PROGRESS MAS

							    FOSTER CARE MONTHLY ASSESSMENT REPORT

                                      DATE:

CHILD/YOUTH NAME:

FOSTER FAMILY NAME:

ADDRESS:

TELEPHONE NUMBER:

ASSESSMENT OF CHILD/YOUTH ADJUSTMENT IN YOUR HOME:




VISITATION FOR MONTH: (INCLUDE DATES/TIME)




HEALTH RECORD: (INCLUDE DATES/TYPE OF SERVICE)




SCHOOL/COUNSELING REPORTS: (ATTACH COPIES)




CLOTHING PURCHASED FOR CHILD/YOUTH FOR THIS MONTH:




OVERALL GENERAL COMMENTS:




FOSTER PARENT                 FOSTER CHILD           CASEWORKER