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The Staff of Adoption by Gentle Care

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The Staff of Adoption by Gentle Care Powered By Docstoc
					                                                                              	
	
	
Dear	Adoptive	Family,	
	
	
If	you	are	like	most	families,	you	are	turning	to	adoption	to	fulfill	your	dream	of	becoming	a	
parent.		The	question	most	frequently	asked	to	us	is,	“Can	you	really	adopt	a	newborn	from	
Ohio?”			
	
The	answer	is	simple.		 Gentle	Care	has	a	wonderful	history	of	placing	over	1,800	healthy	
newborns	 with	 loving	 families.	 	 We	 have	 been	 completing	 adoptions	 since	 1985	 and	 our	
dedication	 to	 our	 clients	 has	 helped	 us	 grow	 into	 the	 most	 successful	 adoption	 agency	 in	
Ohio.	
	
We	accomplished	this	by	our	constant	commitment	to	improving	our	adoption	services	to	
our	 birth	 mothers	 and	 adoptive	 families.	 	 We	 feel	 this	 focus	 on	 improving	 our	 services,	
helped	us	grow	with	our	clients	and	stay	a	step	ahead	of	other	adoption	professionals.	
	
Domestic	 and	 International	 adoption	 presents	 every	 family	 with	 a	 wealth	 of	 options	 and	
challenges.		It	is	important	for	you	to	find	a	professional	who	will	help	guide	you	through	
the	 adoption	 process;	 a	 professional	 to	 answer	 any	 questions	 and	 address	 concerns	 you	
may	 experience	 along	 the	 way.	 	 Finding	 a	 quality	 professional	 is	 the	 most	 important	
decision	you	will	ever	make,	simply	because	that	organization	will	help	you	begin	or	add	to	
your	family.	
	
Should	you	choose	Gentle	Care,	you	will	find	an	experienced	and	dedicated	staff	willing	to	
guide	you	through	the	world	of	domestic	adoption.		Please	find	on	the	following	page	steps	
of	the	adoption	process.	
	
We	 wish	 you	 well	 in	 your	 search	 to	 fulfill	 your	 dream.	 	 After	 reviewing	 our	 adoption	
information,	 should	 you	 feel	 we	 can	 help	 you	 complete	 that	 dream,	 our	 staff	 would	 be	
honored	to	work	with	you.	
	
Sincerely,	
	
The Staff of Adoption by Gentle Care
	
	
	
	
	


Revised 02/10/11
                           Advantages of Adoption by Gentle Care 
 
1. One  of  the  most  experienced  adoption  staffs  in  the  United  States.    This  allows  us  to 
   share  our  intimate  adoption  experience  with  our  clients  thus  making  the  adoption 
   process much easier for our clients. 
 
2. Experience  in  placing  over  1,800  newborns  with  Ohio  families.    Our  proven  and 
   unmatched track record gives clients a strong feeling of confidence because of our past 
   success. 
 
3. We focus primarily on women facing an unplanned pregnancy in Ohio.  We have been 
   building  solid  relationships  since  1985  with  health  care  professionals  who  come  in 
   contact  with  pregnant  mothers  facing  an  unplanned  pregnancy.    These  professionals 
   consistently  turn  to  Gentle  Care  because  we  provide  extraordinary  and  heartfelt 
   services to all of our birth mothers. 
 
4. We will review with you, in detail, your adoption planning questionnaire to provide you 
   with our assessment as to how your responses and family dynamics could affect your 
   waiting time. 
 
5. Ohio has some of the best adoption laws in the United States and most adoptive families 
   find this security comforting. 
 
6. Since  we  primarily  work  with  birth  mothers  in  Ohio,  adoptive  families  enjoy  this 
   convenience  as  they  are  not  forced  to  travel  across  the  United  States  or  travel  to 
   another country to adopt a child. 
 
7. By concentrating our efforts in Ohio; we have built a network of dedicated and qualified 
   staff  members  across  the  state  effectively  allowing  us  to  service  birth  mothers  and 
   adoptive families wherever they may live. 
 
8. We can and do work with families from other states and many come to us because of 
   our solid reputation and the advantages Ohio laws offers to them.  Due to our extensive 
   experience, we welcome the opportunity to work with adoptive families from all over 
   the United States. 
 
9. We  are  a  full  service  adoption  agency.    Full  service  means  we  facilitate  the  entire 
   adoption process for you.  Most families prefer an expert to handle the entire process 
   for  them.    We  do,  however,  offer  quality  independent  adoption  services  if  you  need  a 
   home study or have located a birth mother on your own. 
 
 
 
                                                     
                                                     
                                                     


Revised 07/02/09
                                  Commonly	Asked	Questions	
	
Q.	What	are	Adoption	By	Gentle	Care’s	minimum	requirements	to	adopt?	
    	
     The	 minimum	 age	 requirement	 of	 the	 agency	 is	 21.	 We	 do	 not	 have	 a	 specified	
       maximum	 age	 limit,	 but	 birth	 parent	 requests	 are	 considered	 in	 the	 matching	
       process,	and	age	may	be	a	factor	in	their	decision.		It	is	also	important	to	us	to	work	
       with	and	on	behalf	of	adoptive	parents	who	are	likely	to	adapt	to	the	changing	needs	
       of	a	child.		
	
     If	a	married	couple	is	considering	adoption,	it	is	recommended	they	be	married	at	
       least	two	(2)	years	at	the	time	of	the	application.		
	
     Gentle	Care	will	be	as	flexible	as	possible	in	working	with	adoptive	couples	in	order	
       to	accommodate	any	special	needs	of	the	child.		
	
     Adoptive	parents	will	be	required	to	provide	basic	medical	care	for	the	child	placed	
       in	their	care	including	standard	immunizations.	
	
     Gentle	Care	believes	that	smoking	in	the	home	is	a	threat	to	the	health	of	the	child,	
       and	so	we	are	unwilling	to	place	a	child	in	a	home	where	either	parent	smokes.	
	
     If	both	parents	plan	to	continue	working,	a	six	(6)	week	leave	after	placement	must	
       be	taken	to	care	for	the	child.		This	responsibility	may	be	taken	by	one	(1)	parent	or	
       shared	by	both	parents.	
	
Q.	How	does	Adoption	by	Gentle	Care	differ	from	other	adoption	professionals	in	
Ohio?	
	
Each	 professional	 in	 Ohio	 has	 a	 different	 philosophy.	 	 Our	 philosophy	 is	 to	 be	 the	 best	
adoption	 agency	 in	 Ohio.	 	 We	 have	 led	 other	 adoption	 professionals	 in	 this	 quest	 since	
1985.		Many	of	our	programs	and	services	are	often	mimicked	by	our	competitors	and	we	
feel	imitation	is	a	great	form	of	flattery.			You	may	read	more	about	our	advantages	in	the	
section	entitled	“Advantages	of	Adoption	By	Gentle	Care”.	
	
Q.	What	is	an	average	waiting	time?	
	
Without	 knowing	 your	 family	 dynamics	 and	 your	 responses	 to	 our	 Adoption	 Planning	
Questionnaire,	it	is	difficult	to	estimate.		We	have	found,	however,	that	the	waiting	period	
generally	 ranges	 from	 12	 –	 24	 months	 for	 a	 Caucasian	 child,	 with	 approximately	 75%	 of	
our	families	having	placement	between	12	–	18	months.		If	you	are	open	to	other	races,	the	
waiting	time	can	be	less	although	it	does	depend	on	your	Adoption	Planning	Questionnaire	
responses.	 	 We	 will	 help	 you	 complete	 you’re	 Adoption	 Planning	 Questionnaire	 and	 that,	
coupled	 with	 your	 family	 dynamics,	 will	 allow	 us	 to	 point	 out	 any	 areas	 that	 might	




Revised 02/10/11
positively	 or	 negatively	 impact	 your	 waiting	 time.	 	 This	 will	 allow	 you	 to	 have	 a	 full	
understanding	of	waiting	times	before	you	formally	join	Gentle	Care.	
	
Q.	What	factors	affect	a	family’s	waiting	time?	
	
Over	our	years	of	experience,	we	have	determined	there	are	essentially	four	(4)	factors	that	
can	affect	your	waiting	time;	they	are	as	follows:	
	
     1. The	 amount	 of	 birth	 mothers	 an	 adoption	 professional	 reaches	 compared	 to	 the	
         number	of	adoptive	families	on	their	list.	
     2. The	birth	mother’s	selection	of	a	family.		This	is,	obviously,	an	impossible	variable	
         for	any	professional	to	predict.	
     3. The	 degree	 of	 openness	 a	 family	 has	 on	 their	 adoption	 planning	 questionnaire.		
         Obviously,	the	more	adoption	situations	with	which	you	are	comfortable,	the	more	
         times	we	can	share	your	family	profile	with	inquiring	birth	mothers.	
     4. The	quality	of	the	profile.		In	our	research,	we	have	found	birth	mother’s	prefer	our	
         profiles	because	they	are	professional,	attractively	designed,	and	easy	to	read.	Our	
         profiles	provide	us	a	distinct	advantage	over	other	adoption	professionals.	
	
Q.	What	factors	typically	cause	the	waiting	time	to	be	much	longer	than	the	average?	
	
Since	birth	mothers	select	the	adoptive	family,	we	feel	it	is	important	to	share	the	feedback	
we	have	received	from	birth	mothers.		The	following	situations	are	appealing	to	few	birth	
mothers:	
          Single	parents.	
          If	any	parent	is	older	in	age.	
          If	families	have	more	than	one	child	living	in	their	home.	
          Families	who	do	not	provide	good	photographs	and	information	on	their	profile.	
	
If	 you	 fall	 into	 one	 of	 the	 categories	 above,	 you	 will	 want	 to	 talk	 with	 our	 adoption	
specialists	 to	 determine	 how	 much	 the	 above	 factors	 could	 affect	 your	 waiting	 time.	 	 It	
should	be	noted	that	should	you	fall	into	one	of	the	above	categories,	it	does	not	prevent	
you	from	joining	Gentle	Care.		We	feel	obligated,	as	adoption	professionals,	to	disclose	any	
feedback	received	from	birth	mothers.	
	
Q.	Does	Adoption	by	Gentle	Care	work	with	families	and	children	from	all	races?	
	
Yes.	
	
Q.	What	are	the	costs	to	adopt	through	Adoption	by	Gentle	Care?	
	
The	average	total	cost	to	adopt	ranges	from	$25,000	to	$26,000.		There	are	additional	costs	
that	can	occur	such	as	medical	expenses	and	additional	legal	expenses	for	more	challenging	
cases.	 	 However,	 we	 have	 found	 that	 90%	 of	 our	 adoptions	 fall	 within	 the	 range	 listed	
above.			


Revised 02/10/11
	
         Should	you	only	require	a	portion	of	our	services,	such	as	only	a	home	study,	please	
          see	 the	 insert	 titled	 “Fees	 for	 Individual	 Adoption	 Related	 Services”	 or	 “Pre‐
          Arranged/Identified	Program.”			
	
Q.	What	are	the	initial	fees	to	join	Adoption	by	Gentle	Care?	
	
                               Application	Fee	*	      $195	
                                 Home	Study	*	         $1500	
                             Home	Study	Update	*		     $800	
                             Home	Study	Review	*	      $200	
                                  Activation		*	       $10,000	
                                    Profile	*	         $325	
                                     Match		           $13,500	
                          Medical	(when	applicable)	 Varies	
                                     Legal	            Varies	
                                Living	Expenses	       $3000	
                                           *	non‐refundable.	
	
Special	note:		Should	the	birth	mother	change	her	mind,	you	are	not	responsible	to	pay	any	additional	
agency	fees	as	they	will	be	applied	to	your	next	adoption.		As	noted	previously,	for	most	adoptions	the	
average	 cost	 ranges	 between	 $25,000	 and	 $26,000	 (not	 including	 birth	 parent	 living	 expenses).		
Adoptions	with	medical	bills	and/or	higher	legal	fees	will	range	higher	than	$26,000.	
	
	
Q.	If	there	are	medical	fees	involved	how	does	that	work?	
	
As	stated	previously,	when	applicable,	medical	fees	are	in	addition	to	the	placement	fee.		We	
have	 provided	 a	 general	 estimate	 of	 medical	 care	 expenses	 for	 normal	 delivery	 with	 few	
complications.		It	does	not	take	into	account	Cesarean	Section	costs	or	additional	costs	for	
more	difficult	medical	circumstances.	
	
Once	all	medical	bills	received	by	Gentle	Care	are	paid	with	this	fee	(due	at	placement),	we	
will	 either	 process	 a	 refund	 to	 the	 adoptive	 parents	 or	 we	 will	 invoice	 them	 for	 any	
additional	 medical	 bill	 amounts	 due.	 	 We	 will	 always	 provide	 the	 adoptive	 parents	 with	
statements	 and,	 upon	 request,	 copies	 of	 itemized	 bills.	 	 We	 ask	 that	 all	 medical	 care	
providers	provide	us	with	a	bill	within	90	days	of	the	baby’s	birth,	although	bills	have	been	
known	to	come	in	months	and	even	years	later.	
	
All	 medical	 bills	 received	 by	 Gentle	 Care	 prior	 to	 finalization	 must	 be	 paid	 prior	 to	
finalization.		If	we	have	insufficient	funds	to	pay	all	bills,	and	the	adoptive	parents	have	not	
forwarded	 additional	 monies	 to	 enable	 us	 to	 pay	 the	 bills,	 this	 could	 delay	 your	 adoption	
finalization	date.			
	
	
	


Revised 02/10/11
Adoption	 by	 Gentle	 Care	 will	 apply	 for	 Medicaid	 for	 each	 infant	 to	 cover	 the	 days	 in	 the	
hospital	prior	to	placement.	We	have	been	fairly	successful	in	obtaining	Medicaid	coverage,	
but	if	for	some	reason	Medicaid	is	denied,	the	adoptive	parents	will	be	responsible	for	all	of	
the	child’s	medical	bills.	
	
If	the	adoptive	parents	find	their	own	birth	mother,	the	overall	Agency	fees	are	significantly	
reduced.		However,	there	will	be	a	$500.00	fee	for	Gentle	Care	to	apply	for	Medicaid	for	the	
baby	 in	 these	 cases.	 	 There	 will	 be	 an	 additional	 $500.00	 fee	for	 Gentle	Care	 to	 apply	 for	
Medicaid	for	the	birth	mother	(if	applicable).		The	Medical	Fees	below	would	still	apply	for	
the	birth	mother,	if	appropriate.	
	
                                                      	
                            Medical	Fees	(non‐insured	birth	mothers)	
                                                      	
                       Hospital	‐	Birthmother	           	       	           	             $	3,500.00	
                      Hospital	–	Baby	(application	for	Medicaid)	 										$	0	
                       OB/GYN	‐	Birthmother	             	       	           	             $	3,500.00	
                      Pediatrician	–	Baby	(application	for	Medicaid)						$	0____________	
                                                                                            $7,000.00	
                                                                                              	
                        Medical	Fees	(privately	insured	birth	mothers)	
	
	                     	 Hospital	–	Birthmother	            	       	             	            $1,500.00	
	                     	 Hospital	–	Baby	(application	for	Medicaid)	                           $	0	
	                     	 OB/GYN	–	Birthmother	              	       	             	            $1,000.00	
	                     	 Pediatrician	–	Baby	(application	for	Medicaid)	 $	0                             	
	                     	 	        	        	       	        	       	             												 	$2,500.00	
                                                      	
                             Medical	Fees	(Medicaid	birth	mothers)	
                                                      	
	       	        	       Hospital	‐	Birthmother	           	       									 	                	Medicaid	
	       	        	       Hospital	–	Baby	(application	for	Medicaid)	                          	$	0	
		      	        	       OB/GYN	‐	Birthmother	             	       										 	               	Medicaid	
	       	        	       Pediatrician	–	Baby	(application	for	Medicaid)	 $	0                            	
	       	        	       	       	        	       	        	       													 	            $	0*	
	
*	With	changes	currently	being	made	to	Medicaid,	it	is	possible	that	there	may	be	a	co‐pay	or	
deductible	due	for	the	birthmother.		If	Medicaid	is	denied	for	the	baby,	the	Adoptive	Couple	
will	be	responsible	for	all	medical	fees.	
        	
	
Q.	What	is	MEPA?	
	
It	 stands	 for	 Multiethnic	 Placement	 Act.	 	 It	 is	 a	 federal	 act	 that	 was	 primarily	 created	 to	
prevent	 discrimination	 in	 adoption.	 	 Before	 the	 act,	 some	 adoption	 professionals	 would	
only	place	African	American	children	with	African	American	families	or	Caucasian	children	
with	Caucasian	families.		These	professionals	refused	to	look	at	the	best	interest	of	the	child	
and	rather	looked	at	a	child’s	race	first	and	foremost.		The	act	was	intended	to	make	sure	



Revised 02/10/11
adoption	 professionals,	 when	 deciding	 to	 place	 a	 child	 for	 adoption,	 do	 not	 discriminate	
against	 a	 child	 or	 prospective	 adoptive	 family	 based	 on	 any	 forms	 of	 discrimination	
including	 but	 not	 limited	 to	 race.	 	 Fortunately,	 MEPA	 does	 not	 prevent	 government	
programs	 or	 charitable	 organizations	 from	 providing	 subsidies	 for	 families	 wishing	 to	
adopt	children	who	may	be	more	difficult	to	place.	
	
	
Q.	What	happens	if	I	am	discriminated	against?	
	
If	you	feel	an	adoption	professional	in	Ohio	may	have	discriminated	against	you,	we	have	
enclosed	a	form	that	you	can	submit	to	the	state	of	Ohio.		They	will	review	the	complaint	
and	decide	if	it	is	something	they	should	look	into.	




Revised 02/10/11
                           Steps	to	Join	Adoption	by	Gentle	Care	
                                                 	
    1. Read	over	this	initial	packet	in	its	entirety.	
	
    2. Send	in	the	enclosed	application	called	JFS	01691	Ohio	Department	of	Job	and	Family	
       Services,	Application	for	Child	Placement	form	and	return	it	with	a	fee	of	$195.00	(non‐
       refundable).		It	is	an	application	on	white	paper	and	is	six	(6)	pages	in	length.		
	
    3. Upon	 receipt	 of	 the	 application,	 we	 will	 contact	 you	 acknowledging	 receipt.	 	 You	 will	
       receive	an	invitation	to	the	next	available	Group	and	Assessment	and	Seminar	meetings	
       approximately	eight	(8)	weeks	prior	to	the	scheduled	date.		These	will	provide	a	more	
       detailed	explanation	of	how	the	domestic	adoption	process	works.		
	
    4. After	completion	of	the	required	training,	we	will	begin	the	home	study	process,	which	
       is	handled	by	one	of	our	social	workers.		They	will	meet	with	you	and	any	others	who	
       currently	reside	in	your	home.		It	is	an	assessment	of	the	home	environment	and	your	
       suitability	 to	 provide	 a	 stable,	 secure,	 and	 loving	 home	 for	 a	 child.	 	 In	 some	 cases,	
       families	have	already	completed	the	home	study	process.		In	those	cases,	we	will	simply	
       need	to	review	the	home	study	to	make	certain	it	complies	with	Ohio’s	regulations	and	
       standards.	
	
    5. We	 will	 begin	 the	 adoptive	 family	 profile	 process	 with	 you;	 this	 is	 handled	 by	 our	
       personal	graphic	design	studio,	Digital	Graphiti.		With	your	assistance,	they	will	arrange	
       photographs	 and	 general	 non‐identifying	 information	 regarding	 your	 family	 into	 a	
       professional	 profile.	 	 This	 profile	 is	 how	 the	 majority	 of	 our	 birth	 mothers	 select	 the	
       adoptive	family	with	whom	they	would	like	to	place	their	baby.	
	
    6. We	will	work	with	you	to	fill	out	our	adoption	planning	questionnaire.		It	is	a	series	of	
       questions	we	ask	you,	so	we	know	what	type	of	situations	you	are	comfortable	with	in	
       your	 adoption.	 	 This	 questionnaire	 will	 not	 cover	 every	 possible	 situation,	 but	 it	 does	
       provide	 us	 with	 a	 good	 idea	 of	 your	 comfort	 level,	 so	 we	 can	 most	 appropriately	
       circulate	your	profile.	
	
    7. After	the	above	steps	are	completed,	we	will	send	you	an	activation	agreement;	this	is	
       when	you	will	formally	decide	to	join	Gentle	Care.		It	is	at	this	point	that	you	will	pay	
       your	activation	fee.		This	fee	is	primarily	used	by	us	to	promote	Gentle	Care’s	services	to	
       birth	mothers	considering	adoption.			
	
    8. You	 will	 then	 be	 placed	 in	 our	 pool	 of	 waiting	 adoptive	 families.	 	 As	 birth	 mothers	
       contact	 us,	 we	 compare	 their	 background	 and	 desires	 with	 your	 adoption	 planning	
       questionnaire.		We	then	share	matching	families	with	our	birth	mothers.		They	decide	
       which	 family	 will	 adopt	 their	 baby	 from	 the	 matching	 families	 profiles	 shared	 with	
       them.




    Revised 02/10/11
MEMO 
 
FROM: Adoption by Gentle Care 
TO: All Adoptive Family Applicants 
SUBJECT: Selection of Adopted Child’s Gender 
DATE: March 1, 2009 
 
As you know, the first step required for any person who wishes to adopt a child in Ohio is 
to complete the state form titled “Ohio Department of Job and Family Services 
APPLICATION FOR CHILD PLACEMENT” (JFS 01691). Once completed by you, the 
prospective adoptive parent(s), and submitted to our agency, this form becomes your 
official request to work with Adoption by Gentle Care. 
 
This state application form is designed for people who wish to either become foster parents 
or adoptive parents. As a result, some of the questions/information asked for on the form 
may only apply to those people interested in becoming foster parents. For example, on 
page 4 of 6, on the lower half of page 4, there is a section entitled “TYPE OF CHILD WILL 
CONSIDER”. Specifically, on the very bottom left corner of page form, the category is titled 
“Sex”. In this case, only people interested in becoming foster parents could choose to be 
gender specific, since foster parenting typically involves older children, and obviously 
much more is known about those children in advance of the foster parents accepting a 
match with a specific foster child.  
  
In the case of Adoption by Gentle Care, our policy is that adoptive families may not request 
a specific gender of infant child that they wish to adopt. Rather, we believe that families 
should be equally open to adopting an infant of  either gender. When completing this 
section, we request that all families check the two boxes labeled “Will Consider” for both 
“Male’ and “Female” infants. 
 
Please feel free to contact the agency if you have any questions regarding this Memo. 
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  



Revised 07/02/09
                          Obtaining an Application for Adoption 
                                                  
Families or individuals interested in adopting may obtain a state of Ohio application for. 
“Application for Child Placement” (JFS 01691) in the following way: 
 
   1. Request the form from the Ohio Department of Job and Family Services via their 
       website: www.odjfs.state.oh.us/forms.inter.asp 
 
   2.  Go to our website: www.adoptionbygentlecare.org and download the form 
        
   3. Contact us via web, phone, fax or email requesting a copy of the form be mailed to 
       you. It’s the agencies policy to mail this form, along with other information within 7 
       days of the request. 
        
   4. Stop by our office in person anytime between 8:30‐5:00 Monday‐Friday, no 
       appointment is necessary.  Our address is: 
        
                  Adoption By Gentle Care 
                  380 ½ East Town Street 
                  Columbus, OH 43215 
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  
                                                  


Revised 07/02/09
                                                  Ohio Department of Job and Family Services
                                           APPLICATION FOR CHILD PLACEMENT


                                                               AGENCY USE ONLY
 Assessor Name                                     Agency Name                                   Agency Phone #          Date Completed
                                                   Adoption by Gentle Care                       (614) 469-0007          Application Received


                                                                                   Applying to   Pager or Cell Phone #
 Applicant #1 Name (Please Print)
 First             Middle     Last                             (Maiden)                Foster    Work Phone #

                                                                                       Adopt     Work Fax #

                                                                                   Applying to   Pager or Cell Phone #
 Applicant #2 Name (Please Print)
 First             Middle     Last                             (Maiden)               Foster     Work Phone #

                                                                                      Adopt      Work Fax #

 Street Name & Address (Apt. or Lot #)              City                               State     Zip Code         County


 Home Telephone Number                    Home Fax Number                    Emergency Contact Name           Telephone Number


                                   HOUSEHOLD MEMBERS (If more than 6 people, add another sheet)
                                                                   Household             Household          Household            Household
                           Applicant #1         Applicant #2        Member                Member             Member               Member
         Name
 Relationship to
 Applicant #1
 Date of Birth

 Race*
 Ethnic
 Background*
 School Grade
 Completed
 Marital Status (if
 currently married,
 date of marriage)
 Area of Specialized
 Education if
 applicable)
 Employer or
 Source of Income
 How long with
 this employer
 Occupation
 Gross Annual
 Income
 Days/Hours of
 Work (in normal
 work week)
 Driver’s License
 Number

* For statistical purposes only




JFS 01691 (Rev. 6/2009)                                                                                                               Page 1 of 6
                                                         CRIMINAL HISTORY

 Does any household member, including juveniles 12 - 18 years of age, have a criminal history?        Yes          No If yes, explain below
                                                                                                  Approximate
           Name                       Offense                      City and State                Conviction Date              Sentence




 Has any household member been arrested/convicted for driving while intoxicated (DWI) or driving under the influence (DUI)?
    Yes            No If yes, explain below
                    Number of      Number of        Date of Last         City /State of        On Probation or         License Suspended
      Name           Arrests       Convictions      Conviction          Last Conviction            Parole?                or Revoked?
                                                                                                    Yes       No             Yes         No

                                                                                                    Yes       No             Yes         No



                          SLEEPING ARRANGEMENTS (Indicate where a foster or adopted child will sleep)
                                                                                                             TYPE OF BED(S) Crib, Single,
                                                                                                                 Double, Bunk (If bunk,
       BEDROOM                     FLOOR/LEVEL                             OCCUPANT(S)                       indicate upper - U or lower - L)
 1

 2

 3

 4

 5

 6


 Directions to home from agency




Children placed in the home would attend the following schools
 Elementary School Name                                                  Address

 Middle School or Junior High School Name                                Address

 Senior High School Name                                                 Address


 Name of Public School District                                         Do you plan to home school children?           Yes            No

 If yes, indicate whether your home school plan has been approved by the public school district.       Yes            No




JFS 01691 (Rev. 6/2009)                                                                                                                  Page 2 of 6
 Does any family member smoke?           Yes            No       Is smoking allowed in the house?           Yes              No
 Are there any pets in the home?         Yes           No       If yes, list/describe:
 Do pets meet local safety requirements (Vaccinations, vicious animal restrictions, etc.)?    Yes                 No

 Comments



 Does applicant operate a business from the residence?              Yes          No Explain:
 If yes, is business child care?     Yes          No             Is business adult day care or a rooming house?        Yes        No

 Describe impact of home business on foster care/adoption plan:


                                                                 TRANSPORTATION

 VEHICLES            One car          Two or more cars           Truck       Van        Recreational Vehicle           Motorcycle      Other

 Are vehicles in operable condition?               Yes            No If no, explain

 Are there infant car seats?                       Yes            No          Will Obtain

 Are there toddler car seats?                      Yes            No          Will Obtain

 Do you have proof of insurance for all vehicles?          Yes         No

 Is the home on or within comfortable walking distance of public transportation system (bus, etc.)?         Yes           No

 If yes, distance to nearest transit or bus stop

 Describe alternative transportation plan if family does not own an operating vehicle or live on or within comfortable walking distance of a bus
 stop


               APPLICANT, RESIDENTIAL, EMPLOYMENT AND MARITAL HISTORY (Add extra sheets if necessary)
             Residential History
      List residences for the last 10 years                         Applicant #1                                    Applicant #2
                                                                      Agency use only. How                             Agency use only. How
 Has the applicant been an Ohio resident
                                                     Yes         No   verified?                         Yes       No   verified?
 for the last five years?

 Date moved to current residence

 Previous address (city, state)

 Date moved to this address

 Previous address (city, state)

 Date moved to this address

 Previous address (city, state)

 Date moved to this address




JFS 01691 (Rev. 6/2009)                                                                                                                Page 3 of   6
              Employment History
   List applicant’s employer(s) for the last 10 years:                       Applicant #1                                     Applicant #2
Present employer
Job title
Length of time with present employer
Previous employer
Job title
Dates of employment
Previous employer
Job title
Dates of employment
Previous employer
Job title
Dates of employment
       Marriage/Relationship History                                         Applicant #1                                     Applicant #2
Previous marriage/significant relationship to
Date marriage or relationship began
Date of separation
Date of legal termination
Previous marriage/significant relationship to
Date marriage or relationship began
Date of separation
Date of legal termination

                                                            TYPE OF CHILD WILL CONSIDER

Please tell us what type of child you are interested in fostering or adopting. Check all that apply. If you are applying to foster or adopt a specific
child(ren), put his/her name(s) here
Is this child related to you by blood or marriage?             Yes      No     If applicable, specify relationship
Age                                                                                 Race
               0-2              Will Consider            Will Not Consider          White                            Will Consider      Will Not Consider
               3-5              Will Consider            Will Not Consider          Black/African American           Will Consider      Will Not Consider
               6-8              Will Consider            Will Not Consider          Asian                            Will Consider      Will Not Consider
               9 - 11           Will Consider            Will Not Consider          Native Hawaiian or
                                                                                    Other Pacific Islander           Will Consider      Will Not Consider
             12 - 15            Will Consider            Will Not Consider
                                                                                    American Indian or
              16 - 18           Will Consider            Will Not Consider          Alaskan Native                   Will Consider      Will Not Consider
Number of Children                                                                  Ethnicity:
            One                 Will Consider            Will Not Consider
                                                                                    Hispanic or Latino               Will Consider      Will Not Consider
                  Two           Will Consider            Will Not Consider
                                                                                    Not Hispanic or Latino           Will Consider      Will Not Consider
       Three or more            Will Consider            Will Not Consider
Teen Parent w/ Child            Will Consider            Will Not Consider
Sex                                                                                 Applicant(s) Comments
                 Male           Will Consider            Will Not Consider
              Female            Will Consider            Will Not Consider

JFS 01691 (Rev. 6/2009)                                                                                                                         Page 4 of 6
                                                     EXPERIENCE WITH CHILDREN

 Have you ever been or are you currently certified as a foster caregiver in this state or any other state?         Yes            No
 Have you ever applied for or been approved to adopt a child in this state or any other state?           Yes             No

 If you answered yes to either of these questions, explain here, and identify the agency involved

 Some people have had previous contact with a child welfare agency. Sometimes this is a positive experience, sometimes not so positive.
 Please tell us about any contact either applicant has had with a child welfare agency (Children Services, Child mental health facility,
 community child serving agencies, etc.). Please give the name of the agency, approximate dates of contact and what the contact involved.
 Include both positive and negative experiences.


     Check here if you have no experience with child welfare agencies
 Describe your experience with children other than your own. This may include employment and/or volunteer work.



 References               The state requires three non-relative references for foster care, three non-relative references for adoption, and three
                          non-relative references for a combined foster care/adoption study. Some agencies or local court systems require
                          additional references. If the agency has filled in the blanks below, it or the court has requirements beyond the state
                          rule. If the blanks below contain a number, you will need to supply that number of references. If the spaces are
                          empty, please supply three non-relative references for foster care and four (three from non-relatives) for adoption.

 # of references for foster care       # of references for adoption 5 OR # of references for a combined foster care/adoption study
                                                  Phone                                                                                        Zip
   Reference Name          Relationship          Number                   Street Address                       City              State        Code




 May we contact your employer for a reference? Applicant #1            Yes             No           Applicant #2         Yes             No




          If this box has an X in it your local agency or court requires an employer reference. Your application cannot proceed
          without permission to obtain this reference. Please provide the following information

                   Supervisor's Name        Phone Number             Employer Address                     City                 State      Zip Code
 Applicant #1

 Applicant #2




JFS 01691 (Rev. 6/2009)                                                                                                                       Page 5 of 6
                                                 STATEMENT OF UNDERSTANDING
 I/we understand that this is an application only and additional documents will be required. This will include medical statements, criminal
 background check, homestudy, safety audit of your home, references, and other information or documentation requested by the agency.
 Failure of an applicant to provide required information or documentation or to attend required training within one year from the date the
 completed application is received by the agency will render this application incomplete and the agency’s file on the application will be closed.

 I/we agree to complete orientation and preplacement training as required by the agency.

 This application does not represent a final commitment on either side. Any placement of a child will be by my/our mutual agreement.

 I/we certify that the information contained in this application is accurate and complete to the best of my knowledge.

 I/we understand that providing materially false information will prevent the agency from considering my/our home for placement of a child
 and is grounds for denial or revocation of a foster home certificate.

 If there is any significant change affecting health, marital status, residence, family composition or household occupants, employment or
 criminal charges, I/we agree to notify the agency promptly.

 I/we give permission to the agency to contact any references or agency or association for information regarding any work or involvement with
 the supervision of a child which I/we have done.

 I/we certify that I/we have been given a copy of the rules and/or policies governing the certification of foster homes (Chapters 5101:2-5 and
 5101:2-7 of the Administrative Code), if I/we are applying to be a foster caregiver.

 I/we certify that I/we have been given a copy of the PCSA, PCPA or PNA adoption policy, or summary of the policy, prepared pursuant to
 rule 5101:2-48-05 of the Administrative Code, if I/we are applying to become an adoptive parent.

 Applications for a foster home certificate cannot be accepted by agents of the Ohio Department of Job and Family Services for a residence that
 is licensed, regulated, operated under the direction of or otherwise certified as a facility to care for unrelated persons, by the Ohio Department
 of Education, a local board of education, the Ohio Department of Mental Health, a community alcohol, drug addiction and mental health
 services board, the Ohio Department of Mental Retardation/ Developmental Disabilities, a county board of mental retardation/developmental
 disabilities, the Ohio Department of Health or a juvenile court.

 A person seeking to provide foster care or to adopt a minor who knowingly makes a false statement that is included in the written report of a
 home study conducted pursuant Section 3107.02 or Section 5103.03 of the Revised Code is guilty of the offense of falsification under Section
 2921.13 of the Revised Code. A home study with a knowingly false statement shall not be filed with the court and if filed may be struck from
 the court's records.


          Applicant Name (please print)                                          Signature                                        Date
 Applicant #1


 Applicant #2




 Please tell us how you were referred to this agency.




Note:     Completion of this form is required in order for this agency to carry out its obligations under Chapters 5101:2-5, 5101:2-7,
          and/or 5101:2-48 of the Ohio Administrative Code. Your application cannot be processed unless this form is completed in its
          entirety.




JFS 01691 (Rev. 6/2009)                                                                                                                   Page 6 of 6
                                     Adoption	by	Gentle	Care	
                          Fees	for	Individual	Adoption	Related	Services	
	
Families	need	individual	adoption	services	for	the	following	reasons:	
     They	have	found	a	birth	mother	on	their	own	and	need	a	licensed	agency	to	perform	
        adoption	services.	
     They	are	working	with	a	professional	who	is	not	able	to	perform	services	in	Ohio.	
     They	only	need	international	or	domestic	home	study	services.	
     They	only	need	some	adoption	services	for	various	reasons.	
	
In	these	cases,	we	have	broken	our	fees	down	individually.		The	necessity	for	these	services	
will	be	determined	on	an	individual	basis.		
	
All	fees	are	non‐refundable	and	are	subject	to	change.	
	
A. Independent	Home	Study	          	       	      	      	       	       	      	         $1,500	
    Additional	if	expedited	within	30	days			      	      	       	       	      	         $	200	
B. Home	Study	Update	         	     	       	      	      	       	       	      	         $	800	
C. Home	Study	Update	(if	placement	has	not	occurred	within	two	years	of	the	Home	Study	
    and	Gentle	Care	performed	the	original	Home	Study)		          	       	      	         $	250	
D. Home	Study	Update	(if	placement	has	not	occurred	within	two	years	of	the	Home	Study	
    and	Gentle	Care	did	not	perform	the	original	Home	Study)	 	           	      	         $	600	
E. Home	Study	Conversion	(International	to	Domestic	or	vice	versa)	 	            	         $	600	
	       (if	Gentle	Care	completed	your	Home	Study)	
F. Home	Study	Conversion	(International	to	Domestic	or	vice	versa)	 	            	         $1,000	
	       (if	Gentle	Care	did	not	complete	your	Home	Study)	
G. Pre‐Finalization	Supervision	for	Independent	Domestic	Home	Studies																																																															
    (7	visits	within	6	months)	     	       	      	      	       	       	      	         $1,000		
H. Pre‐Finalization	Supervisory	Visits	(	Independent	Domestic	Home	Study)	
    	 $175/per	visit	
I. Pre‐Finalization	Supervisory	Visits	(Independent	International	Home	Study)
    	 $225/per	visit	
J. Mileage	(if	the	Social	Worker	must	travel	more	than	60	miles	round	trip)	
    	 $Varies				.58.5/per	mile		
K. Legal	termination	of	birth	father/husband	rights	($900	Agency	Attorney	Fee,	            $1,500	
    $350	G.A.L.,	$50	Court	Costs,	$200	Agency	Processing	Fee)	 	          	      							(estimate)			
L. Native	American	Clearance	Check		        	      	      	       	       	      		$90/per	tribe	
M. Special	requests	from	adoptive	parents	to	include	but	not	limited	to	specific	medical	
    tests	not	considered	to	be	routine	medical	policy.		The	fee	shall	include	the	cost	of	the	
    test	requested	and	agency	time	to	facilitate	request	at	the	rate	of	$25	per	hour.	
N. Counseling	for	birth	parents	required	beyond	that	provided	by	Gentle	Care	will	be	
    referred	to	an	appropriate	professional	and	billed	to	adoptive	parents	not	to	exceed	




Revised 02/10/11
   $750	for	each	birth	parent	involved	in	the	placement.		This	can	occur	before	or	after	
   placement.	
O. If	finalization	needs	to	occur	outside	of	Franklin	County	there	will	be	a	document	
   charge	of	$150.		The	adoptive	parents	must	contact	the	Executive	Director	for	
   authorization	of	finalization	in	a	county	other	than	Franklin.	
P. If	surrender	and/or	placement	occurs	on	a	weekend	(after	5:00	p.m.	on	Friday	through	
   Sunday),	on	a	holiday,	or	after	5:00	p.m.	Monday	through	Thursday)	there	will	be	a	
   $200	fee.	
Q. The	agency	will	facilitate	conference	calls	and	meetings	after	placement.		Adoptive	
   parents	are	responsible	for	the	actual	cost	of	any	conference	call	and	staff	services	at	
   the	rate	of	$25/per	hour.	
R. Attorney	fees	incurred	for	legal	representation	of	birth	parent(s)	required	when	birth	
   parent(s)	is	under	18	years	of	age	(estimate:	$500).	
S. Attorney	fees	and	court	cost	for	the	Finalization,	issuance	of	the	Final	Decree	of	
   Adoption	and	birth	certificate	(estimate:	$800)	
T. Foster	Care	costs	(estimate:	$55/day)	
                                                 	
                                    Adoption	by	Gentle	Care	
                               Pre‐Arranged/Identified	Program	
Description	
Many	 birth	 parents	 now	 are	 discovered	 directly	 by	 adoptive	 parents	 and	 it	 is	 often	
necessary	 and	 wise	 to	 enlist	 the	 assistance	 of	 a	 licensed	 child	 placement	 agency	 to	 help	
with	 and/or	 effectuate	 a	 placement.	 	 Gentle	 Care	 is	 available	 to	 assist	 adopting	 parents,	
obstetricians,	 attorneys,	 or	 other	 adoption	 service	 organizations	 or	 individuals	 with	 the	
placement	 of	 a	 child	 in	 a	 pre‐arranged	 circumstance.	 	 In	 these	 cases,	 a	 source	 other	 than	
Gentle	Care	identifies	a	birth	parent	who	wishes	to	place	with	a	particular	adopting	couple	
who	may	or	may	not	be	currently	adopting	through	Gentle	Care.	Gentle	Care	will	make	the	
pre‐arranged	 adoption	 placement	 provided	the	 couple	 meets	 all	 agency	 requirements	 for	
home	 study	 approval.	 	 Gentle	 Care	 facilitates	 the	 Home	 Study	 or	 Home	 Study	 review,	
coordinates	 birth	 parent	 services	 and	 interstate	 compact	 approval	 (if	 applicable),	 and	
answers	jurisdictional	questions	that	develop.	

Ohio	Adoptive	Family	Fees	(All	fees	are	non‐refundable	and	subject	to	change.)	
	
$				1,800	  Administrative	Processing	($300)	and	Home	Study	fee	($1,500	‐	due	before	
             work	begins	with	the	birth	parents	and	prior	to	first	Home	Study	visit)	
          	
$				4,250	  Placement	 fee	 (due	 upon	 placement)	 	 This	 includes	 facilitation	 of	 Certified	
             Adoption	 Assessor	 requirements,	 counseling	 with	 birthparents	 and	 their	
             families,	 executing	 the	 legal	 surrender	 and	 placement	 documents	 and	 the	
             Finalization	 Report	 including	 supporting	 documents	 submitted	 in	 Franklin	
             County.		
	
$							500	 Medicaid	application	for	baby	(due	upon	placement)	


Revised 02/10/11
$				1,000	        Post‐Placement	Visit	fee	(due	upon	placement)		
	
$				7,550	        (or	 $8,050	 if	 Medicaid	 application	 is	 made	 for	 Birth	 Mother)	 Medical	 and	
                   Birth	Parent	Living	expenses	are	NOT	included	in	this	total	
	
$3,000.00          Birth Parent Living Expenses Escrow Account are due before work begins with
                   the birth parent(s).
      Birth parents in Ohio may request living expenses up to $3,000.00. If you are
       matched with a birth mother who has utilized living expenses and she changes her
       mind about her adoption plan, these funds paid out are not refundable. However, any
       remaining balance will be refunded to you upon your written request.
	
*NOTE:	 	 Adoption	 by	 Gentle	 Care	 will	 not	 assess	 additional	 fees	 for	 multiple	 births	 in	
situations	where	all	siblings	are	placed	with	the	same	adoptive	family.	
	
Estimated	medical	expenses	are	escrowed	at	placement.		The	final	total	depends	on	actual	
medical	bills.		Adoptive	parents	will	receive	a	full	accounting	of	expenses.		(See	Medical	and	
Additional	Fees)	
	
If	 Gentle	 Care	 is	 performing	 a	 Home	 Study	 Review	 or	 Home	 Study	 Update,	 the	
Administrative	Processing	and	Home	Study	fee	will	be	adjusted	accordingly.		There	may	be	
other	possible	charges	depending	upon	each	specific	situation.		Specifically,	if	any	legal	fees	
are	incurred	by	Gentle	Care,	the	Adoptive	Family	will	be	responsible	for	these	fees.	

Out	of	State	Adoptive	Family	Fees	(All	fees	are	non‐refundable	and	subject	to	change.)	
	
$				1,000	   Administrative	Processing	and	Home	Study	Review	fee	(due	before	work	
              begins	with	the	birth	parents)	
          	
$				4,250	   Placement	 fee	 (due	 upon	 placement)	 	 This	 includes	 facilitation	 of	 Certified	
              Adoption	 Assessor	 requirements,	 counseling	 with	 birthparents	 and	 their	
              families,	 executing	 the	 legal	 surrender	 and	 placement	 documents	 and	 the	
              Finalization	 Report	 including	 supporting	 documents	 submitted	 in	 Franklin	
              County	if	finalizing	in	Ohio.		
	
$							500	  Medicaid	application	for	baby	(due	upon	placement)	
	
$					*600	   ICPC	 =	 Interstate	 Compact	 for	 the	 Placement	 of	 Children	 (due	 upon	
              placement)	*see	NOTE	below	
	
$							150	  Out	of	State	Finalization	(due	upon	placement)	
	
$				6,500	   (or	 $7,000	 if	 Medicaid	 application	 is	 made	 for	 Birth	 Mother)	 Medical	 and	
              Birth	Parent	Living	expenses	are	NOT	included	in	this	total	
	
$3,000.00 Birth Parent Living Expenses Escrow Account are due before work begins with
              the birth parent(s).


Revised 02/10/11
      Birth parents in Ohio may request living expenses up to $3,000.00. If you are
       matched with a birth mother who has utilized living expenses and she changes her
       mind about her adoption plan, these funds paid out are not refundable. However, any
       remaining balance will be refunded to you upon your written request.
	
*NOTE:		Adoption	by	Gentle	Care	will	not	assess	additional	fees	for	multiple	births	in	
situations	where	all	siblings	are	placed	with	the	same	adoptive	family	with	the	following	
exception:	if	the	placement	is	with	an	out‐of‐state	adoptive	family,	AGC	is	required	to	
complete	a	separate	ICPC	packet	for	each	child.	Therefore,	AGC	will	assess	an	
additional	ICPC	fee	to	the	adoptive	family	for	each	additional	child	that	is	placed	with	
the	family	(e.g.,	if	twin	infants	are	placed	with	a	family,	they	will	be	charged	an	
additional	$600	by	AGC	to	complete	the	additional	ICPC	packet).	
	
Estimated	medical	expenses	are	escrowed	at	placement.		The	final	total	depends	on	actual	
medical	bills.		Adoptive	parents	will	receive	a	full	accounting	of	expenses.		(See	Medical	and	
Additional	Fees)	
	
If	 Gentle	 Care	 is	 performing	 a	 Home	 Study	 Review	 or	 Home	 Study	 Update,	 the	
Administrative	Processing	and	Home	Study	fee	will	be	adjusted	accordingly.		There	may	be	
other	possible	charges	depending	upon	each	specific	situation.		Specifically,	if	any	legal	fees	
are	incurred	by	Gentle	Care,	the	Adoptive	Family	will	be	responsible	for	these	fees.	
	
Independent	Home	Study	and/or	Supervisory	Reports	
	
Gentle	Care	is	available	to	assist	attorneys,	courts,	and/or	Interstate	offices	by	performing	
Home	Studies	and	Post‐Placement	services	for	adoptions	through	sources	other	than	
Gentle	Care,	including	International	Adoptions.		Since	1985,	we	have	earned	a	reputation	
for	providing	professional,	efficient,	and	thorough	Home	Studies	to	agencies	and	courts	
nationwide.		The	Home	Study	fee	is	$1,500	with	an	additional	$200	if	the	Home	Study	
needs	to	be	completed	within	30	days.		This	fee	includes	three	(3)	originals	of	the	Home	
Study.		The	fee	for	Pre‐Finalization	Supervisory	Visits	is	$1,000	for	seven	(7)	visits	due	at	
the	first	visit,	or	$175	per	visit	for	Domestic	adoption,	and	$225	per	visit	for	an	
International	adoption.	Mileage	in	the	amount	of	$.58.5	per	mile	(variable)	will	be	added	if	
the	social	worker	has	to	travel	more	than	60	miles	round	trip.	
	
Independent	Assessor	Services	
	
Gentle	Care	is	also	available	to	assist	other	agencies,	attorneys	and	courts	by	providing	
Assessor	Services	to	birth	parents.		The	Ohio	Department	of	Job	and	Family	Services	
require	that	Social	Workers	and	Counselors	who	work	with	birth	parents	and	adoptive	
parents	be	certified	by	the	state	as	Adoption	Assessors.		The	Social	Work	staff	at	Gentle	
Care	is	Certified	Adoption	Assessors,	and	as	such,	can	meet	with	birth	parents	who	are	
working	with	attorneys,	courts,	or	adoption	facilitators.		The	state	requires	certain	
paperwork	be	completed	with	the	birth	parents	by	a	Certified	Adoption	Assessor.		We	
perform	these	services	for	a	fee	of	$75	per	hour	plus	mileage.	



Revised 02/10/11
                        PRE‐FINALIZATION	ADOPTION	SERVICES	
	
1. Gentle	Care	will	provide	Pre‐Finalization	services	to	the	adoptive	parents	and	the	child	
   from	the	date	of	placement	until	the	issuance	of	the	Final	Decree	of	Adoption.		This	Pre‐
   Finalization	period	can	be	no	less	than	six	(6)	months	from	the	date	of	placement.		A	
   social	worker	will	make	a	home	visit	with	the	adoptive	family	no	later	than	seven	(7)	
   days	following	placement	and	shall	make	face‐to‐face	visits	not	more	than	every	30	
   days	apart	during	the	Pre‐Finalization	period.		All	Post	Placement	visits	will	occur	in	the	
   home.		In	a	two	parent	family,	both	parents	and	the	child	must	be	present	for	each	visit.	
                  	
   The	visits	made	by	the	social	worker	with	the	adoptive	family	are	to	ensure	the	baby	is	
   being	loved	and	cared	for,	and	the	adoptive	parents	are	adjusting	to	their	new	role.		
   During	these	visits	the	social	worker	offers	counseling,	support,	and	makes	an	
   assessment	as	to	the	success	of	the	placement.		
              	
2. Adoptive	parents	are	required	to	send	monthly	photographs	and	letters	to	Adoption	by	
   Gentle	Care	for	the	birth	parent(s)	for	one	(1)	year	(12	consecutive	months)	after	
   placement,	then	twice	per	year	afterwards	until	the	child	reaches	the	age	of	18.		We	also	
   require	that	you	send	photographs	and	letters	within	the	first	week	of	placement.		These	
   pictures	will	be	sent	to	the	birth	parent(s)	at	their	request.			
                                  	
3. Gentle	Care	will	refer	the	adoptive	parents	to	an	attorney	experienced	in	obtaining	
   Final	Decrees	of	Adoption	through	Franklin	County	Probate	Court,	and	will	assist	in	
   providing	the	necessary	documents	to	the	attorney.		All	finalizations	will	occur	in	
   Franklin	County.		If	finalization	needs	to	occur	outside	of	Franklin	County,	the	adoptive	
   parents	must	contact	the	Executive	Director	prior	to	placement	for	approval.	
	
                        POST‐FINALIZATION	ADOPTION	SERVICES	
	
1. Gentle	Care	shall	remain	available	to	birth	parents,	adoptive	families	and	adoptees	to	
   provide	counseling,	education	or	consultation	on	adoption	issues	after	the	Final	Decree	
   of	Adoption	has	been	issued.		In	situations	where	Gentle	Care	is	unable	to	provide	the	
   appropriate	service	needed,	the	agency	shall	make	referrals	to	agencies	or	individuals	
   specializing	in	adoption	issues.		
	
2. Gentle	Care	will	continue	to	facilitate	communication	between	birth	parent(s)	and	
   adoptive	parents.			
	
3. Adoptive	families	will	be	invited	to	the	Gentle	Care	annual	picnic	held	in	Columbus,	
   Ohio.	




Revised 02/10/11
                               
                               
                               
                               
                               
                               
                               
                               
                   Adoption by Gentle Care 
 
           Home Study and Post Adoption 
                    Services  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Revised 07/02/09
What	is	the	home	study	process?	
	
The	Home	Study	is	a	cooperative	effort	between	Gentle	Care	and	the	applicants	to	assess	
the	applicant’s	ability	to	parent	a	child	successfully.		(For	details	about	the	process	see	the	
Home	 Study	 Procedure	 Outline.)	 The	 Home	 Study	 consists	 of	 two	 meetings,	 which	 are	
usually	 held	 in	 the	 applicant’s	 home.	 Once	 all	 documents	 have	 been	 received	 and	
requirements	 met,	 the	 Home	 Study	 process	 will	 be	 complete	 and	 the	 applicants	 will	 be	
notified	by	letter	regarding	final	approval.		The	Home	Study	is	valid	only	in	Ohio	for	two	(2)	
years	 from	 approval.	 Additional	 updates	 to	 the	 Home	 Study	 must	 be	 completed	 at	 least	
once	every	two	(2)	years	unless	you	are	using	the	home	study	to	adopt	outside	of	Ohio,	in	
which	 case	 you	 will	 need	 it	 updated	 annually.	 	 A	 home	 study	 which	 is	 more	 than	 six	 (6)	
years	old	cannot	be	updated.			
	
An	 adoptive	 couple	 may	 already	 have	 an	 approved	 home	 study	 from	 another	 agency,	
whether	 through	 an	 Ohio	 agency	 or	 out	 of	 state	 agency.	 If	 so,	 this	 home	 study	 will	 be	
reviewed	by	Gentle	Care	to	ensure	that	all	Ohio	adoption	regulations	and	requirements	are	
met.	Once	reviewed	and	approved	by	Gentle	Care,	the	home	study	will	be	treated	in	exactly	
the	same	manner	as	if	the	agency	itself	had	completed	it	and	will	be	used	as	an	integral	part	
of	 matching	 the	 adoptive	 couple	 with	 the	 prospective	 birth	 parent(s).	 Specifically,	 Gentle	
Care	will	ensure	that	a	home	study	from	another	agency,	whether	in	state	or	out‐of‐state,	is	
in	full	compliance	with	all	Multi‐Ethnic	Placement	Act	(MEPA)	regulations.		
	
Gentle	Care	works	with	adoptive	couples	in	every	county	and	community	across	Ohio.	To	
complete	the	home	study	process,	the	agency	utilizes	a	number	of	qualified	Licensed	Social	
Workers	(all	of	whom	are	state	certified	Adoption	Assessors),	who	themselves	are	located	
in	various	communities	throughout	Ohio.	Agency	Social	Workers	go	directly	to	the	home	of	
each	adoptive	couple,	wherever	the	couple	may	reside	in	the	state,	to	personally	meet	with	
them	 to	 complete	 the	 home	 study.	 Each	 Social	 Worker	 uses	 the	 same	 procedures	 when	
conducting	 the	 home	 study,	 so	 that	 adoptive	 couples	 are	 assured	 of	 receiving	 the	 same	
thorough	home	study	process,	no	matter	where	they	may	reside	in	Ohio.	
	
As	noted	previously,	initial	home	study	fees	are	$1,500.		Home	Study	Update	fees	(where	
Gentle	Care	completed	the	first	home	study)	are	as	follows:	
            $800			Home	Study	Update	if	a	placement	has	occurred	
            $250			Home	Study	Update	if	a	placement	has	not	occurred		
                                                  	
CRIMINAL	RECORDS	CHECK	
	
A	criminal	records	check	is	required,	as	a	pre‐condition	to	being	approved	for	an	adoptive	
placement,	for	all	prospective	parents	and	all	adult	residents	of	a	potential	adoptive	home.		
Adoption	by	Gentle	Care	will	advise	each	family	on	the	type	of	criminal	background	check	
required	as	follows:	
State	of	Ohio	BCII	plus	FBI	criminal	background	checks	required	for	approval	of	the	
initial	home	study	and	home	study	recertification.					
                                                  	



Revised 02/10/11
                     Adoption	by	Gentle	Care	Home	Study	Procedure	
	
Home	Study	Procedure	Outline	
    Referral	to	Agency	
        Date	applied	to	agency	
        Reaction	to	application	process	
        Number,	place	and	dates	of	interviews	
        Type	of	child	desired	
            1. Age	
            2. Acceptable	handicaps	
            3. Nationality	
            4. Religion	
            5. Reasons	for	preferences	
	
Motive	of	Applicants	
      A. Reasons	for	wanting	to	adopt	
      B. Attitude	concerning	adoption	and	reaction	to	sharing	this	in	interview	
	
Background	
      A. Husband	
          1. Identifying	data	
          2. Description		
          3. Personality	
          4. Health	
          5. Parents	and	Siblings	
          6. Childhood	and	adolescent	experiences	
          7. Adult	relationships	
          8. Education	
          9. Activities,	interests,	and	hobbies	
          10. Employment	
      B. Wife	(Same	as		Husband)	
	
Courtship	and	Marriage,	descriptions	and	adjustment	of	other	children	in	the	home	
	
Family’s	Social	Network	
      A. Friendships	
      B. Social	activities	
      C. Religion	
	
Readiness	for	Adoption	
      A. Resolution	of	infertility,	of	validity	of	decision	not	to	have	a	biological	child	
      B. Parenting	an	adopted	child	
	
Finances	
	


Revised 02/10/11
Description	of	Home	
	
References	
	
Evaluation	
              A. Emotional	maturity	and	stability/mental	health	
              B. Capacity	to	give	and	receive	affection	
              C. Ability	to	provide	for	a	child	
                   1. Financial	
                   2. Health	
                   3. Emotional	
                   4. Educational	
                   5. Parenting	skills	
                   6. Social	support	for	child	
                   7. Physical	environment	
              D. 	Stability	of	marriage	
	
Paperwork	Requirements	
              A. ODJFS	application,	(JFS	form	1691)	
														B.			Income	tax	return	
														C.			Financial	statement	(JFS	1681)	
														D.			Letters	from	employers	
              E. Gentle	Care	reference	information	list	
              F. References	
              G. Criminal	record	check	(BCII	/	FBI)	
              H. Local	criminal	record	check	
              I. Abstract	of	traffic	record	from	BMV	
              J. Gentle	Care	Medical	Release	
              K. Medical	Statement	(JFS	1653)	
              L. Health	Insurance	Information	
              M. Letter	from	Insurance	company	
              N. Marriage	Certificate/Divorce	Decree	
              O. Letter	from	child	care	class	
              P. Infant	CPR	certification	
              Q. Profile	
              R. Program	acceptance	acknowledgement	
              S. Booklist/questionnaire	
              T. Certification of Residency
              U. Emergency Contact Numbers
              V. Fire Inspection
              W. JFS 01673 (Pages 1 – 4)
              X. JFS 01673-A (Pages 1 - 5)
              Y. Home Study Questions
	
Recommendations	



Revised 02/10/11
5101-2:48-19 Sharing and Transferring Adoptive Homestudies

The following definitions apply for the purpose of this rule: “Sharing an adoptive home study”
means forwarding an approved home study to an agency for consideration of potential adoptive
matches.

“Transferring an adoptive home study” means releasing the approved home study and all related
materials to another agency. Upon acceptance of the receiving agency and the execution of the
JFS 1334 (new form) “Recommendation for Transfer or a Foster or Adoptive Home”, the
sending agency is relieved of all the responsibilities related to the approved adoptive family.

If the adoptive family has signed an authorization for release of information, the agency shall
make the home study available for sharing or transferring.

The agency shall release the home study and related materials, including the JFS 1530, “Multiple
Children/Large Family Assessment” within 15 days after the request was made. A reasonable
charge is allowed.

The receiving agency shall not approve the transfer request until the following information is
received and approved by the agency.

               Three new personal references, who are not related to the prospective adoptive
               parent and do not live with the prospective adoptive parent.

               A new criminal record is obtained reviewed and approved by the assessor for all
               persons eligible for a criminal check residing in the home.

               A new safety audit is conducted to verify the home meets all current safety
               standards.

               Documentation of the assessor’s decision to recommend approval of the transfer
               request. The prospective adoptive parent and the sending agency are sent a written
               notice within 5 working days of the decision.

If an incomplete home study is received from an agency, the receiving agency shall notify the
sending agency in writing within 10 days from the date of the receipt of the incomplete home
study. The written notification shall indicate the information needed for the home study to be
considered to be complete. The sending agency should respond within 15 days from the receipt
of the written notification from the receiving agency.

Upon acceptance of the transfer of an adoptive home study, the JFS 1334 shall be completed and
signed by both the sending and receiving agencies.
               Adoption by Gentle Care Home Study Update Procedures

Adoption by Gentle Care shall amend the adoptive home study if:

   Any of the following have occurred since the last home study approval date: change in
   marital status of the adoptive applicant, change in health status of the adoptive
   applicant, finalization of the adoption of a child, birth of a child, death of a household
   member, criminal conviction of an adoptive applicant, change in number of adult
   household members, or the adoptive applicant has moved.
   The adoptive applicant or adoptive home has also been certified as a family foster
   home. The agency shall follow recertification procedures outlined in the rule 5101:2-5-
   24 of the Administrative Code.

No less then ninety (90) or no more than one hundred twenty (120) calendar days
prior to the expiration of the adoptive home study, the agency shall notify the family
of the date of expiration of the home study. The adoptive home study updates shall
be completed prior to the date of expiration, as once a home study has expired, it
cannot be updated. A home study which is more than six years old cannot be
updated. A home study must be current until finalization occurs, not just current
until placement.

When updating the adoptive home study report the assessor shall:
   Conduct a face-to-face interview with the adoptive applicant, which shall take place in
   the home of the applicant
   Assess any family changes since approval of the adoptive home study, which may affect
   the ability of the applicant to successfully parent an adoptive child
   Collect supporting documentation, which shall include, but not be limited to:
        Current child abuse check
        1 reference
   Complete ODJFS form 1385 which addresses all information obtained during interviews
   and review of documentation provided by the applicant. The completed form shall be
   attached to the original home study.

NOTE: All applicants who are denied the opportunity to continue to work with Gentle Care
have the right to request in writing a review of the decision by Gentle Care not to work with
them.
 ADOPTION APPLICATION, HOME STUDY AND HOME STUDY UPDATE PROCEDURES
                        POLICY (5101:2-48-08, 09, 10 &12)
 (Adoption services to applicants seeking special and non-special needs children)


   1. Inquiry Process (5101:2-48-08):

Gentle care shall respond to adoption inquiries within seven (7) working days and shall
provide the following information:

          1)     Copy of Gentle Care’s MEPA complaint adoption policy and summary of
                 policy.
          2)     Description of characteristics and approximate number of available
                 children in Ohio.
          3)     Information concerning: (a) availability of Title IV E adoption assistance
                 and state adoption subsidy programs: (b) AdoptOHIO web address &
                 ODJFS 1675 Ohio Adoption Guide: (c) how to obtain an application: (d)
                 fingerprint & Criminal background check requirements: (e) adoption
                 home study approval process.
          4)     ODJFS 1691 Application for Child Placement.

    2. Application Process (5101:2-48-09):

As part of the home study process, Gentle Care requires proof of current marital status and
proof of Ohio residence for five (5) years for applicant and all adult household members.

Gentle Care requires applicants to submit ODJFS form 1681 regarding the applicant’s
income, assets, and financial responsibilities.

Gentle Care offers assistance in completing the application and securing all required
documents and information.

Gentle Care can terminate the home study process if all required documentation is not
submitted within one (1) year of the receipt of the initial or revised ODJFS 1691.

Gentle Care will accept all applicants who submit a completed ODJFS 1691. See        the
agency Application Process narrative and form, plus the agency policy on “Joint Foster
Care/Adoption Application and Home Study Assessment/Approval Policy” for additional
information.

    3. Home Study Process (5101:2-48-12):

Once the adoptive family has completed and returned the ODJFS 1691 form to the agency,
the home study process will commence within thirty (30) days of the date the agency
receives the ODJFS 1691 “Application for Child Placement”. The assessment will be
completed within one hundred eighty (180) days of the date it is started. If the agency fails
to commence an assessment within thirty (30) days or complete the assessment within one
hundred eighty (180) days, Adoption by Gentle Care will document the reasons why it was
unable to meet one or both of these requirements in the adoptive family’s record.
Commencement of a home study means, at a minimum, scheduling an appointment to
interview the applicant or assuring that the applicant has been informed of the necessary
materials required for the assessor to complete the home study.

The agency’s policy is to require the adoptive family’s attendance and participation at the
mandatory Group and Assessment meeting, as this is an important and integral part of the
overall home study assessment/approval process. As such, the agency will, within thirty
(30) days of receipt of the adoptive family’s ODJFS 1691 “Application for Child Placement”,
notify the family of the next available date for the Group and Assessment, and invite them
to attend this session. This written notification will serve as the commencement of the
home study process.

Completion of the home study and written notification to the applicant of the approval or
denial will be provided within one hundred eighty (180) days of the date the completed
application was submitted which initiated a home study for any applicant seeking a special
needs child.

Completion of the home study and written notification to the applicant of the approval or
denial will be provided within twelve (12) months of the date the completed application
was submitted if not seeking a special needs child.

    4. Completion of Home Study Update Process and Amendment Process (5101:2-48-
       12.1):

Not less than 90 days or more than 120 days prior to the expiration of a home study or
a two (2) year update, the adoptive family should be notified on the JFS 1331 “Notice of
Expiration and Reapplication for a Foster Home Certification or Adoption Home Study
Update/Amendment” (rev. 12/06). If the adoptive parents fail to apply for renewal
within 30 days of the date on the notification letter, the home study will lapse upon the
expiration date, the record shall be closed and the applicant’s must reapply through
the initial home study process. No home study is valid for more than six (6) years from
the original approval date; the home study can no longer be updated. Updates must
include child abuse registry checks.
     JOINT FOSTER CARE/ADOPTION APPLICATION AND HOME STUDY ASSESSMENT
                          PROCESS (5101:2-48-12 (A)


All applicants have a right to a Joint Foster Care/Adoption Home Study; however, Gentle
Care does not offer a joint study, as only adoption services, not foster services, are
provided. Gentle Care shall refer any family who wants a joint study to an agency who
provides joint studies (i.e. the local County Job and Family Services agency in the family’s
county of residence, etc.).

Adoption Application Process:

Applicants are accepted from all families who have submitted their JFS 1691 “Application
for Child Placement”. Adoption by Gentle Care encourages and welcomes a diverse mix of
applicants so that the birth parents we work with will have families representative of the
broader community from which to choose. Adoption by Gentle Care maintains a list of
families who are of various ages, religions, geographical locations and professions. Birth
parents working with Adoption by Gentle Care select the adoptive family themselves. All
applicants, regardless of the agency program they have applied for, go through the same
educational/training process.

All families go through the exact same process when asked to indicate what race they are
open to on their application. At the end of the home study, the Social Worker reviews Form
JFS 1691, “Application for Child Placement” (page 4, paragraph entitled “Type of Child Will
Consider”) with the family, plus the agency’s Adoption Planning Questionnaire. All families
are treated the same in this process.

Home Study Assessment/Approval Process:

Adoption by Gentle Care offers Group and Assessment meetings approximately 4-6 times a
year. This is an orientation meeting for adoptive couples to learn about the agency, the
adoption process, meet the staff, and have their questions answered. They also hear a birth
parent speak who has placed a child through Adoption by Gentle Care. Families are invited
to this meeting after being informed they have been accepted. They are generally invited to
attend in the chronological order applications are received. At the Group and Assessment
meeting, any family who has completed the paperwork for their home study will need to
submit their documents to their Social Worker, who will be assigned at Group and
Assessment. However, all paperwork is not required to be completed prior to the start of
the home study process. If the agency is in need of families, the home study meetings are
scheduled before the adoptive couple attends the Group and Assessment meeting. The
adoptive couple is approved as soon as the home study meetings are complete, they have
completed and submitted all required paperwork and completed the activation process.
The adoptive couples complete the paperwork at their own pace.
                                AGENCY NOTIFICATION

Please notify the agency, if any of the following changes occur in your household, and within
the timelines indicated. If these ODJFS rules are not followed accurately, your home study
could lapse or become invalid. These rules took effect on 7/1/2009.

An approved adoptive parent must notify the recommending agency within ONE HOUR if
any of the following circumstances occur involving the adoptive child whose adoption is
not finalized.

              A serious illness or injury involving medical treatment for the child.

              Death of the adoptive child.

              Unauthorized absence of the adoptive child from the home.

              Removal of the adoptive child from the home by any person or agency, other
              than the placing agency, or attempts at such removal.

An adoptive parent must notify the recommending agency within 24 HOURS or the next
working day if any of the following occur prior to the finalization of the child. This also
includes the time between the approval date and the actual placement of the child in the
home.

              A change in the marital status of the adoptive parent.

              Any serious illness or death of an adopted parent(s) or household member.

              The finalization of an adoptive child placed by a different agency.

              A change in the number of household members through birth or kinship who
              is under 18.

              A change in the number of adults residing with the approved adoptive parent
              (not including an existing household member reaching the age of 18).

              A criminal charge or conviction of any approved adoptive parent or other
              adult household member(s).
              A significant change in financial status/income, which would include the loss
              of a job or having a new job paying significantly less or more than the job
              they had at the time of the home study.

              Change of address or relocation.

New child household members residing with the adoptive parent shall have a (JFS 1653),
medical statement completed within 60 DAYS of becoming a household member.

If an infant is born to an adoptive parent, the agency should document that the adoptive
parent and prenatal care and is receiving periodic medical exams from a physician, the
mother must have a (JFS 1653), medical statement completed within 90 DAYS of the date
the infant became a household member.

Household members turning 18 shall have BCII and FBI checks initiated within 10
WORKING DAYS of the date they turn 18.

New adult household members residing with the approved adoptive parent shall obtain a
BCII, FBI and an Ohio child abuse registry check initiated within 10 DAYS of becoming a
household member.

New adult members of the household residing with the approved adoptive parent shall
have a (JFS 1653) medical form completed within 60 DAYS of becoming a household
member.

Upon notification of the approved adoptive parent moving to a new residence, a safety
audit shall be completed within 10 WORKING DAYS of the notification.

A fire safety inspection must be conducted within 90 DAYS of the change of address.



Please keep this list, so you can refer to it and the timelines, if any above circumstances
should change in your home. Again, failure to notify the agency, following the time frames
above, could cause your home study to lapse or become invalid, thus delaying placement or
finalization.

Please contact the social worker who did your home study, if any of these changes occur, so
she can add an addendum to your home study as soon as possible. If you have any
questions regarding the above rules, you can also contact the social worker who did your
home study.
                               
                               
                               
                               
                               
                               
                   Adoption by Gentle Care 
 
                    Financial Assistance 
 

 

 

 

 



 

 

 

 

 

 

 




Revised 07/02/09
Are	there	any	subsidies	or	financial	assistance	that	we	can	get	to	help	with	adoption	
fees?	
	
There	 are	 organizations	 that	 typically	 help	 lower	 to	 middle	 class	 families	 with	 adoption	
costs.		The	one	we	highly	recommend	is	American	Adoptions,	whose	gift	application	form	
we	have	enclosed	with	this	packet.		Their	main	focus	is	to	help	families	who	are	interested	
in	adopting	minority	children,	special	needs,	and	other	unique	situations.		You	can	submit	
an	 application	 and	 they	 will	 provide	 a	 response	 to	 you	 usually	 within	 30	 days,	 if	 you	 are	
approved.	 	 There	 are	 other	 organizations	 beyond	 American	 Adoptions	 who	 help	 families	
with	their	adoption	costs.		Below	are	some	other	resources.	
	
               Adoption.com:		
            State	of	Ohio	Adoption	Subsidy	Profile	
            Adoption	Subsidy	Advocates:	Adoption	Policy	Resource	
            Adoption	Subsidy:	Negotiating	and	Renegotiating	Your	Child’s…	
            Adoption	Subsidy:	
                Federal	Adoption	Subsidy	Programs	Special	Needs	SSI	or	AFDC	
                NACAC	Subsidy	Fact	Sheets	
                International	Adoptions	and	Adoption	Subsidies		
            In‐Family	Adoptions:	
                Federal	and	state	adoption	assistance/adoption	subsidy	programs	
                   services	and	financial	resources	to	the	adoptive	family	
            Practical	Guide	to	Adoption	Subsidies	(e‐book)	
            Adoption	Subsidy‐Adoption	Week	e‐Magazine	Article	

Tax	Credits	
	
President Obama’s health care bill which was passed in March, 2010 increased the tax
credit to a maximum of $13,170 for 2010, and extended the credit’s expiration date to
December, 2011. It also included an income exclusion, which allows parents to exclude
their employer’s adoption assistance benefits from their net income.

The new law made the tax credit refundable, so that lower income families can claim it. If a
family’s “qualified expenses” exceeds their tax liability, they will receive the difference in the
form of a tax refund. Parents can claim both the credit and the income exclusion for
qualified expenses, but cannot claim both for the same expenses.

Parents are generally eligible to claim the credit in the year that the adoption is finalized,
even if part of those expenses were incurred in the previous year. The income exclusion is
generally available in the year the benefits were received for a domestic adoption. The
maximum available credit begins to phase out at a combined income of about $180,000.

“Qualified adoption expenses” are reasonable and necessary expenses directly related to
adoption. These include agency/attorney fees, court cost and travel. Costs that were
reimbursed by an employer or were funded under a government program are not eligible.



Revised 02/10/11
Because the credit may be taken for each adoption attempt, costs associated with a failed
domestic adoption qualify.

Source: “Adoptive Families Magazine” (October, 2010). Author: Janna J. Annest

This information is intended as a general overview and should not be relied upon as a
substitute for the advice of a qualified tax professional.


Other	Options	
	
 Ask	your	family	if	they	could	provide	a	loan	or	perhaps	even	a	monetary	gift	to	help	
   with	your	adoption	expenses.	
 Consider	bank	loans	to	cover	the	costs	of	your	adoption.	
 Churches	are	often	a	good	source	of	support,	both	financially	and	emotionally.	
 Private	Grants	or	Loans	are	available.	
       www.Helpusadopt.org	
       National	Adoption	Foundation	
          100	Mill	Plain	Road	
          Danbury	Connecticut		06811		
          1‐800‐448‐7061		
       www.adoption‐network.com	
 Try	borrowing	against	Retirement	Funds	or	Life	insurance	policies.			
 Employers	often	provide	for	adoptions	in	their	benefits	packages.	
   (www.AdoptionBenefits.com)	
 	A	practice	that	is	growing	more	common:	insurance	policies	covering	birth	mother	
   medical	expenses.				
 Apply	for	a	financial	gift	from	American	Adoptions.	
	




Revised 02/10/11
                               
                               
                               
                               
                               
                               
                               
                   Adoption by Gentle Care 
 
                       State Resources 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 


Revised 07/02/09
ADOPTION
                                                                                                    Adoption Statistics
Mission
To provide support to local agencies in their efforts to decrease the number of children waiting    • Statewide, in FFY
for permanent homes; to prevent discrimination in the placement of children; to identify and        2005, there were 1,895
recruit permanent families who can meet each child’s needs; and to provide support to families      children entering
to ensure the stability and well-being of the children in their care.                               permanent custody;
                                                                                                    this was a 12 percent
Adoption Services                                                                                   decrease from 2,107
Adoption is a lifelong process and often involves challenges to families. To assure permanency      in FFY 2004.
is maintained, the Ohio Department of Job and Family Services provides a comprehensive
scope of services to birth parents, adoptive parents and adoptive children, particularly those      • The number of
children who have been in foster care. These services are largely provided by public children       children waiting for
services agencies, private child placing agencies, and private noncustodial agencies in             adoption decreased
collaboration with ODJFS.                                                                           from 3,200 in FFY
                                                                                                    20 03 to 2,80 0 in
AdoptOHIO: Decreasing the Number of Waiting Children                                                FFY2005.
On any given day, more than 22,000 children are living with foster families or in another out-
of-home placement setting. Nearly 2,800 of these children are waiting for adoptive families.        • The number of
Children who wait the longest for adoptive families include: African American children; those       adoptions declined
over the age of ten; and/or children who are part of a sibling group. Maintaining the needed        from 2,260 in FFY
number of families to assure the appropriate placement for each child is an enormous task           20 04, to 1,989 in
to accomplish and no one can do it alone. For more information, go to the AdoptOhio web             FFY 2005. This was
site at:                                                                                            an expected decline
http://jfs.ohio.gov/oapl/index.htm                                                                  since the number of
                                                                                                    children waiting for
Ohio Adoption Photo Listing: Recruiting Families                                                    adoption decreased
One of the most important tools in recruiting families for waiting children is the maintenance      7 percent from FFY
of the Ohio Adoption Photo Listing web site. This web site allows potential families to view        2004 to FFY 2005.
pictures and profiles of children who are available for adoption over the Internet and receives
on average, 2,000 visitors per month. This site is updated daily with information about
                                                                                                    • For additional
children who are available for adoption. For more information, go to: http://www.odjfs.state.
                                                                                                    statistics, see
oh.us/oapl.query.asp
                                                                                                    t h e “A d o p t i o n
Preventing Discrimination in Placement                                                              Performance Report
                                                                                                    at http://jfs.ohio.gov/
The Multi-ethnic Placement Act/Inter-Ethnic Placement Amendments (MEPA) of 1994 prohibit
discrimination in placing children for adoption as well as from denying or delaying, or otherwise   ocf/publications.stm
discriminating in making placements on the basis of race, color, or national origin, of a child
or a prospective adoptive family, if the child placing agency receives federal funding.

Similarly, federally funded agencies and sub-recipients may not deny or delay the opportunity
for any person to become an adoptive or foster parent on the basis of race, color, or national
origin. Failure to comply with MEPA can result in a loss of substantial federal funding for Ohio.
To ensure statewide compliance with MEPA, adoption services staff work closely with Ohio
Department of Job and Family Services’ Office of Legal Services, Bureau of Civil Rights, and
the federal Office for Civil Rights, in the development of policy, training and the provision of
technical assistance to foster care and adoption agencies.



          	       	       	       	       	        	     02/08                     Continued
ADOPTION                         	       						 	        	        	       	       	       																							Page 2

Supporting Families Prior to Adoption
Putative Father Registry
The Putative Father Registry is a computerized database maintained by the Ohio Department of Job and Family
Services for men to register if they believe they may
have fathered a child and want to be notified should the child be made available for adoption. The Putative Father
Registry is searched as part of the process to determine whether the child’s ability to be adopted is at risk. If a child is
placed for adoption, the putative father, if listed in the registry, will be notified and can seek legal counsel regarding
his rights.

Supporting Families After Finalization - Adoption Subsidies
Several types of financial subsidies are available to assist the adoptive families in meeting the special needs of their
adopted child/children.

Adoption Assistance
The Title IV-E Subsidy Program was created by the Adoption Assistance and Child Welfare Act of 1980. It provides
federal financial support for adopted children who are described as having special needs. In addition to
a monthly monetary payment, children who are Title IV-E eligible are entitled to other state assistance and services
under the Federal Title XX Program and Medicaid coverage.

State Adoption Subsidy Program
The State Adoption Subsidy program is a financial assistance program which provides monthly maintenance subsidies
to adoptive families who adopt special needs children who are ineligible for Title IV-E. The child or children may also
be eligible for Medicaid coverage. Public Children Services Agencies are responsible for determining eligibility and
administering the state adoption subsidy program.

Post Adoption Special Services Subsidy Program
The Post Adoption Special Services Subsidy (PASSS) Program is designed to assist eligible adoptive families after
finalization. Services include medical, surgical, counseling, psychological, psychiatric and residential treatment.
Ohio is nationally recognized for the program due to an ongoing commitment of support for adoptive children and
their families.

Interstate Compact on Adoption and Medical Assistance
The interstate Compact on Adoption and Medical Assistance Program was developed to ensure that medical coverage
and other adoption services for eligible children continue in their state of residence.The program creates a framework
for formalized interstate cooperation on behalf of an adopted child and his/her family if the family moves from one
state to another. It removes the systematic barriers associated with forms and specific state requirements in obtaining
medical assistance for the adopted child. Each participating state has a compact administrator who helps facilitate
the provision of benefits and services for the special needs of the adopted child. The administrator processes the
necessary paperwork and serves as an informational resource.Today, nearly all states, including Ohio, are represented
in the Interstate Compact on Adoption Program.
Ohio Adoption Photo Listing Web Page: 
www.odjfs.state.oh.us/oapl/query.asp 
 
POLICY ON COMPLAINTS OF ALLEGED DISCRIMINATORY ACTS   (5101:2­33­03) 
 
 
Gentle Care (a PCPA) will provide a written notice of the procedure for any complaints of 
discrimination in the foster care or adoption process that involve race, color, or national 
origin (RCNO) to all individuals inquiring about or applying to be a foster caregiver or 
adoptive parent. The written notice of the procedure for complaints will be provided 
within seven days of the individual’s first contact with the agency. The JFS 02333 
“Discrimination Complaint Form” will be used to file a complaint. 
 
Any individual may file a complaint alleging a discriminatory act, policy or practice in the 
foster care or adoption process of the agency. 
 
Any person, including but not limited to, an employee or former employee of the agency or 
a member of a family which has sought to become a foster caregiver or adoptive parent 
may also file a complaint alleging that he or she was intimidated, threatened, coerced, 
discriminated against or otherwise retaliated against in some way by the agency because 
he or she has made a complaint, testified, assisted, or participated in any manner in an 
investigation, proceeding, or hearing in connection with an allegation what the agency 
engaged in discriminatory acts, policies, or practices as it applies in the foster care or 
adoption process. 
 
The individual filing a complaint shall use the above noted JFS 02333 “Discrimination 
Complaint Form”. The complaint shall be filed within two years from the date of the 
occurrence of the alleged discriminatory act: or two years from the dated of the 
complainant learned or should have known of a discriminatory act, policy or practice. The 
complaint may be filed with any Public Child Services Agency, Private Child Placing Agency 
(e.g. Adoption by Gentle Care), Private Non‐custodial Agency or the Ohio Department of Job 
and Family Services 
 
    When any complaint alleging discrimination in the foster care or adoption process is 
    received by: 
      (1) Adoption by Gentle Care, the agency will forward the complaint to ODJFS within 
          three working days of date of receipt of the complaint. 
       
      (2) ODJFS will notify Adoption by Gentle Care that it is the subject of the complaint 
          within three working days of the receipt of the complaint. 
 
      ODJFS will conduct an investigation of the complaint. Adoption by Gentle Care will not 
      initiate, conduct, or run concurrent investigations surrounding the complaint or take 
      any further action regarding the complainant or the subject of the complaint until the 
      issuance of the final investigation report by ODJFS, unless approved by ODJFS. 
       



Revised 07/02/09
     Adoption by Gentle Care will cooperate fully with ODJFS during the course of the 
     investigation and will submit any information requested by ODJFS not later than 
     fourteen days from the date of the request unless otherwise agreed upon. 
      
     No person who has filed a complaint alleging a discriminatory act, policy or practice  in 
     the foster care or adoption process of Adoption by Gentle Care or who has testified, 
     assisted or participated in any manner in the investigation of a complaint shall be 
     intimidated, threatened, coerced, or retaliated against by any employee or contractor 
     of this agency. 
      
     Adoption by Gentle Care will provide a written notice of the procedures for any 
     complaints of discrimination in the foster care of adoption process within thirty days 
     of the effective date to all foster caregivers certified or in the process of certification 
     and to all individuals who have approved adoptive home studies or who are 
     participating in the adoptive home study process on the effective date of this rule. 
      
     See the attached copy of the JFS 01611, “Non­ Discrimination Requirements for Foster 
     Care and Adoptive Placements”, which is considered to be an integral part of this policy. 
 




Revised 07/02/09
                            Ohio Department of Job and Family Services

               Non-discrimination Requirements for Foster Care and Adoptive Placements

The Multiethnic Placement Act of 1994, 42 U.S.C. 622(b)(9), 671(a)(18), 674(d) and 1996(b) (hereinafter
"MEPA") and Title VI of the Civil Rights Act of 1964, 42 U.S.C. 2000d, et seq as it applies to the foster
care and adoption process (hereinafter "Title VI"), are designed to decrease the time children wait for
foster care and adoption placement, prevent discrimination in the placement of children, and aid in the
identification and recruitment of foster and adoptive families who can meet each child's needs. It prohibits
any agency using federal funds from denying any person the opportunity to become an adoptive parent or
foster caregiver on the basis of race, color or national origin of that person, or of the child involved and
from delaying or denying the placement of a child for adoption or foster care on the basis of race, color or
national origin of the adoptive parent or parents, of the foster caregiver or caregivers, or the child involved.

Under MEPA and Title VI, no agency may routinely consider race, color or national origin as a factor in
assessing the needs or best interests of children. In each case, the only consideration shall be the child's
individual needs and the ability of the prospective foster caregiver or adoptive parent to meet those needs.
Only the most compelling reasons may serve to justify consideration of race, color or national origin as part
of a placement decision. Such reasons emerge only in the unique and individual circumstances of each
child and each prospective foster caregiver or adoptive parent. In those exceptional circumstances when
race, color or national origin need to be taken into account in a placement decision, such consideration must
be narrowly tailored to advance the child's best interest. Even when the facts of a particular case allow
consideration related to race, color or national origin, this consideration shall not be the sole determining
factor in the placement decision.

The following actions by a PCSA, PCPA, or PNA are permitted under MEPA and Title VI:

           •    Asking about and honoring any choice made by prospective adoptive parents or prospective
                foster caregivers regarding what race, color or national origin of child the prospective
                adoptive parents or prospective foster caregivers will accept.

           •    Honoring the decision of a child over 12 years of age to not consent to an adoption when
                that decision has been approved by a court pursuant to section 3107.06 of the Revised Code.

           •    Providing information and resources about adopting a child of another race, color or national
                origin to prospective adoptive parents or prospective foster caregivers who request such
                information and making known to all families that such information and resource are
                available.

           •    Considering the request of a birth parent(s) to place the child with a relative or nonrelative
                identified by name.


           This form is used in compliance with the Ohio Administrative Code rules 5101:2-48-05 and 5101:2-5-13.




JFS 01611 (2/2005)                                                                            Page 1 of 3
          •   Considering race, color or national origin as a possible factor in the placement decision
              when compelling reasons serve to justify that race, color or national origin needs to be a
              factor in the placement decision. Even when the facts of a particular case allow
              consideration related to race, color or national origin, this consideration shall not be the sole
              determining factor in the placement decision.

          •   Discussing the special cultural and physical needs of children of different races, ethnicities,
              and national origins as part of the training which is required of all persons who seek to
              become eligible to be adoptive parents or foster caregivers.

          •   Documenting verbal comments, verbatim, or documenting in detail any other indication
              made by a prospective adoptive family member or prospective foster caregiver family
              member living in the household reflecting a negative perspective regarding the race, color or
              national origin of a child for whom they have expressed an interest in adopting and
              indicating whether those comments were made before or after completion of the cultural
              diversity training which is required for all prospective adoptive or foster care applicants.

The following are examples of actions prohibited under MEPA and Title VI:

          •   Using the race, color or national origin of a prospective adoptive parent or foster caregiver
              to differentiate between adoptive placements for a child, unless an individualized assessment
              has been completed.

          •   Honoring the request of a birth parent(s) to place a child with a prospective adoptive parent
              or prospective foster caregiver of a specific race, color or national origin, unless the birth
              parent(s) identifies a relative or non-relative by name and that person is found to meet all
              relevant state child welfare protection standards, unless the agency determines that the
              placement is not in the best interests of the child.

          •   Requiring a prospective adoptive family or a prospective foster caregiver to prepare or
              accept a transracial adoption or foster care plan.

          •   Using "culture" or "ethnicity" as a proxy for race, color or national origin.

          •   Delaying or denying placement of a child based upon the geographical location of the
              neighborhood of the prospective adoptive family or a prospective foster caregiver whenever
              geography is being used as a proxy for the racial composition of the neighborhood, the
              demographics of the neighborhood, the presence or lack of presence of a significant number
              of persons of a particular race, color, or national origin in the neighborhood or any similar
              purpose.

          •   Requiring extra scrutiny, additional training, or greater cultural awareness of individuals
              who are prospective adoptive parents or foster caregivers of children of a different race,
              color or national origin than required of other prospective adoptive parents or foster
              caregivers.



JFS 01611 (2/2005)                                                                    Page 2 of 3
          •   Relying upon general or stereotypical assumptions about the needs of children of a particular
              race, color or national origin.

          •   Relying upon general or stereotypical assumptions about the ability of prospective adoptive
              parents or prospective foster caregivers of a particular race, color or national origin to care
              for or nurture the sense of identity of a child of another race, color or national origin.

          •   "Steering" prospective adoptive parents or foster caregivers away from parenting a child of
              another race, color, or national origin. "Steering" is any activity that attempts to discourage
              prospective adoptive parents or prospective foster caregivers from parenting a child of a
              particular race, color or national origin.




JFS 01611 (2/2005)                                                                  Page 3 of 3

				
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