Checklist of Standards for Resource Family Homes Initial Home Study Reevaluation

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CP&P 5-34

(rev. 10/2009)

State of New Jersey

DEPARTMENT OF CHILDREN AND FAMILIES

Child Protection and Permanency

Checklist of Standards for Resource Family Homes

Initial Home Study Reevaluation

Resource Family Home Name: ______________________________________________

Address:

City: State:

County:

Zip: _____________

Telephone: Home_______________ Work: _______________ Cell: ________________

Resource Family Support Worker: _______________________ Telephone: _____________

Supervisor: ___________________________________ Telephone:

Local Office Name/Agency Name: __________________ Telephone:

Date Completed: _______________

To receive and maintain a license, a resource home must be in compliance with the standards in the

Manual of Requirements for Resource Family Homes, N.J.A.C. 10:122C. The following standards must be in compliance before a home is recommended for licensure. Some of these standards are best practice issues and should be considered when case conferencing occurs.

Note: Any items marked "No" must include an explanation in the “comments” box at the end of the section.

In Compliance

Yes No N/A

General/Personal Requirements

An applicant for an initial license is at least 18 years of age and a resident of the state of New Jersey.

If there is more than one applicant, each applicant must meet all requirements for licensure.

If not a U.S. citizen, the resource family applicant has a visa or documentation from the U.S. Immigration and Naturalization Services as evidence of legal residency.

The resource family applicant/parent ensures that each child in placement is accorded the rights specified in the Child Placement Bill of Rights Act, as specified in N.J.S.A. 9:6B.

Each applicant and household member cooperates with the Department or contract agency in the completion of all components of the application, home study, and licensing process within the time limits established by the Department.

The resource family applicant cares for no more than four children in placement and six children in total residing in the home. Age capacities are observed.

Child Abuse and Criminal History Record Information (CHRI) checks are completed initially and at renewal for all adult household members and are current within one year.

The resource family applicant/parent provides written consent for the Division to conduct Child Abuse

Record Information checks for each resource parent or applicant and each household member at least 18 years of age, each new household member at least 18 years of age, and each household member who reaches

18 years of age.

The resource family applicant/parent and other adult household members are free of serious criminal convictions which have not otherwise been waived by the Department.

The resource family applicant/parent is of good character and reputation and possesses the appropriate skills, attributes, and characteristics conducive to effectively caring for a child in placement.

The resource family applicant/parent is in sufficient physical, mental, and emotional health to perform duties satisfactorily.

The resource family applicant/parent and household members are free of serious contagious disease.

The resource family applicant/parent and household members refrain from the abuse of drugs and/or alcohol.

Name of Family ___________________________ 1

CP&P 5-34

(rev. 10/2009)

The resource family applicant/parent demonstrates reasonable and mature attitudes toward professional figures and institutions, as determined by a review of references and an assessment of the resource family parent’s interactions during training and home visits by the Department.

The resource family applicant/parent cooperates with any activity as specified in the child’s case plan, including counseling/therapy and visits with the child’s family of origin.

Medical, personal, employment, school/day care, and child care references for each applicant are submitted within required time frames, initially and at license renewal.

The resource family applicant/parent and their family maintain the confidentiality of children in placement.

Identifying information for each child in placement is maintained in the home.

CP&P has assessed all of the following:

Relationships among immediate and extended family members

Expectations of children

Impact a child in placement might have on the family's functioning and the resources available to moderate that impact

 Attitude of the resource family applicant’s/parent's own children toward accepting a child

 The resource family applicant’s/parent’s motivations for taking a child into the home

 The resource family applicant's/parent’s willingness to accept and care for a child despite a child's possible limitations, changing needs, and problems

 The resource family applicant’s/parent’s understanding of the positive and negative aspects of resource parenting

The resource family applicant/parent has sufficient means of financial support, prior to the placement of a child, independent of the board subsidy payments from the Department, to provide necessities of life for his or her own family.

The resource family applicant/parent uses all money received in the name of the child for that child’s care .

The resource family applicant is able to provide sufficient time and attention to each child placed in their home without:

Causing other family members' needs to go unmet

Causing the quality of care to be substantially diminished

Overburdening the resource parent

The resource family applicant/parent demonstrates a willingness to help a child in placement return to his or her own home if reunification is the goal.

The resource family applicant/parent demonstrates a willingness to assist CP&P in keeping and updating a

Life Book for the child.

COMMENTS:

In Compliance

Yes No N/A

Reporting Requirements

The resource family applicant/parent understands that suspected child abuse/neglect must be reported immediately to the State Central Registry (SCR).

The following is immediately reported to OOL and to the Resource Family Support Worker/Unit, Local

Office, or State Central Registry (SCR) after hours:

(1)accident, illness, or hospitalization of child or caregiver; (2) death of child or caregiver; (3) arrest/conviction/guilty plea of a resource family parent or household member; (4) unauthorized absence of a child in placement; (5) unusual incidents; (6) temporary or permanent closing of the home; (7) addition of new household member; (8) events that disrupt the stability of the home; (9) any change in address, telephone number, living situation, employment or number of persons residing in the household.

The following is reported to the Office of Licensing (OOL) and the Local Office within one working day: (1) significant damage to home; (2) proposed use of space not previously approved.

Name of Family ___________________________ 2

CP&P 5-34

(rev. 10/2009)

COMMENTS:

In Compliance

Yes No N/A

Physical Facility and Maintenance Requirements

The resource family home complies with all local and State laws, including the State Uniform Construction

Code and State Uniform Fire Code, regarding the occupancy of a dwelling, health and fire safety provisions.

The resource home is accessible to the Division representative by motor vehicle.

Rodent or insect infestation is controlled, if present.

All corrosive agents, insecticides, bleaches, polishes, aerosol cans, and toxic substances are stored in an area not accessible to children under the age of ten years old or at risk.

All combustible or flammable materials are kept at least three feet away from furnaces, boilers, heaters, fireplaces, wood-burning stoves and hot water heaters.

The resource family applicant/parent does not use spray coatings containing asbestos and will remediate the presence of such coatings if deemed by DCF to be a hazard to the health and safety of children in placement.

Lead-based paint is not used in or on the home and lead-based paint is removed if deemed by the Department to be a hazard to the health and safety of children in placement.

All alcoholic beverages are stored in an area inaccessible to children.

A family caring for infants or toddlers has safety latches on cabinets and closets containing hazardous substances.

A family caring for infants or toddlers has safety gates for stairways/landings.

A family caring for infants or toddlers has protective safety covers for all electrical outlets.

There is a working telephone in the home at all times when children in placement are present.

Major appliances are plugged directly into electrical outlets. Small appliances may be operated by using an appropriately rated power strip. Extension cords are not used.

Kitchen and cooking equipment are kept clean and sanitary.

Toilets, washbasins, bathtubs, showers, kitchen sinks, and other plumbing shall be maintained in good operating and sanitary condition.

Major plumbing, drains, sewer lines, and septic system are operable and in good repair.

At least one toilet, wash basin, and bathtub/shower are in good working order.

The home, land, and outdoor area are free from hazards to the health, safety or welfare of children.

Sufficient natural or artificial light is provided in all rooms used by children in placement.

Light switches, electrical junction boxes, fuse box, electrical control panels, and electrical sockets have protective plate covers.

A minimum temperature of 65 degrees Fahrenheit is maintained in all rooms used by children in placement.

Crawl spaces, attic spaces, and all doors and windows used for natural ventilation have insect screening.

Hot water temperature is not to exceed 120 degrees Fahrenheit and cold water is provided.

Paint on the interior and exterior surfaces of the home, that is accessible to children, is not flaking, peeling or chipping.

Any condition in the interior or exterior of the home that may endanger the health, safety, and well-being of a child in placement is corrected (e.g., double bolted locks that require a key to open are not permitted).

Fire escape routes in the home are not obstructed.

COMMENTS:

Name of Family ___________________________ 3

CP&P 5-34

(rev. 10/2009)

In Compliance

Yes No N/A

Swimming Pools

If the home has a swimming pool or natural bathing area, a ring buoy, extension pole, or other device is present in the pool/natural bathing area for rescue.

Swimming pools/natural bathing areas meet all applicable local ordinances.

Swimming pool/natural bathing areas are enclosed with a barrier approved by the Office of Licensing with self-closing and self-locking gates.

Children are supervised by an approved adult when they are in a swimming pool/natural bathing area.

Although the resource family applicant does not have a swimming pool on the premises, the policy regarding child safety around swimming pools has been reviewed with the applicant/s.

COMMENTS:

In Compliance

Yes No N/A

Firearms and Weapons

All firearms are stored in a locked steel gun vault, approved by the Office of Licensing, with ammunition securely locked separately.

Any chemical weapons, such as mace or pepper spray, stored in the home are inaccessible to children.

Although the resource family applicant does not own any firearms or weapons, the policy regarding firearms and weapons has been reviewed with the applicant/s.

COMMENTS:

In Compliance

Yes No N/A

Pets

All pets have proper vaccinations as recommended by a licensed veterinarian and do not present a health risk or danger to a child.

All pets are domesticated and non aggressive, effectively controlled by leash, command or cage.

Animal waste is disposed of in a manner which prevents material from being a health problem.

Pregnant adolescents in placement must not clean a cat’s litter box.

Each child in placement shall not have contact with sick pets unless approved by a veterinarian.

COMMENTS:

Name of Family ___________________________ 4

CP&P 5-34

(rev. 10/2009)

In Compliance

Yes No N/A

Bedrooms

Each bedroom has two accessible means of exit, one of which is a window or door leading directly outside and suitable for emergency escape or rescue.

An age appropriate standard household bed, bassinet, or crib, located in a bedroom, is provided for each child in placement and is kept in a sanitary condition.

An unfinished attic or unfinished basement is not used for sleeping purposes by any child in the home.

Each child in placement sleeps in a bedroom that is sufficient in size to provide for the safety, privacy, and comfort of the child.

Each bedroom occupied by a child in placement has natural light and ventilation provided by one or more windows opening directly to the exterior.

Each bedroom occupied by a child in placement has a minimum ceiling height of 7 feet.

Each bedroom occupied by a child in placement has a minimum of 50 square feet for the first occupant; an additional 50 square feet for each occupant over age 4; and 30 square feet for each additional occupant under age 4.

Each bedroom occupied by a child in placement is accessible without walking through a bedroom used by another person, unless approved by the Office of Licensing.

COMMENTS:

In Compliance

Yes No N/A

Emergencies (Evacuation, Medical, and Fire Prevention)

A battery-operated or hard wired smoke detector is installed in each floor of the home and operable at all times.

Each child in placement receives age appropriate instruction in how to evacuate the home in the event of a fire or other emergency.

Working fireplaces and electric space heaters are protected by screens, guards, insulation, or any other suitable, non-combustible protective device.

When a wood-burning stove is in use, the resource family applicant/parent ensures that the stove is protected by a screen or age appropriate supervision is provided at all times when children are present.

No portable liquid-fuel-burning heating appliance is used in the home.

Emergency information, such as the 911 telephone number, the poison control center telephone number, and the name address and telephone number of the doctor or hospital used by the child in placement, is located near the telephone or other accessible area.

All combustible or flammable materials are kept at least three feet away from furnaces, boilers, heaters, fireplaces, wood burning stoves, and hot water heaters.

Homes with fuel-burning appliances or an attached garage have at least one operable carbon monoxide detector located adjacent to each bedroom area.

A basic first aid kit or first aid supplies are maintained in the home.

COMMENTS:

Name of Family ___________________________ 5

CP&P 5-34

(rev. 10/2009)

In Compliance

Yes No N/A

Training

Each applicant completes the DCF approved pre-service training prior to licensure.

Each new resource family applicant/parent or caregiver added to the home completes pre-service and inservice training within the time frames determined by the Department.

The annual in-service training is completed, as required.

COMMENTS:

In Compliance

Yes No N/a

SHSP

Current certification in Pediatric or Infant and Child Cardio-Pulmonary Resuscitation is maintained.

Disease-specific training is completed for each medically fragile child in placement.

Weekly or monthly medical journal is maintained, as required by the Department, for each medically fragile child in placement.

COMMENTS:

In Compliance

Yes No N/A

Supervision/Visitation

Supervision appropriate to the child’s age and needs is provided.

The resource family applicant/parent or emergency contact is reachable by telephone.

A child care center or family day care home used for a child in placement is either licensed or registered, as required.

When temporary care is provided for a child in placement on behalf of the resource family parent for more than three consecutive days, the resource parent informs the Department of the arrangements, CARI and

PROMIS/GAVEL checks are completed on the caregiver, the temporary arrangement is approved by the

Department, and the caregiver is trustworthy and well known to the resource family parent.

The resource family applicant/parent complies with the visitation restrictions specified for each child.

Each child in placement has free access to a telephone for conversations with the child's Worker, Law

Guardian, Law Guardian Investigator, and parents with adequate privacy afforded to the child.

There are no tape recorders or any other mechanical or electronic listening devises to monitor telephone calls of a child in placement.

Each child in placement is provided with adequate amounts of stamps and writing materials, or has access to electronic mail, for corresponding with family and friends.

The child in placement is never transported by anyone, including visitors, who appear to be under the influence of drugs or alcohol.

Children in placement are provided with reasonable access to the telephone for conversations with friends.

Name of Family ___________________________ 6

CP&P 5-34

(rev. 10/2009)

COMMENTS:

In Compliance

Yes No N/A

Education

The resource family applicant/parent registers each child in school, ensures each child attends regularly according to school regulations, and cooperates with the educational program of each child in placement.

The resource family applicant/parent encourages good study habits, monitors the child’s academic performance, and maintains contact/communication with school personnel.

Pre-school age children in placement are provided with age-appropriate activities and an environment suitable for their development.

Each child in placement age three or over who is not enrolled in kindergarten, attends an early childhood education program.

Each child in placement has the opportunity for continuity of cultural and ethnic growth and education.

The resource family applicant understands the responsibility to advise CP&P of the child’s academic progress and to request the Worker’s attendance at school conferences or other meetings at the school when necessary.

The resource family applicant understands the responsibility to ensure the opportunity for the continuity of the cultural and ethnic growth and cultural and ethnic education of each child in placement.

The resource family applicant understands that home schooling is not permitted for a child in a CP&P placement.

COMMENTS:

In Compliance

Yes No N/A

Discipline

Discipline of a child in placement is not assigned to unapproved adults or children.

A child in placement is not disciplined or threatened to be disciplined for the misbehavior of another child.

The following forms of discipline are viewed by the Department as punishment and are not used: (1) hitting, shaking, or corporal punishment; (2) forced physical exercise or forcing a child to take an uncomfortable position; (3) subjection to verbal abuse, ridicule, humiliation, or other forms of degradation; (4) deprivation of meals, sleep, clothing, or communication; (5) mechanical or chemical restraints; (6) assignment of overly strenuous work; (7) exclusion from medical treatment, education, or clinical treatment; (8) locking the child out of the home; (9) locking the child in a room or area of the home; (10) withholding or threatening to withhold visits with the child's birth family; (11) removing or threatening to remove the child from the home.

The resource family parent does not utilize restrictive behavior management practices to control or modify the behavior of a child in placement, unless recommended by a physician.

Acceptable approaches to discipline, such as discussing the child's behavior with the child in a supportive manner, early bedtime, brief time-out, withholding of privileges or writing a story or essay may be utilized with each child in placement, as appropriate, based on the age and abilities of the child.

Name of Family ___________________________ 7

CP&P 5-34

(rev. 10/2009)

COMMENTS:

In Compliance

Yes No N/A

Food and Nutrition

Each child in placement is provided at least three nutritious meals daily, with each meal containing a sufficient amount of food and drink.

Meals are selected, stored, prepared and served in a sanitary and palatable manner.

For each infant in placement, the resource family applicant/parent follows a plan (eating schedule, special formula, nutritional needs and introduction of new foods) developed with the infant’s health care provider.

The resource family applicant/parent ensures that the daily diet for each child in placement includes a balance of foods from all essential food groups, in sufficient amounts, and that alternate choices are available for children in placement who require a specialized diet for health or religious reasons.

Daily nutritious snacks are available to children in placement unless medically contraindicated.

A child in placement is not force-fed or otherwise coerced to eat, unless directed by a physician.

COMMENTS:

In Compliance

Yes No N/A

Recreation

The resource family applicant/parent provides opportunities for in-home and community recreational activities, hobbies, and events for each child in placement.

Each child in placement is encouraged to participate in community and school activities, such as scouting, clubs, and sport teams.

COMMENTS:

In Compliance

Yes No N/A

Religion

Each child in placement is afforded the opportunity and transportation to attend religious activities and services in accordance with the faith of the child’s parents.

Each child in placement is not coerced to participate in religious activities and services.

The resource family parent's religious practices do not interfere with a child in placement receiving medical care.

The child in placement may participate in the resource family parent's religious activities or services if the child expresses such interest and the child's parent gives consent.

Name of Family ___________________________ 8

CP&P 5-34

(rev. 10/2009)

COMMENTS:

In Compliance

Yes No N/A

Clothing

A personal supply of adequate, clean, well fitting, and attractive clothing appropriate to the child’s age, season, gender, and community standards is provided.

Clothing is laundered as necessary and maintained in good repair.

The resource family parent does not require a child in placement to wear any article of clothing that identifies the child as a member of an organization unless the child chooses to wear such clothing.

Each child in placement is provided with a chest of drawers or other permanent arrangement for storage of clothing and other personal belongings.

COMMENTS:

In Compliance

Yes No N/A

Transportation

Each resource family parent provides, or arranges for, the routine transportation needs of each child in placement.

Each driver who transports children in placement possesses a current driver’s license, automobile insurance coverage, and a vehicle with ample space, seatbelts or age-appropriate safety seats for each child in placement.

Each resource family parent providing transportation to a child placed with him or her shall maintain current automobile insurance throughout his or her career as a resource family parent.

COMMENTS:

In Compliance

Yes No N/A

Health Care and Medical Treatment

The medical, dental, mental/behavioral health, and other health care needs of each child in placement are adequately and promptly met.

Age appropriate immunizations are maintained for each child living in the home, including each child in placement, unless an exemption for religious or other reasons has been verified by the Department.

All medical, dental, psychological, and psychiatric treatment, or medication administered to a child in placement, is explained to the child in an age-appropriate manner.

Documentation of all medical, dental care, and other health care examinations and treatment is maintained in the home for each child in placement.

Name of Family ___________________________ 9

CP&P 5-34

(rev. 10/2009)

COMMENTS:

In Compliance

Yes No N/A

Health and Hygiene Practices

The resource family parent maintains a smoke-free environment in all indoor areas of the home and in all vehicles used to transport any child in placement. Smoking outdoors is permitted when no child in placement is present.

In the event a serious communicable disease is contracted by anyone in the household: (1) appropriate medical attention is sought; (2) any person posing a risk to others is isolated; (3) the Worker or DCF is contacted to assess the need to call the appropriate public health authorities.

If a serious accident or illness occurs to a child in placement, the resource family parent takes necessary emergency action and immediately notifies the Department office or contract agency having supervision of the child, or the State Central Registry if after hours.

The following items are provided to all children in placement: (1) towels and washcloths; (2) diapers (if appropriate); (3) soap and toilet paper; (4) hygiene supplies that are age appropriate for the child's needs such as toothpaste, toothbrush, shampoo, comb, brush, mouthwash, deodorant, razors, shaving cream, and feminine hygiene articles.

Each child in placement has the opportunity for at least eight hours of uninterrupted sleep each night.

A child who is unable to provide for his or her own personal care and hygiene is bathed and groomed by the resource family parent.

Disposable rubber gloves are used when any person in the home has contact with blood, vomit, urine, fecal matter or other body secretions of any person known to have an infectious disease. The gloves are discarded after each use. Any items that come in contact with these secretions are properly disinfected.

All persons coming in contact with blood, vomit, urine, fecal matter, or other body fluids, wash their hands with a disinfectant soap after each incident.

Each child in placement is instructed in age-appropriate personal care, hygiene and grooming habits, and is permitted to maintain over-the-counter cosmetics, acne preparations, and other personal hygiene supplies.

COMMENTS:

In Compliance

Yes No N/A

Prescription and Non-Prescription Medication

Medication is administered as prescribed by an appropriate medical professional.

Non-prescription medication is administered in accordance with the recommended dosage for the age or weight of the child in placement, as indicated on the label or directed by the child’s medical professional.

All prescription and non-prescription medication (except cosmetic, acne treatment, and personal hygiene) are kept in an area inaccessible to children.

Name of Family ___________________________ 10

CP&P 5-34

(rev. 10/2009)

COMMENTS:

In Compliance

Yes No N/A

Psychotropic Medication

The resource family parent ensures that the child is assessed by a psychiatrist, child psychiatrist, pediatric neurologist, or neuro-developmental pediatrician, to determine the need for, and the possible risks or side effects of, the psychotropic medication.

If a child is in need of psychotropic medication, the resource family parent has obtained consent for psychotropic medication from CP&P. (CP&P obtains consent from the parent, when necessary.)

When a psychotropic medication is recommended as part of a child's treatment plan, the Child Health Unit

Nurse, the Worker, the prescriber, the resource family parent, and the child form the child’s treatment team.

The treatment team monitors the child’s treatment plan, and sets goals for treatment with this medication.

The resource family parent is knowledgeable about the indications for the use of any prescribed psychotropic medication, and the therapeutic benefits and the side effects of such medication.

The resource family parent reports any observed side effects to the Child Health Unit Nurse, the Worker, and the prescriber.

Psychotropic medication is stored in an area inaccessible to children.

Administering or withholding psychotropic medication is not used as punishment or for the convenience of the resource family parent.

Medical review indicating the child’s status, behavior, well-being, side effects, and reason for continuing medication is completed monthly, or when deemed necessary by the prescribing psychiatrist, pediatric neurologist, neuro-developmental pediatrician, mental health clinical nurse specialist, or mental health clinical nurse practitioner.

The resource family parent maintains a medication log which contains the child’s name, type of psychotropic medication, and the date and time whenever the medication is administered.

Although the resource family parent does not currently have any children in placement needing a medication log, the policy regarding the use of medication logs has been reviewed with the resource family parent.

COMMENTS:

The signatures, below, indicate that a series of conferences were held between the Resource Family Support

Worker and the Supervisor throughout the home study process (one conference held every 30 days, at a minimum), to assess progress, compliance, and identify and resolve any item out of compliance (marked “No” on the form).

Name of Resource Family Support Worker Signature Date

Name of Supervisor Signature Date

Name of Family ___________________________ 11

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