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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:

Volume:

X

Forms

Chapter:

A

Forms

5-16-2011

Subchapter:

1

Forms

Issuance:

ICPC30

ICPC Supervision Report - 30 Day

 

Double click here to access the ICPC Supervision Report - 30 Day.   

WHEN TO USE IT

In accordance with Federal Regulation No.11, the ICPC Supervision Report - 30 Day, is used to report on the safety and well-being of children placed in New Jersey from an out-of-state entity.  This is a federal form which is completed by CP&P staff.  See CP&P-VIII-D-3-1200 for the full text of Regulation No.11.

This form is used by the assigned Worker and/or Supervisor for out-of-state youth placed in New Jersey (the receiving state).  Workers complete this form within the first 30 days of receipt of the ICPC 100B, or verbal notification of the placement, and when the initial face-to-face contact with the child occurs. See CP&P Policy CP&P-VIII-D-2-200 and CP&P-VIII-D-2-600.

 

HOW TO USE IT

 

      Access the ICPC Supervision Report - 30 Day through the online computerized Forms Manual IV (by letter).

      Write the report information in a clear and concise manner and be sure to note the level of safety and well-being of the child.  Also note unmet needs along with recommendations to address those needs.

      Workers and/or Supervisors check the appropriate text boxes and indicate whether it is their recommendation to continue the placement, continue supervision, or to terminate supervision.

      Once the recommendation for continued placement and supervision has been made, the Worker and/or Supervisor checks the appropriate text boxes to indicate concurrence with the permanency goal, whether or not to return the child to the parent and terminate jurisdiction, whether to establish guardianship, and whether or not there are other specific permanency issues.

      At this point, send the completed form to the Interstate Services Unit (ISU) for processing. Complete and forward this form electronically to the ISU dedicated mailbox at: dcf.njicpc@state.nj.us.  Workers may also complete the form and send the original hard copy via Inter-office mail to the ISU, Cost Code 916.

 

TIPS FOR COMPLETING THE FORM

 

Local Offices:  Do not forward this form to out-of-state entities.  All ICPC supervision reports are processed through the New Jersey Interstate Services Unit.

Attach Minimum Visitation Requirement (MVR) contact notes and copies of collateral contacts to the Supervision Report at the discretion of supervisory staff.

DISTRIBUTION

Original (Hard or Electronic) -

Interstate Services Unit

Copy

Local Office - Child Case Record