Exhibit D DCS-1227B Subsequent 90 Day Report.pdf
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- Attached to
- Master Agreement AZ|CTR056497
- Contract number
- CTR056497
- Issued by
- Arizona
About this file
This document is a Subsequent 90 Day Report form from the Arizona Department of Child Safety (DCS), specifically the DCS-1227B form dated 02/20. The form is designed for Child Specific Recruitment reporting, providing a structured template for recruiters to document their efforts in finding permanent placement for children in the child welfare system.
The form requires detailed reporting across several key areas, including communication between the recruiter and child, progress and recruitment efforts, contact with previous placements, discussions with current placements about permanency, potential family matches, and identifying barriers to permanency. The document is structured to capture specific, measurable information about recruitment activities, with sections for documenting communication types, recruitment progress, family matching efforts, and strategic planning for the next 90 days. The form emphasizes the need for specific, statistically supported documentation to track and improve child placement efforts.
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Text version
REPORTING DELIVERABLES CHILD SPECIFIC RECRUITMENT
SUBSEQUENT 90 DAY REPORT
ARIZONA DEPARTMENT OF CHILD SAFETY
DCS-1227B
(02/20)
Agency Assigned
Name of Recruiter Assigned
Child’s NamePhone No.
Date of Referral
CHILD’S CID#
Date of Report
Individualized Child Specific Recruitment Plan Report ~ Be specific in answering questions. Include statistics to support documentation
Billable
Detail communication between the recruiter and the child. Enter dates and type of communication the recruiter had with the child; for example, face-to-face visits, telephone calls, text messages, email, etc.
Summary of Progress and Recruitment. Detail the progress made towards achieving the goals/objectives since last report and include the dates and efforts made. If goals have not been achieved, provide a detailed narrative in the challenges/barriers section.
ARIZONA DEPARTMENT OF CHILD SAFETY
DCS-1227B
(02/20)
Individualized Child Specific Recruitment Plan Report ~ Be specific in answering questions. Include statistics to support documentation.
Have any families been staffed for a match meeting? Provide the names of families presented to the DCS Specialist and result of presenting them. Include the date of when the family was presented and if a match meeting was held. If a match meeting has not been held, is there a match meeting scheduled in the future?
For children in family like settings, detail the recruiter’s discussion with the current placement about providing permanency and outcome of discussion.
Detail contact with previous placements. Include when, how, and result.
ARIZONA DEPARTMENT OF CHILD SAFETY
DCS-1227B
(02/20)
Individualized Child Specific Recruitment Plan Report ~ Be specific in answering questions. Include statistics to support documentation.
Next steps: Identify new goals for the next 90 days. Details must be specific to the child and include clear and measurable goals.
Identify barriers towards permanency and detail steps taken to mitigate the barriers. Elaborate on the plan to mitigate barriers, including steps taken, what has or has not worked, and estimated completion date for mitigation steps.
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