2. Driver’s License

3. Social Security Card

4. Background Check (includes FBI fingerprint verification)

5. Request for Criminal History (both c and b are the same form. After completing the form, return to Jonathan’s Place. The next steps will be taken from there.)

6. Authorization for Release of Information

7. Affidavit (Please note, the affidavit will need to be notarized.)

8. Personal References (3 for each person; may submit 3 that are for both parents. Please use the form from Jonathan’s Place.)

9. Medical Clearance Form/Letter

10. Medical History Form

11. TB Test Result (both items j and k can be done at your choice of place. The specification need for the drug test is called a, “pre-employment drug test.”

12. Drug Test Result

13. Birth Certificate (required for any parent who wants to adopt)

14. Other Household Members

15. Driver’s License

16. Social Security Card

17. Background Check (age 14 +)

18. Request for Criminal History (age 14 +)

19. Authorization for Release of Information (age 14 +)

20. Affidavit

21. Medical Clearance Form/Letter

22. Medical History Form

23. TB Test Result

24. Drug Test (age 18 +)

25. Home Study Information

26. Home Study

27. Addendums (when changes are made to the household)

28. Application

29. Questionnaire (There are several questionnaire forms. You will need to find the form suited best for your situation. For example, “single-male” or “single-female” or “joint” (referring to a married couple.”

30. Sensitive Subjects

31. Child’s View (to be completed for each of the family’s existing children. This form is titled “Home Study Questionnaire Child Information.”)

32. Letter to potential foster/adopt child AND a letter to potential foster/adopt child’s parents

33. House Rules

34. Marriage License

35. Divorce Decree

36. 2 years of Tax Returns

37. 2 years of W-2 forms

38. Credit Report (no more than 90 days old at the time it is submitted to agency)

39. Physical Plant

40. Auto Insurance

41. Homeowner’s/Renter’s Insurance

42. Record of Response for Inspection Requests (recorded on Inspection Forms)

43. Fire Inspection (Both items d and e are located on one form. You must make the contact and document on the form the result of your contacts, even if the fire and/or health requests a call/verification from Jonathan’s Place. After you have recorded the result of your efforts of contacting the fire and health inspectors, and/or have completed both inspections, item d has also been completed.)

44. Health Inspection

45. Pet Vaccinations

46. Site Pictures (one of family in front of home/one of back yard/pictures of any driveways, fences, storage areas, gardens, recreation areas, pools, ponds or other bodies of water)

47. Floor Plan (must include dimensions and purposes of all rooms; must clearly identify which bedroom(s) will be used for the foster/adopt child’s bedroom; must clearly identify indoor area space where child will be allowed to play – e.g., family room)

48. Disaster and Evacuation Plan (form plus additional floor plan with all items from Disaster and Evacuation plan clearly marked.)

49. Verification Documentation

50. Foster Family Agreement Form (signed with the agency at the time of verification)

51. Basic Rights & Reporting

52. Behavior Management Form

53. Client’s Rights Form

54. Code of Ethics Form

55. Confidentiality Form

56. Disaster Plan Form

57. Fee & Rate Form

58. Roles & Responsibilities Form

59. Transportation Form

60. Policy & Procedures Form

61. Training Certificates

62. Orientation

63. PRIDE

64. EBI

65. Common Sense Parenting

66. Medication Training

67. CPR and First Aid Certificate (copy of front AND back of card)

68. Record of 40 hours of Supervised Observation training with children

69. Other Training (please include any additional training certificates you have completed within the past year or unexpired certifications/licenses.)Legend: _______ =Forms/documents that are provided by Jonathan’s Place which must be completed, submitted and reviewed before Foster Parent(s) Pre-Service Training begins. _______ = Forms/documents not provided by Jonathan’s Place which must be completed, submitted and reviewed before Foster Parent(s) Pre-Service Training begins. _______ = To be completed during Pre-Service Training or before licensing. Next Pre-Service Training begins September 12, 2009.