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NJ DCF Logo with reverse copy 

 

New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection and Permanency

Effective Date:

2-5-2018

Volume:

X

Forms

Chapter:

A

Forms

Revised Date:

3-1-2021

Subchapter:

1

Forms

Issuance:

5.62

CP&P Form 5-62, Termination of Services to the Young Adult

 

Click here to view, print, or complete DCF Form 5-62, Termination of Services to the Young Adult.

 

Click here to view, print, or complete DCF Form 5-62(S), Termination of Services to the Young Adult.   

 

WHEN TO USE THIS FORM:

 

This letter provides official notice to the young adult in open case status, age 18 to 21, of the Division's intent to terminate his or her case, when the young adult (age 18 to 21) requests his or her case be closed; declines to participate in services or work on their goals; does not comply with policy, including CP&P Form 10-10, Voluntary Services Agreement Between the Young Adult (18-21) and the State of New Jersey; CP&P VI B 1 600, Case Closure for Young Adults Age 18 to 21; moves out of New Jersey and has no intention of returning; or reaches age 21. This letter lists the reason(s) for case closure and advises the young adult that he or she may contact the Administrative Hearings Unit, if he or she disagrees with the agency's decision to terminate.

The Worker prepares the Termination Letter two months before the intended date of termination and provides the young adult with a copy.

HOW TO USE THIS FORM:

 

CP&P Form 5-62, Termination of Services to the Young Adult is prepared using the online form in the computerized forms manual. When preparing individual letters, use Local Office letterhead and enter the name, address and telephone number of the Local Office directly under "Division of Child Protection and Permanency."

 

The Worker:

1.    Enters the information listed below into the form fields of the letter:

·         The date the letter is being prepared

·         The young adult’s name and address

·         The NJS Case ID number

·         The young adult’s name in the salutation portion of the letter, after the word “Dear”

·         Anticipated date of closure

·         Reason(s) for closure (check all that apply)

·         Worker name and phone number

2.    Provides the letter, once signed by the Local Office Manager, to the young adult either in person or by mailing it to their last known address.

 

The Local Office Manager:

1.    Reviews and signs the letter if he or she is in agreement with the decision to close the case, and

2. Returns the signed letter to the Worker, who then provides it to the young adult.

 

DISTRIBUTION

 

Original   -      Young Adult  

 

Copy        -     Case Record