Form Dcf F Cfs0383 PDF Details

Dealing with a child who has been diagnosed with a mental health disorder can be difficult for parents. The Florida Department of Children and Families provides a number of resources to help parents cope with their child's diagnosis and ensure that their child receives the necessary treatment. This guide provides an overview of the resources available from the Florida Department of Children and Families, as well as information on how to access them. If you are a parent in Florida whose child has been diagnosed with a mental health disorder, you may be wondering what resources are available to you. The Florida Department of Children and Families (DCF) offers a variety of services to help parents manage their child's diagnosis and ensure that they receive appropriate treatment. This guide provides an overview of the DCF resources available, as well as information on how to access them. The following sections will provide more detail on each type of resource offered by DCF: Pare

QuestionAnswer
Form NameForm Dcf F Cfs0383
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesdcf_f_cfs0383 checklist group home nj compliance form

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DEPARTMENT OF CHILDREN AND FAMILIES

Division of Safety and Permanence

Personnel Record Checklist – Group Homes

Use of form: Use of this form is voluntary. However, use as a review document by group homes will help ensure compliance with DCF 57.16, 57.17(2), 57.17(3) and 57.37(4). Licensing specialists may also use this form during monitoring visits to document compliance with these rules. Personally identifiable information gathered on this form will be used only to verify compliance with licensing rules.

Instructions: A check mark indicates the required information is in the file. The name, start date and job title must be entered. If additional space is needed, attach separate sheet(s).

Relief help: The personnel record for relief help does not need to contain the physical examination or HealthCheck form. Volunteers: The personnel record for volunteers does not need to contain the physical examination or HealthCheck form, the background check results from the Department of Justice (DOJ), the Department of Health Services (DHS) Response to Caregiver Background Check (IBIS), (the DHS-64 BID form, IS required), the documentation of first aid training, the documentation of CPR training, the documentation of fire safety training, or the documentation of continuing education.

Name – Group Home

Facility ID Number

Address – Group Home (Street, City, Zip Code)

Telephone Number – Group Home

Name

Name

Name

Name

Completed Application Form 57.17(2)(a)

Job title

Date of hire

Address

Birthdate

Training

Education

Work experience

Current address 57.17(2)(b)

Addresses and telephone numbers of references and reference check results 57.17(2)(c)

Caregiver Background Check

DHS-64 BID form, complete and current 57.17(2)(d)

DOJ results 57.17(2)(e)

Response to Caregiver Background Check (IBIS) 57.17(2)(e)

Results of any subsequent investigation related to information obtained from each CBC 57.17(2)(e)

A completed physical examination or HealthCheck form 57.17(2)(g)

Tuberculosis test results 57.17(2)(g)

The staff member’s annual driver’s record, if the staff member is assigned to transport children 57.17(2)(h)

DCF-F-CFS0383 (R. 03/2012)

 

Training Record

 

 

 

 

 

 

 

 

 

 

 

 

 

Document of orientation 57.17(2)(i)

 

 

 

 

 

 

 

 

 

 

 

 

A job description that is signed and dated by the staff member 57.17(2)(f)

 

 

 

 

 

 

 

 

 

 

 

Documentation of all first aid certifications 57.17(2)(j)

 

 

 

 

 

 

 

 

 

 

 

 

Documentation of all CPR certifications

57.17(2)(j)

 

 

 

 

 

 

 

 

 

 

 

 

Automatic external defibrillator training

57.14(4m)

 

 

 

 

 

 

 

 

 

 

 

Documentation of fire safety and evacuation training 57.16(3)

 

 

 

 

 

 

 

 

 

 

 

Documentation of continuing education (at least 24 hours annually) 57.16(5)

 

 

 

 

 

 

 

 

 

 

 

Documentation of infant and toddler training if applicable 57.37(4)

 

 

 

 

 

 

 

 

 

 

 

Any disciplinary actions issued to the employee 57.17(2)(k)

 

 

 

 

 

 

 

 

 

 

 

Written authorization to administer medication to residents 57.25(2)(b)

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE – Licensing Specialist

 

 

 

Date Signed

 

 

 

 

 

 

 

 

 

 

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