptive parent(s) homestudy update, the
written notification shall include, but not be limited to, the date of the approval of the update to the adoptive
homestudy and the date the approved update will expire.
(O)(T) If the decision of the assessor is to deny the updated adoptive homestudy, the written notification shall
contain both of the following:
(1)
A detailed explanation that sets forth the reasons upon which their denial is based.
(2)
Procedures the applicant(s) shall follow for an agency review pursuant to rule 5101:2-48-24 of the
Administrative Code.
(P) When the adoptive parent notifies the agency that any of the changes or circumstances listed in paragraphs
(Q) and (R) of this rule have occurred, the agency shall amend the homestudy. An amendment is a narrative of the
assessor's evaluation of the family and shall be completed and attached to the homestudy within thirty days of the
agency becoming aware that a change has occurred.
(Q)
An adoptive parent shall notify the recommending agency within twenty-four hours of any of the following
circumstances involving the adoptive child whose adoption has not been finalized:
(1)
A serious injury or illness involving medical treatment of the adoptive child.
(2)
The death of the adoptive child.
(3)
Unauthorized absence of the adoptive child from the home.
(4) Removal of the adoptive child from the home by any person or agency other than the placing agency, or
attempts at such removal.
(5)
Any involvement of the adoptive child with law enforcement authorities.
(R)
An adoptive parent shall notify the recommending agency within twenty-four hours or the next working day
if any of the following occur:
(1)
A change in the marital status of an approved adoptive parent(s).
(2)
A change in the health status of an approved adoptive applicant(s) or household member(s).
(3)
The finalization of an adoptive child.
(4) A change in the number of child household members through birth or kinship who have not reached the age
of majority. New child household members residing with the adoptive parent shall have a JFS 01653 completed
within sixty days of the date they became a household member. Household members who turn eighteen years of age
shall have a BCII background check and FBI check, as outlined in rule 5101:2-48-10 of the Administrative Code,
initiated within ten working days of the date they turned eighteen years of age.
(5)
The death of an adoptive parent or any other household member(s).
(6)
A criminal charge or conviction of an adoptive parent(s) or other adult household member(s).
SYNERGY FAMILY FOSTER CARE, INC.
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(7) A change in the number of adults who reside with the adoptive parent (not including an existing household
member who reaches the age of majority). New adult household members residing with the adoptive parent shall
have a JFS 01653 completed within sixty days of the date they became a household member. ABCII background
check and FBI check, as outlined in rule 5101:2-48-10 of the Administrative Code, and a search of the central
registry shall be initiated within ten working days of the date they became a household member.
(8) The physical relocation of the adoptive parent(s) which results in a change of address that is different than the
address listed on the most recent homestudy or homestudy update. A safety audit must be completed at the time of
the amendment.
(9)
A significant change in financial status/income.
5101:2-48-12.2 Completion of Adoption Homestudy Amendments
(A)
An amendment is a narrative of the assessor's evaluation of the approved adoptive parent(s) and family and
shall be completed and attached to the homestudy within thirty days of the agency becoming aware a change
occurred.
(B) If the approved adoptive parent notifies the agency of any changes or circumstances listed in paragraphs (C)
and (D) of this rule occurred, the agency shall amend the homestudy.
(C)
An approved adoptive parent shall notify the recommending agency within one hour of any of the following
circumstances involving the adoptive child whose adoption is not finalized:
(1)
A serious injury or illness involving medical treatment of the adoptive child.
(2)
The death of the adoptive child.
(3)
Unauthorized absence of the adoptive child from the home.
(4) Removal of the adoptive child from the home by any person or agency other than the placing agency, or
attempts at such removal.
(5)
Any involvement of the adoptive child with law enforcement authorities.
(D)
An adoptive parent shall notify the recommending agency within twenty-four hours or the next working day
if any of the following occur prior to finalization of the adoption of the child:
(1)
A change in the marital status of an approved adoptive parent(s).
(2)
Any serious illness or death of an approved adoptive parent(s) or household member.
(3)
The finalization of an adoptive child placed by a different agency.
(4) A change in the number of household members through birth or kinship who have not reached the age of
majority.
(5) A change in the number of adults residing with the approved adoptive parent (not including an existing
household member reaching the age of majority).
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(6)
A criminal charge or conviction of any approved adoptive parent or other adult household member(s).
(7)
A significant change in financial status/income.
(8) The physical relocation of the approved adoptive parent(s) resulting in a change of address different than the
address listed on the most recent homestudy or homestudy update.
(E) New child household members residing with the adoptive parent shall have a JFS 01653 "Medical Statement
for Foster Care/Adoptive Applicant and All Household Members" (rev. 6/2009) completed within sixty days of
becoming a household member.
(F)
If the child is an infant born to the adoptive parent and the agency documents in the case record the adoptive
parent has had prenatal care from a physician during the pregnancy and is receiving periodic medical examinations
from a physician, the JFS 01653 shall be completed within ninety days of the date the infant becomes a household
member.
(G)
Household members turning eighteen years of age shall have a bureau of criminal identification and
investigation (BCII) background check and federal bureau of investigation (FBI) check, as outlined in rule 5101:248-10 of the Administrative Code, initiated within ten working days of the date they turned eighteen years of age.
(H)
New adult household members residing with the approved adoptive parent shall have a JFS 01653 completed
within sixty days of becoming a household member.
(I)
New adult household members residing with the approved adoptive parent shall have a BCII background
check and FBI check, as outlined in rule 5101:2-48-10 of the Administrative Code, and a search of the central
registry initiated within ten working days of the date they became a household member.
(J)
Upon notification of a change of address, the PCSA, PCPA, or PNA shall conduct a safety audit of the new
residence using the JFS 01348 "Safety Audit of a Foster Home," which is also used for adoptive homes (rev.
1/2003).
(K)
The safety audit shall be conducted within ten working days after the notification of the change of address.
(L)
The PCSA, PCPA, or PNA shall require the approved adoptive parent to obtain a fire safety inspection
certifying the new residence is free from conditions hazardous to the safety of an adoptive child.
(M) The fire safety inspection shall be conducted within ninety days of the change of address by a state certified
fire safety inspector or the state fire marshal's office.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: COMPLETION OF THE HOMESTUDY, UPDATES AND ADMENDMENTS FOR AN
ADOPTIVE HOME
POLICY NUMBER: 75
ORC REFERENCE: 5101:2-48-12, 5101:2-48-12.1, 5101:2-48-12.2
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 2/1/02
DATE REVISED: 1/1/05, 1/1/10
A
The homestudy shall be a joint decision making assessment and process involving the applicant and
Synergy Family Foster Care, Inc., which is designed to determine whether adoption and/or foster care is a
viable option for the applicant and the characteristics of children the applicant can best parent.
B
The agency will respect the right of the applicant to select an agency for the purpose of completing the
homestudy assessment. Once the homestudy has been initiated, Synergy Family Foster Care shall maintain
involvement with the applicant through to completion of the homestudy assessment, unless the applicant
requests a transfer or fails to follow through with timely submission of homestudy documents. The agency
shall cooperate with a family who has requested a transfer to another agency pursuant to Rule 5101:2-48-19
of the Administrative Code.
C
Synergy Family Foster Care shall request a check of the child abuse and neglect registry of any other state a
prospective applicant or other adult residing with the prospective adoptive parent has resided in the five
years immediately prior to the application.
D
If Synergy Family Foster Care arranging an adoption initiates an adoptive homestudy with an applicant,
then they shall notify the PCSA in the county the applicant resides. This requirement does not apply to:
1
An adoption by a step-parent whose spouse is a biological or adoptive parent of the minor to be
adopted.
2
An adoption where the PCSA in the county the adoptive applicant resides is contracted with the
PCPA or Synergy Family Foster Care to complete the adoptive applicant's homestudy.
E
The written notification to the PCSA, required in paragraph (D) of this rule, shall be sent within ten days of
the initiation of the homestudy.
F
The written notification required in paragraph (D) of this rule shall include the following information:
1
The applicant's name.
2
The applicant's address.
3
The applicant's telephone number.
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4
The names and dates of birth of all household members at the time of the application.
5
A request for any relevant information, if known, including, at a minimum:
a
Past or present functioning of the prospective adoptive parent.
b
Rule violations involving any foster or pre-adoptive child.
c
Any third party investigations.
d
Information relating to any previous adoption applications and/or placements.
e
Information on the events leading to a removal of any child from the prospective adoptive
family home.
f
Confirmation of household members as determined by a review of agency records.
G
If the PCSA in the county the adoptive applicant resides receives the notification letter, the PCSA shall
provide, in writing, any relevant information listed in paragraph (F) of this rule to the requesting agency
within fifteen days.
H
The PCSA in the county the adoptive applicant resides shall maintain written documentation on each
family they receive a notification letter. If the family is known to the agency and a record exists, the
information shall be merged with the existing file.
I
A multiple children/large family assessment shall be completed for any person seeking to adopt a child
when a family has a total of five or more children residing in the home, including foster children and
children in kinship care; or if the family will have a total of five or more children residing in the home upon
the adoptive placement of a child. The large family assessment shall be completed on the JFS
01530 "Multiple Children/Large Family Assessment" (12/2006) (rev. 12/2006) form and attached to the
JFS 01673, if applicable.
J
Synergy Family Foster Care shall not consider race, color, or national origin of a family for whom that
agency is conducting a homestudy in determining whether a homestudy is approved or disapproved.
K
The race, color or national origin of a child being considered for adoption shall not be a consideration by a
PCSA, PCPA, or PNA in determining whether to approve the family's homestudy.
L
Synergy Family Foster Care shall not discriminate in approving or disapproving a homestudy on the basis
of disability in violation of Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. 794 and of Title II of
the Americans with Disabilities Act of 1990, 42 U.S.C. 1201.
M
If Synergy Family Foster Care determines any statement in a homestudy is false, then Synergy Family
Foster Care shall follow the procedures outlined in rule 5101:2-33-13 of the Administrative Code.
N
Synergy Family Foster Care shall not release a homestudy to any other agency or probate court if it is
determined the application or homestudy contains a false statement knowingly made by the applicant(s),
included in the written report of the homestudy.
O
All homestudies conducted by Synergy Family Foster Care shall be documented on the JFS 01673, or the
JFS 01692 “Application for Adoption of a Foster Child”, as applicable. Stepparent, grandparent and
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international homestudies are exempt from this requirement. The JFS 01698, “Step-parent/Adoption
Homestudy Report” may be used when the court requests Synergy Family Foster Care, Inc. to conduct a
homestudy involving a stepparent adoption.
P
Prior to the end of the assessment process, applicants shall complete and sign the JFS 01673-A "Child
Characteristics Checklist for Foster Care and/or Adoption" (rev. 12/2006) indicating the acceptable
characteristics of the child the applicant is requesting to adopt. Upon completion of the assessment process,
the JFS 01673-A shall be attached to the JFS 01673. International and step-parent adoptions are exempt
from this requirement.
Q
Synergy Family Foster Care shall document information regarding the homestudy process on the JFS
01609 “Family Permanency Planning Data Summary.”
R
The assessment required by paragraph (E) of this rule and as documented through the completion of the
JFS 01673 shall be commenced within thirty days of the date the agency receives the JFS 01691
“Application for Child Placement” signed by the adoptive applicant. The assessment for all applicants
seeking to adopt a child with special needs or without special needs shall be completed within one hundred
eighty days of the date that the agency received the application. If Synergy Family Foster Care fails to
commence a homestudy within thirty days of receiving the application or fails to complete a homestudy
within one hundred eighty days shall document in the applicant’s record the reason(s)the agency was
unable to meet one or both of these requirements. Commencement of a homestudy means, at a minimum,
scheduling an appointment to interview the applicant or assuring that the applicant has been informed of
the necessary materials required for the assessor to complete the homestudy.
S
Homestudies completed by Synergy Family Foster Care, Inc. shall be conducted by an adoption assessor
who meets the requirements contained in rule 5101:2-1-01 of the Administrative Code and is employed by
or under contract with the following:
1
Synergy Family Foster Care, Inc. that has been certified to act as a representative of ODJFS to
recommend foster homes for certification and/or to place children for adoption or to participate in
the placement of children in foster homes or adoption.
T
Upon completion of the homestudy, Synergy Family Foster Care shall document the results of the
homestudy on the JFS 01609 "Family Permanency Planning Data Summary".
U
In addition to completion of the JFS 01673, the following documents shall be completed and attached to the
homestudy document:
1
JFS 01673 – A signed by the adoptive/foster parent(s), assessor and assessor’s supervisor.
2
The JFS 1530, if applicable.
3
The JFS 01693 “Medical Statement for Foster Care/Adoptive Applicant and All Household
Members” completed by a licensed physician, physician assistant, clinical nurse specialist,
certified nurse practitioner or certified nurse-midwife not more than six months prior to an initial
recommendation by the agency for approval.
a
The form shall document that the applicant and all members of the household are free
from any physical, emotional or mental condition which would endanger children or
seriously impair the ability of the household members to care for the child being adopted.
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b
4
The agency may require the medical statements(s) be provided before the person may
participate in any preservice training required by rule 5101:2-48-09 of the Administrative
Code.
The names of three people unrelated to the applicant, that do not reside with the applicant and can
be contacted by the agency as references.
a
The agency may require the person to provide the names of the references and any signed
release of information statements before the person participates in any preservice training
required by rule 5101:2-48-09 of the Administrative Code.
b
The applicant shall provide the name of any other agency or organization the applicant
has had a homestudy approved as well as a written and signed release of information
statement so any such reference may be contacted.
c
Prior to approving the homestudy, the agency shall contact all references given by the
applicant, including any other agency or organization the applicant has been previously
approved as an adoptive parent.
d
All contacts with references shall be documented in the narrative section of the JFS
01673.
1
A fire inspection by a state certified fire safety inspector or the state fire marshal’s office or the
JFS 01348, “Safety Audit of a Foster Home”; the form shall not be dated more than six months
prior to the agency’s recommendation for approval.
2
The JFS 01348 “Safety Audit of a Foster Home”, also used for an adoptive home, and
documentation the residence satisfactorily meets all safety standards.
3
JFS 01681. “Applicant Financial Statement.” This form determines the family’s ability to provide
for the child and to determine the need for an adoption subsidy.
4
The Bureau of Identification and Investigation (BCII) and Federal Bureau of Investigation (FBI)
reports as outlined in rule 5101:2-48-10 of the Administrative Code.
5
A completed water test by an approved Ohio water testing laboratory, if deemed necessary by the
agency.
V
The assessor shall provide written notification to the applicant for approval or denial of the adoption
homestudy. The written notification shall be provided within ten days after the homestudy has been
approved or disapproved.
W
The assessor shall arrive at one or more of the following recommendations at the completion of the
homestudy:
1
Approve the applicants as adoptive parents only;
2
Recommend the certification of the applicants as foster caregivers if the agency in which the
assessor is employed or contracted by is certified to act as a representative of ODJFS to
recommend foster homes for certification;
3
Approve the applicants as adoptive parents and recommend the certification of the applicants as
foster caregivers simultaneously if the caregivers of the agency in which the assessor is employed
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
or contracted by is certified to act as a representative of ODJFS to recommend foster homes for
certification and place children for adoption or to participate in the placement of children in foster
homes and for adoption;
X
Y
4
Deny the adoption application;
5
Recommend that the certification for foster care not be approved; or
6
Deny the adoption application and recommend that the certification for foster care not be
approved.
If the decision of the assessor is to approve the applicant as an adoptive parent or to renew the approval of
an adoptive parent through an updated study, the written notification shall include, but not be limited to, the
following information:
1
Date of approval of the adoptive homestudy or updated adoptive homestudy;
2
A description of the characteristics of the child or children for whom the applicant is being
approved.
If the decision of the assessor is to deny the applicant for adoption or updated adoptive homestudy, the
written notification shall contain both of the following:
1
A detailed explanation of the reason for the denial which sets forth all of the reasons upon which
the denial was based; and
2
A description of procedures for an agency review pursuant to Rule 5101:2-48-24 of the
Administrative Code.
Z
Synergy Family Foster Care, Inc. shall follow procedures contained in Rule 5101:2-5-22 of the
Administrative Code for approval or denial of an applicant for certification as a foster home.
AA
The expiration date of an initial homestudy is six years from the date of the initial approval of the
applicant(s) as adoptive parent(s). No homestudy shall be valid after a six year period. Synergy Family
Foster Care, Inc. shall update an approved adoptive homestudy at least once every two years. Synergy
Family Foster Care shall complete an additional update is one of the following changes occurs in the
family’s composition or life circumstance that alters the validity of information contained in the original
homestudy or subsequent updates that have been completed, and the family is being considered for a
placement of a child:
1
A change in the marital status of an approved adoptive applicant;
2
A significant change in the health status of an approved adoptive applicant;
3
The finalization of an adoption of a child;
4
The birth of a child;
5
The death of a child or household member;
6
A criminal conviction of an approved adoptive applicant;
7
A change in the number of adult household members; or
8
A family’s relocation.
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BB
If a child has been placed in an approved adoptive home, Synergy Family Foster Care shall assure that the
home continues to be in an approved status until the adoption is finalized by updating and amending the
homestudy in accordance with rules 5101:2-48-12.1 and 5101:2-48-12.2 of the Administrative Code.
CC
All homestudies approved on or after December 11, 2006, shall be updated every two years from the date
of approval of the initial homestudy.
DD
Homestudies approved prior to December 11, 2006, shall be updated at every two years. The date of
approval of the most current update becomes the new date to determine the next two-year.
EE
If an approved adoptive home is certified for foster care by the same agency that approved the home for
adoption, the adoptive home shall be updated at the same time the home is initially certified for foster care.
FF
If a certified foster home is approved for adoption by the same agency that certified the home for foster
care, the next adoption update shall be completed when the current foster care certificate is recertified.
GG
When updating the JFS 01673 "Assessment for Child Placement (Homestudy)", the assessor shall complete
the JFS 01385 "Ohio Department of Job and Family Services Assessment for Child Placement Update”.
International-only adoptions are exempt from using the JFS 01385.
HH
Updates to adoption homestudies shall be completed by an assessor employed by Synergy Family Foster
Care meeting the definition of an assessor contained in rule 5101:2-1-01 of the Administrative Code.
II
Synergy Family Foster Care shall not consider race, color, or national origin of a family for whom that
agency is conducting an update to a homestudy in determining whether a homestudy is approved or
disapproved. Synergy Family Foster Care shall not consider the race, color or national origin of the child a
family indicates an interest in adopting in determining whether to approve or disapprove the update to the
adoptive family's homestudy.
JJ
Synergy Family Foster Care shall not discriminate in approving or disapproving an update to a homestudy
on the basis of disability in violation of Section 504 of the Rehabilitation Act of 1973,29 U.S.C. 794
(1/2/2006) and Title II of the Americans with Disabilities Act of 1990, 42 U.S.C. 1201 (1/2/2006).
KK
Synergy Family Foster Care shall notify the adoptive parent(s) of the date of expiration of the homestudy
not fewer than ninety days or more than one hundred twenty days prior to the expiration date. The
notification shall:
LL
Identify any information or documentation the adoptive parent(s) is required to submit for the homestudy
update.
MM
Be completed on the JFS 01331 "Notice of Expiration and Reapplication for a Foster Home Certification or
Adoption Homestudy Update/Amendment." (rev. 12/2006).
NN
Following agency notification to the prospective adoptive parent as required by paragraph (KK) of this
rule, if application process pursuant to rule 5101:2-48-09 of the Administrative Code.
OO
Prior to the recommendation for and expiration of a current homestudy, if an adoptive applicant has reapplied to update a current homestudy, an assessor shall complete a JFS 01385. The agency shall attach the
following documents to the JFS 01385:
1
The most recent JFS 01653 "Medical Statement for Foster Care/Adoptive Applicant and All
Household Members" completed for the applicant and all household members by a licensed
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
physician, physician assistant, clinical nurse specialist, certified nurse practitioner or certified
nurse-midwife. The agency may require a new JFS 01653 if the agency deems it necessary.
2
A minimum of one written reference from a professional knowledgeable of the prospective
adoptive parent(s) family dynamics, or if a reference is not available from a professional, one
personal reference from someone aware of the prospective adoptive parent(s) family's functioning.
The personal reference shall not be completed by a relative.
3
A report of a physical, psychiatric or psychological examination or treatment of the caregiver or
prospective adoptive parent(s) or other household member(s) if required by the agency to ensure
the safety, health or care of an adoptive child. The examination shall be conducted by a licensed
physician, psychologist, or other certified or licensed professional.
4
A fire inspection by a state certified fire safety inspector or the state fire marshal's office using the
JFS 01200 "Fire Inspection Report for Residential Facilities Certified by ODJFS", fire safety
approval or other form used for a local or state fire inspection, if the agency deems it necessary to
ensure the home is free from conditions that may be hazardous to the safety of an adoptive child.
5
The JFS 01348 "Safety Audit of a Family Foster Home," also used for adoptive homes; if there is
a reason for concern relative to the home's continued safety. The JFS 01348 must document the
residence satisfactorily meets all safety standards.
6
The JFS 01681 "Applicant Financial Statement." (rev. 10/2000), if any substantial changes to the
prospective adoptive parent(s) financial situation occurred.
7
A completed water test by an approved Ohio water testing laboratory, if deemed necessary by the
agency.
PP
Synergy Family Foster Care shall request a search of the central registry of abuse and neglect from the
applicant. This search is to be used to determine the suitability of the adoptive applicant as an adoptive
parent.
QQ
Preparation of summary report of involvement of an applicant and other adult household members in
reports of child abuse and neglect contained in SACWIS.
1
A summary report shall be placed in each adoptive home record. Prior to the placement of each
child in the applicant's home, the summary report shall be considered as a tool to help determine
the appropriateness of the placement.
2
One summary report shall be prepared for each applicant's home. The summary report shall
include, for each applicant and each adult member of the household, a chronological list of abuse
and neglect determinations or allegations in which the person was involved where a PCSA has
done one of the following:
a
Determined that abuse or neglect occurred.
b
Initiated an investigation, and the investigation is ongoing.
c
Initiated an investigation, and the agency was unable to determine whether abuse or
neglect occurred. This provision is limited to report dispositions the PCSA determined to
be unable to locate.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
3
4
The summary report shall not contain any of the following:
a
Any information concerning a report of abuse or neglect where the PCSA determined that
abuse or neglect did not occur or was unsubstantiated.
b
The name of the person who or entity that made, or participated in the making of, the
report of abuse or neglect. This includes any additional collateral contact who made, or
participated in, the report of abuse or neglect.
c
Any information the release of which is prohibited by state or federal law.
d
The name of or other identifying information regarding a child.
If the search indicates there are no allegations or reports of involvement in child abuse or neglect
investigations for any applicant or adult household member, the summary report shall indicate that
there is no record involving any applicant or adult household member in an allegation or report of
involvement in a child abuse or neglect investigation reported to SACWIS or the central registry.
RR
Once a homestudy is approved, a new criminal records check pursuant to rule 5101:2-48-10 of the
Administrative Code shall be conducted for the adoptive parent(s) and each adult member of the household
very four years at the time of the update.
SS
The agency shall conduct a criminal records check on each adult residing in the household within sixty
days of the effective date of this rule if the last criminal records check was completed more than four years
ago.
TT
After the criminal records check is completed, the agency shall conduct continued criminal records checks
pursuant to paragraph (RR) of this rule.
UU
An assessor's update of the homestudy shall include a minimum of one face to face home visit with each
member of the household currently residing in the home. The interview with other household member(s)
may be joint visits.
VV
The assessor shall provide written notification to the applicant(s) of approval or denial of the update to the
adoption homestudy. The written notification shall be provided to the adoptive family within ten days of
completion of the homestudy update.
WW
If the decision of the assessor is to recommend the approval of an adoptive parent(s) homestudy update,
the written notification shall include, but not be limited to, the date of the approval of the update to the
adoptive homestudy and the date the approved update will expire.
XX
If the decision of the assessor is to deny the updated adoptive homestudy, the written notification shall
contain both of the following:
1
A detailed explanation setting forth the reasons for denial.
2
Procedures the applicant(s) shall follow for an agency review pursuant to rule 5101:2-48-24 of the
Administrative Code.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
YY
An amendment is a narrative of the assessor's evaluation of the approved adoptive parent(s) and family and
shall be completed and attached to the homestudy within thirty days of the agency becoming aware a
change occurred.
ZZ
If the approved adoptive parent notifies the agency of any changes or circumstances listed in paragraphs
(AAA) and (BBB) of this rule occurred, the agency shall amend the homestudy.
AAA
An approved adoptive parent shall notify the recommending agency within one hour of any of the
following circumstances involving the adoptive child whose adoption is not finalized:
BBB
1
A serious injury or illness involving medical treatment of the adoptive child.
2
The death of the adoptive child.
3
Unauthorized absence of the adoptive child from the home.
4
Removal of the adoptive child from the home by any person or agency other than the placing
agency, or attempts at such removal.
5
Any involvement of the adoptive child with law enforcement authorities.
An adoptive parent shall notify the recommending agency within twenty-four hours or the next working
day if any of the following occur prior to finalization of the adoption of the child:
1
A change in the marital status of an approved adoptive parent(s).
2
Any serious illness or death of an approved adoptive parent(s) or household member.
3
The finalization of an adoptive child placed by a different agency.
4
A change in the number of household members through birth or kinship who have not reached the
age of majority.
5
A change in the number of adults residing with the approved adoptive parent (not including an
existing household member reaching the age of majority).
6
A criminal charge or conviction of any approved adoptive parent or other adult household
member(s).
7
A significant change in financial status/income.
8
The physical relocation of the approved adoptive parent(s) resulting in a change of address
different than the address listed on the most recent homestudy or homestudy update.
CCC
New child household members residing with the adoptive parent shall have a JFS 01653 "Medical
Statement for Foster Care/Adoptive Applicant and All Household Members" (rev. 6/2009) completed
within sixty days of becoming a household member.
DDD
If the child is an infant born to the adoptive parent and the agency documents in the case record the
adoptive parent has had prenatal care from a physician during the pregnancy and is receiving periodic
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
medical examinations from a physician, the JFS 01653 shall be completed within ninety days of the date
the infant becomes a household member.
EEE
Household members turning eighteen years of age shall have a bureau of criminal identification and
investigation (BCII) background check and federal bureau of investigation (FBI) check, as outlined in rule
5101:2-48-10 of the Administrative Code, initiated within ten working days of the date they turned
eighteen years of age.
FFF
New adult household members residing with the approved adoptive parent shall have a JFS 01653
completed within sixty days of becoming a household member.
GGG
New adult household members residing with the approved adoptive parent shall have a BCII background
check and FBI check, as outlined in rule 5101:2-48-10 of the Administrative Code, and a search of the
central registry initiated within ten working days of the date they became a household member.
HHH
Upon notification of a change of address, the PCSA, PCPA, or PNA shall conduct a safety audit of the new
residence using the JFS 01348 "Safety Audit of a Foster Home," which is also used for adoptive homes
(rev. 1/2003).
III
The safety audit shall be conducted within ten working days after the notification of the change of address.
JJJ
The PCSA, PCPA, or PNA shall require the approved adoptive parent to obtain a fire safety inspection
certifying the new residence is free from conditions hazardous to the safety of an adoptive child.
KKK
The fire safety inspection shall be conducted within ninety days of the change of address by a state certified
fire safety inspector or the state fire marshal's office.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: PREFINALIZATION SERVICES
POLICY NUMBER: 76
ORC REFERENCE: 5101:2-48-17
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 2/1/02
DATE REVISED: 3/1/07, 4/20/09, 1/1/10
A
Within four days after a placement for adoption, an assessor from the Synergy Family Foster Care, Inc.
shall contact the adoptive family by telephone to determine how the placement is progressing. A home
visit shall be made by the assessor no later than seven days following placement.
B
The assessor shall make monthly face-to-face contact with the adoptive parent and the child throughout the
finalization period.
1
The post placement visit shall occur no later than thirty days after the assessor’s last face-to-face
home visit with the adoptive parent(s) and the child.
2
Post placement visits shall continue to be held by the assessor in the home monthly at a minimum.
a
b
C
D
The assessor shall make face-to-face visits in the home with any household member
whose permanent residence is the adoptive home shall be made every 60 days.
Also at a minimum, 2 face to face visits in the home prior to finalization with any
household members whose permanent residence is the adoptive home although he or she
may temporarily reside elsewhere. No less than sixty days between visits.
Pre finalization services shall be provided to the adoptive parent and the child from the date of adoptive
placement of the child until the issuance of a final decree of adoption. The assessor shall provide or
arrange for, at a minimum, the following prefinalization services, as applicable:
1
Case management;
2
Counseling;
3
Crisis services;
4
Diagnostic; and
5
Therapeutic services.
Prefinalization services listed in paragraph (C) of this rule shall be provided or arranged for by the assessor
for the child and the adoptive parent through one or more of the following:
1
Information and referral services to community resources;
2
Direct services from Synergy Family Foster Care, Inc.; or
3
Services from community service providers.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
E
The assessor shall gather and document at minimum information to determine how the placement is
progressing from the perspective of the adoptive parent(s), child, and all other household members.
Documentation made by the assessor shall include information relevant to the JFS 01699, if applicable to
the person(s) the assessor is making contact.
F
The assessor shall complete the ODJFS 01699, “ODJFS Prefinalization Adoption Assessment Report” prior
to the issuance of a final decree of adoption or finalization of an interlocutory order of adoption. The report
shall include the following information:
1
Dates of contacts with the child or adoptive family pursuant to the requirements of this rule;
2
Information regarding the child and adoptive family’s adjustment to the adoptive placement;
3
Present and anticipated needs of the child and the adoptive family for postfinalization adoptive
services, Title IV-E adoption assistance, state adoption subsidy and Medicaid;
4
Physical, mental and developmental condition of the child;
5
Biological family background of the child, including identifying information about the biological
or other legal parents, if known;
6
Reasons for the child’s placement with the adoptive family and the circumstances under which the
child was placed in the home of the adoptive family;
7
Adoptive family members’ attitudes toward the proposed adoption;
8
If the child is an Indian child as defined in 25 U.S.C.A. 1903 (4), how the placement complies
with the “Indian Child Welfare Act of 1978”, 25 U.S.C.A. 1901, as amended.
9
Prefinalization services which have been requested, provided or agreed upon; and
10
Prefinalization services planned, but not provided, and the reason the services were not provided.
G
The assessor shall file the JFS 01699, “ODJFS Prefinalization Adoption Assessment Report” with the court
where the adoption petition is pending no later than twenty days prior to the date scheduled for the final
hearing on the adoption unless the court determines there is good cause for filing the report at a later date.
H
The JFS 01699. “ODJFS Prefinalization Adoption Assessment Report” is not required for foster caregivers
who are utilizing the JFS 01692, “ODJFS Application to Adopt a Foster Child” pursuant to Rule 5101:248-11.1 of the Administrative Code.
i
When an adoptive child is placed in an approved adoptive parent(s) home and the adoptive parent(s) or
other household member(s) knowingly make a false statement that results in the assessor reassessment of
an approved or updated home study, the adoptive parent(s) or household member(s) is guilty of the offense
of falsification under section 2921.13 of the Revised Code. The assessor shall report incidents of
falsification according to procedures pursuant to rule 5101:2-33-13 of the Administrative Code.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: GOOD CAUSE POLICY FOR YEARLY TRAINING HOURS
POLICY NUMBER: 77
ORC REFERENCE: 5101:2-5-13(A)(14)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 2/1/02
A
DATE REVISED: 3/1/07
Except as provided in section 5103.033 of the Revised Code, the Department of Job and Family Services
may not renew a foster home certificate under section 5103:03 of the Revised Code unless the foster
caregiver successfully completes the required amount of continuing training according to the plan
developed and implemented under section 5103:035 of the Revised Code.
1
Each foster caregiver is required to have at least thirty hours each year of continuing training
documented in the foster caregivers file.
B
Synergy Family Foster Care, Inc. has established and implemented a policy regarding good cause for a
foster caregiver’s failure to complete the continuing training in accordance with division (A) of this section.
If the foster caregiver complies with the policy, as determined by Synergy Family Foster Care, Inc., the
Department of Job and Family Services may renew the foster caregiver’s foster home certificate.
C
If the foster caregiver’s are unable to meet the thirty hours of required continuing training due to one of the
following reasons then a corrective action plan will be completed for the foster home. What constitutes
good cause:
D
1
A documented illness by a licensed physician;
2
A critical emergency, which may include but not be limited to, a death in the immediate family,
job related incident that may take a foster caregiver away from home, or a serious illness of a
family member where the foster caregiver has to provide care for the individual; o
3
A lack of accessible training programs;
4
The foster caregiver has served in active duty outside Ohio with a branch of the armed forces of
the United States for more than thirty days in the preceding two year period; or
5
The foster caregiver has served in active duty as a member of the Ohio organized militia, as
defined in section 5923.01 of the Revised Code, which includes the Ohio national guard, the Ohio
naval militia and the Ohio military reserve, for more than thirty days in the preceding two year
period and that active duty relates to either an emergency in or outside of Ohio or to military duty
in or outside of Ohio.
Synergy Family Foster Care, Inc. will develop a scheduled corrective action plan that provides for prompt
completion of the continuing training not to exceed over a three month time period. The corrective action
plan will include the amount of hours of continuing training that will need to be completed with a set time
frame for completion. Synergy Family Foster Care, Inc. will work with the foster caregiver to provide the
hours or find available training that meets the requirements of the agency.
1
The additional time for a caregiver who has served in active duty shall be one month for each
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
month the caregiver was on active duty. Any required training that is not met at the end of a foster
caregiver’s certification period applying the preceding sentence shall be waived by Synergy
Family Foster Care. When a waiver of training is approved by Synergy Family Foster Care under
this paragraph, the required training for the next certification period shall be the same as for any
other caregiver operating a foster home of the type for which the foster caregiver is certified.
Synergy Family Foster Care shall document any such extension of time in the foster caregiver’s
record.
E
If the foster caregiver is still unable to meet the continuing training requirements in accordance with
division (A) of this section then the agency will recommend revocation of the foster home certificate to the
Department of Job and Family Services. If the foster home currently has any placements in the home then
the recommending agencies will be notified of the recommendation for revocation and plans for removal of
the placements will be made between Synergy Family Foster Care, Inc. and the recommending agency.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: EXPENDITURE POLICY
POLICY NUMBER: 78
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 6/1/02
DATE REVISED:
A
No donations to other public or private organizations as indicated by the guidelines of the Federal Tax
Exemption Status.
B
No loans shall be given to any employees, Board members or foster parents of Synergy Family Foster Care,
Inc.
C
No purchase of items or equipment for personal use. Property of Synergy Family Foster Care, Inc. will be
used to perform described job duties and for the purpose for which it was purchased.
D
No dues for clubs will be paid from Synergy Family Foster Care, Inc. income that is not directly related to
the function and mission of the agency. Excluded clubs may include but not be limited to civic, social,
dining and county clubs. All club or associations enrollments will be voted on by the Board before
applying.
E
Synergy Family Foster Care, Inc. will not pay for any alcoholic beverages, fines or penalties, parking or
traffic violations.
F
Receipts must accompany all allowable expenditures and when a receipt is not available then a written
itemized and detailed receipt must be submitted to the Business Administrator for approval.
G
All purchases over $1000 will be approved by the board and noted in the minutes.
H
Any services requiring a contract will have a minimum of three quotes with the best quote and services
being accepted.
I
No fees will be paid toward the expenses of family members when accompanying an employee on a
conference or trip unless awarded through an incentive or bonus program.
J
Synergy Family Foster Care, Inc. will not contribute toward any lobbying activity.
K
No assets maybe converted for personal use.
L
Any credit cards obtained by Synergy Family Foster Care, Inc. will not be used for any personal use. Only
the individual(s) given permission are authorized to utilize a Synergy Family Foster Care, Inc. credit card.
The board will have the say in who is authorized to utilize the credit card with notations made in the board
minutes along with a contract with the stated individual.
1
The limit will remain at $1000 unless pre-approved by the board.
2
The bill will be paid in full each month the statement is received.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
3
M
N
Any purchases by the credit card will be coded to the expense that they correspond to each month
when the statement from the credit card company is received.
Only the Executive Director may sign to incur debt in the name of Synergy Family Foster Care, Inc. upon
the Boards approval and knowledge before doing so. The board will be given an opportunity to review the
budget for the funds being requested and approve prior to the signing of any loan acceptance.
All purchases will be made utilizing the federal tax-exempt status at all times possible.
O
Synergy Family Foster Care, Inc. will pay the registration fees for all trainings and conferences that are job
or agency related for employees to attend. Synergy Family Foster Care, Inc. will also cover the expense for
food, lodging, car rental and airline tickets in accordance with federal government tax guidelines if deemed
necessary for the employee to attend the training or conference. Upon return the employee must submit all
receipts to the Business Administrator and turn in a summary report on the material covered during the
training or conference.
P
If a signature stamp is utilized for checks and/or reports then the person whose signature is on the stamp is
the only individual permitted to make use of the stamp. Signature stamps are to be kept in a locked
compartment at all times when not in use. Unauthorized use of a signature stamp by an employee other
then whose signature is on the stamp could result in immediate termination.
Q
Equipment purchased with funds from Synergy Family Foster Care, Inc. may only be sold off if first
approved by the board. All equipment and assets may only be sold at fair market value once it has served
the agencies purpose and is no longer needed as agreed by the board, then a range of an acceptable value
will be determined and that will be the asking price for the given item.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: CHANGING THE CERTICATION OF A FOSTER CAREGIVER FROM ONE TYPE OF FOSTER
HOME TO ANOTHER; PHASE-IN PERIOD FOR SPECIALIZED FOSTER HOMES
POLICY NUMBER: 79
ORC REFERENCE: 5101:2-5-25
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/03
A
DATE REVISED:
No child placed in a family foster home on or before the effective date of this rule shall be moved to
another placement solely because of the failure of the foster caregiver to meet the requirements for
treatment or medically fragile foster homes found in this chapter or in Chapter 5101:2-7 of the
Administrative Code.
1
Except as indicated in paragraph (A)(2) of this rule, a currently certified foster caregiver, who, on
the effective date of this rule, is serving a foster child considered to be in need of placement in a
treatment or medically fragile foster home, shall not change their foster home certification to a
treatment foster home or a medically fragile foster home until the first recertification of the home
that is due after the effective date of this rule.
2
A foster caregiver whose recertification is due within ninety days after the effective date of this
rule shall not change their foster home certification to a treatment foster home or a medically
fragile foster home until the second recertification date after the effective date of this rule.
Thereafter, the provisions of paragraph (C) to (F) of this rule shall apply.
B
Synergy Family Foster Care, Inc. shall not recommend a foster caregiver be certified to operate more than
one type of foster home at the same time. A foster home may accept a foster child that is assessed as
needing care at or below the level of care for which the home is certified.
C
Whenever a foster caregiver who is certified to operate a foster home wishes to seek to change the foster
home’s certification to another type of certification, the foster caregiver shall submit a written request to
Synergy Family Foster Care, Inc.
D
If a foster caregiver seeks to change the foster home's certification to a treatment foster home or a
medically fragile foster home, the agency shall determine if the foster caregiver meets the qualifying
experience requirements contained in paragraph (A) of rule 5101:2-7-16 or 5101:2-7-17 of the
Administrative Code. If the foster caregiver meets those requirements, the agency shall proceed as in
paragraph (E) of this rule. If the foster caregiver does not meet those requirements, the agency shall not
proceed with the foster caregiver's request. Failure of a foster caregiver to prove to the recommending
agency's satisfaction that the foster caregiver meets the qualifying experience requirements of paragraph
(A) of rule 5101:2-7-16 or 5101:2-7-17 of the Administrative Code does not constitute denial of
certification and is not subject to appeal pursuant to Chapter 119. of the Revised Code.
1
Synergy Family Foster Care, Inc. shall ensure that all the preplacement training requirements of a
foster caregiver contained in rule 5101:2-5-33 of the Administrative Code have been completed
prior to recommending the home to the Ohio department of job and family services (ODJFS) for
another type of certification.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
2
Pursuant to sections 5103:032, 5103.033, and 5103.039 of the Ohio Revised Code, Synergy
Family Foster Care, Inc. shall not approve a waiver of any preplacement training requirements for
the first certification of the new type of foster home.
3
Notwithstanding paragraph (D)(2) of this rule, pursuant to section (3) of Substitute House Bill 332
as enacted by the 123rd Ohio General Assembly, a foster caregiver holding a valid family foster
home certificate on January 1, 2001 shall not be required to meet the additional preplacement
training requirements of paragraphs (C)(3) and (C)(7) of rules 5101:2-5-33 of the Administrative
Code.
4
Training that may be considered as meeting either a requirement for preplacement training for a
specialized foster caregiver or a requirement for continuing training for a family foster caregiver,
may be counted as meeting either requirement, even though the caregiver may be certified to
operate only one type of foster home at a time.
5
At the discretion of Synergy Family Foster Care, Inc., for a currently certified foster caregiver who
is seeking to change the type of foster home for which the caregiver is certified, preplacement or
continuing training courses successfully completed within the most recent three year period from
the date of the caregiver’s written request to Synergy Family Foster Care, Inc. to be certified as a
different type of foster home, may be counted towards meeting the preplacement requirements for
the new type of foster home.
6
When the change in type of foster home certification takes place during a foster caregiver’s
certification period, if the foster home’s certification designation is changing from a certification
designation that has more stringent requirements to a certification designation that has less
stringent requirements, the new certification period for the foster home shall be until the end of the
caregiver’s current certification period.
7
If the foster home’s certification designation is recommended to change from a certification
category that has less stringent requirements to a certification category that has more stringent
requirements, the new certification period will be for two years, effective from the date ODJFS
receives the JFS 01317 “Recommendation for Certification/Recertification of a Foster Home”
recommending the change.
8
When Synergy Family Foster Care, Inc. recommends that a foster caregiver’s certification be
changed to another type of foster home, the recommendation shall be submitted as a change to
ODJFS on the JFS 01317. The FACSIS resource identification number shall remain the same as
the previous identification number, except that the fourth and fifth digits of the number shall be
changed to reflect the appropriate FACSIS resource identification code for the type of foster home
to which the caregiver is changing. Not later than the date Synergy Family Foster Care, Inc.
submits the JFS 01317, Synergy Family Foster Care, Inc. shall also submit the necessary data to
ODJFS to register the change in the ODJFS FACSIS system with the updated FACSIS resource
identification number.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: PREPLACEMENT AND CONTINUING TRAINING PROGRAMS
POLICY NUMBER: 80
OAC REFERENCE: 5101:2-5-40
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/03
DATE REVISED: 1/2/07
A
A Private noncustodial agency (PNA) that seeks to operate a preplacement training program or a continuing
training program shall submit its training proposal(s) for approval to the agency’s assigned ODJFS district office
licensing specialist. Each training proposal submitted to ODJFS shall be approved for submission by the
Administrative Director of the agency. Submission and approval of training proposals shall follow the time frames
listed in paragraphs (A)(1), (A)(2) and (A) (3) or paragraph (E) of this rule.
An agency’s approved foster caregiver orientation and training plan in effect on October 15, 2000 shall continue in
effect until one hundred twenty days after the effective date of this rule.
The first training proposal due after the effective date of this rule shall be submitted no later than ninety days after
the effective date of this rule. The training proposal, when approved, shall be valid until December 31, 2004.
Thereafter, a training proposal shall be submitted to ODJFS by October fifteenth of every even-numbered year
beginning October 15, 2004. An approved training proposal shall be valid for two calendar years beginning January
1, 2005.
B
Upon receipt of an agency’s training proposal, ODJFS shall review the proposal for compliance with the
requirements set forth in this rule. If ODJFS approves the proposal, it shall notify the agency in writing within thirty
calendar days of ODJFS receipt of the proposal. If ODJFS does not approve the proposal it shall notify the agency
in writing, within thirty calendar days of ODJFS receipt of the proposal, of the reasons why the proposal was not
approved. If the proposal was not approved, ODJFS shall advise the agency of how to revise the proposal so the
department can approve it. The agency shall submit a revised proposal within fifteen calendar days.
C
If ODJFS does not approve an agency’s training proposal, or if a previously approved training proposal or
plan expires, the agency shall not operate a preplacement or continuing training program for foster caregivers until a
training proposal has been approved by ODJFS.
D
The proposal shall include the following information:
The type(s) of training programs to be offered and the projected outcomes for each program. Types of training
programs include the following:
a
home;
Preplacement training for prospective foster caregivers seeking certification to operate a family foster
b
Continuing training for foster caregivers certified to operate a family foster home;
c
home;
Preplacement training for prospective foster caregivers seeking certification to operate a treatment foster
d
Continuing training for foster caregivers certified to operate a treatment foster home;
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e
Preplacement training for prospective foster caregivers seeking certification to operate a medically fragile
foster home; and/or
f
Continuing training for foster caregivers certified to operate a medically fragile foster
home.
A statement outlining the types of foster caregivers the training program addresses.
The organization and structures of the training program which shall clearly identify who will be responsible for
operating the training program, the staffing level of the program, the person(s) responsible for policy decisions
regarding the training program, and whether part of the training program functions will be subcontracted to other
individuals, agencies or entities.
The policies and procedures of the training program which include, at a minimum, the following information:
a
Policies and procedures for assessing foster caregiver training needs and utilizing foster caregivers
continuing training plans as the basis for determining course offerings and
frequency of course offerings;
b
Policies and procedures for developing and evaluating courses which comprise the training program,
including policies and procedures for assessing successful completion of a course by the prospective foster caregiver
or foster caregiver and procedures for notifying the recommending agency with which a prospective foster caregiver
or a foster caregiver is affiliated of the successful completion of the course.
c
Policies and procedures for the selection and evaluation of qualified trainers;
d
Policies and procedures for notifying agencies and foster caregivers of courses offered by
training program;
e
Policies and procedures for accepting applications for training courses and scheduling
the
training; and
f
Policies and procedures for maintaining training records, tracking attendance at the training by course
offering and by foster caregiver, including notification to the agency of foster caregiver attendance.
g
Policies and procedures for a written evaluation of the effectiveness of the courses offered and the overall
effectiveness of the training program. The policies and procedures shall specify that these evaluations will take
place at least once every two years.
A description of course offerings which contain, at a minimum, all of the following information:
a
Course title and description;
b
Target audience (family foster caregivers, treatment or medically fragile foster caregivers, pre-adoptive
infant foster caregivers);
c
Course learning objectives
d
Training hours;
e
Course outline; and
f
Qualifications of the trainer.
The training program budget, including administrative costs, trainer costs, and training rental costs.
G
Pursuant to sections 5103.039 of the Revised Code, agencies applying to be approved to operate a
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preplacement training program for persons seeking certification to operate a family foster home shall offer training
courses addressing all of the following areas:
The legal rights and responsibilities of foster caregivers;
2
The policies and procedures of the recommending agency regarding foster caregivers;
The ODJFS requirements for certifying foster homes;
The effects placement, separation, and attachment issues have on children, their families, and foster caregivers;
Foster caregivers’ involvement in permanency planning for children and their families;
The effects of physical abuse, sexual abuse, emotional abuse, neglect and substance abuse on normal human growth
and development;
Behavior management techniques;
Effects of caregiving on children’s families;
At least three hours of cultural issues in placement training including cultural diversity training and overview of the
Multiethnic Placement Act as amended;
Prevention, recognition, and management of communicable diseases;
Community health and social services available to children and their families;
CPR and First Aid;
The substance of section 2151.62 of the Revised Code which deals with the information required to be shared with a
foster caregiver when a child who has been adjudicated a delinquent child for the commission of certain violent
crimes is placed in a foster home; a course addressing section 2151.62 of the Revised Code shall be not less than one
hour long; and
Preparing adolescents for independent living(for a prospective foster caregiver who will be providing care for a
youth expected to remain in foster care until the youth’s eighteenth birthday).
H
Pursuant to sections 5103.0310 of the Revised Code, agencies applying to be approved to operate a
continuing training program for persons seeking recertification to operate a family foster home shall offer training
courses addressing all of the following areas:
Parents and foster caregivers as part of child protection teams;
The dynamics of child abuse and neglect and recognizing and preventing child abuse and neglect;
The effect of child abuse and neglect on child development;
How foster caregivers should work with children and their families regarding placement, separation, and attachment
issues;
Behavior management techniques;
Foster caregivers’ working with children’s families;
Effects of caregiving on children’s families;
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Caring for children who have been sexually abused;
Cultural competency;
Substance abuse and dependency;
Symptoms of mental illness and learning disorders;
Developmentally appropriate activities for children; and
Preparing adolescents for independent living (for a foster caregiver who will be providing care for a youth expected
to remain in foster care until the youth’s eighteenth birthday).
I
Pursuant to sections 5103.039 of the Revised Code, agencies applying to be approved to operate a
preplacement training program for persons seeking certification to operate a specialized foster home shall offer
training courses addressing all of the following areas:
All of the courses listed in paragraph (G) of this rule, except that the ODJFS requirements for certifying foster
homes shall pertain to the type of specialized foster home the person seeks to operate and the cultural issues in
placement training shall be at least three ours in length;
Issues concerning physical restraint techniques and the appropriate use of physical restraints;
Special education surrogate parent training;
Certification in a First Aid training program and a child and adult CPR training program such as those training
programs offered by the American Red Cross, The American Heart Association, or the equivalent, and
Courses specific to the types of children placed in the type of specialized foster home the person seeks to operate.
J
Pursuant to sections 5103.0310 of the Revised Code, agencies applying to be approved to operate a
continuing training program for persons seeking recertification to operate a specialized foster home shall offer
training courses addressing all of the following areas:
All of the courses listed in paragraph (H) of this rule;
Issues concerning physical restraint techniques and the appropriate use of physical restraints; and
Up to eight hours of special education surrogate parent training; and
Continuous maintenance of certification in a First Aid training program and a child and adult CPR certification
training program such as those training programs offered by the American Red Cross, the American Heart
Association, or the equivalent.
K
Agencies submitting training proposals shall comply with payment and/or reimbursement procedures
outlined in rule 5101:2-5-38 of the Administrative Code.
L
Pursuant to section 5101.034 of the Revised Code if Synergy Family Foster Care, Inc. operates a
preplacement training program or continuing training program approved by ODJFS shall make the program
available to foster caregivers without regard to the type of recommending agency from which a foster caregiver
seeks a recommendation and without charge to the foster caregiver. An agency may restrict enrollment based on a
predetermined number of course participants that is clearly identified on course announcements or registration
materials. Foster caregivers not associated with the agency providing the training shall be registered for such
training on a first come first served basis, without regard to the type of recommending agency with which a foster
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caregiver is associated. An agency may refuse a foster caregiver admission to a training session if no arrangement
has been made with the foster caregiver’s recommending agency to cover the cost of providing the training to the
caregiver.
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TITLE: ADDITIONAL REQUIREMENTS FOR SFFC TO ACT AS A REPRESENTATIVE OF ODJFS IN
RECOMMENDING TREATMENT FOSTER HOMES FOR CERTIFICATION
POLICY NUMBER: 81
ORC REFERENCE: 5101:2-5-36, 5101:2-5-13(A)(16)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/03
DATE REVISED: 6/1/03, 3/1/07
A
Beginning twenty-seven months after the effective date of this rule, no child who has special or exceptional
needs as described in rule 5101:2-47-18 of the Administrative Code shall be placed in a foster home unless
the foster caregiver has been certified to operate a treatment foster home pursuant to this rule and the
requirements contained in rule 5101:2-7-16 of the Administrative Code.
B
A treatment team shall be assigned to each child with special or exceptional needs placed in a treatment
foster home.
C
An initial service plan shall be completed by the treatment team for each child with special or exceptional
needs placed in a treatment foster home no later than thirty days after placement. The service plan shall be
reviewed and revised, if necessary, at least once every ninety days thereafter. Service plan development
and any revisions shall be completed by the treatment team leader with approval of the treatment team
leader’s supervisor who shall be a member of Synergy Family Foster Care, Inc.’s professional treatment
staff. All treatment team members shall be notified in advance of each treatment team meeting and invited
to participate. Documentation of the invitation shall be maintained in the child’s record.
D
The service plan for a child with special or exceptional needs placed in a treatment foster home shall
include:
1
Treatment goals, clinical and/or rehabilitative services and other necessary interventions for the
child and his family.
2
The method by which the goals, rehabilitative services, and other necessary interventions will be
attained and progress evaluated.
3
The projected length of the child’s stay in treatment foster care.
4
The criteria to be met for the child’s reunification with his parent(s)/family or guardian or the
projected post-treatment setting into which the child will be placed upon attainment of the
treatment goals.
5
Service to be provided or arranged for the child after discharge from the treatment foster care
program.
6
How the child’s permanency plan for family reunification, adoption, independent living or a
planned permanent living arrangement, as specified in the custodial agency’s case plan, will be
attained.
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E
An individual plan for respite care shall be developed for each child with special or exceptional needs
placed in treatment foster care. The use of respite care shall comply with Synergy Family Foster Care,
Inc.’s respite care policy prepared pursuant to rule 5101:2-5-13 of the Administrative Code. A copy of the
individual plan for respite care for each foster child with special or exceptional needs placed in a treatment
foster home shall be included in the child’s case record.
1
Respite care shall be only with the approval of the administrative director of the specialized foster
care program or his/her designee.
2
The administrative director of the specialized foster care program will select and approve respite
care providers based on their experience or equivalence as noted in policy # 1.2 and 1.4 to work
with the specialized needs of the children placed in respite care. Only approved respite care
providers shall be utilized.
3
An approved respite care provider who is not certified as a foster caregiver or specialized foster
caregiver shall receive at least 12 hours of orientation and training relevant to the children served
by the specialized foster care program and have a criminal record check conducted as for a foster
caregiver pursuant to Rule 5101:2-5-091 of the OAC prior to providing respite care.
4
A respite care provider shall not provide respite care for children for more than two consecutive
weeks unless the provider is certified as a specialized foster caregiver.
5
Prior to each occasion of respite care, the recommending agency shall provide the respite care
provider with a copy of the JFS 01443, “Child’s Education and Health Information” or the form
the agency uses in lieu of the JFS 01433 completed for the child pursuant to rule 5101:2-39-092 of
the Administrative Code as part of his case plan and at least a written summary of the child’s
service plan, and any information required to be shared with a foster caregiver by rule 5101:2-4290 of the Administrative Code. In addition, for a medically fragile child, any nursing treatment
plan containing physician orders shall be provided. The information required by this paragraph
shall be provided to the respite care provider by the agency that has approved the respite care
provider. Documentation that this has been done shall be maintained in the child’s case record by
the agency that approved the respite care provider.
6
For each occasion of respite care, a respite care provider shall provide a written report of the
child’s stay in respite care to the specialized foster caregiver.
7
A respite care provider for a medically fragile child shall be certified as a foster caregiver for
medically fragile children or be a licensed medical professional.
F
Synergy Family Foster Care, Inc. shall ensure that a member of Synergy Family Foster Care, Inc.’s
professional staff shall be on-call for treatment foster caregivers and children with special or exceptional
needs placed in a treatment foster home on a twenty-four hour, seven day a week basis.
G
Synergy Family Foster Care, Inc. shall ensure that treatment foster caregivers are provided with a manual
containing all policies, procedures and other information related to the treatment foster care program no
later than the date the individual becomes certified to operate a treatment foster home.
H
Synergy Family Foster Care, Inc. shall coordinate with Synergy Family Foster Care, Inc. holding custody
of a child in treatment foster care or the child’s parent or guardian for the provision of all rehabilitative
services and other necessary interventions contained in the child’s service plan and any revisions thereto.
Synergy Family Foster Care, Inc. shall also implement those aspects of the child’s service plan that are its
responsibility.
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I
Synergy Family Foster Care, Inc. shall ensure that a discharge summary is prepared pursuant to rule
5101:2-5-17 of the Administrative Code for each special or exceptional needs child discharged from a
treatment foster home. This paragraph does not apply to a child who has been enrolled only for respite
services.
J
At the time of placement and whenever additional information becomes available, Synergy Family Foster
Care, Inc. shall disclose to the treatment foster caregiver all information available to Synergy Family Foster
Care, Inc. about the child and his family pursuant to rule 5101:2-42-90 of the Administrative Code.
Documentation of the receipt of this information shall be maintained in the treatment foster caregiver’s
record and in the child’s record.
K
Synergy Family Foster Care, Inc. shall assure that all professional treatment staff required to be licensed
shall be appropriately licensed. Professional treatment staff shall demonstrate to the employing or
contracting agency that the training required for professional licensure shall be in topics appropriate to
treatment foster care.
L
All professional treatment staff shall annually complete at least fifteen hours of training specific to
treatment foster care issues and the mission of Synergy Family Foster Care, Inc.
M
Synergy Family Foster Care, Inc. shall ensure that all professional treatment staff is provided with a manual
of all policies and procedures relevant to the treatment foster care program at the beginning of their
employment with Synergy Family Foster Care, Inc.
N
Synergy Family Foster Care, Inc. shall not prohibit treatment foster caregivers from participation in any
formal or informal support groups organized for the purpose of supporting foster caregivers.
O
1
With the exception of the provisions of paragraph (N) (2) of this rule, a treatment foster caregiver
may provide foster care for not more than five foster children, two of whom may have exceptional
needs as described in rule 5101:2-47-18 of the Administrative Code requiring their placement in a
treatment foster home. Any exceptions to the number of exceptional needs children to be served,
must have specific justification in accordance with Synergy Family Foster Care, Inc.’s policy for
matching foster children and treatment foster caregivers pursuant to rule 5101:2-5-13 of the
Administrative Code. Such justification, which may include the need to place a sibling group, or
the abilities of a particular foster caregiver(s) in relation to the exceptional needs of a particular
child, shall be documented in the child’s case record and in the treatment foster home record. If
more than two exceptional needs children are placed in a treatment foster home, all agencies
holding custody of any other children placed in the home shall be notified by Synergy Family
Foster Care, Inc. recommending certification of the home within seventy-two hours of the
additional exceptional needs child’s placement.
2
A treatment foster caregiver who is also an appropriately trained and licensed professional such as
a social worker, professional counselor, psychologist or teacher, or who has a minimum of a
bachelor’s degree in a child development or social services field and five years of child care
experience and training related to serving children in foster care, and whose primary means of
support is from reimbursement as a treatment foster caregiver, may provide care for not more than
five treatment foster children placed in the caregiver’s home.
3
Children placed in a foster home on the effective date of this rule shall not be moved to another
placement solely to meet this requirement.
Synergy Family Foster Care, Inc. shall ensure that professional treatment staff shall have weekly
consultation and face-to-face contact at least every two weeks with each treatment foster home serving a
child with special or exceptional needs and at least one member of each treatment foster caregiver couple or
co-parents. At least one of the face-to-face contacts each month shall take place in the treatment foster
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home.
P
Synergy Family Foster Care, Inc. shall ensure that professional treatment staff shall have at least weekly
contact and face-to-face meetings at least every two weeks with each special or exceptional needs child
placed in a treatment foster home. At least one of the face-to-face contacts each month shall take place in
the treatment foster home.
Q
Synergy Family Foster Care, Inc. shall ensure that treatment foster caregivers keep a written record of the
behavior and progress towards achieving treatment goals as identified in the child’s service plan for each
foster child placed in a treatment foster home. The written record shall be maintained current and kept in
the manner prescribed by the treatment foster care program.
R
Synergy Family Foster Care, Inc. shall assure that treatment foster caregivers are aware of the potential side
effects of any prescribed medication for children placed in their home.
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POLICY AND PROCEDURES
TITLE: ADDITIONAL REQUIREMENTS FOR SFFC TO ACT AS A REPRESENTATIVE OF ODJFS IN
RECOMMENDING MEDICALLY FRAGILE FOSTER HOMES FOR CERTIFICATION
POLICY NUMBER: 82
ORC REFERENCE: 5101:2-5-37
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/03
DATE REVISED: 6/1/03
A
Beginning twenty-seven months after the effective date of this rule, no child who has special or exceptional
needs as described in rule 5101:2-47-18 of the Administrative Code shall be placed in a foster home unless
the foster caregiver has been certified to operate a treatment foster home pursuant to this rule and the
requirements contained in rule 5101:2-7-16 of the Administrative Code.
B
A treatment team shall be assigned to each child with special or exceptional needs placed in a treatment
foster home.
C
An initial service plan shall be completed by the treatment team for each child with special or exceptional
needs placed in a treatment foster home no later than thirty days after placement. The service plan shall be
reviewed and revised, if necessary, at least once every ninety days thereafter. Service plan development
and any revisions shall be completed by the treatment team leader with approval of the treatment team
leader’s supervisor who shall be a member of Synergy Family Foster Care, Inc.’s professional treatment
staff. All treatment team members shall be notified in advance of each treatment team meeting and invited
to participate. Documentation of the invitation shall be maintained in the child’s record.
D
The service plan for a child with special or exceptional needs placed in a treatment foster home shall
include:
1
Treatment goals, clinical and/or rehabilitative services and other necessary interventions for the
child and his family.
2
The method by which the goals, rehabilitative services, and other necessary interventions will be
attained and progress evaluated.
3
The projected length of the child’s stay in treatment foster care.
4
The criteria to be met for the child’s reunification with his parent(s)/family or guardian or the
projected post-treatment setting into which the child will be placed upon attainment of the
treatment goals.
5
Service to be provided or arranged for the child after discharge from the treatment foster care
program.
6
How the child’s permanency plan for family reunification, adoption, independent living or a
planned permanent living arrangement, as specified in the custodial agency’s case plan, will be
attained.
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E
An individual plan for respite care shall be developed for each child with medically fragile needs placed in
treatment foster care. The use of respite care shall comply with Synergy Family Foster Care, Inc.’s respite
care policy prepared pursuant to rule 5101:2-5-13 of the Administrative Code. A copy of the individual
plan for respite care for each foster child with medically fragile needs placed in a treatment foster home
shall be included in the child’s case record.
1
Respite care shall be only with the approval of the administrative director of the specialized foster
care program or his/her designee.
2
The administrative director of the specialized foster care program will select and approve respite
care providers based on their experience or equivalence as noted in policy # 1.2 and 1.4 to work
with the specialized needs of the children placed in respite care. Only approved respite care
providers shall be utilized.
3
An approved respite care provider who is not certified as a foster caregiver or specialized foster
caregiver shall receive at least 12 hours of orientation and training relevant to the children served
by the specialized foster care program and have a criminal record check conducted as for a foster
caregiver pursuant to Rule 5101:2-5-091 of the OAC prior to providing respite care.
4
A respite care provider shall not provide respite care for children for more than two consecutive
weeks unless the provider is certified as a specialized foster caregiver.
5
Prior to each occasion of respite care, the recommending agency shall provide the respite care
provider with a copy of the JFS 01443, “Child’s Education and Health Information” or the form
the agency uses in lieu of the JFS 01433 completed for the child pursuant to rule 5101:2-39-092 of
the Administrative Code as part of his case plan and at least a written summary of the child’s
service plan. In addition, for a medically fragile child, any nursing treatment plan containing
physician orders shall be provided. The information required by this paragraph shall be provided
to the respite care provider by the agency that has approved the respite care provider.
Documentation that this has been done shall be maintained in the child’s case record by the agency
that approved the respite care provider.
6
For each occasion of respite care, a respite care provider shall provide a written report of the
child’s stay in respite care to the specialized foster caregiver.
7
A respite care provider for a medically fragile child shall be certified as a foster caregiver for
medically fragile children or be a licensed medical professional.
F
Synergy Family Foster Care, Inc. shall ensure that a member of Synergy Family Foster Care, Inc.’s
professional staff shall be on-call for treatment foster caregivers and children with special or exceptional
needs placed in a treatment foster home on a twenty-four hour, seven day a week basis.
G
Synergy Family Foster Care, Inc. shall ensure that treatment foster caregivers are provided with a manual
containing all policies, procedures and other information related to the treatment foster care program no
later than the date the individual becomes certified to operate a treatment foster home.
H
Synergy Family Foster Care, Inc. shall coordinate with Synergy Family Foster Care, Inc. holding custody
of a child in treatment foster care or the child’s parent or guardian for the provision of all rehabilitative
services and other necessary interventions contained in the child’s service plan and any revisions thereto.
Synergy Family Foster Care, Inc. shall also implement those aspects of the child’s service plan that are its
responsibility.
I
Synergy Family Foster Care, Inc. shall ensure that a discharge summary is prepared pursuant to rule
5101:2-5-17 of the Administrative Code for each special or exceptional needs child discharged from a
treatment foster home. This paragraph does not apply to a child who has been enrolled only for respite
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POLICY AND PROCEDURES
services.
J
At the time of placement and whenever additional information becomes available, Synergy Family Foster
Care, Inc. shall disclose to the treatment foster caregiver all information available to Synergy Family Foster
Care, Inc. about the child and his family pursuant to rule 5101:2-42-90 of the Administrative Code.
Documentation of the receipt of this information shall be maintained in the treatment foster caregiver’s
record and in the child’s record.
K
Synergy Family Foster Care, Inc. shall assure that all professional treatment staff required to be licensed
shall be appropriately licensed. Professional treatment staff shall demonstrate to the employing or
contracting agency that the training required for professional licensure shall be in topics appropriate to
treatment foster care.
L
All professional treatment staff shall annually complete at least fifteen hours of training specific to
treatment foster care issues and the mission of Synergy Family Foster Care, Inc.
M
Synergy Family Foster Care, Inc. shall ensure that all professional treatment staff is provided with a manual
of all policies and procedures relevant to the treatment foster care program at the beginning of their
employment with Synergy Family Foster Care, Inc.
N
Synergy Family Foster Care, Inc. shall not prohibit treatment foster caregivers from participation in any
formal or informal support groups organized for the purpose of supporting foster caregivers.
1
With the exception of the provisions of paragraph (N) (2) of this rule, a treatment foster caregiver
may provide foster care for not more than five foster children, two of whom may have exceptional
needs as described in rule 5101:2-47-18 of the Administrative Code requiring their placement in a
treatment foster home. Any exceptions to the number of exceptional needs children to be served,
must have specific justification in accordance with Synergy Family Foster Care, Inc.’s policy for
matching foster children and treatment foster caregivers pursuant to rule 5101:2-5-13 of the
Administrative Code. Such justification, which may include the need to place a sibling group, or
the abilities of a particular foster caregiver(s) in relation to the exceptional needs of a particular
child, shall be documented in the child’s case record and in the treatment foster home record. If
more than two exceptional needs children are placed in a treatment foster home, all agencies
holding custody of any other children placed in the home shall be notified by Synergy Family
Foster Care, Inc. recommending certification of the home within seventy-two hours of the
additional exceptional needs child’s placement.
2
A treatment foster caregiver who is also an appropriately trained and licensed professional such as
a social worker, professional counselor, psychologist or teacher, or who has a minimum of a
bachelor’s degree in a child development or social services field and five years of child care
experience and training related to serving children in foster care, and whose primary means of
support is from reimbursement as a treatment foster caregiver, may provide care for not more than
five treatment foster children placed in the caregiver’s home.
3
Children placed in a foster home on the effective date of this rule shall not be moved to another
placement solely to meet this requirement.
O
Synergy Family Foster Care, Inc. shall ensure that professional treatment staff shall have weekly
consultation and face-to-face contact at least every two weeks with each treatment foster home serving a
child with special or exceptional needs and at least one member of each treatment foster caregiver couple or
co-parents. At least one of the face-to-face contacts each month shall take place in the treatment foster
home.
P
Synergy Family Foster Care, Inc. shall ensure that professional treatment staff shall have at least weekly
contact and face-to-face meetings at least every two weeks with each special or exceptional needs child
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POLICY AND PROCEDURES
placed in a treatment foster home. At least one of the face-to-face contacts each month shall take place in
the treatment foster home.
Q
Synergy Family Foster Care, Inc. shall ensure that treatment foster caregivers keep a written record of the
behavior and progress towards achieving treatment goals as identified in the child’s service plan for each
foster child placed in a treatment foster home. The written record shall be maintained current and kept in
the manner prescribed by the treatment foster care program.
R
Synergy Family Foster Care, Inc. shall assure that treatment foster caregivers are aware of the potential side
effects of any prescribed medication for children placed in their home.
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POLICY AND PROCEDURES
TITLE: PAYMENT OF FOSTER CAREGIVER TRAINING STIPENDS; REIMBURSEMENT OF
TRAINING ALLOWANCES TO SFFC
POLICY NUMBER: 83
ORC REFERENCE: 5101:2-5-38
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/03
DATE REVISED: 1-24-10, 9/29/16
A
Synergy Family Foster Care, Inc. shall make stipend payments to foster caregivers under our supervision to
compensate such foster caregivers for their cost of attending training sessions. Such stipend payments must
be made to the foster caregiver within sixty calendar days of the completion of the training event. Such
stipend payments may not be held or otherwise deferred pending reimbursement by ODJFS. The stipend
rate paid by Synergy Family Foster Care, Inc. shall be ten dollars per foster caregiver per training hour
successfully completed within a training session that is a minimum of one training hour in duration.
B
Synergy Family Foster Care, Inc. may decline to make a stipend payment to a foster caregiver if the
Synergy Family Foster Care, Inc. determines that the foster caregiver has not successfully acquired the
skills the training was designed to impart, or that the training was beyond the scope of the foster caregiver’s
individualized training plan, or that the training hours received were in excess of the minimum levels
specified in sections 5103.031 and 5103.032 of the Revised Code. Synergy Family Foster Care, Inc. may
decline to make stipend payment where the training the foster caregiver received was part of a program of
self-directed study or otherwise not delivered in a conventional or traditional setting where the principal
transfer of knowledge occurred through the physical presence of a trainer whose responsibility it was to
impart instruction to the foster parent. Synergy Family Foster Care, Inc. will defer the payment of stipend
payments for pre-placement or continuing training until the foster caregiver has received the first child into
their care.
C
Beginning with the effective date of this rule, ODJFS will reimburse Synergy Family Foster Care, Inc. for
stipend payments made to foster caregivers pursuant to paragraph (A) of this rule.
D
For pre-placement training, Synergy Family Foster Care, Inc. will reimburse the foster caregiver for 36
hours. We provide 36 hours of pre-placement training to all levels of foster parents.
E
ODJFS will defer reimbursement of stipends paid by Synergy Family Foster Care, Inc. for all preplacement training until the foster caregiver has received their foster care certification. All claims for
allowance payments and stipend reimbursements must be perfected within eighteen calendar months
subsequent to the month in which the training occurred. Claims made after that time frame will not be
honored and the foster family will not be reimbursed for pre placement training.
F
For continuing training, Synergy Family Foster Care, Inc. will reimburse stipend payments per the
following schedule of training hours:
1
For a pre-adoptive infant home, not more than twelve training hours for each caregiver that is
required to be trained.
2
For a family foster home, not more than forty training hours for each caregiver that is required to
be trained per certification period.
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3
G
For a specialized foster home, not more than six training hours for each caregiver that is required
to be trained per certification period.
All training will be logged in SACWIS monthly by our licensing specialist. Synergy is reimbursed by
ODJFS middle of the following month. Foster parents are paid within the month they took the training.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: TERMINATION OF A FOSTER HOME CERTIFICATE
POLICY NUMBER: 84
ORC REFERENCE: 5101:2-7-27
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/03
DATE REVISED:
A
When a foster caregiver notifies Synergy Family Foster Care, Inc. of the voluntary terminations of the
foster home certificate, Synergy Family Foster Care, Inc. shall, within two working days of receipt of the
notice, notify any other agency which has a foster child placed within the home.
B
Synergy Family Foster Care, Inc. shall, within thirty calendar days of the effective date of a voluntary
termination, submit the information by way of the FACSIS reporting mechanism and a JFS 01317
“Recommendation for Certification/Recertification of a Foster home” to ODJFS indicating that the foster
home certificate has been voluntarily terminated, and that the foster home record is closed.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: SYNERGY FAMILY FOSTER CARE TRAINING PROGRAM
POLICY NUMBER: 85
OAC REFERENCE: 5101:2-5-40(G)(3)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 4/10/03
DATE REVISED: 11-1-14
A
The executive director will be responsible for operating and overseeing the training program. The
executive director will be responsible for developing and scheduling the training program on a yearly basis.
The executive director will be responsible for submitting the training program as required and indicated by
the ODJFS.
B
The executive director will be responsible for the staffing level of the program. The staffing level will be
maintained at a level that will meet the needs of the foster parents. Synergy staff members will be trained
to provide continuing training to foster parents on a monthly basis. Synergy staff will receive on-going
training to ensure competency in providing training to foster parents.
C
The executive director will be responsible for policy decisions regarding the training program. The policies
will be reviewed and approved by the board of directors and submitted to the ODJFS when new policies are
developed or changes are made to current policies and training decisions.
D
Trainings for CPR, First Aid training will be conducted by certified agencies or individuals trained and
approved to provide the training. The training schedules will be provided to the foster parents and the cost
of the trainings will be covered by Synergy Family Foster Care as approved through the training program
and reimbursement policies. If the outside source does not provide competency testing over the material
trained then Synergy Family Foster Care, Inc. will provide post-testing of the parents to gage the
knowledge gained by the training. If foster parents receive training from sources other than Synergy
Family Foster Care, Inc. then the parent will need to provide a copy of their training certificate to Synergy
Family Foster Care, Inc. in order to credit the training hours received.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: MATCHING SPECIALIZED FOSTER CAREGIVERS WITH CHILDREN
POLICY NUMBER: 86
ORC REFERENCE: 5101:2-5-13(A)(17)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 6/1/03
DATE REVISED:
A
Synergy Family Foster Care, Inc. will assess the needs of the child being referred for placement and take
into consideration specific needs such as: mental health, physical health, education, transportation,
socialization, physical limitations, communication, and recreational.
B
Synergy Family Foster Care, Inc. will assess the abilities of the specialized foster caregiver to provide the
level of care needed for the child and their access to: mental and physical health facilities, special education
opportunities in the community, appropriate transportation, socialization opportunities in the surrounding
community, accessibility of the home for physical limitations of the child, ability to communicate
affectively with the child, and recreational opportunities in the community.
C
The parents must be able to meet or provide for the existing needs of the child and be able to adapt to any
future needs that may arise.
D
The information regarding the needs of the child will be gathered at the time of intake from the
recommending agency with the use of the agency intake packet and any other pertinent information given
by the recommending agency worker.
E
Synergy Family Foster Care, Inc. will take into consideration when placing a treatment or medically fragile
child in a specialized foster home the following information on the family: caregivers’ homestudy and
approval recommendation according to age, sex, and number of children, experience and specialized
training to meet the needs of a specific child, current placements, family dynamics, ability to meet respite
needs, ability to meet physical challenges and time constraints required for the child’s care and access to
community resources.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: BEHAVIOR INTERVENTION POLICY FOR TREATMENT AND/OR MEDICALLY FRAGILE
FOSTER CARE PROGRAM
POLICY NUMBER: 87
ORC REFERENCE: 5101:2-5-13(A)(23)
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 6/1/03
DATE REVISED:
A
Synergy Family Foster Care, Inc. will utilize behavior intervention procedures or a combination of
procedures to prevent harm to the child or others and excessive destruction to property.
B
Intervention will be at the least intrusive and least disruptive to the child. When opportunities permit
positive behavioral interventions will be used versus negative consequences or disciplinary actions taken.
Synergy Family Foster Care, Inc. does not permit or train on any type of physical restraint unless
recommended, trained and supervised by a counselor, therapist or treatment team.
C
Acceptable behavior intervention procedures will include: natural and logical consequences, positive
reinforcement, use of reward systems, redirection, give acceptable choices that the child can make, put in
situation that allows for successful behavior, removal from the situation or change of environment, timeout, limited isolation in appropriate location, loss of privileges, grounding, or extra assigned chores.
1
Natural and logical consequences are consequences that fit the punishment or are the result of the
action. Natural and logical consequences may be used at all age levels with children at an age
appropriate development. Children with limited or delayed development may require alternative
consequences based on their knowledge and abilities.
2
Positive reinforcement is giving praise or rewards for acceptable and expected behavior to
reinforce the behavior. The reward needs to be meaningful to the child to encourage continued
positive behavior. Verbal praise should be given immediately following the desired action.
Positive reinforcement may be used at all age and developmental levels. Positive reinforcement is
the highly recommended form of behavior intervention.
3
Reward systems are developed to track and praise or reward positive behavior. Children are able
to earn recognition and earned privileges through positive behavior and completion of chores.
The reward system is acceptable for all age levels based on age appropriate development.
Children with limited or delayed development may require alternative reward system based on
their knowledge and abilities.
4
Redirection is used to interrupt a negative behavior and introduce the acceptable behavior.
Redirection should clearly state the acceptable behavior that is being requested. Redirection can
be used at all age levels based on age appropriate development. Children with limited or delayed
development may require alternative redirection based on their knowledge and abilities.
5
Giving choices allows the child to gain control and choose between 2-3 acceptable actions that the
parent will allow and can follow through with. Parents need to be very clear in providing choices
and willing to accept the decision of the child. Giving choices may be used all ages levels based
on age appropriate development. Children with limited or delayed development may require
alternative choices based on their knowledge and abilities.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
6
Putting children in situations that they can succeed is setting the stage for the child to make
appropriate choices and situations for positive behavior. This can lead to children gaining control
over acceptable behavior and put in situations to practice the behavior. Putting children in
situations for success may be used all ages levels based on age appropriate development. Children
with limited or delayed development may require alternative situations for success based on their
knowledge and abilities.
7
Removal from the situation or change of environment is with use of all of the above listed
techniques with the parents intervening and making decisions for the child. This child is unable to
make the appropriate decision so the parent steps in and makes the decision for them. This may be
the only intervention needed or further consequences may be warranted based the severity of the
action. Removal from the situation or change of environment may be used all ages levels based
on age appropriate development. Children with limited or delayed development may require
alternative strategies based on their knowledge and abilities.
8
Time-out is removal from the action and placed in an area that is not pleasurable for the child, ex.
chair, stair step, bench, etc. Parents may place child in time-out for 1 minute of each year of the
child’s age. Time-out gives the child time to reflect on the unacceptable actions and calm down
and regain composure before retuning to normal activity. Time-outs may be used all ages levels
based on age appropriate development. Children with limited or delayed development may
require alternative time-outs or length of time in time-out based on their knowledge and abilities.
9
Limited isolation in appropriate location is removal from an activity and placed away from or in
designated area during the activity. This would not be used with children who may harm
themselves, others or destruction of property. Parents may place children in bedrooms or
designated spot away from the activity limiting their participation. This may be used in situations
where the child has lost the privilege to participate in a certain activity. Limited isolation in
appropriate location may be used all ages levels based on age appropriate development. Children
with limited or delayed development may require alternative isolation areas based on their
knowledge and abilities.
10
Loss of privileges, grounding and extra assigned chores is punishments utilized when other forms
of intervention are not affective. Parents may only use loss of privileges, grounding, and extra
assigned chores for a limited period of time for each separate incident. These forms of
intervention should be used after all other interventions have failed. Loss of privileges, grounding,
and extra assigned chores should only be used after conferring with a case manager for acceptance
of the appropriate punishment. Loss of privileges, grounding and extra assigned chores may be
used all ages levels based on age appropriate development. Children with limited or delayed
development may require alternative Loss of privileges, grounding and extra assigned chores
based on their knowledge and abilities.
a
Parents serving children who have medical, developmental and psychological
deficiencies will discuss the use of any restrictive behavior intervention prior to
implementation with the assigned case manager, county case worker and mental health
professionals.
D
Behavior intervention may not be used in cases where the intervention would be detrimental to the health
and welfare of the child as indicated by a counselor, therapist or treatment team.
E
Use of a behavior intervention to be used will take into consideration and be consistent with the child’s
needs and any disabilities of the child.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
F
A counselor, therapist or members of the treatment team will be involved in designing, approving and
implementing the behavior interventions. The treatment team supervisor will be responsible for monitoring
and supervising the implementation of the behavior interventions.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: NON-DISCRIMINATION REQUIREMENTS FOR FOSTER CARE PLACEMENTS
POLICY NUMBER: 88
ORC REFERENCE: 5101:2-4-18.1
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/05
DATE REVISED:
A
Synergy Family Foster Care, Inc. shall not deny any person the opportunity to become a foster caregiver on
the basis of race, color or national origin of that person, or of the child involved; nor shall Synergy Family
Foster Care delay or deny the placement of a child into foster care on the basis of race, color or national
origin of the foster caregiver or of the child involved.
B
The Multiethnic Placement Act of 1994 as amended by Section 1808 of the Small Business Job Protection
Act of 1996, 42 U.S.C. 622(b)(9), 671(a)(18), 674(d) and 1996(b) (hereinafter “MEPA”) and Title VI of
the Civil Rights Act of 1964, 42 U.S.C. 2000d, et seq. as they apply to the foster care process (hereinafter
“Title VI”), do not supercede the provisions of the Indian Child Welfare Act of 1978, 25 U.S.C.A. 1901 et
seq.
C
Synergy Family Foster Care shall not routinely consider race, color or national origin as a factor in
assessing the needs or best interests of children. In each case, the only consideration shall be the child’s
individual needs and the ability of the prospective foster caregiver to meet those needs.
D
Only the most compelling reasons may serve to justify the consideration of race, color or national origin as
part of a placement decision. Such reasons emerge only in the unique and individual circumstances of each
child and each prospective foster caregivers. In those exceptional circumstances when race, color or
national origin need to be taken into account in a placement decision, such consideration must be narrowly
tailored to advance the child’s best interests. Even when the facts of a particular case allow consideration
related to race, color or national origin, this consideration shall not be the sole determining factor in the
placement decision.
E
The following actions by Synergy Family Foster Care are permitted as it applies to the foster care process.
1
Asking about and honoring any initial or subsequent choices made by prospective foster
caregivers regarding what race, color or national origin of child the prospective foster caregivers
will accept.
2
Providing information and resources about fostering a child of another race, color or national
origin to prospective foster caregivers who request such information and making known to all
families that such information and resources are available.
3
Considering the race, color or national origin as a possible factor in the placement decision when
compelling reasons serve to justify that the race, color or national origin need to be a factor in the
placement decision pursuant to paragraph (G) of this rule. Even when the facts of a particular case
allow consideration related to the race, color or national origin, this consideration shall not be the
sole determining factor in the placement decision.
4
Promoting cultural awareness, including awareness of cultural and physical needs that may arise in
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
the care of children of different races, ethnicities and national origins as part of the training which
is required of all applicants who seek to become foster caregivers.
5
F
G
Documenting verbal comments, verbatim, or describing in detail any other indications made by a
prospective foster caregiver family member living in the household or any other person living in
the household reflecting a negative perspective regarding the race, color or national origin of a
child for whom the prospective foster family have expressed an interest in fostering or adopting.
The documentation shall indicate whether those comments were make before or after completion
of the cultural diversity training which is required for all foster care applicants. Documentation
shall be included in the family’s homestudy, update, or an addendum to the homestudy or update
prior to consideration of placement or a matching conference. For the purposes of this rule, a
matching conference is the process of determining the most appropriate foster care family for the
child based on the child’s special needs. The matching committee may consider the information in
determining if the placement is in the child’s best interests.
The following actions by Synergy Family Foster Care are prohibited as it applies to the foster care process:
1
Using the race, color or national origin of a prospective foster caregiver to differentiate between
foster care placements for a child, unless the procedures in paragraph (G) of this rule are followed.
2
Requiring a prospective family to prepare or accept a transracial foster care plan.
3
Using “culture” or “ethnicity” as a proxy for race, color or national origin.
4
Delaying or denying placement of a child based upon the geographical location of the
neighborhood of the prospective foster caregiver whenever geography is being used as a proxy for
the racial composition of the neighborhood, the demographics of the neighborhood, the presence
or lack of presence of a significant number of persons of a particular race, color or national origin
in the neighborhood or any similar purpose.
5
Requiring extra scrutiny, additional training, or greater cultural awareness of individuals who are
prospective foster caregivers of children of a different race, color or national origin required of
other prospective foster caregivers.
6
Relying upon general or stereotypical assumptions about the needs of children of particular race,
color or national origin.
7
Relying upon general or stereotypical assumptions about the ability of prospective foster
caregivers of a particular race, color or national origin to care for or nurture the sense of identity of
a child or another race, color or national origin.
8
“Steering” prospective foster caregivers away from parenting a child of another race, color or
national origin. “Steering” is any activity that attempts to discourage prospective foster caregivers
from parenting a child of a particular race, color or national origin.
When medical or psychological evaluations, school records, or other material documented in the file,
including statements made by the child to a caseworker, indicate that there may be compelling reasons to
consider needs the child may have regarding race, color, or national origin in the placement process, the
child shall be referred to a licensed child psychiatrist, licensed child psychologist, licensed independent
social worker or licensed professional clinical counselor for an assessment of whether the child has
individual needs involving race, color or national origin. At the time of the referral, the custodial agency
shall initiate and subsequently complete the JFS 01688 “Individualized Child Assessment” using the
following procedures:
1
Within ten days of the decision that a child should be assessed pursuant to paragraph (G) of this
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
rule, the caseworker shall complete “Section I” of the JFS 01688 and submit the HFS 01688 and
all relevant medical or psychological evaluations, school records, or other material documented in
the file to the caseworker’s supervisor and the agency’s MEPA monitor.
2
If both the supervisor and the MEPA monitor determine that the documented material contained in
the case file indicates that there may be compelling reasons to consider needs the child may have
regarding race, color or national origin in the placement process, the child shall be referred within
an additional ten days for an individual child assessment as indicated in paragraph (G) of this rule.
At the time of the referral, the agency shall send the licensed professional the original JFS 01688
and all relevant medical or psychological evaluations, school records, or other material
documented in the file. The licensed professional shall be requested in writing by the supervisor
to complete and sign “Section II” of the original JFS 01688 and return it within sixty days to the
agency with a copy of the requested assessment attached. The licensed professional shall be
requested to determine whether the child has needs involving race, color or national origin or any
other needs of a psychological or behavioral nature and, if so, to specify what those needs are and
how these needs may impact a potential foster placement.
3
No licensed professional may complete an assessment pursuant to paragraph (G) of this rule until
Synergy Family Foster Care has provided the licensed professional with the JFS 01607 “MEPA
Educational Materials.” The licensed professional conducting the assessment shall not be
employed by the custodial agency.
4
Synergy Family Foster Care shall obtain the professional’s signature on the JFS 01608 “Licensed
Professional’s Statement” acknowledge receipt of the educational material and the opportunity to
obtain technical assistance regarding the material. A copy of the signed JFS 01608 shall be
provided to ODJFS within ten days of receipt by Synergy Family Foster Care.
5
The JFS 01688 and the supporting materials shall be considered as part of the placement decision
process. Each completed JFS 01688 shall remain effective for twelve months from the date of the
final decision as documented on the JFS 01688.
6
A copy of each completed JFS 01688 and the assessment of the licensed professional shall be sent
to ODJFS within ten days of the date the agency received it.
H
The custodial agency shall maintain in the child’s case file the completed original JFS 01688 and all
medical or psychological evaluations, school records, or other material in the file.
I
For each child who has had a referral for an assessment regarding needs the child may have regarding race,
color or national origin, the custodial agency shall complete the JFS 01688 documenting the placement
decision-making process and final placement decision and submit it to ODJFS within ten days of the date
the agency completed the JFS 01688.
J
Synergy Family Foster Care shall not intimidate, threaten, coerce, or in any way discriminate or retaliate
against any person who has filed an oral or written complaint, testified, assisted, or participated in any
manner in the investigation of an alleged violation of MEPA and Title VI. This includes any potential or
actual adoptive or foster family, any Synergy Family Foster Care or any employee of any other agency with
responsibilities regarding the care or placement of a child in the temporary or permanent custody of
Synergy Family Foster Care, such as a guardian ad litem (GAL) or court appointed special advocate
(CASA) volunteer, Prohibited retaliatory conduct includes, but is not limited to, reduction in the amount of
foster care payments which a family should receive based on the child’s needs and unwarranted poor
evaluations of an employee by his or her supervisor.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: NON-DISCRIMINATION REQUIREMENTS FOR ADOPTIVE PLACEMENTS
POLICY NUMBER: 89
ORC REFERENCE: 5101:2-48-13
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/05
DATE REVISED:
A
Synergy Family Foster Care, Inc. shall not deny any person the opportunity to become a adoptive family on
the basis of race, color or national origin of that person, or of the child involved; nor shall Synergy Family
Foster Care delay or deny the placement of a child into foster care on the basis of race, color or national
origin of the adoptive family or of the child involved.
B
The Multiethnic Placement Act of 1994 as amended by Section 1808 of the Small Business Job Protection
Act of 1996, 42 U.S.C. 622(b)(9), 671(a)(18), 674(d) and 1996(b) (hereinafter “MEPA”) and Title VI of
the Civil Rights Act of 1964, 42 U.S.C. 2000d, et seq. as they apply to the foster care process (hereinafter
“Title VI”), do not supercede the provisions of the Indian Child Welfare Act of 1978, 25 U.S.C.A. 1901 et
seq.
C
Synergy Family Foster Care shall not routinely consider race, color or national origin as a factor in
assessing the needs or best interests of children. In each case, the only consideration shall be the child’s
individual needs and the ability of the prospective adoptive family to meet those needs.
D
Only the most compelling reasons may serve to justify the consideration of race, color or national origin as
part of a placement decision. Such reasons emerge only in the unique and individual circumstances of each
child and each prospective adoptive parents. In those exceptional circumstances when race, color or
national origin need to be taken into account in a placement decision, such consideration must be narrowly
tailored to advance the child’s best interests. Even when the facts of a particular case allow consideration
related to race, color or national origin, this consideration shall not be the sole determining factor in the
placement decision.
E
The following actions by Synergy Family Foster Care are permitted as it applies to the adoption process.
1
Asking about and honoring any initial or subsequent choices made by prospective foster
caregivers regarding what race, color or national origin of child the prospective adoptive parents
will accept.
2
Honoring the decision of a child over twelve years of age to not consent to an adoption when that
decision has been approved by a court pursuant to section 3107.06 of the Revised Code.
3
Providing information and resources about adopting a child of another race, color or national
origin to prospective adoptive parents who request such information and making known to all
families that such information and resources are available.
4
Considering the race, color or national origin as a possible factor in the placement decision when
compelling reasons serve to justify that the race, color or national origin need to be a factor in the
placement decision pursuant to paragraphs (I) and (J) of this rule. Even when the facts of a
particular case allow consideration related to the race, color or national origin, this consideration
shall not be the sole determining factor in the placement decision.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
F
G
5
Promoting cultural awareness, including awareness of cultural and physical needs that may arise in
the care of children of different races, ethnicities and national origins as part of the training which
is required of all applicants who seek to become adoptive parents.
6
Documenting verbal comments, verbatim, or describing in detail any other indications made by a
prospective adoptive family member living in the household or any other person living in the
household reflecting a negative perspective regarding the race, color or national origin of a child
for whom the prospective foster family have expressed an interest in adopting. The
documentation shall indicate whether those comments were make before or after completion of the
cultural diversity training which is required for all adoptive applicants. Documentation shall be
included in the family’s homestudy, update, or an addendum to the homestudy or update prior to
consideration of placement or a matching conference. For the purposes of this rule, a matching
conference is the process of determining the most appropriate adoptive family for the child based
on the child’s special needs. The matching committee may consider the information in
determining if the placement is in the child’s best interests.
The following actions by Synergy Family Foster Care are prohibited as it applies to the adoption process:
1
Using the race, color or national origin of a prospective adoptive family to differentiate between
adoptive placements for a child, unless the procedures in paragraph (I) of this rule are followed.
2
Requiring a prospective adoptive family to prepare or accept a transracial foster care plan.
3
Using “culture” or “ethnicity” as a proxy for race, color or national origin.
4
Delaying or denying placement of a child based upon the geographical location of the
neighborhood of the prospective adoptive family whenever geography is being used as a proxy for
the racial composition of the neighborhood, the demographics of the neighborhood, the presence
or lack of presence of a significant number of persons of a particular race, color or national origin
in the neighborhood or any similar purpose.
5
Requiring extra scrutiny, additional training, or greater cultural awareness of individuals who are
prospective adoptive parents of children of a different race, color or national origin required of
other prospective adoptive parents.
6
Relying upon general or stereotypical assumptions about the needs of children of particular race,
color or national origin.
7
Relying upon general or stereotypical assumptions about the ability of prospective adoptive
parents of a particular race, color or national origin to care for or nurture the sense of identity of a
child or another race, color or national origin.
8
“Steering” prospective adoptive parents away from parenting a child of another race, color or
national origin. “Steering” is any activity that attempts to discourage prospective adoptive parents
from parenting a child of a particular race, color or national origin.
When medical or psychological evaluations, school records, or other material documented in the file,
including statements made by the child to a caseworker, indicate that there may be compelling reasons to
consider needs the child may have regarding race, color, or national origin in the placement process, the
child shall be referred to a licensed child psychiatrist, licensed child psychologist, licensed independent
social worker or licensed professional clinical counselor for an assessment of whether the child has
individual needs involving race, color or national origin. At the time of the referral, the custodial agency
shall initiate and subsequently complete the JFS 01688 “Individualized Child Assessment” using the
following procedures:
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
1
Within ten days of the decision that a child should be assessed pursuant to paragraph (G) of this
rule, the caseworker shall complete “Section I” of the JFS 01688 and submit the HFS 01688 and
all relevant medical or psychological evaluations, school records, or other material documented in
the file to the caseworker’s supervisor and the agency’s MEPA monitor.
2
If both the supervisor and the MEPA monitor determine that the documented material contained in
the case file indicates that there may be compelling reasons to consider needs the child may have
regarding race, color or national origin in the placement process, the child shall be referred within
an additional ten days for an individual child assessment as indicated in paragraph (G) of this rule.
At the time of the referral, the agency shall send the licensed professional the original JFS 01688
and all relevant medical or psychological evaluations, school records, or other material
documented in the file. The licensed professional shall be requested in writing by the supervisor
to complete and sign “Section II” of the original JFS 01688 and return it within sixty days to the
agency with a copy of the requested assessment attached. The licensed professional shall be
requested to determine whether the child has needs involving race, color or national origin or any
other needs of a psychological or behavioral nature and, if so, to specify what those needs are and
how these needs may impact a potential adoptive placement.
3
No licensed professional may complete an assessment pursuant to paragraph (I) of this rule until
Synergy Family Foster Care has provided the licensed professional with the JFS 01607 “MEPA
Educational Materials.” The licensed professional conducting the assessment shall not be
employed by the custodial agency.
4
Synergy Family Foster Care shall obtain the professional’s signature on the JFS 01608 “Licensed
Professional’s Statement” acknowledge receipt of the educational material and the opportunity to
obtain technical assistance regarding the material. A copy of the signed JFS 01608 shall be
provided to ODJFS within ten days of receipt by Synergy Family Foster Care.
5
The JFS 01688 and the supporting materials shall be considered as part of the placement decision
process at each matching conference in which the child is considered for a match with a family.
Each completed JFS 01688 shall remain effective for twelve months from the date of the final
decision as documented on the JFS 01688. Documentation of how race, color or national origin
impacted the placement decision shall be documented on the JFS 01689 “Documentation of the
Placement Decision-Making Process” pursuant to rule 5101:2-48-16 of the Administrative Code.
6
A copy of each completed JFS 01688 and the assessment of the licensed professional shall be sent
to ODJFS within ten days of the date the agency received it.
H
The custodial agency shall maintain in the child’s case file the completed original JFS 01688 and all
medical or psychological evaluations, school records, or other material in the file.
I
Synergy Family Foster Care shall not intimidate, threaten, coerce, or in any way discriminate or retaliate
against any person who has filed an oral or written complaint, testified, assisted, or participated in any
manner in the investigation of an alleged violation of MEPA and Title VI. This includes any potential or
actual adoptive or foster family, any Synergy Family Foster Care or any employee of any other agency with
responsibilities regarding the care or placement of a child in the temporary or permanent custody of
Synergy Family Foster Care, such as a guardian ad litem (GAL) or court appointed special advocate
(CASA) volunteer, Prohibited retaliatory conduct includes, but is not limited to, reduction in the size of an
adoption subsidy which a family should receive based on the child’s needs, and unwarranted poor
evaluations of an employee by his or her supervisor.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: PROCEDURES FOR COMPLAINTS OF ALLEGED DISCRIMINATORY ACTS, POLICIES OR
PRACTICES IN THE FOSTER CARE OR ADOPTION PROCESS THAT INVOLVE RACE,
COLOR OR NATIONAL ORIGIN.
POLICY NUMBER: 90
ORC REFERENCE: 5101:2-33-03
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 1/1/05
DATE REVISED:
A
Synergy Family Foster Care, Inc. shall provide a written notice of the procedures for any complaints of
discrimination in the foster care or adoption process that involve race, color or national origin to all
individuals inquiring about or applying to be a foster caregiver or adoptive parent. Such notice shall be
provided within seven days of the individual’s first contact with the agency.
B
Any individual may file a complaint alleging a discriminatory act, policy or practice involving race, color
or national origin in the foster care or adoption process of a PCSA, PCPA, PNA or ODJFS.
Any person, including but not limited to, an employee or former employee of a PCSA, PCPA or PNA or a
member of a family which has sought to become a foster caregiver or adoptive parent, may also file a
complaint alleging that he or she was intimidated, threatened, coerced, discriminated against or otherwise
retaliated against in some was by a PCSA, PCPA, PNA or by ODJFS because he or she has made a
complaint, testified, assisted, or participated in any manner in an investigation, proceeding, or hearing in
connection with an allegation that a PCSA, PCPA, PNA or ODJFS engaged in discriminatory acts, policies,
or practices as it applies in the foster care or adoption process.
C
D
E
The individual filing a complaint shall use the JFS 02333 “Discrimination Complaint Form.” The
complaint shall be filed within two years from the date of the occurrence of the alleged discriminatory act;
or two years from the date upon which the complainant learned or should have known of a discriminatory
act, policy or practice. The complaint may be filed with:
1
Any PCSA, PCPA or PNA; or
2
The ODJFS
When any complaint alleging discrimination involving race, color or national origin in the foster care or
adoption process is received by:
1
Synergy Family Foster Care shall forward the complaint to ODJFS within three working days of
date of receipt of the complaint.
2
ODJFS shall notify the PCSA, PCPA or PNA that is the subject of the complaint within three
working days of the receipt of the complaint.
ODJFS shall conduct an investigation of the complaint. The PCSA, PCPA or PNA that is the subject of the
complaint shall not initiate, conduct, or run concurrent investigations surrounding the complaint or take any
further action regarding the complainant or the subject of the complaint until the issuance of the final
investigation report by ODJFS, unless approved by ODJFS.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
F
The PCSA, PCPA or PNA that is the subject of the complaint shall cooperate fully with ODJFS during the
course of the investigation and shall submit any information requested by ODJFS not later than fourteen
days from the date of the request unless otherwise agreed upon.
G
ODJFS shall conduct an investigation that shall include, but is not limited to:
1
Face-to-face interviews with the complainant, the respondent and all relevant witnesses.
2
Issuance of a final investigation report to the complainant and the PCSA, PCPA or PNA that is the
subject of the complaint. The report shall include the allegations, background information,
analysis, determination and recommendations and shall be issued within ninety days of the receipt
of the initial complaint.
If unanticipated circumstances require additional time to complete the investigation or to issue the
final report, ODJFS will notify the complainant and the PCSA, PCPA or PNA that is the subject of
the complaint of the need for additional time.
H
Upon completion of the final investigation report, ODJFS shall determine if any action against Synergy
Family Foster Care is warranted. For noncompliance by Synergy Family Foster Care, ODJFS may take
action concerning the agency’s certificate pursuant to Chapter 5101:2-5 of the Administrative Code.
I
No person who has filed a complaint alleging a discriminatory act, policy or practice involving race, color
or national origin in the foster care or adoption process of Synergy Family Foster Care or who has testified,
assisted or participated in any manner in the investigation of a complaint shall be intimidated, threatened,
coerced, or retaliated against by any employee or contractor of Synergy Family Foster Care or ODJFS.
J
Nothing in this rule or in an agency’s policy shall prohibit an individual from filing a complaint with the
United States Department of Health and Hyman Services (HHS), office for civil rights (OCR) alleging
discrimination that involves race, color or national origin in the foster care or adoption process of Synergy
Family Foster Care or ODJFS.
K
The requirements of rules 5101:2-33-04 and 5101:2-48-24 of the Administrative Code do not apply to
complaints of discrimination in the foster care or adoption process that involve race, color or national
origin.
L
Synergy Family Foster Care shall provide written notice of the procedures for any complaints of
discrimination in the foster care or adoption process that involve race, color or national origin within thirty
days of the effective date to all foster caregivers certified or in the process of certification and to all
individuals who have approved adoptive homestudies or who are participating in the adoptive homestudy
process on the effective date of this rule.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: ADOPTION ADMINISTRATIVE FALSIFICATION PROCEDURES
POLICY NUMBER: 91
ORC REFERENCE: 5101:2-33-13
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 3/1/07
DATE REVISED:
A
Synergy Family Foster Care, Inc. upon an internal investigation shall refer all cases to the county
prosecutor in which there is probable cause to believe that falsification of an adoptive application or home
study has been committed under section 2921.13 of the Revised Code.
B
The assessor of Synergy Family Foster Care shall report in writing a person who knowingly makes a false
statement on an application or home study document during the home study process to the agency
administrator within three days of the assessor’s determination of possible falsification. The written
statement shall include, but is not limited to:
C
1
The original application completed by the applicant.
2
Documentation verifying the information reported on the application or in the home study by the
applicant is knowingly false.
Synergy Family Foster Care shall within fourteen days of the determination of falsification, send a
notification letter to the applicant indicating that the information submitted to the agency had been
determined to be knowingly false. The notice shall include procedures for an agency review and shall
include all of the following information:
1
Date notification letter is prepared by the assessor.
2
Mailing address of the applicant(s).
3
A statement indicating the home study process will discontinue because the agency has probable
cause to believe the information provided by the applicant on the JFS 01691, “Application for the
Placement of a Child” or during the home study process is knowingly false.
4
A copy of the information that is alleged knowingly false.
5
Documentation verifying the information submitted on the JFS 01691 or during the home study
process that is knowingly false.
6
A statement indicating that all cases in which it is determined by the agency the applicant made
knowingly false statements will be referred to the county prosecutor office in the county the
applicant(s) reside.
7
The applicant(s) right to an agency review to respond to the alleged falsification.
8
A statement indicating that if the applicant(s) fails to respond within the fourteen day period the
applicant(s) application is withdrawn, and the action of refusing to respond to allegations of
knowingly making false statement(s) has resulted in the applicant(s) selecting themselves out of
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
continuing the home study process.
9
D
Notification letter shall be mailed to the applicant by certified mail.
If the applicant responds within fourteen days of the date of receipt of the written notice alleging
falsification, the agency is responsible for reviewing information received form the adoptive applicant
within twenty-one days of receipt of the applicant(s) response. Synergy Family Foster Care shall conduct
an internal investigation that shall include but not limited to:
1
Face-to-face visit with the adoptive applicant, and all relevant witnesses, if available.
2
Issuance of a final investigatory report to the adoptive applicant(s) that is the subject of the
investigation. The report shall include the allegations, relevant background information deemed
appropriate by the agency, the results of the investigation and recommendation of whether or not
the agency found probable cause to indicate the applicant(s) made knowingly false statements on
the application for child placement or during the home study process. Synergy Family Foster Care
shall notify the applicant(s) no later than ten days after the agency review.
3
If unanticipated circumstances require additional time to complete the investigation or to issue the
final report, Synergy Family Foster Care shall notify the adoptive applicant that is the subject of
the investigation of the need for additional time. The extension shall not be longer than fourteen
days after the agency notifies the applicant(s) of the need for additional time to complete the
investigatory report.
E
Synergy Family Foster Care shall provide written notification, within thirty days, to the adoptive applicant
of any action to be taken.
F
Upon completion of the final investigation report and the agency determines there has been no falsification
made by the applicant(s), Synergy Family Foster Care shall resume the home study process if the
applicant(s) chooses to proceed. The home study shall be completed within one hundred eighty days from
re-commencement.
G
Synergy Family Foster Care shall include in the adoptive family case record all documentation which
supports the agency’s action in determining the results and recommendation of the internal investigation.
H
When an adoptive child is placed in an approved adoptive parent(s) home and the adoptive parent(s) or
other household member(s) knowingly made a false statement that results in the assessor’s reassessment of
an approved or updated home study, the prospective adoptive parent(s) or other household member(s) is
guilty of the offense of falsification under section 2921.13 of the Revised Code. The assessor shall report
incidents of falsification according to the procedures pursuant to paragraphs (B), (C) (1) to (C) (7), (E), (F)
and (G) of this rule.
I
Synergy Family Foster Care’s administrator must determine in twenty-four hours of completing the
agency’s internal investigation, if there is probable cause related to the adoptive child’s safety and wellbeing to remove the child from the adoptive parent(s) home until the result of an investigation is rendered.
J
Synergy Family Foster Care shall notify the recommending agency when an adoptive child is placed in an
approved adoptive parent(s) home and the adoptive parent(s) or other household member(s) knowingly
make a false statement that results in the assessor’s reassessment of an approved or updated home study
and an internal investigation determines the adoptive parent(s) or other household member(s) is guilty of
the offense of falsification under section 2921.13 of the Revised Code.
1
The assessor shall report incidents of falsification according to procedures outlined in this rule.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: DISASTER PREPAREDNESS PLAN
POLICY NUMBER: 92
ORC REFERENCE: 5101:2-5-13.1
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 9-25-08
A
DATE REVISED:
Synergy Family Foster Care, Inc will implement this plan in the event of a natural or man-made disaster
that would compromise the care and services that we provide to our children in care. This will also discuss
what would be done in the event that the building that the agency resides in is damaged as a result of such
disaster and how Synergy Family Foster Care Inc. will maintain services to our children and families.
1
Synergy Family Foster Care Inc. feels that all members of the staff are essential in regards to the
operation of the agency. Due to our size we feel that all staff members would be able to help out
in the event of a disaster and perform the duties that are needed to reestablished services to our
clients.
2
At the time of any disaster that would make the current work space uninhabitable we would utilize
our own homes as a work location on a temporary basis. We would then assess the current space
to see if it is salvageable and make any needed decisions regarding a new work location.
3
Synergy Family Foster Care Inc. utilizes a voice mail and on call system that is portable and can
be moved if something happens to the physical location of the agency. The phone system will be
moved and relocated to maintain voice mail and on call functions if it is not damaged during the
disaster. We would also utilize cell phones and email if available to inform staff of the current
situation of the business. In the event that this is not available staff and foster caregivers will be
instructed to check local radio and newspapers for information regarding the status of the agency.
In the event that phone service is up and working all staff and foster caregivers will be notified by
phone on the status of the agency and what steps they need to take to make sure care is provided to
the children in care. Lastly, if it is safe to do so staff that are able may make contact with foster
caregivers by driving to their homes. We would also be in contact with any and all custodial
agency to let them know of the situation with the agency and how we may be contacted in the near
future and what plans the agency has to get things running normally.
4
Synergy Family Foster Care Inc. will continue to make necessary contact with foster caregivers
and the children in the homes at the time of a disaster. Visits to the home will also be continued as
long as it does not put the agency staff in any danger or compromise their safety. We would also
contact any and all custodial agencies and work in collaboration with them to make sure the
services are provided to foster caregivers and the children in their care.
5
Synergy Family Foster Care Inc. will utilize the above mentioned forms of communication to
speak with foster caregivers and make sure the services to the children in their care are not
compromised. Staff will coordinate with one another to make sure that all families are contacted
and no one is left out or forgotten. We will utilize our agency directory to make sure all families
are accounted. If any foster home is damaged and unable to safely house a child we will help the
families locate to an alternative place to stay or try to move children to a safer environment. We
will make all attempts to make sure that foster families are safe and the children in their homes are
being cared for.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
6
Synergy Family Foster Care will continue all services that we currently provide to children as long
as it does not place staff at risk by putting them in an unsafe environment. Synergy Family Foster
Care Inc. will do all it can to get things back to normal after any disaster in order to maintain
continuity.
7
All family and children files are kept in a filing cabinet on the premises of Synergy Family Foster
Care Inc. All agency forms, foster caregiver records, financial records, child records that are on
our computer system will be backed up monthly with a thumb drive and then placed in a fire safe
box at the agency. This would help minimize the total destruction of records at the time of a
disaster. Also the utilization of SACWIS would help in the event of a disaster where needed
records or files were destroyed in a disaster.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
TITLE: PNA CASE PLANS AND ADMINISTRATIVE CASE REVIEWS FOR DIRECT PLACEMENTS
POLICY NUMBER: 93
ORC REFERENCE:
DEVELOPED BY: Tom Stetzer, LSW
REVIEWED BY: Synergy Board of Trustees
DATE DEVELOPED: 4/1/12
DATE REVISED:
A
Synergy Family Foster Care which accepts a direct placement of a child from a parent, guardian or
custodian, shall develop and prepare a case plan within thirty days from the date of placement on the child
and family which shall be a separate part of the case record. If the child is placed for less than thirty
consecutive days, a case plan is not required.
B
Synergy Family Foster Care shall develop, review or amend the case plan only with the participation of the
child’s parent, guardian or custodian. A case plan or amendment to the case plan shall be signed by the
child’s parent, guardian or custodian. A copy of the signed case plan or any amendment to the case plan
shall be provided to the child’s parent, guardian or custodian.
C
Synergy Family Foster Care which has accepted a direct placement of a child shall complete an
administrative review of the case plan no later than six months after the date of placement.
D
After the first administrative review, Synergy Family Foster Care shall continue to conduct administrative
reviews every six months.
E
Each administrative review required for a child in a direct placement shall comply with the following
requirements:
1
2
The administrative review shall be conducted by a review panel of at least three persons. The
review panel shall include at a minimum:
a
A case worker with day-to-day responsibility for, or familiarity with the management of
the child’s case plan; and
b
A person who is not responsible for the management of the child’s case plan, or the
delivery of services to the child or his parent, guardian, or other individual holding
custody of the child.
The administrative review shall include a joint meeting by the review panel with:
a
The child if age appropriate,
b
The child’s parent, guardian, or custodian,
c
The child’s substitute caregiver,
d
Any other person the agency deems appropriate.
SYNERGY FAMILY FOSTER CARE, INC.
POLICY AND PROCEDURES
3
All persons shall be given the opportunity to submit any written materials to be included in the
child’s case record. If a parent, guardian, custodian or substitute caregiver declines to participate
in the administrative review after being contacted, Synergy Family Foster Care does not have to
include then in the joint meeting.
4
The administrative review shall be summarized in writing by Synergy Family Foster Care to
include all of the following:
a
A conclusion regarding the appropriateness of the child’s placement;
b
The extent of compliance by all parties with the case plan;
c
The extent of progress made toward alleviating the circumstances that precipitated the
parent, guardian or custodian to enter into a direct placement agreement with the agency;
d
An estimated date by which the child may be returned home, placed with a relative or
other suitable nonrelative or prepared for independent living;
e
An explanation regarding any changes that Synergy Family Foster Care is proposing in
the case plan; and
f
The names of all persons who participated in the administrative review.