Form CFS 458-C Let Me Tell You About My Child - Illinois

Form CFS458-C or the "Let Me Tell You About My Child" is a form issued by the Illinois Department of Children and Family Services.

The form was last revised in November 1, 2016 and is available for digital filing. Download an up-to-date Form CFS458-C in PDF-format down below or look it up on the Illinois Department of Children and Family Services Forms website.

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CFS 458-C
State of Illinois
11/2016
Department of Children and Family Services
LET ME TELL YOU ABOUT MY CHILD
Please share information about your child that would be helpful to the foster or relative caregiver caring for them.
Child’s name
Prefers to be called:
Age
Birthday
What should we know about your child’s sleeping habits? (for example: bedtime, wakes up during the night,
naps, needs a nightlight, has nightmares, sleeps soundly, hard time waking up, etc.)
What should we know about your child’s bathing, grooming, dressing and bathroom routine? (for example:
uses diapers or training pants, needs help with bathing, can care for him/herself, has special skin needs or allergies,
dresses without help, bed wetting, special hair/skin care etc.)
What should we know about your child’s eating habits? (for example: eats balanced meals, special diet, infant
formula, skips meals, fussy eater, does not like certain foods or allergies, foods likes/dislikes etc.)
What should we know about your child’s health? (for example: doctor, dentist, immunization history, history
of illnesses, allergies, asthma, takes medicine, vision or hearing problems, hospitalizations, any upcoming
appointment, attends therapy or counseling etc.)
What should we know about your child’s education? (for example:
school, grade, favorite subject,
reports/projects due, special school needs, takes medication, do they receive medication at school, needs help with
homework, attendance/behavior/performance, early intervention services, special education, vocational or
education goals etc.)
Does your child help with work around the house? (for example: does dishes, helps with younger children,
can shop for groceries, gets an allowance, specific chores they enjoy etc.)
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CFS 458-C
State of Illinois
11/2016
Department of Children and Family Services
LET ME TELL YOU ABOUT MY CHILD
Please share information about your child that would be helpful to the foster or relative caregiver caring for them.
Child’s name
Prefers to be called:
Age
Birthday
What should we know about your child’s sleeping habits? (for example: bedtime, wakes up during the night,
naps, needs a nightlight, has nightmares, sleeps soundly, hard time waking up, etc.)
What should we know about your child’s bathing, grooming, dressing and bathroom routine? (for example:
uses diapers or training pants, needs help with bathing, can care for him/herself, has special skin needs or allergies,
dresses without help, bed wetting, special hair/skin care etc.)
What should we know about your child’s eating habits? (for example: eats balanced meals, special diet, infant
formula, skips meals, fussy eater, does not like certain foods or allergies, foods likes/dislikes etc.)
What should we know about your child’s health? (for example: doctor, dentist, immunization history, history
of illnesses, allergies, asthma, takes medicine, vision or hearing problems, hospitalizations, any upcoming
appointment, attends therapy or counseling etc.)
What should we know about your child’s education? (for example:
school, grade, favorite subject,
reports/projects due, special school needs, takes medication, do they receive medication at school, needs help with
homework, attendance/behavior/performance, early intervention services, special education, vocational or
education goals etc.)
Does your child help with work around the house? (for example: does dishes, helps with younger children,
can shop for groceries, gets an allowance, specific chores they enjoy etc.)
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What does your child do for fun? (for example: likes playing with others, has a favorite game or sport, likes
reading or drawing, likes playing alone, special interests, favorite TV show, are they a part of any organized
activities, involvement with a mentor (i.e. girl scouts, sports, church groups etc.)
What should we know about your family’s culture and religious traditions? (for example: member of
religious community, attends religious services regularly, requires special diets, celebrates religious/culture
holidays, observes religious practices, family traditions etc.)
Who are the people important to your child? (for example: siblings, grandparents, aunts, uncles, neighbors,
friends, classmates, teachers, coaches, church members etc.)
What is special about your child? (their strengths or special interests/talents, fears, comfort items – like teddy
bears, blankets, etc.)
What else should a caregiver know to care for your child?
For older children, tell us any particular challenges with caring for your child? (for example: very active,
runs away, sexual behavior, experimenting with alcohol or drugs, parenting, delinquency history, curfew, work
history, etc.)
Parent’s Name:
Date Completed:
Caseworker’s Name:
Date Completed:
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