background shadows

NJ DCF Logo with reverse copy

 

New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection and Permanency

Effective

Date:

Volume:

X

Forms

Chapter:

A

Forms

5-10-2010

Subchapter:

1

Forms

Issuance:

14.231

CP&P Form 14-231, Adoption Subsidy Addendum Agreement for Post Adoption Child Care

 

Click here to view, complete, and print the CP&P Form 14-231, Adoption Subsidy Addendum Agreement for Post Adoption Child Care.

 

WHEN TO USE IT

 

Use this form to:

 

•           Outline for the adoptive parent the terms and conditions of the Post Adoption Child Care program administered by the Division of Family Development (DFD), including that the program may be subject to discontinuation and may not cover all child care costs; and

 

•           Inform the adoptive parent that the application must be returned to the appropriate Child Care Resource and Referral (CCR&R) agency in the county, within 90 days of the adoption finalization, or eligibility will be forfeited.

 

HOW TO USE IT

 

•           Enter the child's name and name of the CP&P representative using the on-line template in the computerized Forms Manual.

 

•           Within one week following the adoption finalization, send the form to the adoptive parent(s).

 

•           Include the CP&P Form 14-230, Post Adoption Child Care Referral Letter to Adoptive Parent, in the packet to the adoptive parent.

 

•           The prospective adoptive parent signs the CP&P Form 14-231.

 

•           Send a copy of the signed form to the appropriate county CCR&R agency with a copy of the CP&P Form 14-230, Post Adoption Child Care Referral Form to Adoptive Parent, and either the CP&P Form 14-232, Post Adoption Child Care Referral Form (Continuation of Service), or CP&P Form 14-233, Post Adoption Child Care Referral Form (Non-continuation of Service).

 

TIPS FOR COMPLETING THE FORM

 

See CP&P-IV-C-8-900, Post Adoption Child Care (PACC), and CP&P-IV-C-8-200, Processing the Adoption Subsidy, and its subsections for more details regarding the discussion of the PACC program with prospective adoptive parents and processing the PACC referral.

 

Note:  The CP&P Adoption Worker was required to give to each parent (resource or select home) adopting a child under the age of six the DCF pamphlet entitled "Post Adoption Child Care (PACC): A Guide for Adoptive Parents." The adoptive parent must sign an acknowledgment receipt that he or she received the pamphlet.  Include the signed verification of the parent's receipt of the PACC pamphlet with the CP&P Form 14-219, Basis for Subsidy Eligibility, and send to the Office of Adoption Operations in the subsidy request package.

 

DISTRIBUTION

 

Original          -           Adoptive parents (for signatures)

                       

-           After all parties sign the agreement, file it in the Family's Adoption Subsidy Folder

 

Copy               -           Adoptive parents

 

                        -           Local Office Child Care Liaison

 

                        -           CCR&R agency