Concurrent Planning

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					                                                         Concurrent Planning
                                                       Date of Removal to 30 Days


Names of Parents:                                                                   Date of Removal:

Names and Dates of Birth of Children:



Social Worker:                                                                      Date of Review:


Full Disclosure                                                  Notes                     Paternity

1. In the last 22 months, how long has each        ________________________________        1. Have the following fathers been identified for
child been in foster care?                                                                 each child?
                                                   ________________________________            Man listed on the birth certificate
                                                                                               Man listed on the Putative Father
2. Which family members have received full         ________________________________        registry
disclosure regarding ASFA timeframes?                                                          Man who acknowledges paternity
    Mother                All fathers              ________________________________            Man adjudicated as the biological father
    Maternal              Paternal                                                             Man living with the birth mother who
    Grandparents          Grandparents             ________________________________        identifies himself as the father
    Mother’s siblings     Father’s siblings                                                    Spouse of the birth mother at the time of the
    Child(ren)            Other family             ________________________________        conception and/or birth of the child
    Other (specify)       supports                                                             Father identified in a child support order
                                                   ________________________________            Man identified by the mother as the child’s
                                                                                           father
3. How has full disclosure been documented?        ________________________________
                                                                                           2. Has a referral been made to the Parent
                                                   ________________________________        Locator Service for absent parents?
4. Have all resource parents received adequate                                                Yes              No
information to keep each child safe and meet his   ________________________________           N/A (no absent parents)
or her needs?
    Yes            No                              ________________________________

                                                   ________________________________


                                                                                                                                          1
Family Engagement/Case Planning                                 Notes                 Relatives

1. Was Family Group Decision Making                ________________________________   1. Has a genogram been completed with the
utilized?                                                                             family?
    Yes          No                                ________________________________      Yes            No

                                                   ________________________________
Contacts/Visitation                                                                   2. Has an ecomap been completed with the
                                                   ________________________________   family?
1. Has an adequate visitation schedule been                                              Yes            No
established with all parents (see standard for     ________________________________
minimums)?
    Yes              No                            ________________________________   3. Which maternal and paternal relatives and
                                                                                      fictive kin have been contacted about their
                                                   ________________________________   willingness to be a resource for placement or
2. Has visitation been arranged with maternal                                         other support?
and paternal relatives?                            ________________________________
    Yes             No                                                                4. Does a Parent Locater Service referral need
                                                   ________________________________   to be made to locate relatives?
                                                                                          Yes             No
3. Has visitation been arranged between siblings   ________________________________
who are not placed together?
    Yes             No              N/A            ________________________________   Assessment/Services

A. If no, explain why.                             ________________________________   1. What poor prognosis and strength indicators
                                                                                      have been identified for the family?
                                                   ________________________________
                                                                                      2. Has the Child and Family Social and Medical
                                                   ________________________________   Information Form been completed for each
                                                                                      child?
                                                   ________________________________       Yes            No

                                                   ________________________________   3. What reasonable efforts have been made to
                                                                                      prevent removal?
                                                   ________________________________
                                                                                      4. How have these efforts been documented?
                                                   ________________________________

                                                   ________________________________

                                                                                                                                       2
Placement                                                        Notes
                                                   ________________________________
1. Where is each child placed?
      Relative foster home with potential for      ________________________________
      permanency
      Non-relative foster home with potential      ________________________________
      for permanency
      Relative, temporary foster home              ________________________________
      Non-relative, temporary foster
      home                                         ________________________________
      Other (specify)
                                                   ________________________________

2. Which siblings are placed together?             ________________________________

3. If all siblings are not placed together, what   ________________________________
efforts are being made to place them together?
                                                   ________________________________
4. Has an ICPC been initiated for prospective
relative placements?                               ________________________________

   Yes              No               N/A           ________________________________

5. Has an ICPC Regulation 7 been considered?       ________________________________
   Yes           No
                                                   ________________________________

                                                   ________________________________

                                                   ________________________________

                                                   ________________________________

                                                   ________________________________

                                                   ________________________________

                                                   ________________________________


                                                                                      3
                                                       Date of Removal to 30 Days

Names of Parents:                                                                   Date of Removal:

Names and Dates of Birth of Children:



Social Worker:                                                                      Date of Review:


ICWA                                                             Notes                     D. Has response been received from all tribes
                                                   ________________________________        and/or BIA with tribal membership status?
1. Have inquiries been made to all parents and                                                Yes             No
extended family members to ascertain if there is   ________________________________
Indian ancestry for the child(ren)?                                                        3. If the child(ren) is Indian, are they placed
    Yes              No                            ________________________________        according to ICWA placement preferences?
                                                                                              Yes               No
                                                   ________________________________
2. Does the child(ren) have Indian ancestry?                                               4. If the child(ren) is Indian, did an expert
    Yes             No                             ________________________________        witness testify at the adjudicatory hearing?
                                                                                              Yes               No
 If yes, have the following tasks been             ________________________________
completed?
                                                   ________________________________
A. Biological parent(s) or family member
completed the Indian Status Information form.      ________________________________
   Yes             No
                                                   ________________________________
B. Biological parent(s) or family member
completed the Ancestry form                        ________________________________
   Yes             No
                                                   ________________________________
C. Tribal membership inquiry sent to all tribes
and/or BIA                                         ________________________________
   Yes            No
                                                   ________________________________

                                                   ________________________________

                                                                                                                                             4
    Concurrent Planning – Additional Notes
         Date of Removal to 30 Days

_




                                             5
                                                         Concurrent Planning
                                                            1 to 3 Months


Names of Parents:                                                              Date of Removal:

Names and Dates of Birth of Children:



Social Worker:                                                                 Date of Review:



Have all prior concurrent planning action                      Notes                  Family Engagement/Case Planning
steps been resolved?
   Yes             No                             ________________________________    1. Which family members were engaged in the
                                                                                      development of the family’s case plan?
Full Disclosure                                   ________________________________       Mother                  All fathers
                                                                                         Maternal                Paternal
1. Have the parents, relatives and child(ren)     ________________________________       Grandparents            Grandparents
been informed of both the primary and                                                    Mother’s siblings       Father’s siblings
secondary permanent plans?                        ________________________________       Child(ren)              Other family
   Yes             No                                                                    Tribe                   supports
                                                  ________________________________       Other (specify)

2. Have all resources parents received adequate   ________________________________
information to make an informed decision in                                           2. Is the case plan written in measurable terms
supporting each child in his or her permanency    ________________________________    so it is evident when safety threats have been
plan?                                                                                 reduced?
    Yes            No                             ________________________________        Yes             No

                                                  ________________________________

Paternity                                         ________________________________

1. Have all absent parents been located?          ________________________________
   Yes              No
                                                  ________________________________

                                                                                                                                        6
Contacts/Visitation                                           Notes                 Relatives

1. Has the social worker had adequate contact    ________________________________   1. Have diligent and continuous efforts been
with the parents to support them in moving                                          made to locate relatives?
forward with their case plan?                    ________________________________      Yes              No
   Yes               No
                                                 ________________________________
                                                                                    2. How have these efforts been documented?
2. Are those contacts adequately documented in   ________________________________
FOCUS?
   Yes             No                            ________________________________   3. Have any additional relatives been identified?
                                                                                        Yes            No
                                                 ________________________________
3. Has the social worker had monthly face to
face contact with each child?                    ________________________________   4. Has an ICPC been initiated for out of state
   Yes              No                                                              relatives?
                                                 ________________________________        Yes          No

4. Are those contacts adequately documented in   ________________________________
FOCUS?                                                                              Assessment/Services
   Yes             No                            ________________________________
                                                                                    1. Have the needs for all parents been assessed
                                                 ________________________________   and referrals made for services?
5. Is visitation between the mother and the                                            Yes              No
child(ren) occurring per the standard?           ________________________________
    Yes              No
                                                 ________________________________   2. Have the needs of each child been assessed
                                                                                    and referrals made for services?
6. Is visitation between the father(s) and the   ________________________________      Yes              No
child(ren) occurring per the standard?
    Yes              No                          ________________________________
                                                                                    3. What has been started for each child’s Life
                                                 ________________________________   Book?
7. Do any barriers to visitation exist?
   Yes              No                           ________________________________

8. Are any changes to the visitation plan        ________________________________
needed?
   Yes            No                             ________________________________

                                                                                                                                      7
Placement                                                       Notes                 Court

1. Mark each child’s primary permanency plan       ________________________________   1. If there was a judicial finding of aggravated
with a 1 and secondary plan with a 2:                                                 circumstances, did a permanency hearing take
        Return Home                                ________________________________   place within 30 days?
        Permanent placement with other parent                                             Yes              No
        Adoption by Relative                       ________________________________
        Adoption by Non-Relative
        Guardianship with Relative                 ________________________________
        Guardianship with Non-Relative
        Other Planned Permanent Living             ________________________________
        Arrangement
                                                   ________________________________

2. Are these the same permanency goals             ________________________________
contained in FOCUS and on the most recent
Alternate Care Plan?                               ________________________________
   Yes             No
                                                   ________________________________

3. Is each child in a potentially permanent        ________________________________
placement?
    Yes              No                            ________________________________

                                                   ________________________________
A. If no, what needs to happen in order for each
child to be in a concurrent planning placement?    ________________________________

                                                   ________________________________

                                                   ________________________________

                                                   ________________________________

                                                   ________________________________

                                                   ________________________________

                                                   ________________________________

                                                                                                                                         8
                                                               1 to 3 Months

Names of Parents:                                                                 Date of Removal:

Names and Dates of Birth of Children:



Social Worker:                                                                    Date of Review:


ICWA                                                              Notes

1. If the child(ren) is Indian, has the tribe been   ________________________________
invited to participate in case planning and kept
apprised of what is happening in the case?           ________________________________
    Yes               No                N/A
                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________


                                                                                                     9
Concurrent Planning – Additional Notes
            1 to 3 Months




                                         10
                                                          Concurrent Planning
                                                             3 to 6 Months

Names of Parents:                                                               Date of Removal:

Names and Dates of Birth of Children:



Social Worker:                                                                  Date of Review:


Have all prior concurrent planning action                       Notes                  Family Engagement/Case Planning
steps been resolved?
   Yes             No                              ________________________________    1. Have the original safety issues been reduced
                                                                                       to a sufficient level so it is probable each child
Full Disclosure                                    ________________________________    can be safe with the parent or caregiver?

1. Have case plan progress and permanent           ________________________________    2. Have the parents made adequate progress on
placement options been discussed with all of the                                       their case plan to retain reunification as the
following:                                         ________________________________    primary permanency goal?
     Mother                 Father(s)                                                      Yes               No
     Child(ren)             Relatives              ________________________________
     Resource families                                                                 A. If no, has voluntary relinquishment of
                                                   ________________________________    parental rights been discussed with the parents?
2. Have all resources parents received adequate                                            Yes              No
information to make an informed decision in        ________________________________
supporting each child in his or her permanency                                         3. Will the parents be able to achieve
plan?                                              ________________________________    reunification by 12 months?
    Yes            No                                                                      Yes              No
                                                   ________________________________
                                                                                       A. If no, what are the barriers to success?
Paternity                                          ________________________________
                                                                                       4. Does the case plan need to be revised before
1. Have all paternity issues been resolved?        ________________________________    the next court review?
    Yes              No                                                                    Yes              No
                                                   ________________________________
                                                                                       5. What additional safety issues been identified
                                                                                       since the case has been opened?
                                                                                                                                       11
Contacts/Visitation                                           Notes                 Relatives

1. Has the social worker had adequate contact    ________________________________   1. Have any additional relatives been identified?
with the parents to support them in moving                                             Yes             No
forward with their case plan?                    ________________________________
   Yes               No
                                                 ________________________________   2. If ICPC home study results have not been
                                                                                    received, has assistance been requested from the
2. Are those contacts adequately documented in   ________________________________   Idaho ICPC Administrator to access home study
FOCUS?                                                                              results and placement recommendations?
   Yes             No                            ________________________________      Yes               No

                                                 ________________________________
3. Has the social worker had monthly face to                                        3. ICPC placement authorizations remain valid
face contact with each child?                    ________________________________   for six months. Has a request for renewal or
   Yes              No                                                              assistance been made through Idaho’s ICPC
                                                 ________________________________   Administrator to make sure all ICPC placement
                                                                                    authorizations remain current?
4. Are those contacts adequately documented in   ________________________________       Yes            No
FOCUS?                                                                                   N/A (no ICPC renewals needed)
   Yes             No                            ________________________________

                                                 ________________________________
5. Is visitation between the mother and the
child(ren) occurring per the standard?           ________________________________
    Yes              No
                                                 ________________________________
6. Is visitation between the father(s) and the
child(ren) occurring per the standard?           ________________________________
    Yes              No
                                                 ________________________________
7. Do any barriers to visitation exist?
   Yes              No                           ________________________________

8. Are any changes to the visitation plan        ________________________________
needed?
   Yes            No                             ________________________________



                                                                                                                                  12
Assessment/Services                                              Notes                 Placement

1. Has information been collected from all          ________________________________   1. Is each child in a potential permanent
service providers regarding the family’s progress                                      placement?
toward achieving case plan goals?                   ________________________________      Yes               No
   Yes              No
                                                    ________________________________
                                                                                       A. If yes, has the family been referred for an
2. Have services been appropriate or helpful to     ________________________________   updated PRIDE study which includes an
the family in achieving their case plan                                                adoption recommendation or an adoptive home
objectives?                                         ________________________________   study?
    Yes             No                                                                    Yes               No
                                                    ________________________________

3. Has the Social and Medical Information           ________________________________   B. If no, what steps are being taken to ensure
Form been updated with additional background                                           each child is moved to a permanent placement?
and social history information?                     ________________________________
   Yes               No
                                                    ________________________________   C. If no, does each child have contact and
                                                                                       visitation with a potential permanent caregiver?
4. For youth age 15 or older, has an Ansell-        ________________________________       Yes              No
Casey Assessment been completed?
   Yes             No                               ________________________________

                                                    ________________________________
5. For youth age 15 or older, has an
Independent Living Plan been developed and          ________________________________
services put into place?
   Yes               No                             ________________________________

6. Have the needs of each child been assessed       ________________________________
and relevant services been provided?
   Yes              No                              ________________________________

                                                    ________________________________

                                                    ________________________________


                                                                                                                                     13
                                                                3 to 6 Months

Names of Parents:                                                                  Date of Removal:

Names and Dates of Birth of Children:



Social Worker:                                                                     Date of Review:


ICWA                                                                                      5. If the child(ren) is Indian, is their current
                                                                   Notes                  placement in accordance with ICWA placement
1. If the child(ren) is Indian, has the tribe(s)                                          requirements?
and/or BIA responded to tribal membership             _______________________________         Yes              No
inquiries?
    Yes               No                              ________________________________

2. Is the child(ren)’s tribe participating in case    ________________________________
planning and kept apprised of what is
happening?                                            ________________________________
    Yes               No
                                                      ________________________________
3. Has there been tribal (or BIA) notification of
all court hearings?                                   ________________________________
     Yes            No
                                                      ________________________________
4. If the child(ren) is Indian, is their identified
permanent placement in accordance with ICWA           ________________________________
placement requirements?
    Yes              No                               ________________________________

                                                      ________________________________

                                                      ________________________________

                                                      ________________________________


                                                                                                                                        14
Concurrent Planning – Additional Notes
            3 to 6 Months




                                         15
                                                         Concurrent Planning
                                                            6 to 9 Months

Names of Parents:                                                              Date of Removal:

Names and Dates of Birth of Children:



Social Worker:                                                                 Date of Review:


Have all prior concurrent planning action                                             Family Engagement/Case Planning
steps been resolved?                                           Notes
   Yes             No                                                                 1. Is progress on the case plan sufficient to
                                                  ________________________________    reunify at or before the permanency hearing?
Full Disclosure                                                                           Yes               No
                                                  ________________________________
1. Have case plan progress and each child’s                                           2. Does the primary permanency goal need to
identified concurrent plan goals been discussed   ________________________________    be changed or updated on the Alternate Care
with all of the following:                                                            Plan and/or FOCUS?
    Mother                   Father(s)            ________________________________        Yes            No
    Child(ren)               Relatives
    Resource families                             ________________________________    3. Has the case been staffed with the
                                                                                      Permanency Committee to confirm or select
2. Have all resources parents received adequate   ________________________________    each child’s permanency goal and placement?
information to make an informed decision in                                               Yes             No
supporting each child in his or her permanency    ________________________________
plan?                                                                                 4. If the permanency goal is Other Planned
    Yes            No                             ________________________________    Permanent Living Arrangement (OPPLA), have
                                                                                      all other permanency options been exhausted?
                                                  ________________________________         Yes           No
Paternity
                                                  ________________________________
1. Have all paternity issues been resolved?
    Yes              No                           ________________________________

                                                  ________________________________

                                                                                                                                      16
Contact/Visitation                                             Notes                 Assessment/Services

1. Have the parents maintained frequent           ________________________________   1. Have adequate services been provided to all
consistent and quality visitation?                                                   parents to support successful reunification?
    Yes              No                           ________________________________       Yes              No

2. Do there need to be any changes to the         ________________________________   A. If not, what barriers exist, services are
visitation plan?                                                                     needed and what reasonable or active efforts
     Yes            No                            ________________________________   have been made to overcome those barriers?

3. Have ongoing visits occurred between           ________________________________   2. For each child who is not likely to return
siblings not living together?                                                        home, has the social history been started?
     Yes              No                          ________________________________       Yes             No
                                                                                         N/A (each child likely to return home)
4. Has each child’s other connections been        ________________________________
maintained (i.e. relatives, friends, cultural)?
    Yes               No                          ________________________________   Placement

5. Has the social worker had adequate contact     ________________________________   1. For each child in a permanent placement,
with the parents to support them in moving                                           does the family have a current home study with
forward with their case plan?                     ________________________________   a recommendation for adoption?
    Yes              No                                                                  Yes             No
                                                  ________________________________       N/A (no child is in a permanent placement or
6. Are those contacts adequately documented in                                       the concurrent plan does not include adoption)
FOCUS?                                            ________________________________
    Yes             No
                                                  ________________________________
7. Has the social worker had monthly face to
face contact with each child?                     ________________________________
    Yes             No
                                                  ________________________________
8. During those visits, has the social worker
discussed permanency, safety and well-being       ________________________________
goals with each child?
    Yes             No                            ________________________________

9. Are those contacts adequately documented in    ________________________________
FOCUS?
    Yes             No                            ________________________________

                                                                                                                                     17
                                                             6 to 9 Months

Names of Parents:                                                               Date of Removal:

Names and Dates of Birth of Children:



Social Worker:                                                                  Date of Review:


ICWA                                                            Notes

1. If the child(ren) is Indian, is the tribe       ________________________________
participating in case planning and kept apprised
of what is happening?                              ________________________________
    Yes               No
                                                   ________________________________

                                                   ________________________________

                                                   ________________________________

                                                   ________________________________

                                                   ________________________________

                                                   ________________________________

                                                   ________________________________

                                                   ________________________________

                                                   ________________________________

                                                   ________________________________



                                                                                                   18
Concurrent Planning – Additional Notes
            6 to 9 Months




                                         19
                                                         Concurrent Planning
                                                           9 to 12 Months


Names of Parents:                                                              Date of Removal:

Names and Dates of Birth of Children:



Social Worker:                                                                 Date of Review:

                                                               Notes
Have all prior concurrent planning action                                             Family Engagement/Case Planning
steps been resolved?                              ________________________________
   Yes             No                                                                 1. Is progress on the case plan sufficient to
                                                  ________________________________    reunify at or before the permanency hearing?
Full Disclosure                                                                           Yes               No
                                                  ________________________________
1. Have case plan progress and each child’s                                           2. Does the primary permanency goal need to
identified concurrent plan goals been discussed   ________________________________    be changed or updated on the Alternate Care
with all of the following:                                                            Plan and/or FOCUS?
    Mother                   Father(s)            ________________________________        Yes            No
    Child(ren)               Relatives
    Resource families                             ________________________________    3. Has the case been staffed with the
                                                                                      Permanency Committee to confirm or select
2. Have all resources parents received adequate   ________________________________    each child’s permanency goal and placement?
information to make an informed decision in                                               Yes             No
supporting each child in his or her permanency    ________________________________
plan?                                                                                 4. If the permanency goal is Other Planned
    Yes            No                             ________________________________    Permanent Living Arrangement (OPPLA), have
                                                                                      all other permanency options been exhausted?
3. What is each child’s understanding of the      ________________________________         Yes           No
permanent plan?
                                                  ________________________________

                                                  ________________________________


                                                                                                                                      20
Contact/Visitation                                             Notes                 Assessment/Services

1. Have parents maintained frequent consistent    ________________________________   1. Have adequate services been provided to all
and quality visitation?                                                              parents to support successful reunification?
    Yes              No                           ________________________________       Yes              No

2. Do there need to be any changes to the         ________________________________   2. Has each child received options counseling to
visitation plan?                                                                     make an informed decision about his or her
     Yes            No                            ________________________________   permanent plan?
                                                                                         Yes             No
3. Have ongoing visits occurred between           ________________________________
siblings not living together?                                                        3. Has each child’s social history been
     Yes              No                          ________________________________   completed?
                                                                                         Yes             No
4. Has each child’s other connections been        ________________________________
maintained (i.e. relatives, friends, cultural)?                                      4. Has each child’s Child and Family Social and
    Yes               No                          ________________________________   Medical Information Form been updated?
                                                                                         Yes             No
5. Has the social worker had adequate contact     ________________________________
with the parents to support them in moving                                           5. Is each child’s Life Book up to date?
forward with their case plan?                     ________________________________       Yes              No
    Yes              No
                                                  ________________________________   6. Reasonable efforts to finalize a permanent
6. Are those contacts adequately documented in                                       plan   have OR       have not been made.
FOCUS?                                            ________________________________
    Yes             No
                                                  ________________________________   Placement
7. Has the social worker had monthly face to
face contact with each child?                     ________________________________   1. If a permanent placement has disrupted or
    Yes              No                                                              has not been identified, have child-specific
                                                  ________________________________   recruitment efforts been started?
8. During those visits, has the social worker                                            Yes              No
discussed permanency, safety and well-being       ________________________________
goals with each child?                                                               2. Does judicial consent to utilize media
    Yes             No                            ________________________________   recruitment efforts need to be requested at the
                                                                                     permanency hearing?
9. Are those contacts adequately documented in    ________________________________       Yes              No
FOCUS?
    Yes             No                            ________________________________

                                                                                                                                       21
                                                                9 to 12 Months

Names of Parents:                                                                   Date of Removal:

Names and Dates of Birth of Children:



Social Worker:                                                                      Date of Review:



ICWA                                                                Notes

1. If the child(ren) is Indian, is the tribe           ________________________________
participating in case planning and kept apprised
of what is happening?                                  ________________________________
    Yes               No
                                                       ________________________________
2. If the child(ren) is Indian, has the tribe and/or
BIA been notified of the permanency hearing in         ________________________________
accordance with ICWA notification
requirements?                                          ________________________________
    Yes               No
                                                       ________________________________

                                                       ________________________________

                                                       ________________________________

                                                       ________________________________

                                                       ________________________________

                                                       ________________________________

                                                       ________________________________

                                                       ________________________________

                                                                                                       22
Concurrent Planning – Additional Notes
           9 to 12 Months




                                         23
                                                            Concurrent Planning
                                                              12 to 15 Months


Names of Parents:                                                                 Date of Removal:

Names and Dates of Birth of Children:



Social Worker:                                                                    Date of Review:


Have all prior concurrent planning action                         Notes                  4. Have the birth parents been given the
steps been resolved?                                                                     opportunity to sign the release of their
   Yes             No                                ________________________________    identifying information to the adoptive parents?
                                                                                            Yes              No
Full Disclosure                                      ________________________________       N/A (the permanency plan is not adoption)

1. Have case plan progress and each child’s          ________________________________    Family Engagement/Case Planning
identified concurrent plan goals been discussed
with all of the following:                           ________________________________    1. Is progress on the case plan sufficient to
    Mother                   Father(s)                                                   reunify at or before the permanency hearing?
    Child(ren)               Relatives               ________________________________        Yes               No
    Resource families
                                                     ________________________________    2. Does the primary permanency goal need to
2. Have all resources parents received adequate                                          be changed or updated on the Alternate Care
information to make an informed decision in          ________________________________    Plan and/or FOCUS?
supporting each child in his or her permanency                                               Yes            No
plan?                                                ________________________________
    Yes            No                                                                    3. Has the case been staffed with the
                                                     ________________________________    Permanency Committee to confirm or select
3. Is each child prepared for his or her alternate                                       each child’s permanency goal and placement?
permanency plan?                                     ________________________________        Yes             No
   Yes              No
                                                     ________________________________    4. If the permanency goal is Other Planned
                                                                                         Permanent Living Arrangement (OPPLA), have
                                                     ________________________________    all other permanency options been exhausted?
                                                                                              Yes           No
                                                                                                                                         24
Contact/Visitation                                             Notes                 Assessment/Services

1. Have the parents maintained frequent           ________________________________   1. Have adequate services been provided to all
consistent and quality visitation?                                                   parents to support successful reunification?
    Yes              No                           ________________________________       Yes              No

2. Do there need to be any changes to the         ________________________________   2. Has each child received options counseling to
visitation plan?                                                                     make an informed decision about his or her
     Yes            No                            ________________________________   permanent plan?
                                                                                         Yes             No
3. Have ongoing visits occurred between           ________________________________
siblings not living together?
     Yes              No                          ________________________________   Placement

4. Has each child’s other connections been        ________________________________   1. If the identified permanent placement has
maintained (i.e. relatives, friends, cultural)?                                      disrupted, or has not yet been identified, which
    Yes               No                          ________________________________   ongoing child-specific recruitment efforts are
                                                                                     being made?
5. Has the social worker had adequate contact     ________________________________       Re-contacting relatives, previous foster
with the parents to support them in moving                                           parents and other connections
forward with their case plan?                     ________________________________       Internet adoption exchanges (Wednesday’s
    Yes              No                                                              Child, NW Adoption Exchange, AdoptUSKids)
                                                  ________________________________       Televised Wednesday’s Child production
6. Are those contacts adequately documented in                                           Wednesday’s Child newspaper feature
FOCUS?                                            ________________________________       Other
    Yes             No
                                                  ________________________________   2. If the permanent plan is OPPLA, has the
7. Has the social worker had monthly face to                                         foster parent signed a Declaration of
face contact with each child?                     ________________________________   Commitment?
    Yes              No                                                                  Yes              No
                                                  ________________________________
8. During those visits, has the social worker
discussed permanency, safety and well-being       ________________________________
goals with each child?
    Yes             No                            ________________________________

9. Are those contacts adequately documented in    ________________________________
FOCUS?
    Yes             No                            ________________________________

                                                                                                                                   25
Court                                                          Notes

1. Has the termination report to the court been   ________________________________
written?
    Yes             No                            ________________________________
    N/A (permanent plan is not adoption)
                                                  ________________________________
2. Has a petition for termination of parental
rights been filed?                                ________________________________
    Yes              No
    N/A (permanent plan is not adoption)          ________________________________

                                                  ________________________________

                                                  ________________________________

                                                  ________________________________

                                                  ________________________________

                                                  ________________________________

                                                  ________________________________

                                                  ________________________________

                                                  ________________________________

                                                  ________________________________

                                                  ________________________________

                                                  ________________________________

                                                  ________________________________

                                                  ________________________________

                                                  ________________________________

                                                                                     26
                                                                12 to 15 Months

Names of Parents:                                                                   Date of Removal:

Names and Dates of Birth of Children:



Social Worker:                                                                      Date of Review:



ICWA                                                                Notes

1. If the child(ren) is Indian, is the tribe           ________________________________
participating in case planning and kept apprised
of what is happening?                                  ________________________________
    Yes               No
                                                       ________________________________
2. If the child(ren) is Indian, has the tribe and/or
BIA been notified of the permanency hearing in         ________________________________
accordance with ICWA notification
requirements?                                          ________________________________
    Yes               No
                                                       ________________________________
3. If the child(ren) is Indian, has the tribe and/or
BIA been notified of the hearing to terminate          ________________________________
parental rights in accordance with ICWA
notification requirements?                             ________________________________
    Yes               No
                                                       ________________________________
4. If the child(ren) is Indian and the permanency
plan is adoption, is an expert witness scheduled       ________________________________
to testify at the termination hearing?
    Yes               No                               ________________________________

                                                       ________________________________

                                                       ________________________________

                                                                                                       27
Concurrent Planning – Additional Notes
           12 to 15 Months




                                         28
                                                          Concurrent Planning
                                                            15 to 22 Months

Names of Parents:                                                               Date of Removal:

Names and Dates of Birth of Children:



Social Worker:                                                                  Date of Review:

                                                                Notes
Have all prior concurrent planning action                                              Family Engagement/Case Planning
steps been resolved?                               ________________________________
   Yes             No                                                                  1. If termination of parental rights has not
                                                   ________________________________    occurred, does the case plan continue to address
Full Disclosure                                                                        the parents?
                                                   ________________________________        Yes              No
1. Is each child prepared for his or her
permanency plan?                                   ________________________________
   Yes              No
                                                   ________________________________
2. Has full disclosure of each child’s Child and
Family Social and Medical Information Form,        ________________________________
social history, educational, medical and mental
health records been made to the adoptive           ________________________________
family?
    Yes              No                            ________________________________
    N/A (permanent plan is not adoption)
                                                   ________________________________
3. If yes, have records disclosed been
documented on the Adoption Information             ________________________________
Disclosure form?
   Yes              No                             ________________________________

                                                   _______________________________

                                                   ________________________________

                                                                                                                                     29
Contact/Visitation                                             Notes                 Assessment/Services

1. If termination of parental rights has not      ________________________________   1. Are supports and/or services for each child
occurred, have the parents maintained frequent                                       and their resource family in place to ensure a
contact and quality visitation?                   ________________________________   stable and successful placement?
   Yes              No                                                                   Yes             No
                                                  ________________________________
2. Have ongoing visits occurred between                                              2. Have the needs of each child been addressed
siblings not living together?                     ________________________________   to prepare him or her for adoption?
    Yes              No                                                                  Yes             No
                                                  ________________________________       N/A (permanent plan is not adoption)
3. Has each child’s other connections been
maintained (i.e. relatives, friends, cultural)?   ________________________________   3. For youth age 15 or older, is the Independent
   Yes               No                                                              Living Plan current?
                                                  ________________________________      Yes             No
4. Has the social worker had monthly face to
face contact with each child?                     ________________________________   A. Are the current Independent Living services
   Yes              No                                                               meeting the needs of each youth?
                                                  ________________________________      Yes              No
5. During those visits, has the social worker
discussed permanency, safety and well-being       ________________________________
goals with each child?
   Yes              No                            ________________________________   Placement

6. Are those contacts adequately documented in    ________________________________   1. Has the Adoptive Placement Agreement (or
FOCUS?                                                                               Legal Risk Adoptive Placement Agreement)
   Yes             No                             ________________________________   been signed?
                                                                                         Yes           No
                                                  ________________________________       N/A (permanent plan is not adoption)

                                                  ________________________________

                                                  ________________________________

                                                  ________________________________

                                                  ________________________________

                                                  ________________________________

                                                                                                                                      30
Adoption/Guardianship Assistance                                  Notes                 Court

1. Which parts of the adoption or guardianship       ________________________________   1. Copies of which documents necessary to
assistance application have been completed?                                             finalize each child’s adoption have been
    Part 1                                           ________________________________   received?
    Part 2                                                                                  Three certified copies of all orders
    N/A (permanent plan is not adoption or           ________________________________   terminating parental rights
guardianship after termination of parental rights)                                          Certified birth certificate for each child
                                                     ________________________________       Certified death certificate for each deceased
2. Has an Adoption Assistance Agreement or                                              parent
Guardianship Assistance Agreement been               ________________________________       Current (within three years ) criminal
signed?                                                                                 history clearances for the adoptive parents and
    Yes              No                              ________________________________   any adult residing in their home
    N/A (permanent plan is not adoption or                                                  Hospital birth records for each child
guardianship after termination of parental rights)   ________________________________       N/A (permanent plan is not adoption)

                                                     ________________________________   2. Has the Adoption Report to the Court been
                                                                                        written?
                                                     ________________________________       Yes            No
                                                                                            N/A (permanent plan is not adoption)
                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                                                                                                       31
                                                              15 to 22 Months

Names of Parents:                                                                 Date of Removal:

Names and Dates of Birth of Children:



Social Worker:                                                                    Date of Review:


ICWA                                                              Notes

1. If the child(ren) is Indian, has the tribe been   ________________________________
notified of adoption or guardianship proceedings
in accordance with ICWA notification                 ________________________________
requirements?
    Yes               No                             ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________

                                                     ________________________________


                                                                                                     32
Concurrent Planning – Additional Notes
           15 to 22 Months




                                         33
                                                      Concurrent Planning Summary

Names of Children:

Names of Parents:                                                               Date of Removal:

Social Worker:

                                                             Full Disclosure
Date of              Date of Review   Action Needed                                                        Completed/Date
Removal to 30
Days                 ____________     __________________________________________________________________     ____________
                     ____________     __________________________________________________________________     ____________
                     ____________     __________________________________________________________________     ____________
                     ____________     __________________________________________________________________     ____________

1 to 3 Months        ____________     __________________________________________________________________     ____________
                     ____________     __________________________________________________________________     ____________
                     ____________     __________________________________________________________________     ____________
                     ____________     __________________________________________________________________     ____________

3 to 6 Months        ____________     __________________________________________________________________     ____________
                     ____________     __________________________________________________________________     ____________
                     ____________     __________________________________________________________________     ____________

6 to 9 Months        ____________     __________________________________________________________________     ____________
                     ____________     __________________________________________________________________     ____________
                     ____________     __________________________________________________________________     ____________

9 to 12 Months       ____________     __________________________________________________________________     ____________
                     ____________     __________________________________________________________________     ____________
                     ____________     __________________________________________________________________     ____________

12 to 15             ____________     __________________________________________________________________     ____________
Months               ____________     __________________________________________________________________     ____________
                     ____________     __________________________________________________________________     ____________

15 to 22             ____________     __________________________________________________________________     ____________
Months               ____________     __________________________________________________________________     ____________
                     ____________     __________________________________________________________________     ____________
                                                                                                                            34
                                                        Paternity

Date of          Date of Review   Action Needed                                                        Completed/Date
Removal to 30
Days             ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

1 to 3 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

3 to 6 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

6 to 9 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

9 to 12 Months   ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

12 to 15         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

15 to 22         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

                                                                                                                        35
                                              Family Engagement/Case Planning

Date of          Date of Review   Action Needed                                                        Completed/Date
Removal to 30
Days             ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

1 to 3 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

3 to 6 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

6 to 9 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

9 to 12 Months   ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

12 to 15         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

15 to 22         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

                                                                                                                        36
                                                    Contact/Visitation

Date of          Date of Review   Action Needed                                                        Completed/Date
Removal to 30
Days             ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

1 to 3 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

3 to 6 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

6 to 9 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

9 to 12 Months   ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

12 to 15         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

15 to 22         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

                                                                                                                        37
                                                        Relatives

                 Date of Review   Action Needed                                                        Completed/Date
Date of
Removal to 30    ____________     __________________________________________________________________     ____________
Days             ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

                 ____________     __________________________________________________________________     ____________
1 to 3 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

                 ____________     __________________________________________________________________     ____________
3 to 6 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

                 ____________     __________________________________________________________________     ____________
6 to 9 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

                 ____________     __________________________________________________________________     ____________
9 to 12 Months   ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

                 ____________     __________________________________________________________________     ____________
12 to 15         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

                 ____________     __________________________________________________________________     ____________
15 to 22         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

                                                                                                                        38
                                                   Assessment/Services

Date of          Date of Review   Action Needed                                                        Completed/Date
Removal to 30
Days             ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

1 to 3 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

3 to 6 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

6 to 9 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

9 to 12 Months   ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

12 to 15         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

15 to 22         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________


                                                                                                                        39
                                                       Placement

Date of          Date of Review   Action Needed                                                        Completed/Date
Removal to 30
Days             ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

1 to 3 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

3 to 6 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

6 to 9 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

9 to 12 Months   ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

12 to 15         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

15 to 22         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________


                                                                                                                        40
                                              Adoption/Guardianship Assistance

Date of          Date of Review   Action Needed                                                        Completed/Date
Removal to 30
Days             ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

1 to 3 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

3 to 6 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

6 to 9 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

9 to 12 Months   ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

12 to 15         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

15 to 22         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________


                                                                                                                        41
                                                         Court

Date of          Date of Review   Action Needed                                                        Completed/Date
Removal to 30
Days             ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

1 to 3 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

3 to 6 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

6 to 9 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

9 to 12 Months   ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

12 to 15         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

15 to 22         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________


                                                                                                                        42
                                                         ICWA

Date of          Date of Review   Action Needed                                                        Completed/Date
Removal to 30
Days             ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

1 to 3 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

3 to 6 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

6 to 9 Months    ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

9 to 12 Months   ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

12 to 15         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________

15 to 22         ____________     __________________________________________________________________     ____________
Months           ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________
                 ____________     __________________________________________________________________     ____________


                                                                                                                        43

				
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