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New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection and Permanency

Effective Date:

Volume:

X

Forms

Chapter:

A

Forms

11-16-09

Subchapter:

1

Forms

Issuance:

14.202

CP&P Form 14-202, Child Care Reference

Click here to view, print, or partially complete the CP&P Form 14-202, Child Care Reference.

WHEN TO USE IT

Use the CP&P Form 14-202, Child Care Reference, to obtain reference information from all individuals and/or agencies for whom a prospective or licensed resource family parent has provided child care services including adoptive care, foster care, day care/baby-sitting (on a regular basis), volunteer services, or other care, as indicated on the CP&P Form 5-2, Resource Family Home Application, or as indicated on the Resource Family Home Reevaluation.

HOW TO USE IT

·         Complete the text fields on the top of page 1 (i.e., "return to," "attention," and "regarding") using the on-line template found in the computerized Forms Manual (11-20). Then print out the form and mail it to the appropriate recipient. Note: The form may also be printed out and completed entirely by hand.

·         Send the CP&P Form 14-202 with a copy of the CP&P Form 5-23, Cover Letter, and a copy of the signed CP&P Form 26-15, Authorization for Release of Information, to all individuals and agencies, including other units of CP&P, for whom a prospective or licensed resource family parent has provided child caregiving services.  Also send this form to individuals for whom day care/babysitting services were provided, on a regular basis, by the prospective or licensed resource family parent.

·         The person completing the reference request mails the form back to the Local Office or sponsoring agency.  This form is not valid if received from or through the subject of the reference request.

·         Place a copy of the CP&P Form 5-23, Cover Letter, in the prospective or licensed resource family parent's home record to verify that the reference was sent.

DISTRIBUTION

Original

-

Individual or agency for whom the prospective or license resource family parent has provided child caregiving service

 

-

Prospective or licensed resource family parent's home record when returned to CP&P or sponsoring agency

Copy

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Prospective or licensed resource family parent's home record