Form CFS1448-G "Extended Family Support Program Closing Report" - Illinois

Form CFS1448-G is a Illinois Department of Children and Family Services form also known as the "Form Cfs1448-g "extended Family Support Program Closing Report" - Illinois". The latest edition of the form was released in June 1, 2015 and is available for digital filing.

Download an up-to-date Form CFS1448-G in PDF-format down below or look it up on the Illinois Department of Children and Family Services Forms website.

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Download Form CFS1448-G "Extended Family Support Program Closing Report" - Illinois

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CFS 1448-G
6/2015
State of Illinois
Department of Children and Family Services
Extended Family Support Program
Closing Report
CASE INFORMATION
Provider:
Worker:
Client:
SCR ID#:
st
Referral Date:
1
Contact Date:
st
1
Assessment Date:
Closing Date:
SERVICES
Service Requested (SR) - Service Provided (SP) - Obtained Objective (OO)
SR
SP
OO
Assistance enrolling my relative’s child in my local school district
Assistance obtaining the IDHS child-only grant
Assistance obtaining the Day Care
Assistance obtaining medical benefits, food stamps or other entitlements
Assistance obtaining beds for my relative’s child
Assistance obtaining dressers, clothes or other items for my relative’s child
Assistance obtaining adequate housing
Assistance obtaining counseling for my relative’s child
Assistance obtaining assistance from kinship support groups
Provide list of service providers in area
Referral for Community Services:
Other:
Other:
If any assistance listed above was requested but was not provided or obtained, explain why:
Family Meeting: Did a Biological Parent attend the Family Meeting?
Yes
No
PROTECTIVE ISSUES
C/L Referral Date:
C/L Determined Date:
Unusual Events
Protective issues were present
Child Abuse Hotline was called after case was referred to EFSP
DCFS took custody of the children
UIR completed on the family
If a box was checked, please explain:
CFS 1448-G
6/2015
State of Illinois
Department of Children and Family Services
Extended Family Support Program
Closing Report
CASE INFORMATION
Provider:
Worker:
Client:
SCR ID#:
st
Referral Date:
1
Contact Date:
st
1
Assessment Date:
Closing Date:
SERVICES
Service Requested (SR) - Service Provided (SP) - Obtained Objective (OO)
SR
SP
OO
Assistance enrolling my relative’s child in my local school district
Assistance obtaining the IDHS child-only grant
Assistance obtaining the Day Care
Assistance obtaining medical benefits, food stamps or other entitlements
Assistance obtaining beds for my relative’s child
Assistance obtaining dressers, clothes or other items for my relative’s child
Assistance obtaining adequate housing
Assistance obtaining counseling for my relative’s child
Assistance obtaining assistance from kinship support groups
Provide list of service providers in area
Referral for Community Services:
Other:
Other:
If any assistance listed above was requested but was not provided or obtained, explain why:
Family Meeting: Did a Biological Parent attend the Family Meeting?
Yes
No
PROTECTIVE ISSUES
C/L Referral Date:
C/L Determined Date:
Unusual Events
Protective issues were present
Child Abuse Hotline was called after case was referred to EFSP
DCFS took custody of the children
UIR completed on the family
If a box was checked, please explain:
Extended Family Support Program
Closing Report (page two)
Client:
SCR ID#:
GUARDIANSHIP
Guardianship Applied:
Guardianship Obtained:
Guardianship Status
Guardianship Was Not Sought
Caregiver never wanted guardianship
Caregiver changed mind before guardianship application
Parent contested guardianship
Parent removed children from home
Child lives with a different caregiver
DCFS denied due to positive CANTS or LEADS results
Agency does not believe client is an appropriate caregiver
Other:
Guardianship Sought But Not Obtained
Caregiver no longer wants guardianship
Parent removed children from home
Parent contested guardianship
Child lives with a different caregiver
Court denied due to positive CANTS or LEADS results
Agency does not believe client is an appropriate caregiver
Other:
Guardianship Was Obtained
Already Had Guardianship When Case Opened
Other:
CLIENT STABILITY AT CASE CLOSING
Caregiver And Children Are:
More stable than when family was initially assessed
As stable as when family was initially assessed
Less stable than when family was initially assessed
If less stable, please explain:
Placement of children on closing date (CD) and 30 days after closing (AC) date:
CD AC
With client
With natural parents
With other relatives
DCFS ward
Other:
______________________________________________________
Caseworker Signature
Date
______________________________________________________
Supervisor Signature
Date
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