Exhibit C DCS-1227A Child Specific Recruitment Plan.pdf

Did AUK or CHG play a role in identifying the placement?

CHILD SPECIFIC RECRUITMENT PLAN (CSRP REPORT)

ARIZONA DEPARTMENT OF CHILD SAFETY

DCS-1227A

(02/20)

Agency Assigned

Name of Recruiter Assigned

Date of Referral Second 90 Day CSRP DueDate Initial CSRP Due Subsequent 90 Day Follow-up CSRP Due Subsequent 90 Day Follow-up.

Indicate sequence of CSRP if 3rd or greater in sequence

Date of Birth

Date of Birth

Email

Child’s NamePhone No.

CHILD’S PID# JD#

Child Information ~ Complete one form for each child. Submit sibling groups together.

Finalized CSR ~ Incomplete plans will be denied and returned to contractor.

Getting Ready to Recruit Checklist

Yes Yes

Yes Yes Yes

No No

No No No

Is the child part of a sibling group? If yes, are the siblings to be placed together?

Is the date of adoption included?

Was the Adoption Finalized

What was successful that can/should be incorporated in other CSR’s?

Closed by ADCS

Adoption FinalizedChild Placed

Permanent Connection Found

Activity Date Completed/ Expected to be Completed

Additional Information

AUK Registration

Media Release (acquired by assigned Child Safety Specialist)

Meet with Child Safety Specialist

Access to Child’s case file to “Mine” for information / If so;

what resulted from the file dig? Number of relatives past placement discovered?

Meet with Child

Talk to other Team members/Current-Past Care Givers

Obtain recent Photograph of the Child of high resolution or obtained by CHG Photoshoot Prepare/Update Child’s Profile

CFT’s attended dates

Specific Recruitment Activities (Flyer, Narratives, etc.)

Submit for DCS approval Other:

ARIZONA DEPARTMENT OF CHILD SAFETY

DCS-1227A

(02/20)

Initisal CSR Report ~ Incomplete plans will be denied and returned to Contractor

Are the recruitment activities specific to the child? Example: A child with medical needs are we recruiting within the medical community?

Describe the initial visit with the child, and any subsequent visits - including date(s) and location(s)

Are there clear and measurable goals? Include estimated completion dates for all activities

What is the child’s desired goal and outcome?

What was the result of the file being mined/number of relatives/past placements and other connections/neighbors/friends, etc., identified.

When/how has the recruiter been in contact with the DCS case manager?

What family finding measures/activities will be utilized?

When/how has the recruiter been in contact with the current placement?

What media recruitment efforts will be made (CHG, AUK, Wednesday’s Child, etc.) and when will this be completed?

What “out of the box” efforts will be made?

Narrative ~ (Summary to include: background, needs, strengths, interests, family desired, etc. that will drive the recruit plan.)

Discussion Guide for Child Interviews

What adults does the child look forward to spending time with?

Who did you share holidays or special occasions with. Who would you call if you had great news to share? Who would you call if you were having a rough day”? Who are the child’s relatives/significant others?

What adult(s) does the child miss from their past placements?

When the child lived at home, who did they see at holidays? Who came to birthday parties?

The interviewer should always review the file and talk to the Child Safety Specialist, current caregiver, and other relevant team members (therapist, GAL, CASA, etc.) before talking to the child. It is extremely important to be aware of subjects that may be triggers for the child.

It is also important that the interviewer be aware of resources that the child may discuss that have been deemed unavailable by the child’s team. When asking the child questions, it is important to document all identifying information the child is able to provide

CHILD SPECIFIC RECRUITMENT PLAN (CSRP REPORT)

ARIZONA DEPARTMENT OF CHILD SAFETY

DCS-1227A

(02/20)

Discussion Guide for Child Interviews ~ continued

What are the child’s current interest and hobbies?

What would the child’s ideal day look like?

What family setting would be ideal for the child?

What would the child like to learn to do if they could? What would the child like to get better at?” (ex. Math, soccer, drawing, etc.)

What are the child’s future plans and hopes for education and career?

If that ideal family wasn’t available, who would the child want to have as a permanent connection?

What is the child’s idea of a family?

What would the child like to share about themselves with the family who is considering a permanent relationship with the child?

The interviewer should always review the file and talk to the Child Safety Specialist, current caregiver, and other relevant team members (therapist, GAL, CASA, etc.) before talking to the child. It is extremely important to be aware of subjects that may be triggers for the child.

It is also important that the interviewer be aware of resources that the child may discuss that have been deemed unavailable by the child’s team. When asking the child questions, it is important to document all identifying information the child is able to provide

CHILD SPECIFIC RECRUITMENT PLAN (CSRP REPORT)

ARIZONA DEPARTMENT OF CHILD SAFETY

DCS-1227A

(02/20)

DCS-1227A

(02/20)

Ext.

Ext.

Ext.

Ext.

Ext.

Ext.

Name (First, Last, MI)

Name (First, Last, MI)

Name (First, Last, MI)

Name (First, Last, MI)

Name (First, Last, MI)

Name (First, Last, MI)

Email Address

Email Address

Email Address

Email Address

Email Address

Email Address

Phone No.

Phone No.

Phone No.

Phone No.

Phone No.

Phone No.

Address

Address

Address

Address

Address

Address

City

City

City

City

City

City

State

State

State

State

State

State

ZIP

ZIP

ZIP

ZIP

ZIP

ZIP

Recruitment Team Members

List names of team members and stakeholders who have agreed to help find a permanent home for the child.

DCS-1227A

(02/20)

C hi ld ’s

S up p o rt R es o ur ce s Su p p or t

Re so ur ce s N am e of C on ta ct D at e of

C on ta ct

A d d re ss Ph on e

Re su lts o f C on ta ct

Pa te rn al

R el at iv es

M at er na l R el at iv es

N ei gh bo rs

Fr ie nd s

Te ac he rs

Pa st

Pl ac em en ts

Pl ac em en ts o f S ib lin gs

O th er

A d d it io na l I nf o rm at io n

DCS-1227A

(02/20)

Sp ec ia liz ed In d iv id ua liz ed

C

SR

A ct iv it ie s Su m m ar y p la n to r ec ru it f o r th is c hi ld

. W he re c o lla te ra l m at er ia ls u se d

Fo r ex am p le : T he c hi ld li ke s ho rs es s o

I w en t to x yz e q ui ne g ro up o

R es ul ts w er

Re cr ui tm en t

G oa ls D at

C om p le te d Ta rg et

D at e Re su lts o r

H ow m an y fo llo w ed u p on

A d d it io na l I nf o rm at io

DCS-1227A

(02/20)

C o m m un it y, S ta te w id e

N at io na l R es o ur ce s

A ct iv ity

D at e C om p le te d O ut co m es

D es cr ib e ho w t he f am ily

/c hi ld (r en ) h av e b ee n su p p o rt ed f ro m p la ce m en t th ro ug h fi na liz at io n.

R eq ui re d on fi na liz at io n re po rt s