Form CFS968-62E "Caseworker Preparation Checklist for Ilo/Tlp Staffing" - Illinois

What Is Form CFS968-62E?

This is a legal form that was released by the Illinois Department of Children and Family Services - a government authority operating within Illinois. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2002;
  • The latest edition provided by the Illinois Department of Children and Family Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CFS968-62E by clicking the link below or browse more documents and templates provided by the Illinois Department of Children and Family Services.

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Download Form CFS968-62E "Caseworker Preparation Checklist for Ilo/Tlp Staffing" - Illinois

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CFS 968-62E
DEPARTMENT OF CHILDREN AND FAMILY SERVICES
8/2002
CASEWORKER PREPARATION CHECKLIST FOR ILO/TLP STAFFING
Directions: This checklist is to be used by the caseworker to assist him/her in gathering the
information to bring to an ILO/TLP Staffing as required under PG 2002. , ILO/TLP Approval
Procedures. A copy of this checklist and attachments are to be sent to each staffing participant
prior to the staffing. Each document should be clearly numbered in accordance with the numbers
listed below.
1. An initial draft of form CFS 968-62B, ILO/TLP Safety and Risk Management Plan, to
be finalized during the staffing
2. An initial draft of form CFS 968-62C, ILO/TLP Wraparound Plan, to be finalized
during the staffing
3. The current CFS 497, Client Service Plan, for the child and the family
4. A summary of the youth’s placement history (not CM07 screen prints)
5. If applicable, a copy of any current SACY protective plan
6. If available, a copy of the original social history
7. If available, a copy of a social history addendum current within 6 months
8. If available, copies of court orders entered within the last 12 months
9. If available, copies of any court reports submitted within the last 12 months
10. Educational/Vocational Information
A summary of the youth’s educational history including, but not limited to, the
o
school the youth is currently attending and a summary of attendance
The number of high school credits earned
o
If applicable, a copy of the youth’s Individual Education Plan (IEP)
o
If applicable, a summary of any vocational testing of the youth within the past 12
o
months
If applicable, a summary of the youth’s employment history
o
11. A copy of the Department recognized Life Skills Assessment completed within
previous 12 months
12. Medical/Developmental Information
A summary of the youth’s medical history
o
A summary of any medications the youth is taking
o
If applicable, documentation of any developmental disability the youth may have
o
If applicable, documentation identifying the youth’s handicap code as contained
o
in the Department’s CYCIS system
13. A summary of any history the youth has regarding physical aggressiveness toward
other persons and/or property, particularly if such aggression has resulted in police
reports, arrest, serious injury, etc.
14. If appropriate, current status of referral to the appropriate Pre-Admission Screening
agent (PAS)
15. If available, a copy of reports submitted within the last 12 months from any service
provider for the youth
16. If applicable, a summary of any income and/or savings the youth has currently
17. If applicable and immediately available, the most current psychological and/or
psychiatric report
18. Listing of any ILO or TLP provider(s) who has been identified as being potentially able
to meet the needs of the youth
CFS 968-62E
DEPARTMENT OF CHILDREN AND FAMILY SERVICES
8/2002
CASEWORKER PREPARATION CHECKLIST FOR ILO/TLP STAFFING
Directions: This checklist is to be used by the caseworker to assist him/her in gathering the
information to bring to an ILO/TLP Staffing as required under PG 2002. , ILO/TLP Approval
Procedures. A copy of this checklist and attachments are to be sent to each staffing participant
prior to the staffing. Each document should be clearly numbered in accordance with the numbers
listed below.
1. An initial draft of form CFS 968-62B, ILO/TLP Safety and Risk Management Plan, to
be finalized during the staffing
2. An initial draft of form CFS 968-62C, ILO/TLP Wraparound Plan, to be finalized
during the staffing
3. The current CFS 497, Client Service Plan, for the child and the family
4. A summary of the youth’s placement history (not CM07 screen prints)
5. If applicable, a copy of any current SACY protective plan
6. If available, a copy of the original social history
7. If available, a copy of a social history addendum current within 6 months
8. If available, copies of court orders entered within the last 12 months
9. If available, copies of any court reports submitted within the last 12 months
10. Educational/Vocational Information
A summary of the youth’s educational history including, but not limited to, the
o
school the youth is currently attending and a summary of attendance
The number of high school credits earned
o
If applicable, a copy of the youth’s Individual Education Plan (IEP)
o
If applicable, a summary of any vocational testing of the youth within the past 12
o
months
If applicable, a summary of the youth’s employment history
o
11. A copy of the Department recognized Life Skills Assessment completed within
previous 12 months
12. Medical/Developmental Information
A summary of the youth’s medical history
o
A summary of any medications the youth is taking
o
If applicable, documentation of any developmental disability the youth may have
o
If applicable, documentation identifying the youth’s handicap code as contained
o
in the Department’s CYCIS system
13. A summary of any history the youth has regarding physical aggressiveness toward
other persons and/or property, particularly if such aggression has resulted in police
reports, arrest, serious injury, etc.
14. If appropriate, current status of referral to the appropriate Pre-Admission Screening
agent (PAS)
15. If available, a copy of reports submitted within the last 12 months from any service
provider for the youth
16. If applicable, a summary of any income and/or savings the youth has currently
17. If applicable and immediately available, the most current psychological and/or
psychiatric report
18. Listing of any ILO or TLP provider(s) who has been identified as being potentially able
to meet the needs of the youth
INSTRUCTIONS
This form is a tool for the caseworker to use in gathering necessary information
for the required staffing. Specific directions are included on the form itself. In
gathering this information it is important that the caseworker remember the
following:
a)
When a copy of a document is asked for, provide clear copies
b)
Avoid multiple copies of the same documents. If a document
provides information for more than one item on the checklist, use
a cross referencing process to identify where one item in the
checklist may be found in a different checklist item.
c)
When the checklist calls for summary information it means
concise, pertinent, and clear summary information as opposed to
pages of detail.
d)
To assist with all that needs to be done in a staffing, it is helpful for
the caseworker to work with the identified provider to complete
initial drafts of the Safety/Risk Plan and the Wraparound Plan to
distribute at the staffing. See #1 and #2 on the checklist.
e)
Remember to number each attachment to correspond to the
numbered items on the checklist.
f)
Check only those items that are attached and numbered. If an
important item is not available, include a numbered page that
explains why it is not available, and check the appropriate box on
the form.
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