background shadows

 

 

New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection & Permanency

Effective Date:

 6-28-2018

Volume:

X

Forms

Chapter:

A

Forms

Revised Date:

6-28-2018

Subchapter:

1

Forms

Issuance:

3.4

CP&P Form 3-4, Request to Create an Unlicensed/Uncontracted Resource/Service in NJS

 

Click here to view, complete, or print CP&P Form 3-4, Request to Create an Unlicensed/Uncontracted Resource/Service in NJS.

 

WHEN TO USE IT

 

The form documents the request for an unlicensed or uncontracted resource or service in NJ SPIRIT.

 

 

HOW TO USE IT

 

The Resource Worker or Caseworker prints out and completes the form using information about the unlicensed or uncontracted resource or service. The Local Office Manager must approve the resource or service. The Department of Children and Families (DCF) Business Office approves the form and inputs the information from the form into NJS.

 

INSTRUCTIONS FOR COMPLETING THE FORM

 

Staff that have identified a need to create an unlicensed or uncontracted resource or service for a Local Office or other unit completes the form. Each piece of information identified on the form is entered on the lines provided. Once completed by the Resource Worker, Caseworker, or other staff, the form is submitted to the Local Office Manager for approval.

 

Forward the completed form to the DCF Business Manager for signature. If approved, the DCF Business Office staff enters the information into NJS.

 

Attach a copy of the vendor’s professional credentials and licenses if applicable. If the vendor does not already contract with DCF, attach a copy of the vendor’s NJ START registration.

 

 

DISTRIBUTION

 

Original Copy

-

DCF Business Office

Copy

-

CP&P Area Office and CP&P Local Office or other unit’s files