Form CFS1448-B "Extended Family Support Program Case Ineligible" - Illinois

What Is Form CFS1448-B?

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 June 1, 2015;
  • 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 CFS1448-B 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 CFS1448-B "Extended Family Support Program Case Ineligible" - Illinois

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CFS 1448-B
State of Illinois
6/2015
Department of Children and Family Services
Extended Family Support Program
Case Ineligible
Provider:
Referral Date:
Client:
SCR ID#:
First Contact Attempt:
(Must be within one business day of contact date)
Contact Date:
(If more than one day from referral, consult Section 3.3 of EFSP Program Plan
Check the Initial Eligibility Criteria not met:
The Provider did not receive the referral from DCFS-OHACA
The caregiver is not relative or godparent
The child is not residing in the home of a relative
The relative is not providing the primary care for the child
The child has not been living with the caregiver for more than 14 days
The biological parent is living with the caregiver and can care for the child
The biological parent intends to become caregiver during the next 90 days.
The relative caregiver is no longer seeking services
Other:
Caseworker:
Phone #:
Supervisor:
Phone #:
I have discussed the case with the worker and have reviewed the file and certify that the information on this form is
contained in the case file
Supervisor Signature
Date
CFS 1448-B
State of Illinois
6/2015
Department of Children and Family Services
Extended Family Support Program
Case Ineligible
Provider:
Referral Date:
Client:
SCR ID#:
First Contact Attempt:
(Must be within one business day of contact date)
Contact Date:
(If more than one day from referral, consult Section 3.3 of EFSP Program Plan
Check the Initial Eligibility Criteria not met:
The Provider did not receive the referral from DCFS-OHACA
The caregiver is not relative or godparent
The child is not residing in the home of a relative
The relative is not providing the primary care for the child
The child has not been living with the caregiver for more than 14 days
The biological parent is living with the caregiver and can care for the child
The biological parent intends to become caregiver during the next 90 days.
The relative caregiver is no longer seeking services
Other:
Caseworker:
Phone #:
Supervisor:
Phone #:
I have discussed the case with the worker and have reviewed the file and certify that the information on this form is
contained in the case file
Supervisor Signature
Date