Refuge House Policies & Procedures
CHILD-PLACING AGENCY POLICIES .............................................................................................................................. 3
Statement of Services ........................................................................................................................................................... 3
FOSTER CARE ......................................................................................................................................................................... 5
Selection Criteria for Applicants, Foster Parents, and Child Care Staff ............................................................................. 5
Foster Parent Training Requirements ................................................................................................................................. 6
Criteria for Determining Characteristics of Children Who May Be Placed in an Agency Home ....................................... 9
Rights and Responsibilities ................................................................................................................................................ 10
Placement of Emergency and Non-Emergency Children/Admission ................................................................................. 36
Respite Plan and Reimbursement ...................................................................................................................................... 39
Pre-Service Training Policy for Foster Parents and Child Care Staff .............................................................................. 40
Conflict of Care ................................................................................................................................................................. 41
Individual Service Plan Review Policy .............................................................................................................................. 42
Foster Home Verification .................................................................................................................................................. 45
MEDICAL AND DENTAL CARE......................................................................................................................................... 48
Medical and Dental Care .................................................................................................................................................. 48
Emergency Medical Care .................................................................................................................................................. 50
Records Retention Policy ................................................................................................................................................... 51
CHILD RIGHTS ...................................................................................................................................................................... 52
Child’s Rights .................................................................................................................................................................... 52
Meal Plan…………………………………………………………………………………………………………………39
Preparation for Adult Living……………………………………………………………………………………………..45
Policy on Child’s Contact with Biological Family, Including Siblings ............................................................................. 62
`SUBSTITUTE CARE INTAKE ............................................................................................................................................ 63
Screening Procedures for Foster Parents and Child Care Staff ........................................................................................ 63
Sample Placement Agreement............................................................................................................................................ 64
Written Notice to Parents/Managing Conservators ........................................................................................................... 65
Discharge/Removal of Children ........................................................................................................................................ 69
Subsequent Placements……………………………………………………………………………………………………54
CLIENT RIGHTS ................................................................................................................................................................... 73
Appeal Process for Agency Clients .................................................................................................................................... 73
PROBLEM MANAGEMENT ................................................................................................................................................ 74
Discipline and Behavior Management ............................................................................................................................... 74
Restraint Policy ................................................................................................................................................................. 80
Chemical Dependency……………………………………………………………………………………………………..63
ADMINISTRATION ............................................................................................................................................................... 82
Informing Licensing Representative of Changes ............................................................................................................... 82
Evaluation for On-Going Compliance with Minimum Standards and Documenting/Correcting All Non-Compliance .... 83
Responding to Patterns of Non-Compliance with Minimum Standards............................................................................. 84
Decision Tree for Reporting and Investigating Allegations or Incidents .......................................................................... 85
Incident Reports ................................................................................................................................................................. 90
Foster Family Annual Evaluation of Quality ..................................................................................................................... 92
Governing Body’s Responsibilities .................................................................................................................................... 94
FISCAL ACCOUNTABILITY ............................................................................................................................................... 95
Budget ................................................................................................................................................................................ 95
Reserve Funds .................................................................................................................................................................... 96
Informing Licensing Representative of Changes
Refuge House Policies & Procedures
REPORTS AND RECORDS .................................................................................................................................................. 97
Runaways ........................................................................................................................................................................... 97
REQUIRED MATERIAL ....................................................................................................................................................... 99
Fee Policy .......................................................................................................................................................................... 99
STRUCTURE OF A CHILD PLACING AGENCY ........................................................................................................... 100
Level 1 Child Placing Staff Services ................................................................................................................................ 100
Agency Homes Meet Minimum Standards ....................................................................................................................... 102
PERSONNEL POLICIES ..................................................................................................................................................... 103
Personnel Qualifications and Responsibilities ................................................................................................................ 103
Job Descriptions .............................................................................................................................................................. 104
Volunteers ........................................................................................................................................................................ 118
Screening Program .......................................................................................................................................................... 119
Informing Licensing Representative of Changes
Refuge House Policies & Procedures
Child Placing Agency Policies
Child-Placing Agency Policies
Subject
Applicable Standards
Date Board Approved
Policy:
Statement of Services
1400.2
04/28/03; Changes Approved 3/07/06
Refuge House will provide a full spectrum of foster care services to the children referred to this
agency for care.
Procedure:
1) Children Served
Refuge House accepts children of all ages and both sexes who can benefit from foster/adoptive
care. Children’s needs must fall within the range of levels of care Basic through Specialized.
Since children’s needs often change, we will adjust the level of services within the same home
if possible, rather than asking the child to move because his/her needs have changed.
Children’s needs sometimes do not fit into neat categories, such that we will develop
foster/adoptive homes prepared to cope with the unique situation of children who are both
emotionally and behaviorally disturbed and children with developmental disabilities.
We only accept children who are placed by the Department of Family and Protective Services,
and they have in common the experience of having been abused and/or neglected by their
families.
2) Foster Care Programs
Therapeutic Foster Care-The therapeutic program is structured family living in homes in which
experience, well-trained professional foster/adoptive parents and their families help
emotionally and behaviorally disturbed children to shape their skills and abilities to the point
they no longer require specialized care. Components of the program include comprehensive
support for the foster family, counseling/therapy from qualified therapists, remedial
educational help, and aggressive service planning.
3) Staffing
Refuge House seeks out bright, capable and caring individuals to be a part of our agency
family. All professional staff has college degrees in social work or other human services fields
and relevant experience. In addition to this, all staff and foster/adoptive families are asked to
sign the Refuge House Statement of Faith when they become affiliated with Refuge House.
This is to ensure that all are aware of the Christian philosophy and principles which Refuge
House strives to support in all that we do, and to set the expectation up from that these
principles and beliefs will be upheld by all.
Refuge House staff members are ably assisted in working with children by our team of
consultants including, but not limited to, licensed social workers and therapists, a psychologist,
psychiatrists, physicians, nurses and trainers. Decisions are made via team consensus
whenever possible.
Although they are not part of our staff, DFPS caseworkers, and parents who are working toward
reunification are all considered to be valued members of the Refuge House team.
4) Description of Services
a. Case Planning
A temporary individual service plan is ready for the child and foster/adoptive parents
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within 72 hours of placement, based primarily upon written referral material. The
initial individual service plan is completed within the first 30 days of placement in
consultation with the child, the managing conservator, the child’s parent(s), Refuge
House Staff, foster parents and professional consultants. The service plan is reviewed
and updated by the interdisciplinary treatment team every six (6) months for children
with basic needs and quarterly for children with therapeutic needs. Addendums are
made to the service plan as needed when individual items are changed.
b. Case Management
Experienced staff ensure that children’s individual service plans are carried out,
through at least weekly contact, including, but not limited to, at least two home visits
per month and two telephone contacts per month for homes with children leveled
moderate or above and at least one home visit per month and three telephone contacts
per month for homes with basic level of care children. There will be at least one on
call Case Manager available via cell phone 24 hours a day, seven days a week, to
support foster/adoptive parents.
c. Preparation of Foster/Adoptive Families
Refuge House accepts experienced, successful foster/adoptive parents, or
foster/adoptive parents who have completed the required 40 hours of pre-service
training. Thereafter, Refuge House staff and consultants provide training opportunities
through which single foster/adoptive parents gain 50 hours of in-service training per
year, and married couples each get 30 hours for a total of 60 training hours for the
family unit. Our foster/adoptive parents often obtain training specific to one
prospective child’s needs from our personnel.
At the time of placement of a foster/adoptive child in a particular home, the Level One
Child Placing Staff and the Executive Director will assess and evaluate the home and
make a determination regarding the appropriateness of future placements in that
particular home.
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Foster Care
Foster Care
Subject
Applicable Standards
Date Board Approved
Selection Criteria for Applicants, Foster Parents, and Child Care Staff
3100.2a, 3100.2c
04/28/03, Changes Approved 3/07/06
See Standard 2320.1, Screening Program for Foster Parents, Child Care Staff.
(Pg. 82)
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Foster Care
Subject
Applicable Standards
Date Board Approved
Policy:
Foster Parent Training Requirements
2410.0 and 3100.3
04/28/03, Changes Approved 3/07/06
Refuge House foster and adoptive families will be well prepared and capable of dealing with
the behaviors exhibited by children in their home. They will understand the needs of
therapeutic children and youth, and they will ensure that DFPS licensing standards are met.
Refuge House will only verify therapeutic foster/adoptive homes.
Procedure:
1. All prospective foster/adoptive parents must attend an orientation class. This will include information
about the mission and vision, services provided, and Roles and Responsibilities. This class is one (3)
hours and will not count towards annual training hours.
2. All prospective foster/adoptive parents must attend pre-service training that will be provided to them
by Refuge House (or in association with other local child-placing agencies) before the verification of
their home. Pre-service training is 40 hours of classroom time.
Pre-service training will include the following classes for therapeutic foster/adoptive homes:

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PRIDE classes (30 hours)
First Aid and CPR (4 hours)
Medication Training – Psychotropic Medications (2 hours)
Behavior Management – PMAB (8 hours), 4 hours yearly udate
PRIDE Classes include the following:
 Connecting with Pride (3 hours)
 Teamwork Towards Permanence (3 hours)
 Meeting Developmental Needs: Attachment (3 hours)
 Meeting Developmental Needs: Loss (3 hours)
 Strengthening Family Relationships (3 hours)
 Meeting Developmental Needs: Discipline (3 hours)
 Understanding and responding to the Issues of Sexual Abuse (3 hours)
 Continuing Family Relationships (3 hours)
 Planning for Change (3 hours)
 Taking PRIDE: Making an Informed Decision (3 hours)
3. Experienced foster/adoptive parents are those foster/adoptive parents who have already received the
training outlined above and who have been previous foster parents for therapeutic children. These
parents must have been actively fostering children within the last 12 months. Experienced
foster/adoptive parents will not be required to repeat PRIDE training for verification of the home when
transferring from another agency. Those who have current certification in First Aid or CPR will not
need to repeat this training until their certification expires.
4. For those potential foster/adoptive parents who took PRIDE classes over a year prior to applying for
verification through and who do not have experience in providing foster care, the PRIDE classes will
need to be repeated. PRIDE classes may be taken at any local agency offering classes.
5. Foster/adoptive parents must take Medication training and Behavior Management training on an annual
basis. This training must be provided by approved staff.
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6. Medication training includes basic pharmacology – classifications of medications, desired actions,
monitoring of side effects and adverse reactions. Medication administration and documentation is
taught as well as related policies and procedures.
7. The Case Manager will ensure documentation of this training according to the agency’s criteria.
Documentation of this training according to the agency’s criteria. Documentation will include the date
of training, subject, number of hours attended, and the name of the training provider.
8. Professional staff is responsible for attending 30 hours of training each year within the social,
psychological, or behavioral fields of study and/pr area of licensure including the courses listed below,
if applicable. All qualifying clock hours must relate directly to child-placing responsibilities. For Level
1 Child-Placing Staff, a minimum of 20 clock hours are needed annually with 10 clock hours relating
directly to child placing responsibilities.
9. Single foster/adoptive parents are responsible for attending an additional 50 hours of training each
year, married couples totaling to 60 hours. Refuge House will provide ongoing in-service training
opportunities for the foster/adoptive parents and staff. Topics to be offered by for annual training
requirements will include:
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Counseling and Active Listening (1 hour)
Self-determination (1 hour)
Youth Rights (1 hour)
Cultural Diversity (2 hours)
Shaken Baby Syndrome and Sudden Infant Death Syndrome (2 hours)
Professionalism and Evaluations (2 hours)
Monitoring and Supervision (1 hour)
Respite Care (1 hour)
Risk Management (6 hours)
Documentation (3 hours)
Quarterly Individual Service Plans (3 hours)
Working with Sexually Abused Children (3 hours)
Learning Theory (1 hour)
Motivation Systems (2 hours)
Observing and Describing Behavior (1hour)
Effective Praise (1 hour)
Preventive Teaching (1 hour)
Corrective Teaching (1 hour)
Teaching Self Control (1 hour)
Other topics will be offered depending upon the needs of the children and current licensure standards. It is
the responsibility of the individual receiving the training to ensure documentation is turned in for all training
received to the Case Manager. The Case Manager will help the foster/adoptive parents develop a plan in order
to acquire necessary training.
10. Staff and foster/adoptive parents are also able to receive training hours for:
 Attending pre-service training for review
 Attending seminars which are relevant to their responsibilities
 Reading professional publications and writing a brief synopsis (each 30 pages of reading is equal
to one hour; no more than 12 hours of the required trianing hours may be earned this way)
 Viewing videotapes or listending to cassette tapes pre-approved by the Case Manager.
 Hosting new families for observation in the home and training the parent(s) in the specific
items listed on the training verification form (up to nine hours for experiences foster/adoptive
parents only.)
11. Staff cannot take vacation time unless their training hours are current.
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12. Foster/adoptive parents who lack training hours and are not responding to a plan to acquire needed
training will not receive new children in their home. For more information, see the policy for
responding to chronic non-compliance with licensing standards and/or Refuge House policies and
procedures.
13. When foster/adoptive parents complete training in excess of the minimum annual requirement, up to
half of the following year’s annual training requirement may be accrued from the extra hours acquired
during the previous year.
14. At least 75 % of the required annual training for foster/adoptive parents must consist of the course
work from an accredited educational institution; workshops, seminars, other direct training provided
by qualified agencies, organizations and individuals; in-service training; or self-instruction programs.
To qualify, in-service training and self-instruction programs must include stated learning objectives,
curriculum and learning activities, and an evaluation component.
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Subject
Applicable Standards
Date Board Approved
Policy:
Criteria for Determining Characteristics of Children Who May Be Placed in an Agency
Home
3100.2b
04/28/03; Changes Approved 3/07/06
Refuge House assures that the knowledge base, skill level and personal abilities of foster parents
are considered at time of verification for the health, safety and well-being of children placed in
the home.
Procedure:
The Level 1 Child Placing Staff, with input from the Executive Director and Child and Family Coordinators, will
review the foster family file at time of verification and make a determination as to specific characteristics of
children that, when placed will have successful outcomes in the specific home environment.
Criteria to be considered will include:

The age of the parents - infants and toddlers (age 2 and younger) will generally not be placed in a
home if the main caretaker is 65 years old and above.

A single foster parent – a foster child of the opposite sex will not be placed in the home of single foster
parent from age 13 or older unless the foster family has a proven record and experience fostering.

The age and gender of children in the home – consideration will be given to assure protection before
placing teenagers (age 13 and above) into homes with teenagers (foster and biological) of the opposite
sex.

A newly verified foster family with no previous fostering experience – to allow for experience to
validate success in outcomes in a variety of situations, a newly verified foster family will be allowed to
care for no more than four foster children initially. Therapeutic children with fewer needs will be
placed with this type of family until three (3) months of experience is obtained. At the end of three
(3) months, the family will be re-evaluated to continue or remove admission limitations. (Refuge
House staff will make every effort to abide by this policy, however, sometimes this will not be possible
in the situation of emergency placements due to the limited information that is often available at the
time of placement. In

The strengths and experiences of foster parents with certain types of behavior management skills will
be considered when reviewing a child’s history before making a placement recommendation.
The foster family will be evaluated monthly to ensure family development. Pertaining to the above-mentioned
criteria, the visit will focus on areas of strength and opportunities for improvement and/or specialized training
as referred to in the Monthly Evaluation of Foster/Adopt Home form.
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Subject
Applicable Standards
Date Board Approved
Policy:
Rights and Responsibilities
3100.2d Contract 3A-B, 13 A.1, 14 C, 16 A-F, 19 E, 32 A.1, 33 A.13a-b
04/28/03; Changes Approved 3/07/06
The relationship between Refuge House and foster families will be specifically defined. This will
allow potential foster families to make an informed decision about working with the agency.
Procedure:
Both Refuge House and families have obligations to one another and to the children receiving care. These
responsibilities will be provided in writing and reviewed at time of orientation to the agency.
1) Placement procedures
a. Roles and Responsibilities of Refuge House
i. Matching Process – when a child is available for care and a family profile matches with
the child’s needs, the family will be notified by the Intake Coordinator and given verbal
information about the child. The CPMS along with the Intake Coordinator, will qualify
families based on discussion of criteria that include:

Physical capacity

Current family circumstances such as the amount of time since last placement
or the amount of since last child left

Strength of the home’s behavior management program

Foster family preferences, biases of family
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Temperaments
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Recreational resources

Desires of the family and desires of the foster child, interests, ages

Previous experiences of foster family, rural vs. urban issues

Effects of other in the home
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Current compliance with licensure standards
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Visitation transportation requirements

CCMS availability
The family is then selected through mutual consent of Refuge House and the family,
based on background information available about the child and family strengths. This
process is also followed for subsequent placements, however, before a child can be
moved from one home to another, prior written approval must be obtained from the
managing conservator. In the event of an emergency, and if prior approval cannot be
obtained, the Department must be notified of the move within 24 hours or the next
working day.
ii. Pre-placement – Refuge House provides the selected foster family an opportunity to
meet the child as well as review any available information prior to final approval of an
admission. The Placement staff present at time of placement will interview the
child(ren) being placed individually to ensure they feel safe and comfortable in the
home. The Placement staff will also interview the caregivers to ensure they feel
comfortable with the placement. After individual interviews, the Placement staff will
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meet with caregiver(s) and child(ren) being placed to review rules of the house,
preferred de-escalation techniques, participation in religious activities and any other
expectations of the family or the child. The Placement worker will confer with the
DFPS worker and caregiver(s) in regard to visitation arrangements or special
appointments.
iii. Admission – placement of the child with the family is the responsibility of Refuge House
acting in consultation with the family, Case Manager and professional support staff. As
much information as is known will be shared about the child including reasons for being
in care and past placements. Refuge House will provide to the foster family
information about the child. If available at admission, RH will provide information to
the foster parents, and as it becomes available within the first 30 days of placement.
This information will include (when available and applicable):
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Placement Authorization (DFPS and/or Refuge House)
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Authorization for medical, psychological and dental care (“Attachment B”)
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New Placement Worksheet
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Identifying Information – birth certificate and social security card

Discussion of information from the Common Application
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School records/educational portfolio
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Discussion of information from Psychological/psychiatric diagnostic evaluation
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Discussion of medical and dental information and medications
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Medicaid card or temporary number
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Immunization records
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Photograph of the child at the time of placement
iv. Intake Follow-up – within the first 30 days of placement, Refuge House Intake
Coordinator will ensure the following:
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All placement paperwork (or official requests) is filed in the child’s record
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Child’s record is complete with placeholder letter and all applicable forms
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Child 7-day Orientation acknowledgement is in the child’s record
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Foster Family 7-day follow up has been completed
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School District Notification/ECI Request has been submitted
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Updated Admission Assessment is in the child’s record for emergency
placement(within 20 days of placement)
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Psychological/Development is requested
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Therapist is identified and contact has been made. If the child comes into care
in therapy, then therapy must be scheduled within the first 30 days.
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Psychiatric evaluation has been conducted if Medicaid is active
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Medical exam is completed
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Dental exam is scheduled
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TB Test is completed
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Applicable school records are in the file
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
If the child is in Special Education, the Transition ARD is scheduled and records
from the prior school are requested
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An educational portfolio has been provided to the foster parent
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Case Manager is notified of any special appointments, i.e. PPTs, family
visitations
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Written documentation of CPS Communication Restrictions
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Family Placement Log and Child Placement Log are updated
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Intake Checkout Form is completed and signed by Intake and Case Manager and
filed in the Communication section of the child’s records.
**As soon as all paperwork is compiled, Intake Coordinator will submit to YFT for Level
of Care.
b. Roles and Responsibilities of the Foster Family
i. Availability –Agency homes must ensure that they can be contacted and are able to
confer with necessary parties in order to make a placement decision on short notice. If
Refuge House has repeated difficulty making contact with a potential Agency home, or
if the decision-making process is delayed by the caregivers, the caregivers must be
willing to accept longer periods of time without a placement.
ii. Matching Process – when a foster family is contacted with a potential placement it is
the obligation of the family to assess the child’s needs in relationship to the family’s
strengths and weaknesses and make a determination to accept or to decline the
placement.
iii. Pre-placement – the foster family is responsible for meeting the child, dialoguing with
the child about themselves and the family, and reviewing written material and verbal
information available about the child at the time of placement. The family may still
decline placement of the child at this time.
iv. Admission – upon acceptance of the child to the home, the foster family signs all
necessary documents. The foster family must open the home and allow themselves to
be accessible to the Case Manager. The foster family welcomes a new child to the
home and orients them. The family reviews the rules of the house and the daily
schedule with the individual so that expectations are understood. Caregivers assist
Placement worker in completing clothing inventory and remaining Placement
paperwork.
2) Treatment Process
a. Roles and Responsibilities of Refuge House
i. Service Plan – the Intake Coordinator is responsible for providing a copy of the 72hours service plan as soon as it is prepared, within 72 hours of placement. The initial
individual service plan (ISP) will be developed within 30 days and updated semiannually or quarterly as appropriate with child’s Type of Service. ISP Participants must
be given 2 weeks’ notice of the ISP developmental meeting, which shall take place not
more than 10 days before the effective date of the ISP. In the development of the ISP,
the treatment team takes into consideration all information available, which may be
provided by the child, foster parents, school, therapist, psychiatrist and psychologist,
in addition to the case management notes leading up to the ISP. The Case Manager
also reviews written documentation from the foster family and other professionals on a
routine basis. The following items require an ISP addendum:

Change in Treatment Team Member (Case Manager, CPS Caseworker, Attorney
Ad-litem, Therapist, Psychiatrist)
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
Change in Medication

Change in Placement or Address Change
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Psychological Evaluation Received
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Safety Plan
The following incidents trigger an ISP review:

Change in Type of Service or Service Level
The following incidents trigger an ISP update:

YFT Level of Care Review
Educational/Developmental - Within one business day of placement, Intake
Coordinator will notify the local school district or an early intervention program that
the child is living in the district area and will be attending or needing their services.
This will be done by written correspondence and will be placed in the child’s record.
Case Manger will request school records on a quarterly basis to ensure the child’s
education portfolio contains the most current information available. Case Manager will
attend ARDS and meetings as needed to advocate for the child. Case manager will
ensure that any developmental delays are addressed, and appropriate interventions
will be identified and/or developed to assist the caregiver in providing the needed
services to help the child improve their level of functioning.
Medical/Dental - The Case Manager ensures that each child receives regular medical
and dental checkups. Refuge House staff will assist the family in locating professionals
accepting Medicaid, as needed, for evaluations and ongoing care. Refuge House case
manager will ensure that medical and dental forms are reviewed so that all instructions
and follow-up recommendations have been adhered to. Case Manager ensures that the
annual medical exam includes a vision and hearing check, unless prior documentation
demonstrates that these exams have been conducted. Case Manager initials the
Medical/Dental forms and files in the child’s record. After the initial medical exam,
every child must receive at least one well-child exam per calendar year. After initial
dental exam and cleaning, the child must follow the dentist’s recommendations for
follow-up care. If a child is under the care of a specialist, case manager will ensure
that all physician’s orders/recommendations are followed. In the event that a child is
hospitalized, case manager or on-call worker will accompany or meet caregiver at the
hospital and provide support, encouragement and assistance as needed. Case manager
will notify the CPS worker of hospitalization, complete the incident report and notify
licensing within the specified timeframe. Case manager will submit hospital stay letter
and obtain CPS worker signature. If the child stays in the hospital longer than initially
authorized on the Hospital Stay Letter, case manager will complete an additional
Hospital Stay Letter and obtain the necessary signature(s). Upon child’s discharge,
case manager will obtain discharge paperwork from the hospital and review for any
changes to medication or follow-up activities. Case manager will complete any
required documentation and perform necessary notifications. All hospitalization
paperwork will be filed in the child’s record. If, for any reason, an instance occurs
where a child’s medical or dental treatment is in danger falling out of compliance, the
case manager is responsible for identifying the situation and completing a variance to
be submitted to licensing as soon as the situation is known.
Psychological – Within the first 30 days of placement, Intake Coordinator will request a
psychological or developmental evaluation. Upon receipt of the evaluation, Case
Manager will review and initial the evaluation and the recommendations and draft a
response regarding how the treatment team will fulfill the recommendations contained
therein. The response will be included in the child’s ISP by completing an ISP
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Addendum. If the recommendations will not be followed, the response must contain
the justification for that decision. Psychological evaluation will be updated
periodically, anywhere from 12 to 18 months.
Therapy – If a child coming into care has been in therapy, Case Manager ensures that
therapy begins within 30 days of placement as long as Medicaid is active and current.
If Medicaid is not active, therapy will begin at the earliest available appointment once
the issue is resolved. If a child’s psychological evaluation recommends therapy, the
child will be scheduled to have therapy sessions at the first available time according to
the therapist’s schedule. Case Manager ensures that Moderate and Specialized levels
of care receive therapy at least twice monthly, and more often if the therapist
recommends. Basic level children may receive therapy per a therapist or psychologist’s
recommendation. Case Manager reviews therapy notes to identify issues, concerns or
items requiring follow up and to ensure the following elements are incorporated on the
note:
 A date, beginning and an end time,
 legible and completed within the timeframe set by Refuge House,
 note demonstrates consistency with the service plan, psychological evaluation
and/or psychiatric evaluation,
 documents individual short and long term treatment goals, DFPS permanency
planning goals and progress toward those goals,
 frequency in the provision of therapy, dates included
Case Manager ensures notes are initialed and filed in the child’s record in a timely
manner.
Psychiatric – If a child requires psychiatric services, the Case Manager ensures that the
child is seen by the psychiatric provider at least once per quarter, and more often if
the doctor’s recommendations specify. Case Manager will confirm with caregivers that
necessary medication is appropriately dispensed and available to the child.
Psychiatrist permitting, a case manager (not necessarily each child’s case manager)
will be present at all med-check appointments. Presiding case manager will collect all
medication logs and verify for completeness and accuracy. If the presiding case
manager identifies any of the following conditions on the medication logs: a child
receives the wrong medication, child receives medication prescribed to someone else,
wrong dosage, wrong time, skipped or missed dose, expired medication, not following
med instructions, not stored as required; case manager will complete a Medication
Error Form and discuss the circumstances surrounding the medication error with the
caregiver. In the event that a child’s medication changes as a result of a med-check
appointment, the presiding case manager will complete the following forms and
documentation:
 ISP Addendum (child record, email to CPS worker)
 Information and Consent Form (to Foster Parent, child file)
 New med-logs
Following a med-check appointment, presiding case manager will submit medication
logs to Quality Assurance the following business day.
Incidents - The Case Manager notifies their Supervisor or on-call Supervisor
immediately upon receiving information about serious incidents, or an incident in
which the seriousness is unclear. The Supervisor notifies the Administrator/Treatment
Director to report a serious incident. Administrator/Treatment Director determines
what additional notifications are necessary. Documentation of incidents is completed,
signature obtained and filed in the child’s record. A copy of reportable incidents is
maintained in the Incident Report File in a secure location for two years.
Travel - The Case Manager communicates regularly with the managing conservator
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including routine updates, urgent and emergency situations. The Case Manager
notifies, in writing, the Managing Conservator of the foster parents’ plans when
traveling exceeds 72 hours with a foster child. The Case Manager must also notify, in
writing, the managing conservator when foster families travel outside the State of
Texas. The Case Manager will communicate approval to the family as the managing
conservator gives written authorization. The Case Manager and professional on-call
staff are available to the foster parents 24 hours per day for support and assistance as
needed.
Recreational Activities – Refuge House case manager will work with caregivers to
ensure that each child has adequate and appropriate activities, both structured and
unstructured, and assist in finding the resources necessary to meet the child’s
recreational goals. Refuge House will review activities calendars and activities to
ensure that the following items are documented on the recreation calendar:
 Monthly fire drills
 Weekly family meetings for children 2 years and above
 Structured, unstructured and recreational activities (all children should have at
least one unstructured activity per week, and children 2 and above should have
at least one structured activity per week)
 Travel and overnights
 Therapeutic Values (Specialized)
PAL (Preparation for Adult Living) – When a child turns 15 and a half years old,
Refuge House case manager will ensure the child is enrolled in a PAL program.
Child Record Maintenance – By the 15th of each month, Case Manager is responsible for
ensuring that any missing paperwork is requested at least monthly and the request has
been filed in the child’s record. Case Manager is responsible for ensuring that any
regularly required updates to the child record are completed, including
 Report Card Form is completed
 Therapy Notes are read and initialed
 Foster Parent Notes are read and initialed
 Recreation Calendars (including therapeutic values for Specialized children)
are reviewed and initialed
 Psychological is read and initialed, recommendations are incorporated into
service plan or addendum
 Overnight/Travel log
 Phone Contact Log is filed
 Confirm due dates and currency for the following: ISP, Psychological,
Medical, Dental, CPS Service Plan, PC/PPT/Group Conference
appointments, ARDs
 Physical record is maintained in good condition
Ongoing Training, Support and Education – RH case manager will provide regular
training and support to Agency homes in the areas of policy & procedure, Agency
standards, issues affecting foster children and children with behavioral problems, as
well as identifying resources for ongoing training and support. RH case manager may
conduct training and provide technical assistance, review areas of non-compliance and
develop plans of corrective action during regularly scheduled home visits.
ii. Discharge –
If a recommendation is made to discharge a child, the Treatment Team will meet to
discuss the necessity of discharging the child from Refuge House care. If the decision is
made to discharge the child, a 30-day notice letter will be drafted by the CPMS and
signed by the Administrator. This letter will be submitted to the CPS Worker and
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placed in the child’s record in the Discharge section. In the event of a planned
discharge, a discharge summary will be completed and submitted to the child’s CPS
worker on or before the day of discharge. Details of the discharge can be found in the
Discharge Policy and Discharge Procedure.
Emergency removals will be accomplished in an orderly fashion. Refuge House has the
right to remove a child from a foster family at the agency’s discretion at any time.
Progress of children who have left the home will be shared periodically for the benefit
of general interest about the child and of growing as a foster family in assessing skills
and best practices. Contact information (address and phone number) will not be
shared and is considered outside the scope of necessary information for the purposes
stated above.
All information that is shared is under generally accepted standards of privilege and
confidentiality.
iii. Family Monitoring – Refuge House maintains responsibility for regular supervision of
the foster family. This includes one in-home visit, one other face-to-face visit, and at
least two additional phone contacts per month to ensure that each family receives four
(4) quality contacts per month. With all new placements foster families will be
contacted within seven (7) days to assure the family has the needed supports to
provide for the child. This follow-up contact will be documented and filed in the
child’s record in the placement log section. The Case Manager will provide quarterly
feedback to the foster family assessing status on compliance with Minimum and LOC
Standards, as well as an annual assessment reviewing the quality of care provided.
Refuge House will document all contacts with its foster families. These contacts are
included in the child’s month-end narrative and/or the family’s quarterly review.
b. Roles and Responsibilities of the Foster Family
i. Availability – Agency homes must ensure that they can be contacted and are able to
confer with necessary parties regarding the children placed in their care and represent
the child as necessary.

When children are placed in an Agency home, caregiver will provide Refuge
House at least one contact phone number to ensure that Agency staff can make
direct contact with a caregiver in any given 24-hour period. In the event that
Agency staff makes 3 unsuccessful attempts to contact a caregiver in a 24-hour
period, the Agency home will receive technical assistance or a corrective
action plan, which may include a citation.

Caregivers must ensure they are available to represent the child in all facets of
their treatment, academic, medical/dental, legal and social and recreational
concerns or designate an appropriate representative. **Any person
accompanying a child to a medical/dental treatment must be a designee on
the “Medical Consenter Form”.

Caregivers are required to accommodate and/or facilitate unplanned situations
which arise in the Agency home, such as emergency hospitalizations,
alternative school transportation, transportation to work and juvenile court
proceedings.
ii. Service Plan –

Within 20 days of placement and every ISP cycle thereafter, caregiver will
participate with treatment team in developing goals and outcome measures in
a child’s Initial Service Plan. Caregivers must acknowledge their participation
and agreement with the plan by providing their signature on the plan.
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
The foster family is responsible for carrying out the plan of service for the child
by instructing the child on the Service Plan goals and ensuring the child
understands the goals and the methods to accomplish them, taking into
consideration the child’s age and developmental level.

Caregivers are responsible for accurately reporting child’s progress throughout
the course of the child’s placement in the home, in order to support the child’s
ongoing development. The mechanisms a caregiver uses to report progress to
Refuge House are foster parent notes, incident reports, activity/recreation
calendars, medical/dental forms, school reports and direct contact with
treatment staff by home visits, phone visits and general conversations with the
treatment team.

Foster parents are responsible to keep 6 months’ worth of service plans in their
home, and be able to provide to CPS worker on an visits.
iii. Medical/Dental –

Caregiver makes appointments and transports to medical,
psychiatric/psychological and dental appointments as needed.

Caregiver must obtain written documentation about the appointment and to
complete all recommendations including prescriptions and follow-up
appointments.

Foster parent will ensure that documentation is provided on the appropriate
forms, completed in their entirety.
a. Medical/Dental treatment form
b. Prescription Medication Logs
c. Over-the-Counter Medication Logs

Caregiver may give a child vitamins, but must provide documentation on the
Over-the-Counter Medication Log for children over the age of 5 years

Foster parent must submit Medical/Dental treatment forms and supporting
documentation to the Agency within 1 business day of the treatment by fax or
email.

Medications
a. When a physician writes a new prescription, existing medication
related to the new prescription should be disposed of appropriately.
b. Read and sign Psychotropic Medical Consent form when new
psychotropic meds are prescribed.
c. New prescriptions should be started within 24 hours of the prescription.
d. If caregiver encounters a problem with filling a prescription due to
Medicaid issues, it is the responsibility of the caregiver to pay for the
prescription and follow up with Medicaid or CPS for reimbursement.
e. If a foster parent continues to have difficulty in getting a prescription
filled, caregiver must contact their case manager or on-call worker
prior to the 24-hour deadline to begin dispensing the medication to the
child.
f.
Caregiver must follow all aspects of the medication instructions,
including time, dosage, frequency, with food, on an empty stomach,
avoidance of dairy products, etc.
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g. If a caregiver fails to dispense a prescribed medication to a child within
the specified timeframe, Agency may issue Medication Error form and
issue a citation to the Agency home. Medication Errors may result in
any of the following corrective actions:
1. Technical Assistance
2. Citation
3. Suspension of placement and retraining
4. Loss of license

Side effects or adverse reactions to treatment or any medication
a. Immediately contact a healthcare professional and follow their
instructions
b. Contact case manager or on-call worker
c. Document adverse reactions, time and date of call to the healthcare
professional, name and title of the healthcare professional, healthcare
professional’s recommendations for ensuring the child’s safety
d. Seek further medical care for the child if the condition does not
improve or appears to worsen

Medication logs
a. Medication logs should be completed at the time the medication is
dispensed
b. Medication should be dispensed within 10 minutes (before or after) the
prescribed time
c. Exceptions should be noted, such as child refusal, medication is
discontinued by physician, child has side effects or adverse reactions,
child is hospitalized, medication is dispensed at school, child is ill,
runaway
d. All medication logs should be brought to med-check visits, including
over-the-counter medications
e. Psychotropic med logs are due at each med-check
f.
Non-psychotropic prescriptions and over-the-counter med logs are due
with the monthly foster parent paperwork
iv. Educational – school enrollment and attendance.

Foster parents are to take the lead in enrolling and introducing the child to the
school within the first 3 calendar days of placement when school is in session.

Foster parents also understand that any child placed will need to attend a local
TEA accredited school.

If the child is enrolled in a school requiring tuition, it is the foster parent’s
responsibility for covering all costs associated with the child’s education.

Caregiver must obtain written approval from the CPS worker for the child to
attend any school other than a TEA accredited public school and provide
documentation of approval for the child’s record prior to enrollment.

Caregivers will maintain necessary school contacts, such as attending meetings
with school officials, ARD meetings, PTA meetings, parent-teacher conferences
and other activities in which the child may become involved.
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
Withdrawing the child from school is the responsibility of the caregiver once a
child has been discharged from the Agency home.

Foster parent will ensure that the Agency has received any school records
provided directly to the caregiver, including all progress notes, report cards,
teacher notes and school behavioral incident reports.

Foster parent must be an active participant in the child’s educational
experience by providing adequate time and appropriate environment for the
child to complete their schoolwork, as well as ensuring the child’s attendance
in school by providing necessary transportation.

Caregiver should encourage the child to participate in appropriate and
available school activities when possible, in order to ensure the child receives
the greatest benefit from the educational resources provided.
v. Spiritual – church attendance and involvement.

It is the foster parents’ obligation to encourage spiritual growth.

At pre-placement, caregiver must discuss with the child the home’s
involvement in religious activities and the expectations for the child’s
involvement.

Caregiver will not coerce or force a child to accept a particular set of beliefs,
however the child as a member of the family is expected to participate in
church-related activities or functions. Church attendance will be in
accordance with the habits of the family based upon the pre-placement
agreement between the child and foster family.

Caregivers should encourage children to participate in children’s church or
youth groups. The child’s obligation to attend church does not override the
child’s right to his own beliefs without fear of punishment.

If the child requests an opportunity to practice another (traditional) belief,
caregiver(s) must provide reasonable opportunity for the child’s exercise of his
faith. (For example, a private place to read the Talmud and pray.)
vi. Recreational – participation in community and social activities.

Caregiver(s) ensures that opportunities to participate in community activities,
such as school sports, or other extracurricular school activities, church
activities or local social events are available to the child, as well as adequate
leisure time.

Caregiver(s) ensure that children over the age of 2 years have at least one
structured and one unstructured activity each week, which includes
identifying, enrolling, funding and providing transportation to and from the
activity.

For a Specialized or Treatment Service child, caregiver will provide specific
information regarding behaviors a child exhibits and special needs to the
designated activity supervisor.

For children under the age of 2 years, at least one unstructured activity is
required per week, such as a play date, trip to the park or Sunday school
attendance.

Caregiver(s) must determine that each recreational activity is designed to meet
the child’s therapeutic, developmental and medical needs, as well as ensuring
that appropriate supervision (based upon caregiver ratios, Type of Service and
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Service Level, age and developmental level) is provided for the duration of the
activity.

Caregiver(s) must document recreational activities and provide a monthly
calendar to Refuge House no later than the 3rd day of the following month.

Caregiver(s) must provide the child opportunity to participate in family events.

Activity & Recreational calendars must include the following:
a. Child’s name
b. Month
c. Weekly family meetings (for children 2 and above)
d. Monthly fire drill
e. All appointments (including medical/dental, bio-visits, overnights)
f.
Who supervises/transports to each activity
g. Daily routine (M-F, weekends, holidays)
vii. Travel and Overnights –

Caregiver informs Agency of all overnights and travel, according to the policies
and procedures for each type of episode.

Caregiver(s) will ensure that all overnight stays and travel away from the foster
home are requested, approved and/or documented according to Agency
policies and procedures within the timeframe specified by the type of
overnight or travel.

Caregiver(s) are not permitted to travel with a child for more than 72 hours or
out of the State of Texas without prior written approval from Refuge House and
CPS.

Caregiver(s) will ensure that the safety and well-being of child(ren) placed in
their care is not compromised under any circumstance during travel or
overnight stays, including adequate supervision

Caregiver(s) is responsible for providing all documentation for the duration of
the travel or overnight stay, including medication logs, incidents and caregiver
notes.

Weekender – A Weekender lasts 48 hours or less, does not require written
approval from the CPS worker and is only available for infants and toddlers up
to 3 years of age or with written Agency approval in specific cases. Prior to
requesting a Weekender for child 4 years and over, the following criteria must
be met
a. Agency home has been in good standing for a year or more
b. Child Care Services only
c. Basic or Moderate level
d. Passing in school
e. No Safety Plan or significant behavioral issues
The following procedure must be followed in order for a child to participate in
a Weekender
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f.
Foster Care
Caregiver provides, at a minimum, 72-hour advance notice to Agency in
written form, unless prior written arrangements are already
documented and approved
g. Refuge House requires Treatment Director approval, as well as written
CPS approval for children 4 years and older
h. Caregiver receives written authorization from Agency prior to the
Weekender
i.
Caregiver provides Alternative Care Fact Sheet to the substitute care
provider
j.
Caregiver ensures they are available to substitute care provider by
phone 24 hours a day for the entire weekend or episode
k. Caregiver ensures that substitute care provider understands the
responsibility and requirements
l.
Caregiver ensures medication is provided, dispensed and documented
according to medication directions and RH policies by either calling and
reminding or personally dispensing the medication. Caregiver is fully
responsible for ensuring the medication is dispensed as directed.
m. Caregiver documents Weekender on Activity/Recreational calendar and
caregiver notes

Mini-break – A mini-break is defined as a regular in-home or out-of-home stay,
less than 72 hours, supervised by a Refuge House authorized Mini-break
provider. Mini break provider requirements are found in the Caregivers policy.
Caregiver must notify Refuge House in writing (email, fax or letter) prior to a
mini-break episode. Failure to notify Refuge House in advance of a mini-break
may result in mini-break privileges for the Agency home being revoked for a
period of 3 months.
a. Caregiver provides advance notice to Agency in written form
b. Caregiver receives authorization from Agency prior to Mini-break
c. Caregiver ensures that Mini-break provider is able to manage the shortterm care according to the child’s service plan
d. Caregiver provides pertinent information and items to Mini-break
provider,
1. Medications, including medication directions,
2. Med logs,
3. Copy of Medicaid card,
4. Copy of DFPS placement authorization,
5. Copy of Medical Consenter form,
6. RH contact information,
7. Supervision requirements, including Safety Plan,
8. Behaviors and risk factors,
9. Scheduled appointments or activities (including visits and
recreational activities)
e. Caregiver collects applicable documentation (including notes, and med
logs) from Mini-break provider
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f.

Foster Care
Caregiver documents Mini-break on Activity/Recreational calendar and
caregiver notes.
In-home Substitute Care – In home substitute care lasts more than 72 hours
and 14 days. Supervision is provided by licensed Refuge House providers.
a. Caregiver provides 3 weeks’ advance notice to Agency in written form
b. Refuge House requires a Substitute Care Justification Form, Treatment
Director approval, and written approval from CPS Worker(s)
c. Caregiver receives authorization from Agency prior to Substitute Care
d. Caregiver ensures that Substitute Care provider is able to manage the
short-term care according to the child’s service plan
e. Caregiver provides pertinent information and items to Substitute Care
provider,
1. Medications, including medication directions,
2. Med logs,
3. Copy of Medicaid card,
4. Copy of DFPS placement authorization,
5. Copy of Medical Consenter form,
6. RH contact information,
7. Supervision requirements, including Safety Plan,
8. Behaviors and risk factors,
9. Scheduled appointments or activities (including visits and
recreational activities)
f.
Caregiver collects applicable documentation (including notes, and med
logs) from Substitute Care provider
g. Caregiver documents Substitute Care on Activity/Recreational calendar
and caregiver notes.

Intermittent Alternative Care- Intermittent Alternative Care is defined as out-ofhome substitute care lasting between 72 hours and 14 days whose purpose is to
provide relief to the primary caregiver(s). Intermittent Alternative Care is provided only
by Agency licensed foster care providers. Each child placed in alternative intermittent
care must wait at least 10 days before returning to alternative intermittent care, unless
the Agency home providing the alternative intermittent care is used exclusively for this
purpose. For each Agency home providing Intermittent Alternative Care, the home
must wait a minimum of 10 days between Intermittent Alternative Care placements and
may only provide IAC for a maximum of 60 days per year, unless the home is solely
used for this purpose. A child may be in Alternative care for 14 consecutive days, not
to exceed 40 days per year. Pertinent information regarding the child and the child's
routine must be provided to Intermittent Alternative Care providers using Child
Alternative Care Fact Sheet.
All episodes of intermittent alternative care must be accompanied by an Alternative
Care Justification form and approved in writing prior to the child's placement in
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alternative care. The form and approval must be stored in the both the Agency home
record and the child's record.
a. Caregiver submits a request for Alternative Care at least 3 weeks’ prior
to the episode.
b. The Agency home providing the Alternative Care must also have a
Justification form authorized by the Treatment Director ensuring that
the children already placed in the home will not be negatively affected
by the Alternative Care episode.
c. Caregiver ensures that Alternative Care provider is able to manage the
short-term care according to the child’s service plan
d. Alternative Care provider must ensure that all requirements of the
child care ratio and supervision plans, including safety plans are met at
all times during the episode.
e. Once Caregiver receives authorization from Agency prior to Alternative
Care, the following expectations will apply
f.
Caregiver provides pertinent information and items to Mini-break
provider,
1. Medications, including medication directions,
2. Med logs,
3. Copy of Medicaid card,
4. Copy of DFPS placement authorization,
5. Copy of Medical Consenter form,
6. RH contact information,
7. Supervision requirements, including Safety Plan,
8. Behaviors and risk factors,
9. Scheduled appointments or activities (including visits and
recreational activities)
g. Caregiver collects applicable documentation (including notes, and med
logs) from Alternative care provider
h. Caregiver documents Alternative Care on Activity/Recreational
calendar and foster parent notes.

Mini-break Reimbursement – Caregiver may request reimbursement for one
mini-break episode per calendar quarter for an Agency home, and one minibreak episode per 6 months for an Agency group home. Determination of
reimbursement rate is based upon actual number of foster children placed in
the home. An Agency home may not request reimbursement for Basic only or
fewer than 2 foster children. A group home (for the purposes of mini-break
reimbursement) is one caring for 7 or more foster children. Reimbursement
rate for 6 or fewer foster children is $140 per calendar quarter.
Reimbursement rate for 7 or more children is $600 per 6 months.

For additional policies and procedure regarding travel and overnight stays,
refer to the POLICIES
ii. Daily Supervision – Caregiver(s) is responsible for the supervision of all child(ren)
placed in their care. Supervision requirements may vary depending on the Type of
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Service and Service Level. Caregiver(s) will comply with all supervision requirements
and instructions specified in each child’s service plan, as well as any safety plans that
are in place. All children (Basic, Moderate, Specialized) have supervision requirements
and plan based on Type of Service, Service Level, age, developmental level and
specific risk factors. For children at every service level, caregivers provide a normal
and least restrictive family setting that is designed to maintain or improve the child’s
functioning by:
1. Establishing clear rules appropriate to the developmental and functional levels of
the child.
a. Caregivers will establish written rules for the foster home that will be kept
in the family’s file at RH office and will be posted in the home
b. Will be verbally shared with the child at the time of placement or the
follow day
c. Will be evaluated with the treatment team at the time of the individual
service plan for their appropriateness for the child’s developmental and
behavioral needs
2. Establish a clear system of rewards and consequences
a. Foster parents will outline a system of rewards and consequences for based
on the child’s age, developmental, type of service and service level,
rewards and consequences will be kept in the family’s record and posted in
the home
b. Will be verbally shared with the child at the time of placement or the
follow day
c. Will be discussed and evaluated with the treatment team at the time of the
individual service plan for their appropriateness for the individual child
3. Supervising a child through guidance to insure the child’s safety and sense of
security
Basic – Supervision is determined for each child based upon their age, developmental
level, mood, environment, past experience, behaviors, behavioral history. Infants and
toddlers (up to 3 years of age) are to be monitored continuously, including auditory
and/or visual awareness. This may be accomplished through the use of monitoring
equipment.
Moderate – All components that apply to a child at the Basic Service Level also apply to
a child at the Moderate level. Additionally, foster parents provide regular daily
supervision with appropriate intermittent interventions typically consisting of verbal
guidance, assistance and monitoring. In rare cases where a Moderate child is also
classified as a Treatment Service child, supervision requirements would be the same as
those for a Specialized child.
A child at the moderate level has more routine supervision with additional structure
and support. Child may have time by himself, but caregiver must conduct intermittent
checks to ensure the child’s safety and well-being during on-going activity. A Moderate
level child may have a job (if age and developmental level are appropriate). Caregiver
arranges and supervises recreational activities, documents the daily routine and gives
the child opportunity to direct their own activities when appropriate.
Specialized – All components that apply to a child at the Basic and Moderate Levels,
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apply to a child at the Specialized level. Close daily supervision that is continuously
gauged, taking into account age, medical, physical and mental conditions and other
factors that affect the amount of supervision required at any given time, as well as
determining if the child is at immanent risk of harming themselves or others. Caregiver
will not be engaged in tasks or activities that interfere with the ability of the caregiver
to interact with the child, either verbally or visually, meaning the caregiver should be
able to either see or hear the foster child at all times and ensure they have adequate
time and ability to react to situations that may arise suddenly. In cases where a child
is at immanent risk of harm to self or others, caregiver should provide line-of-site
supervision until a safety plan is in place.
Treatment Services – Treatment Services who are classified as Treatment Services due
to emotional disorders, such as mood disorders, psychotic disorders or disassociative
disorders will follow the same supervision requirements as that of a Specialized child
and will always have a safety plan developed in order to help them transition into a
less restrictive environment.
Safety Plan - When a child presents a risk of harm to self or others, Agency will
develop a written Safety Plan, which may include continuous observation until the
danger has subsided and the child’s condition is stabilized. The caregiver will comply
with and follow all aspects of the written Safety Plan for the duration of the plan.
Treatment team will incorporate any persistent issues necessitating a safety plan into
supervision requirements of future service plans.
iii. Incidents – An incident is a non-routine occurrence that has or may have dangerous or
significant consequences on the care, supervision and/or treatment of the child. In any
case that a caregiver is uncertain regarding the type of incident, the caregiver should
err on the side of caution and contact their case manager or on-call worker.

Minor Incidents – Child bit another person not requiring medical treatment,
hitting with an open hand, hitting with a closed fist, child threw an object out
of anger, child pulled another person’s hair, child shoved another person, child
kicked another person
a. Caregiver will document minor incidents on a Minor Incident Report, as
well as documenting the incident in the foster parent notes
b. Caregiver will submit minor incidents with the monthly paperwork, due
by the 3rd calendar day of the following month
c. If a child has 3 or more minor incidents of a given type in one (1) day,
the caregiver must contact the case manager (or on-call worker) within
2 hours of the last incident so that a non-reportable incident report can
be completed
d. If more than 5 incidents occur within a 7-day timeframe, the caregiver
must contact the case manager or on-call worker to notify them so that
a meeting with the treatment team can be planned to generate a
safety plan or alter the current safety plan.

Non-reportable Incidents – Physical altercation between children in the home,
suicidal/homicidal ideation, sexual activity (consensual or acting out), a
personal restraint, drug or alcohol use, property damage or theft, major
behavioral issues, Medical (Emergency or Urgent Care that that does not fall
into the Reportable Incident category; seizures that do not rise to the level of a
reportable incident; see Reportable Serious Incident)
a. Caregiver must report incident to Case Manager or on-call worker
within 2 hours of the incident
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b. Caregiver must provide detailed information when reporting incidents
to Agency staff
c. Caregiver must follow recommendations made by the worker

Reportable – Suicidal gesture or attempt; indictment, charge or arrest; child
dies in care; non-consensual sexual abuse committed by a child against another
child; any consensual activity between children with more than 24 months
difference in age or when there is a significant difference in the developmental
level of the children or failure to make a reasonable effort to prevent sexual
conduct harmful to a child; physical abuse committed by a child against
another child (physical injury that results in substantial bodily harm and
requiring emergency medical treatment, excluding any accident or failure to
make a reasonable effort to prevent an action by a person that results in
physical injury that results in substantial bodily harm to a child); an adult who
has contact with a child has a communicable disease or a child contracts a
communicable disease; critical injury or illness that warrants treatment by a
medical professional or hospitalization, including dislocated, fractured or
broken bones, concussions, lacerations requiring stitches, second and third
degree burns and damage to internal organs; allegation of abuse, neglect or
exploitation of a child or any incident where there are indications that a child
in care may have been abused, neglected or exploited; child runaway;
a. Caregiver must report incident to Case Manager or on-call worker
within 2 hours of the incident
b. Caregiver must provide detailed information when reporting incidents
to Agency staff
c. Caregiver must follow recommendations made by the worker
iv. Documentation – providing the Case Manager with current, accurate, and complete
data and information concerning the child by timely completion of foster parent
progress notes and all other documentation required.
As-needed Documentation/Notification: The following documentation is submitted to
Agency according to the following parameters:

Medical/Dental treatment – within one business day of the appointment

School report cards, progress notes, behavioral issues – within one business day
of receipt

Travel Requests over 72 hours or outside the State of Texas – at least 3 weeks
prior to scheduled travel date

In-home Subsititute Care over 72 hours – at least 2 weeks prior to planned
event

Intermittent Alternative Care – at least 3 weeks prior planned event

Weekender and Mini-Break – notification to RH Case Manager or On-call worker,
prior to the event
Monthly Documentation: The following documentation is due no later than the 3 rd
calendar day of each month. If the 3rd of the month falls on a weekend,
documentation is due on the preceding business day:

Foster parent notes

Monthly activities/recreation calendar
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
Medication logs (homes where children do not receive psychotropic meds)
Note: Medication logs for Agency homes where children see a psychiatrist
should be brought to EACH med-check visit for all children

School records

Minor incident reports
v. Discharge –
Planned Discharge - If a caregiver voluntarily wishes to have a child in their care
discharged from their home, the caregiver must provide a 30-day written notice to the
Agency and confirm its receipt with the case manager, unless the child is hospitalized.
Emergency Discharge – An emergency discharge may occur in the following scenarios.
An emergency discharge does not necessarily mean immediate removal of a child from
a home, unless there is significant risk to the child or another individual.
CPS Initiated Discharge – As managing conservator, CPS may choose to end placement
of a child at their discretion. This may or may not involve advanced notice. All
discharge procedures will still be followed in the event of a CPS initiated discharge.
Foster parents will perform the following discharge procedures:
a. Withdraw the child from school the day of discharge or the day before.
b. Provide current Educational Portfolio to discharge worker.
c. Provide current prescriptions/medications to discharge worker.
d. Complete Child Property Inventory with discharge worker.
e. Provide all outstanding caregiver paperwork within a week or at the case
manager’s next home visit, including but not limited to caregiver notes,
activity/recreation calendars, medication logs, medical/dental treatment
forms
vi. Family Monitoring –
Agency Home Visits – Caregiver agrees to facilitate routine home visits by the RH case
manager. Typically, an Agency home will have 1 or 2 routine home visits per month, or
more as needed. At least once per quarter, all licensed caregivers and residents
(including biological children and foster children) for an Agency home must be present
and available for interview during a routine home visit. Caregiver will allow enough
time for case manager to speak with each foster child individually and conduct ongoing training. Caregiver should ensure that all licensing standards are met and home
is ready for a walkthrough prior to each Agency home visit. It is the caregiver’s
responsibility to maintain a safe physical environment and to maintain compliance with
all the home requirements for continued verification.
Agency Phone Visits – Caregiver agrees to be available for the scheduled Agency phone
visits, and be able to provide details about each child’s behavior. In some cases, RH
case manager may request a time to speak with one or more foster children placed in
the home. Caregiver shall allow for enough time in order to accomplish the interview
with RH case manager.
Agency Unannounced Visits - At least once per year, RH Quality Assurance team will
conduct an unannounced home visit. Caregiver must allow the Agency worker to enter
the home and assess the environment according to licensing standards and RH Policies.
Agency worker may provide technical assistance during this visit. Caregivers are
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expected to make necessary changes recommended by Quality Assurance, RH Case
Manager or other Agency personnel.
Investigations – In any instance when an Agency home is under investigation, caregiver
must allow Agency personnel into the home to perform and complete the investigation.
Other Party Visits – Caregiver must be prepared for visits from multiple entities,
including, but not limited to CASA, attorney ad-litem, therapist, CPS worker, CPS
supervisor, RCCL licensing rep and licensing investigators. Caregiver must make every
reasonable attempt to accommodate monitoring entities, including permitting entry to
the home and scheduling of visits.
2) Information Sharing
a. Roles and Responsibilities of Refuge House
i. Considering a placement – when a foster family has been requested to consider taking a
child into their home, initially as much information as is know will be shared verbally
by the Case Manager or Child and Family Coordinator. This will include the reason the
child has been brought into foster care, past placements and the reason the child was
moved from the placements.
ii. At Placement – upon admission or within 30-60 days depending on the type of
placement (such as routine or emergency) the Case Manager or the Child and Family
Coordinator will provide written information about the child. This will include:

Identifying Information – birth certificate and social security card

A summary of social and family history (verbal)

School records

Psychological/psychiatric diagnostic evaluation

Medical and dental evaluations (verbal)

Authorization for medical, psychological and dental care

Medicaid card

Immunization records

Placement Authorization
iii. After Discharge - Refuge House will share information about children who have left the
home if known for the purpose of the foster family growing in assessment skills,
general care, and best practices. Contact information (address and phone number) will
not be shared and is considered outside the scope of necessary information for the
purposes stated.
All information that is shared is under generally accepted standards of privilege and
confidentiality.
b. Roles and Responsibilities of the Foster Family
i. Considering a Placement – when contemplating taking a foster child into the home,
verbal information received should be shared with the biological family members in the
home who could assist and lend support in making a decision. If not enough
information has been given by the Case Manager or the Child and Family Coordinator to
be able to make a decision comfortably, it should be conveyed to the Case Manager or
the Child and Family Coordinator so that he/she can research possible solutions.
ii. At Placement – foster parents are obligated to review all written material made
available the day of placement. If information is inadequate to provide safe and
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effective care for the child, this is to be discussed with the Case Manager for timely
resolution.
iii. After Discharge – Foster parents may request an update on children who have left the
home out of genuine interest and for the purpose of learning and improving the skill
level of the foster family.
3) Training
a. Roles and Responsibilities of Refuge House
i. Pre-Service Training (before verification) – Refuge House is responsible for providing
orientation and a portion of the pre-service training classes to all prospective foster
families.
Classes taught by Refuge House include:

PRIDE classes (or in association with other local child placing agencies)

Behavior Management

Medication training/Psychotropic medications
Refuge House will assist families in locating classes for CPR and First Aid.
ii. In-Service Training (after verification) – Refuge House will provide ongoing training
opportunities, free of charge, on certain days throughout the year.
iii. Cost of Training – training provided by Refuge House is available to foster parents at no
charge. (This includes training done in association with other local child-placing
agencies).
iv. Monitoring of Training – The Case Manager and Foster Home Developer assist in the
tracking of hours completed by foster parents and provide regular updated and
reminders of renewal dates and continued training hours needed to fulfill
requirements, however caregivers are responsible for ensuring their training is current
and complete. The Case Manager and/or Foster Home Developer will initiate a plan for
a family to acquire needed training when a family is behind and closely monitor this
until training is current.
b. Roles and Responsibilities of the Foster Family
i. Pre-Service Training – each foster parent must attend an orientation class. This
includes information on the mission and vision of Refuge House, services provided, and
Roles and Responsibilities. This is a two (2) hour session and does not count toward
pre-service or annual training hours.

Orientation – 2 hours
o
Refuge House philosophy
o
Organizational structure
o
Policies
o
Programs Offered (foster care, adoption)
o
Characteristics of the Children we serve
o
Relevant applicable rules
All prospective foster parents are required to schedule and attend Pre-Service Training
and to complete homework in a timely fashion. The required training from families
providing therapeutic care to children is a total of thirty (30) hours for fostering and
foster/adopt. This includes:

CPR and First Aid (does not count toward pre-service hours)
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
Shaken Baby/SIDS

PRIDE Classes – 12 hours

Behavior Management – 16 hours initially with an 8 hour annual update

Medication Training/Psychotropic Medications – 2 hours

Adoption Caregivers – additional training required
Experienced foster/adoptive parents are those foster/adoptive parents who have
already received the training outlined above and who have experience in working with
therapeutic foster children. These parents must have been actively fostering children
within the last 12 months. Experienced foster/adoptive parents will not be required to
repeat PRIDE training for verification of the home. Those who have current
certification in First Aid or CPR will not need to repeat this training until their
certification expires. Experienced foster families will need to complete Behavior
Management and Medication Training before verification as a family with Refuge
House.
Pre-Service Experience – An Agency home whose caregivers do not have adequate preservice experience will select one of the following options:
1. Completing 40 hours of observation training with a tenured foster family, prior
to receiving any placement into their home.
2. Accepting only unleveled emergency placements or routine Basic level
placement and completing 30 full days of regular placement prior to accepting
a child at the Moderate or Specialized level or Treatment Services child.
Transfer – For Agency homes transferring from another agency, the Agency home must
meeting the following requirements

RH Orientation Training

Current CPR/First aid

Current Medication Training

Current SAMA training

Current ongoing training

6 weeks to complete RH Medication Training
Returning to Active Status – For Agency homes that are returning to Active status after
being inactive for under 1 year, caregivers in an Agency home must meet the following
requirements

Current CPR/First aid

Current Medication Training

Current SAMA

Resume pro-rated ongoing training
ii. In-Service Training (after verification) – Refuge House will provide ongoing in-service
training opportunities for the foster/adoptive parents. A variety of topics will be
offered by Refuge House for this annual training. In order to be eligible for Mini-break
reimbursements, caregivers must have current ongoing training. . Foster parents who
lack training hours and are not responding to a plan to acquire needed training will not
receive new placements in their home.
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Married caregivers - each family unit is required to complete 60 hours of annual inservice training, each caregiver completing 30 hours individually.
Unmarried couples – Single training requirement applies to each caregiver.
Single caregivers – each individual is required to complete 50 hours annually
Opportunities to obtain training hours include:

Attending pre-service training for review

Face-to-face training with Agency personnel during home visits

Seminar attendance which are relevant to their positions, including sessions at
the Annual Foster Parent Conference

Reading professional publications approved by the Treatment Director and
writing a brief synopsis (each 30 pages of reading is equal to one hour)

Viewing videotapes or listening to cassette tapes pre-approved by the
Treatment Director (may not exceed 25% of ongoing training requirements)

Hosting new families for observation in the home and training the parent (s) in
specific areas (up to nine hours for experienced foster parents only)

No more than one third of required training hours may come from selfinstructional training.
iii. Cost of Training – CPR and First Aid are not provided by Refuge House. Cost of these
classes is the responsibility of the foster parent (s). Generally training provided
outside the agency is the family’s responsibility unless arrangements have been made
with the Case Manager Supervisor. Travel expenses and childcare costs during training
are the responsibility of the foster family.
iv. Monitoring of Training – it is the responsibility of the individual receiving training to
ensure documentation is turned into the Case Manager or Foster Home Developer for all
training completed. When a caregiver completes training in excess of the minimum
requirements, up to 10 hours of the following year’s annual training requirements may
be carried over from the prior year.
4) Communication Process
a. Roles and Responsibilities of Refuge House
General Communication – Every Agency home is assigned to a case manager. The case
manager acts as the central point of contact and is responsible for each child placed in that
home, as well as most facets of the Agency home monitoring process. Following are the
regular contacts Refuge House will have with an Agency home:
o
Case Manager / Case Aid – maintains general and routine contact with an Agency
home at least once weekly, either by home visit, face-to-face visit or phone visit.
o
Foster Home Developer – conducts/facilitates Agency homescreening and ongoing
Agency home file maintenance and updates
o
Intake Coordinator – arranges placements and 30-day follow-up activities
o
Case Manager Supervisor, Treatment Director, Administrator, Executive Director handles non-routine occurrences, problem resolution and provides necessary
authorizations
o
Quality Assurance – ensures compliance and quality of care
o
Operations/Office Manager – provides support for non-treatment issues, such as
reimbursement questions
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o
Foster Care
On-call worker (972.834.0900) – provides 24 hour by 7 days a week availability,
specifically for after hours and weekend support and emergencies
Notification – Any of the above-mentioned parties may contact a caregiver at an Agency home
for any issue that could significantly impact their ability to care for the children placed in
their home. If a caregiver has questions or concerns regarding information or
recommendations, the caregiver may contact individuals through the chain of command: Case
Manager, Case Manager Supervisor, Treatment Director, Executive Director.
b. Roles and Responsibilities of the Foster Family
Availability - Agency homes must ensure that they can be contacted and are able to confer
with necessary parties regarding the children placed in their care and represent the child as
necessary, and also to make a placement decision on short notice. If Refuge House has
children placed in an Agency home and is unable to make contact within a reasonable
timeframe, Agency will follow procedures for corrective action. If Refuge House has repeated
difficulty making contact with a potential Agency home for a placement, or if the decisionmaking process is delayed by the caregivers, the caregivers must be willing to accept longer
periods of time without a placement. Agency homes where children are currently placed
must ensure they have at least one active telephone available at all times and must notify
the Agency if this primary contact changes.
Regular Communication – Caregiver must recognize the importance of the Agency’s
continual involvement in the care of the children placed in the home. Therefore, providing
consistent and detailed feedback regarding significant issues in each child’s daily life is
critical to the relationship between the Agency and the caregiver. This feedback takes the
form of a variety of mechanisms, including verbal and written communication through visits,
conference calls, emails, regular paperwork and faxes.
Notification - Caregiver responsible for notifying Refuge House of specific incidents, events
or occurrences within timeframes as stipulated for each type of incident or occurrence.
Many times, this notification is required prior to an event or occurrence.
Agency Homes - Specifically relating to an Agency home. Following is a list ofChanges
to an Agency home’s physical characteristics or location, new household members or
household leaving the home, changes to family composition (including pets), change of
job status or major life events, significant legal events. Any event that could impact a
caregiver’s ability to monitor or care, including serious illness or injury, for children
placed in their home should be reported to Agency staff as soon as the knowledge of
the event is known. The preceding list is not exhaustive; if a caregiver has any
question regarding the significance of an event, the caregiver should err on the side of
caution and follow up with their case manager.
Children Placed in Care – If there is any significant change to a child’s status
including, but not limited to emotional, behavioral, medical/dental, legal,
educational, spiritual, caregiver shall notify the case manager as soon as possible. In
the case of emergency or significant incident, caregiver shall notify on-call worker.
5) Support Services
a. Roles and Responsibilities of Refuge House
i. Mini-breaks – Refuge House will encourage and support foster families in taking a break
from the care of children in their home. A mini-break is up to 72-hours and is
facilitated by a Mini-break provider. Refuge House provides certification and
authorization for Mini-break providers. Refuge House provides reimbursement to
caregivers ($140 quarterly for 2-6 foster children, $600 semi-annually for 7-12 foster
children).
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ii. Weekenders – Refuge House encourages families who have been providers for a year or
more to take advantage of Weekenders, up to 48 hours for a child to stay overnight out
of the home. Prior authorization and approval by Treatment Director is required.
iii. Support Groups – Refuge House will assist in organizing foster families to meet
periodically. This will be for the purpose of peer support and information sharing. A
moderator will be provided to keep the group on task, lend expertise and assure a
positive experience.
iv. Community Support – Refuge House Case Manager will provide information on and
encourage participation in local foster parent associations as well as provide
information on becoming a member of Texas State Foster Parents, Inc.
v. Foster Parent Relations – Refuge House encourages communication between tenured
and experienced caregivers and provides contact information and attempts to facilitate
mentoring relationships when requested.
b. Roles and Responsibilities of Foster Families
i. Mini-breaks and Weekenders – Caregivers are encouraged to explore the opportunities
available, such as Weekenders and Mini-breaks. Caregivers must be current on
requirements and in good standing with the Agency to request the benefit of a minibreak or a weekender. For Agency group homes, caregivers are required to establish
the relationship between their home and that of a Substitute Care Provider. For
Agency homes, caregivers are encouraged to recommend potential mini-break
providers and ensure they are authorized by Refuge House.
ii. Support Groups - foster families will be encouraged to set aside time to be active in
parents’ support group. Parents need to provide feedback to the Case Manager as to
need and usefulness.
iii. Community Support – foster families will be strongly encouraged to become a part of
the local foster parent association as available as well as with Texas State Foster
Parents, Inc. for training and fellowship opportunities.
iv. Foster Parent Relations – Refuge House caregivers are encouraged to seek out
additional support and training from other caregivers and Agency staff. Caregivers may
contact their case manager or foster home developer to inquire of available resources
for mentoring.
6) Reimbursement
a. Roles and Responsibilities of Refuge House
i. Per Diem Payment – Refuge House will pay the foster family a per diem amount
according to the payment schedule for each child who is placed in the foster home.
Children who are placed with Refuge House are in the conservatorship of DFPS. Their
expenses are covered by DFPS according to their level of care as assigned by Youth for
Tomorrow (YFT). Refuge House per diem payments are as follows:
Basic
$20.56 / day
Moderate
$35.97 / day
Specialized
$46.25 / day
Refuge House will pay the per diem amount on the 15th and the last working day of the
month or five working days after receipt of all required monthly documentation for the
services provided in the previous month.
Payment will not be paid to the foster family for certain days that are not payable by
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DFPS. These days may include date of dismissal of a child, days spent in juvenile
detention or for hospitalization.
If a child transfers to another foster home, the per diem amount for the day of transfer
will be paid to the receiving foster family. A child must have spent the night in the
foster home for the family to be paid for that day.
Upon termination of a foster family, Refuge House will have 30 days from date of
termination to make final payment.
ii. Respite – Refuge House will reimburse $140.00 for two days of respite care per month
per family for two to six children in the home and $175.00 per family for more than six
children in the home that are leveled Moderate or Specialized. For families of one
Moderate or Specialized child going into respite care they will be reimbursed $65 per
month. Basic Service Level respite is reimbursed at $60 for two consecutive days each
quarter for two to six Basic Service Level children and $30 for one child per two
consecutive days per quarter. Payment can be made to the foster family or to the
respite provider as previously arranged.
iii. Clothing – Refuge House does not provide a clothing allowance, however, the Refuge
House case manager will assist the family in obtaining a clothing voucher from the
county of the children placed within the home.
iv. Transportation – Refuge House will reimburse for transportation for Service Plan
requirements only. This includes, but is not limited to, medical appointments,
therapy, and family visits. This will be reimbursed at a rate of 0.30 cents per mile.
Mileage reimbursement is only for transports that exceed 75 miles round trip.
v. Property Damage – Refuge House will not cover property damage.
vi. Christmas Gifts
vii. Special Events
b. Roles and Responsibilities
i. Per Diem Payment – According to DFPS, it is the expectation that 75% of the per diem
reimbursement goes toward the care of the child, which includes room and board,
clothing, hygienic supplies, activities and recreation, transportation, gifts and personal
rewards. Items purchased on behalf of, or for the use of an individual child are
understood to be their personal property and should go with the child at discharge.
Personal items should be current and updated on child’s inventory within a reasonable
timeframe.
ii. Expense Reimbursements – Caregivers must submit all required monthly
documentation, including expense reports, to Refuge House no later than the 3rd day of
following month in order to be reimbursed for their expense report.
iii. Respite – foster families make their own arrangements with a respite provider.
Alternative or substitute care form. They are to inform the case manager in writing the
plans for respite care by the 21st of the current month for the next month. This will
include the method of payment, which can either be made directly to the respite
provider or to the foster family. If the foster family pays the respite provider Refuge
House requires a receipt verifying that payment has been made.
iv. Clothing and Personal Possessions– a minimum of $2.00 per day of the foster care per
diem rate paid to the foster parents is to be spent on clothing for an average of
$180.00 per quarter. Foster parents agree to arrange for adequate clothing, personal
supplies and allowances for the child. Clothing shall be suitable for the child’s age and
size and it shall be comparable to clothing of other children in the community. As
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foster parents purchase new clothing for the foster child, these items are to be
considered his possessions and may not be retained by the foster family when the child
is discharged. All clothing receipts must be saved with the child’s name clearly written
on it. A child shall have some choice in the selection of his or her own clothing.
v. Transportation – foster families must submit a mileage log by the 5 th of the following
month in order to obtain reimbursement.
7) Grievances
a. Roles and Responsibilities of Refuge House.
When a disagreement about an agency decision is received verbally from an individual, the
Case Manager will make every attempt to resolve the issue immediately.
If a satisfactory solution has not been made, the Administrator will receive the issue in writing.
The Administrator will gather information from individuals directly involved and will attempt to
resolve the presenting issue. The response will be communicated verbally and in writing within
10 working days of receipt of the concern. The response will include specific reasons or
policies substantiating the decision. If a satisfactory solution still has not been found, the
individual may send a copy of the written appeal to the Executive Director. The Executive
Director will respond within 10 working days verbally and in writing again citing specific
reasons or policy substantiating the decision. If the issue still has not been resolved to the
individual’s satisfaction, a Refuge House board member will be available to meet and review
the facts and events with specific individuals involved. A follow-up written response will be
sent within 10 working days of the meeting date. This will again include specific reasons or
policy supporting the decision.
b. Roles and Responsibilities of Foster Families
When a foster parent has a disagreement, the issue should be communicated to the Case
Manager verbally. Foster parents should advocate yet be cognizant of unrealistic expectations
so as to allow for a solution to be reached as quickly if at all possible. If the concern persists,
the individual should contact the Administrator in writing. Once a response is obtained, if the
solution still is not satisfactory, the written concern should be forwarded to the Executive
Director. The individual will receive a response from the Executive Director. If the individual is
still not satisfied with the responses obtained, the individual may request in writing a meeting
with one board member and all individuals involved. All parties involved agree to abide by this
final decision. A final decision will be made and sent to the individual.
Note: This policy does not address adoption at this time. The policy will be updated to include
adoption at the time the adoption application is applied for.
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Subject
Placement of Emergency and Non-Emergency Children/Admission
Applicable Standards
Date Board Approved
Policy:
04/28/03; Changes Approved 3/07/06
Refuge House staff will ensure that all documentation is received at time of placement, and will
have a structural flow for child admissions.
Procedure:
Non-Emergency
ALL PERSPECTIVE CHILD ADMISSIONS MUST BE PRESENTED TO LEVEL 1 CHILD-PLACING STAFF.
1) CPS Case Workers must provide the following information:

Name, date of birth, gender, ethnicity

Service Level

Placement History (Including reasons for discharge)

Permanency Plan

Medical/Dental Exams

Current Psychological Evaluations

Current Psychiatric Evaluations/Information

Common Application

Biological family visitation information

Birth Certificate and social security card

Reason for needing placement

Guarding Ad Litem Information

Estimated length of stay

Court order and court affidavit

School history

Communication restrictions

Immunization Record

Medicaid Card/number
3) Once the Child and Family Coordinator and the Level 1 Child-Placing Staff have collected the
child(ren)’s information and has reviewed all documentation, the matching process will begin.
Once a match has occurred the Child and Family Coordinator will consult with the family and
get back with the CPS Case Worker as soon a possible. The same process will occur if
placement is needed after hours. The Level One Child-Placing Staff will sign off on and
approve all intake paperwork and placements. (If the placement is an emergency placement all
paperwork will be completed and/or collected within 30-60 days).
4) Once a child has been accepted, verbally, into the Refuge House program, the following
paperwork will be completed before placement occurs:
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
Tracking Sheet

Initial Intake Information Sheet

Intake Study

Pre-Placement Form

Action Sheet
AFTER PAPERWORK IS COMPLETED THE PLACEMENT MAY TAKE PLACE AT THE REFUGE HOUSE
FOSTER HOME. AT THE TIME OF PLACEMENT THE FOLLOWING PAPERWORK WILL BE COMPLETED:

Communication Restriction Sheet

School Information Sheet

Refuge House Placement Authorization

DFPS Placement Authorization

DFPS Authorization for Medical, Dental, and Psychological Care

Children’s Rights Form

Grievance Procedure Form

Initial 72-Hour Plan will be conducted

Clothing Inventory

Refuge House Placement Log
Emergency Placement
ALL EMERGENCY ADMISSIONS MUST BE PRESENTED TO LEVEL 1 CHILD-PLACING STAFF.
2) CPS Case Workers must provide the following information:

Name, date of birth, gender, ethnicity

Placement History (if known)

Common Application (short form)

Biological family visitation information, if known

Reason for needing placement

Estimated length of stay, if known

Court order

Communication restrictions
3) Once the Child and Family Coordinator has collected as much information as possible about the
child(ren) and the child(ren)’s information is reviewed by Level One Child Placing Staff, the
matching process will begin. Once a match has occurred the Child and Family Coordinator will
consult with the family and get back with the CPS Case Worker as soon a possible. The same
process will occur if placement is needed after hours.
4) Once a child has been accepted, verbally, into the Refuge House program, the following
paperwork will be completed before placement occurs:

Tracking Sheet

Initial Intake Information Sheet

Intake Study
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
Foster Care
Action Sheet
AFTER PAPERWORK IS COMPLETED THE PLACEMENT MAY TAKE PLACE AT THE REFUGE HOUSE
FOSTER HOME. AT THE TIME OF PLACEMENT THE FOLLOWING PAPERWORK WILL BE COMPLETED:

Refuge House Placement Authorization

DFPS Placement Authorization

DFPS Authorization for Medical, Dental, and Psychological Care

Children’s Rights Form

Grievance Procedure Form

Initial 72-Hour Plan will be conducted

Clothing Inventory

Refuge House Placement Log
Refuge House will only place children when a DFPS authorized worker is present for placement of the
child(ren).
Refuge House will comply with the federal Health Insurance Portability and Accountability Act of 1996 (HIPPA)
when pertaining to the information on a child placed by DFPS. If Refuge House is not possible to do so, Refuge
House will work with the child’s caseworker and DFPS residential contract manager to obtain the permissions
as necessary.
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Foster Care
Subject
Respite Plan and Reimbursement
Applicable Standards
Date Board Approved
Policy:
04/28/03; Changes Approved 3/07/06
Refuge House will provide support to the foster/adoptive parent in their provision of care and
treatment for the children placed in their home.
Procedure:
3) Foster/adoptive parents will be encouraged and supported in taking a break from the care of
the children in their home by participating in the respite program.
4) Refuge House will reimburse $140.00 for two days of respite care per month per family for two
to six children in the home and $175.00 per family for more that six children in the home that
are leveled Moderate or Specialized. For families of one Moderate or Specialized child going
into respite care they will be reimbursed $65 per month. Basic Service Level respite is
reimbursed at $60 for two consecutive days each quarter for two to six Basic Service Level
children and $30 for one child per two consecutive days per quarter. Payment can be made to
the foster family or to the respite provider as previously arranged.
5) Each foster/adoptive family will have the opportunity to be reimbursed for up to two respite
days each month for a total of 24 respite days per year. Unused dollars may not be
accumulated. A respite provider authorized to provide respite care by Refuge House must
provide this service. Respite providers must have a current and clear Criminal History and
CAPS record, and must attend classes in CPR, Medications, Behavior Management, and First
Aid.
6) Foster/adoptive parents will make their own arrangements with a respite provider, with the
Case Manager and Executive Director’s approval in writing by the 21 st of the month preceding
the desired respite care for the following month.
The foster/adoptive parents should leave emergency phone numbers and an emergency back-up plan with both
the Case Manager and the respite provider if the foster/adoptive parent will be unavailable to help in a crisis.
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Foster Care
Subject
Applicable Standards
Date Board Approved
Pre-Service Training Policy for Foster Parents and Child Care Staff
3100.3
04/28/03; Changes Approved 3/07/06
See Standard 2410.1, Training Plan or Program.
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Subject
Applicable Standards
Date Board Approved
Policy:
Conflict of Care
3100.5
04/28/03; Changes Approved 3/07/06
Refuge House assures that the health, safety and well-being of children in foster and adoptive care
will be upheld.
Procedure:
Refuge House will only be verifying homes for therapeutic care. Basic care children will only be
accepted into homes as part of a sibling group.
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Foster Care
Subject
Applicable Standards
Date Board Approved
Policy:
Individual Service Plan Review Policy
3420.1 Contract 7 A-G, 13 A-E
04/28/03; Changes Approved 3/07/06
In order to consider thoroughly the needs of the foster/adoptive family and reduce the risk of
foster care placement disruption, a service plan must be developed and reviewed to address the
needs of the child and of the prospective foster/adoptive family.
Procedure:
1) Individual Service Plan
a. The Case Manager completes an Temporary Service Plan within 72 hours of the time a
child is admitted to Refuge House. An Initial Individual Service Plan (ISP) is due within
thirty (30) days after a child’s admission or transfer from another agency.
b. A child’s team is involved in the development of the service plan and written notice is
given as an invite to the development of the plan to all parties involved on or in the
Treatment Team. This includes the child, the parents or managing conservator,
Administrator, Treatment Director, professional consultants, and the foster/adoptive
parents. Participation in the service plan process is documented in the child’s file.
c. The service plan:
i. Identifies a child’s needs relating to activities of daily living and development.
This includes:

A child’s special needs such as medical, dental, developmental,
recreational, educational, social and emotional needs.

A plan to prepare for adult living for children 16 years or older.

Behavior counseling, and supervision including activities of daily living
skills, therapy, crisis intervention, case planning and coordination, and
diagnostic assessment.
ii. Provides strategies to meet these needs, including instructions to
foster/adoptive parents or other persons involved in the child’s care.
Instructions must include specific information about:

Supervision (24 hour care, including food, clothing, room and board,
and personal items)

Discipline or behavior management

Travel and visits away from home
iii. Identifies expected outcomes of the placement. This includes:

The permanency plan for the child

The expected length of time in care
d. The service plan draft is completed by the Case Manager and routed to the Case
Manager Supervisor and then on to the Treatment Director and Administrator for final
approval. The draft is then routed to the team members. A signature and date sheet
is provided to note approval.
e. Changes are made as recommended by the team and final approval is obtained from
the Treatment Director.
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f.
Foster Care
The service plan is reviewed with the child, if applicable to the child’s age and ability
to respond orally and behaviorally to such a discussion. The ISP is then signed and
placed in the child’s file. A copy of the plan is sent to the DFPS caseworker and the
team members.
2) Service Plan Review
a. The Case Manager has full responsibility for preparing and organizing the service plan
reviews. The child’s parents or managing conservator will be notified of a service plan
review in advance. The notification will be documented in the child’s record. Letters
of the ISP meetings due are mailed two (2) weeks prior to the actual meeting.
b. At a minimum, the Refuge House Case Manager will make diligent efforts to involve the
following persons in the service plan review: the child, the child’s parents or managing
conservator, Administrator, Refuge House professional consultants, and the
foster/adoptive parents of the child, if applicable. Participation in the service plan
review process is documented in the child’s file.
c. For children with basic needs, a service plan review must be conducted every six
months. For children having therapeutic needs, a quarterly Service Plan Review is due
every ninety (90) days after the date of the Individual Service Plan. Foster/adoptive
parents and the Case Manger prepare the service plans in conjunction with the other
team members. All children placed in a home will be synchronized for quarterly/biannual Service Plan Reviews as much as possible. In the process of synchronizing the
review dates, no children with therapeutic needs will go more than 90 days without a
review. If requirements for reviewing progress differ from one agency to another, the
team will adhere to the most stringent standards.
d. The Service Plan Review must include:
i. An evaluation of progress toward meeting identified needs.
ii. Any new needs identified since the plan was developed or last reviewed.
iii. Strategies to meet these needs, including instructions to foster/adoptive
parents or other persons involved in the child’s care. Instructions must include
specific information about:

Supervision

Discipline or behavior management

Travel and visits away from home
iv. Any changes to the expected outcomes of placement, the permanency plan,
and the estimated length of time in care.
v. Reasons for continued placement, if the review shows no progress towards
meeting the identified needs of the child.
e. A draft of the Service Plan Review is completed by the Case Manager and approved by
the Treatment Director. The signature routing process, as stated in the initial service
plan process, occurs.
f.
Corrections are made as recommended by the team. The Treatment Director reviews
and approves the corrections. The plan is reviewed with the child, if appropriate. The
original updated service plan is then placed in the child’s file with a copy sent to the
managing conservator and the team members.
g. As changes to the ISP occur, service plan revisions are written by the Case Manager and
signed by the Treatment Director, Administrator and all relevant members of the
treatment team. ISP revisions are due within 72 hours of update.
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h. Should placement disruption occur, the child’s service plan is reviewed by the team
and recommendations are made. Planned subsequent placement options through the
matching process then begin as determined by the Level 1 Child-Placing Staff.
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Foster Care
Subject
Applicable Standards
Date Board Approved
Foster Home Verification
3620.6
04/28/03; Changes Approved 3/07/06
Sample copy of the Foster Parent Agreement:
REFUGE HOUSE, INC. FOSTER PARENT AGREEMENT
Refuge House, Inc. agrees to provide services to the foster home of:
____________________________________________________________________________
under the following conditions:
1. Refuge House, Inc. will pay foster parents a per diem amount according to the payment schedule for
each child who is placed in the foster home. The per diem rates are as follows:
BASIC
$20.56/day
MODERATE
$35.97/day
SPECIALIZED
$46.25/day
Refuge House, Inc. will pay the per diem and any other allowances set forth herein by the fifteenth (15) and
the thirtieth (30) or thirty-first (31) day of the month after semi-monthly documentation is submitted and
accepted by Refuge House, Inc. for services provided the preceding month.
Other reimbursements that foster parents may receive during the course of care:
Respite – Refuge House will reimburse $140.00 for two days of respite care per month per family for two
to six children in the home and $175.00 per family for more than six children in the home that are leveled
Moderate or Specialized. For families of one Moderate or Specialized child going into respite care they will
be reimbursed $65 dollars per-month. Basic service level Respite is reimbursed at $60 dollars for two
consecutive days each quarter for two to six Basic service level children and $30 for one child per two
consecutive days per quarter. Payment can be made to the foster family or to the respite provider as
previously arranged.
Clothing – Refuge House does not provide a clothing allowance, however, the Refuge House case
manager will assist the family in obtaining a clothing voucher from the county of the children placed
within the home.
Transportation – Refuge House, Inc. will provide mileage reimbursement for Individual Service Plan
requirements only. This includes, but is not limited to, medical appointments, therapy, and family visits.
The reimbursement rate is $ 0.30 per mile. Mileage reimbursement is only for transports that exceed 50
miles round trip.
2. Foster parents will not accept a non-relative child for 24-hour care from any other source other than
Refuge House, Inc.
3. In the instance where the Child has to be hospitalized for any amount of time, Refuge House, Inc. will
reimburse the foster family only for the days CPS approves.
4. A foster child will only be released with the consent of Refuge House, Inc.
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5. Refuge House, Inc. retains the right to remove a foster child at their discretion.
6. Refuge House, Inc is responsible for regular supervision and visits of the foster home.
7. Visitation arrangements for foster children to and from the home will be agreed upon by DFPS and
Refuge House, Inc. Documentation of visitation agreements shall be made in appropriate log notes.
8. The foster parents agree to provide Refuge House, Inc. with prior notice when they wish to take a foster
child for a trip overnight, or out of the region or state, and agree to meet all conditions necessary as
required by DFPS and Refuge House, Inc.
9. Refuge House, Inc. agrees to provide a medical consent form at the time of each child’s placement.
Copies of this medical consent form will be filed in the child’s record and in the foster home record.
10. Inactive homes will be re-evaluated before additional placements are made.
11. Foster parents agree to maintain compliance with Refuge House, Inc. Policies and Procedures and DFPS
Minimum Standards.
12. Foster parents agree to periodic visits and inspections of the foster home by the Licensing Division of
DFPS at all reasonable times.
13. Foster family homes will not care for more than six children, and foster group homes will not care for
more than 12 children (including the children of the foster family).
14. Not more than two infants under 18 months old will be cared for in any agency foster home. If two
infants are in the home, not more than two other children under six years old shall be placed in the
home. These numbers include the children of the foster family.
15. Foster parents agree to participate in service plan development and implementation.
16. Foster parents agree not to accept any individual 18 years old or older for care into the foster home who
is not related to the foster family or the children in care.
17. Foster parents agree to notify Refuge House, Inc. before accepting a relative into the home for care or to
reside.
18. Foster parents will notify Refuge House, Inc. before moving to another residence. Refuge House, Inc.
will not use that home until temporary verification for the new location can be issued. Approval of the
new residence is valid for only 6 months from the date of issuance and is not renewable. Verification of
the foster home at the new address will be completed before the expiration of the temporary verification
or Refuge House, Inc. shall not use that home.
19. Foster parents will take the necessary measures to keep the home and grounds clean from rodents,
insects and stray animals.
20. Foster parents agree that providers of respite care will meet pre-service training requirements for respite
parents.
21. Discipline measures must be consistent with licensing standards and with Refuge House, Inc. set policies
on child management and discipline.
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22. Child care will be with a licensed facility or with individuals at least 21 years old whose criminal history
and central registry background check has been completed.
22. Foster parents agree that they will provide, in a timely manner, all required reports to Refuge House, Inc.
regarding foster children and other events or occurrences impacting the provision of foster care as
established by DFPS Minimum Standards.
23. Foster parents agree to arrange for adequate clothing, personal supplies, and allowance for the Child.
Clothing shall be suitable for the child’s age and size and it shall be comparable to clothing of other
children in the community. The Child shall have some choice in selecting his or her own clothing.
24. Refuge House, Inc. is responsible for the admission and discharge of all foster children in the home.
Foster parents must give 24-hour notice for an emergency removal of a child from the home. For a nonemergency, foster parents must allow 30 days for removal of a child.
25. Foster parents agree to give 30-days notice to Refuge House, Inc. to discontinue foster parenting. An
exit survey will be completed upon termination.
26. Foster parents agree to the terms set forth in DFPS Contract Section V that is attached hereto and
incorporated by reference for all purposes.
_______________________________
Refuge House, Inc. Representative
________________
Date
_______________________________
Foster Mother Signature
________________
Date
_______________________________
Foster Father Signature
________________
Date
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Refuge House Policies & Procedures
Medical and Dental Care
Medical and Dental Care
Subject
Applicable Standards
Date Board Approved
Policy:
Medical and Dental Care
1700.1 Contract 3.A
04/28/03; Changes Approved 3/07/06
Refuge House assures that children and youth receive medical and dental care appropriate for their
age to promote preventative health and medical care as needed for illness and urgent issues.
Procedure:
1) At this time, Refuge House only accepts children under its contract with DFPS. All children
entering care with Refuge House are Medicaid eligible. The policy will be reviewed as other
funding sources become available.
Every effort will be made to continue medical and dental care with the child’s current care
provider when a local relationship has been established and payment can be made through
insurance coverage.
An assessment will be done to determine when the child’s last medical and dental check-up
was completed. Past medical and dental records will be requested if a source can be
established. A new patient appointment for medical care and exam will be occur within 30
days of placement. Medical records will be reviewed by the treatment team within the initial
30 days of placement.
Foster and adoptive families will utilize a Medicaid provider for medical care and a dentist who
accepts Texas Health Steps as payment for dental care. This will include medical and dental
care during the time a child is placed with an adoptive family prior to consummation. Foster
and adoptive families are responsible for scheduling, transporting and attending all medical
and dental appointments.
At a minimum, each child will have age appropriate medical and dental assessments as
established by pediatric and adult medicine preventive health guidelines. Recommendations
for follow-up medical and dental care will be made by the appropriate professional.
The foster or adoptive family will notify the Case Manager of appointments that have occurred
and recommendations made. The foster or adoptive family will make follow-up appointments.
When illness occurs, foster and adoptive families will arrange for medical/dental care. The
established primary care provider will be notified whenever possible for direction and care.
The Case Manager will be notified of the action taken, treatment, and recommendations. All
doctor and dental appointments will be documented in the child’s record to include plan and
follow-up recommendations.
2) Medications
The foster parents or an adult staff member must administer all medications, unless a child is
participating in a medically approved self-medication program. The discussion will occur with
the child’s treatment team, a plan developed and documented in the ISP. A doctor’s order will
be obtained to denote medical authorization.
All medications are stored in the original containers. Prescription medications are labeled with
the medication name and dose, the child’s name, date prescription was filled, instructions for
administering the medication and the ordering physician’s name.
The administration of medication is documented on a child specific medication log. This
includes the name and dose of the medication, the administration time and the initials of the
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Medical and Dental Care
person giving the medication (with a full signature listed on the log). The Case Manager will
review the log on a regular basis to assure compliancy of medication administration as ordered
by the physician. Completed monthly logs will be maintained in the child record.
Individuals prescribed psychotropic medications or medications to control inappropriate
behavior will have medications reviewed monthly for effectiveness, side effects, and continued
need by the prescribing physician. Documentation will be kept in the child’s record.
Recommendations for therapy for children on psychotropic medications are recommended by a
psychological clinician to assure the child is working towards decreasing the dosage and
eventual discontinuation of the medicine.
Childhood Immunizations will be kept current as recommended by the Texas Department of
Health. This includes screening for tuberculosis, which is also recommended by TDH.
All medications are kept out of reach of the children or in a locked cabinet. Medications
needing refrigeration must be separated from food in a designated safe container. All
medications that are outdated are disposed of. When a child leaves a home, current
prescription medication is given to the managing conservator when possible or disposed of.
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Refuge House Policies & Procedures
Medical and Dental Care
Subject
Applicable Standards
Date Board Approved
Policy:
Emergency Medical Care
1710.2
04/28/03; Changes Approved 3/07/06
When a life threatening emergency occurs, emergency medical care will be provided in a timely
basis
Procedure:
1. Call 911 to activate the emergency medical system.
2. Provide appropriate first aid until the emergency personnel arrive.
3. Accompany the child to the hospital.
4. Notify the Case Manager as soon as possible after help has arrived.
5. The Case Manager will complete an Incident and Injury Report documenting the events as they
occurred. The Case Manager will then provide the Managing Conservator with a copy of the form by
the next business day. If after hours, the Case Manager will call Statewide Intake at 1-800-2525400.
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Refuge House Policies & Procedures
Medical and Dental Care
Subject
Applicable Standards
Date Board Approved
Policy:
Records Retention Policy
1920.6 1920.7 1920.8
04/28/03; Changes Approved 3/07/06
Client records will be maintained in a safe and confidential manner in accordance with the
process established by the agency and Minimum Standards & Guidelines for Child-Placing
Agencies by Department of Family and Protective Services.
Procedure:
Establishing and Maintaining Records
1.
2.
3.
4.
5.
Client records will be established at the time of placement with the agency.
Records will be kept in a uniform manner.
Permanent case records will be kept at the agency office for a minimum of five (5) years after
discharge and then placed in permanent storage. The best options for storage of records on
microfilm, optional disc and hard format (paper) will be researched at the time of need.
All foster/adoptive home records will follow the same storage process as client records as stated in
number three (3) above.
Records will be kept in a secure area inaccessible to unauthorized persons.
Confidentiality of Client Information and Records
1.
2.
3.
4.
5.
Information regarding clients will be kept confidential.
Access to records will be limited to employees of the agency, designated agency staff, and
consultants who have a duty authorized contractual agreement with the agency. All individuals
will be required to sign a confidentiality statement.
Licensing representatives from the Department of Family and Protective Services and other
surveyors form authorized agencies will have full access to agency and client records.
Consent signatures for release of information will be obtained prior to giving any information to an
individual or organization not listed above.
Client records will be closely monitored and signed out if removed from the designated record
area.
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Child Rights
Child Rights
Subject
Applicable Standards
Date Board Approved
Policy:
Child’s Rights
1620.1, 1620.2, 1630 and 3100.6
04/28/03; Changes Approved 3/07/06
Refuge House is dedicated to promoting, without discrimination, the well-being and best interests
of children and to provide professional services, characterized by competence, compassion and
integrity. Each child shall be respected with dignity, and individuality, and their rights shall be
preserved and protected.
Procedure:
1) It is the obligation of Refuge House staff to treat children with full respect as individuals, will
all their rights guaranteed, while teaching them to respect the rights of other.
2) Because we are an organization concerned with children’s rights, any report of suspected abuse
or violation of rights will be reported to the Department of Family and Protective Services.
Investigations will follow as conducted or instructed by DFPS.
3) Children shall not be discriminated against because of race, sex, language, natural origin,
sexual orientation, physical or other handicaps, religion, or personal opinions.
4) Children shall have the right to express themselves freely, as long as their expressions do not
interfere with the safe and orderly operation of the program or except where free expression
would be inappropriate due to the unique vulnerability of children to improper influence.
5) Children are allowed to keep and use personal possessions as long as the possessions do not
endanger the safety of the program, disrupt programs and activities, encourage delinquent subcultural values, or appeal to the unique vulnerability of children to improper influence.
6) Children have the right to be protected from physical and psychological harm.
7) No child of any age should ever be shaken.
8) Children can participate in decision-making where they are personally affected, and decisions
concerning children in placement will be as fair as possible.
9) Children can have access to their attorney for private consultation.
10) Children shall be informed of all rights, policies, procedures, and rules affecting them while in
Refuge House’s care. This shall include involvement in the development of on-going treatment
goals and long-term placement goals.
11) Records of the children and information regarding the children are kept confidential.
12) Children have the right to be free of coercion regarding participation in public events, media
presentations, and fund-raising events.
13) Children have the right to continued sibling contact, which may include written
correspondence and/or telephone contact. When the child’s treatment team/managing
conservator/court has determined that contact is contraindicated, the reasons must be
documented in the service plan and reviewed at least monthly.
14) Unless parental rights have been terminated by the court or relinquished, or unless contacts
are not in the child’s best interests as determined by the child’s treatment team and/or are
court ordered, contacts between children and their parents must be allowed. This contact
includes sending and receiving mail, as well as telephone conversations with family members or
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Child Rights
managing conservators. All reason for restrictions must be explained to the child and
documented in the child’s record. If restrictions continue longer than one month and the child
or his/her family continues to request contact, Level 1 Child-Placing Staff must evaluate these
restrictions at least monthly. Reasons for the continued restrictions must be explained to the
child and documented in his/her record. If communications or visits are limited for practical
reasons (such as expense), the limits must be documented in the child’s record.
15) Money a child earns or is given as a gift or allowance is his/her personal property. A child’s
money shall be accounted for separately from the agency’s funds or the funds of the family
with whom he/she is placed. A child may not be required to use his/her personal money to pay
for room and board, unless it is part of the service plan and approved in writing by the
managing conservator and the Refuge House Staff.
16) Refuge House shall participate with the child regarding withdrawals from an individual savings
account. Such withdrawals shall require at lease two of the following signatures: child, foster
parent, Case Manager.
17) At the time of the pre-placement visit, the foster parent will inform the child of the foster
family’s plan for attending church, including the specific church, frequency and duration. The
child is advised that participation is voluntary; however, required supervision may limit options
for the child during the foster family’s participation in religious activities. The child will be
advised that they should choose, Refuge House will attempt to find another foster home that
can better meet the needs of the child should any particular home’s religious activities be
objectionable for the child. The children will have a choice in their place of worship, subject
to the availability of such choices and appropriate supervision. If the child’s religious
preference is different that that of the foster family, all attempts will be made to honor the
child’s religious preference. Example: A child who is of the Jewish faith is placed with a foster
family who is of the Baptist Faith. Every effort will be made by that family to locate a
synagogue in the community and transport the child to temple each Saturday for worship.
However, the child may also be requested to attend the Baptist church on Sundays with the
family, if alternative appropriate supervision is not available during that time.
18) Children have the right to initiate a grievance, complaint, or an abuse/neglect allegation and
to have the issue resolved promptly, without fear of reprisal.
19) Any employee, foster parent, volunteer working with the children place with Refuge House is
responsible to report immediately any suspected incident of abuse or neglect of a child place in
care to the agency’s Treatment Director or to the Case Manager.
20) A child’s right include the following:
a. Right to nourishment.
b. Right to communicate with others.
c. Right to respect of body and person.
d. Right to privacy. A child may not be strip-searched. If there is probable cause to
believe that child may be in possession of something that my cause harm to themselves
or others, the foster parents may search their belongings. In these situations, a
witness should be present. Foster parents may ask the child to open pockets, remove
jackets and shoes, they may ask the child to open and shake their mail in the foster
parents’ presence. Foster parents may search suitcases before and after visits to
inventory items.
e. Right to knowledge of, and disagreement with, file material.
f.
Right not to be given meaningless work.
g. Right to earn privileges at any reasonable time.
h. Right to basic clothing necessities suitable to their size and age.
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i.
Right to training and equipment for personal care, hygiene and grooming.
j.
Right to natural elements (fresh air, light, sunshine) and freedom of movement.
k. Right to sleep in one’s own bed.
l.
Right to interact with others.
m. Right to informed consent.
n. Right to initiate grievance.
o. Right to have an interpreter when needed.
p. Right to appropriate discipline as described by Refuge House discipline policy and as
specified in the Minimum Standards and Guidelines for Child-Placing Agencies free from
any harsh, cruel, unusual, unnecessary, demeaning, or humiliating discipline or
punishment, or from any physical punishment.
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Child Rights
Subject
Meal Plan
Applicable Standards
Date Board Approved
04/28/03; Changes Approved 3/07/06
Children in the care of Refuge House, Inc. shall be provided food of adequate quality and in sufficient quantity to supply the
nutrients needed for proper growth and development.
(1) Children must have a minimum of three meals daily.
(2) Children must be provided nutritious snacks between mealtimes.
(3) All milk and milk products shall be grade A pasteurized or from sources approved by the Texas Department of Health.
(4) No more than 14 hours may pass between the last meal or snack of the day and the serving of the first meal of the
following day.
The following is an example of types of food that are to be served to the children in the care of Refuge House,
Inc. in an attempt to ensure that their nutritional needs are being met. A sample meal pattern is also included.
The meal pattern is not a requirement, but is meant to serve as an example of a menu that would properly meet
the nutritional needs of children.
1) Milk group supplies these key nutrients: Calcium, riboflavin (vitamin B2) and protein for strong bones and teeth,
healthy skin, and good vision. It is best to serve fluid milk, low fat and regular cheeses, and low fat and regular
yogurt to meet the milk requirement. Children over two years of age may be offered low fat milk products.
Milk
Cheese *
Yogurt
Whole
Low Fat
Skim
Non-fat
Dry
Buttermilk
Cheddar
Commercial yogurt,
American
Regular,
Cottage ** Low fat,
Monterey
Plain,
Jack
Swiss
Or flavored
Mozzarella
Ricotta **
* Do not count the same slice of cheese as both milk and meat.
** Double serving is required.
2) Vegetable and fruit groups supply these key nutrients: vitamins A and C for night vision and to help resist infections
and to heal wounds.
a)
Vitamin A Foods
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Vegetables and fruits, 1/4 cup serving (about 1,500 or more international units of vitamin A)
Beet greens
Dandelion greens
Peppers, sweet red
Carrots
Kale
Pumpkin
Chard, Swiss
Mangoes
Sweet potatoes
Chili peppers, red
Mixed vegetables
Spinach
Collards
Mustard greens
Turnip greens
Peas and carrots (canned or
Squash, winter (acorn, butternut,
Cress, garden
frozen)
Hubbard)
1/4 cup serving (about 750 - 1,500 international units of vitamin A)
Apricots
Cantaloupe
Broccoli
Chicory greens
1/2 cup serving (about 750 - 1,500 international units of vitamin A)
Asparagus, green
Endive, curly
Cherries, red sour
Escarole
Chili peppers, green (fresh)
Nectarines
Tomato juice or reconstituted paste or puree
Papayas
Purple plums (canned)
Prunes
Tomatoes
Peaches (except canned)
The vegetables and fruits listed supply at least 750 international units of vitamin A per 1/4 or 1/2 cup serving. When these
vegetables and fruits are served at least three times a week in recommended amounts along with a variety of additional
vegetables and fruits used to meet the vegetable and fruit requirement, the vitamin A content generally meets 1/2 of the
recommended dietary allowance for each age group.
b) Vitamin C Foods
1/4 cup serving (about 25 milligrams or more of vitamin C)
Acerola
Guavas
Broccoli
Orange juice
Brussels sprouts
Chili peppers, red and green
1/4 cup serving (about 15 - 25 milligrams of vitamin C)
Cauliflower
Grapefruit-orange juice
Collards
Kale
Cress, garden
Kohlrabi
Grapefruit
Kumquats
Grapefruit juice
Mangoes
1/4 cup serving (about 8 - 15 milligrams of vitamin C)
Asparagus
Okra
Cabbage
Raspberries, red
Cantaloupe
Rutabagas
Dandelion greens
Sauerkraut
Honeydew melon
Spinach
Potatoes (baked, boiled, or
steamed)
Potatoes (reconstituted, instant,
mashed, vit. C restored)
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Oranges
Papayas
Peppers, sweet red and green
Mustard greens
Strawberries
Tangerine juice
Tangerines
Pineapple juice (vit. C restored canned)
Tangelos
Turnip greens
Turnips
Tomatoes
Tomato juice (reconstituted paste
or puree)
Sweet potatoes (except those
canned in syrup)
Refuge House Policies & Procedures
Child Rights
The vegetables and fruits listed supply about eight milligrams or more vitamin C (ascorbic acid) per 1/4 cup serving. When
these vegetables and fruits are served daily in recommended amounts along with a variety of additional vegetables and fruits
to meet the vegetable and fruit requirement, the vitamin C content generally meets 1/2 of the recommended dietary allowance
for each age group.
c) Other Foods
Apples, Applesauce
Avocados
Bananas
Bean sprouts
Beans, green or wax
Beets
Berries (black, blue, etc.)
Celery
Chinese cabbage
Corn
Cranberries
Cranberry sauce
Dates
Eggplant
Figs
Fruit cocktail
Fruits for salads
Grapes
Lettuce
Mushrooms
Olives
Onions
Parsley
Parsnips
Cowpeas, immature seeds
Peas and carrots (canned)
Peaches (canned)
Pears
Pimentos
Pineapple
Plums
Radishes
Raisins
Rhubarb
Squash, summer
Watercress
Watermelon
Cucumbers
Fruit juices (apple, grape, pineapple,
etc.)
Potatoes (mashed, fried, etc.)
3) Meat/meat alternative group supplies these key nutrients: protein, niacin, iron, and thiamin (vitamin B1) for muscle,
bone, and blood cells and healthy skin and nerves.
Meat: canned, dried, fresh, and frozen
Beef
Lamb
Chicken
Luncheon meats
Fish/shellfish
Liver and other organ meats
Pork
Turkey
Veal
Alternate group
Cheese *
Dry peas
Lentils
Dry beans
Eggs
Nuts and seeds (peanuts, almonds, pecans, sunflower seeds, pumpkin seeds, cashews)
Vegetable protein (when mixed with meat, poultry, or fish)
* Do not count the same slice of cheese as both milk and meat.
4) Grain group supplies these key nutrients: carbohydrate, thiamin (vitamin B1), iron and niacin for energy and a
healthy nervous system.
All of the following must be enriched or whole grain.
Sliced Breads: French, raisin, rye, soy, white, whole wheat
Crackers: graham, saltines, soda, melba toast, zwieback
Bagels
English muffins
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Rice
Refuge House Policies & Procedures
Barley
Biscuits
Boston brown bread
Bread sticks
Bulgur
Chow mein noodles
Cornbread
Croissants
Dumplings
Breakfast cereals, dry or
cooked
Child Rights
Farina
Fruit breads
Grits
Hush puppies
Macaroni
Muffins
Noodles
Pancakes
Pizza crust
Rolled wheat or oats
Rolls and buns
Soft pretzels
Sopapillas
Spaghetti
Spoon bread
Sweet rolls
Syrian bread (pita)
Tortillas
Ravioli pasta
Waffles
Serve several good sources of iron each day.
1) Meat and meat alternate
Dry beans and peas
Peanut butter
Eggs
Shellfish
Meats in general, especially liver and other organ meats
Turkey
2) Vegetables and fruits
Dried fruits: apples, apricots, dates, figs, peaches, prunes, raisins
Vegetables: Dark green, leafy: beet greens, chard, collards, kale, mustard greens, spinach, turnip
greens
Apricots (canned)
Brussels sprouts
Potatoes (canned)
Asparagus (canned)
Cherries (canned)
Sauerkraut (canned)
Beets (canned)
Grapes (canned)
Squash (winter)
Broccoli
Parsnips
Sweet potatoes
Bean sprouts
Peas, green
Tomatoes (canned)
Beans-green, wax, lima
Vegetable juice (canned)
Tomato juice, paste, puree, sauce
(canned)
3) Bread and bread alternate
All enriched or whole grain bread and bread alternates
The following should be omitted or limited:
Sugar-coated cereals
Potato chips
Snack chips
Bacon
Sausage
Candy
Doughnuts
Fruit flavored drinks (use only
100% juice)
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Coffee
Tea
Soft drinks
Brownies and cookies with icing
Refuge House Policies & Procedures
Child Rights
Rich pastries and other food high in sugar, fat, and salt
SAMPLE MEAL PATTERN
The following meal pattern is an aid to menu planning. This distribution of food is not required as long as the total required
servings are met during the day.
Possible Food Choices
Breakfast or AM Snack
Lunch
PM Snack
Milk/Milk Product
Bread/Cereal
Milk and/or Milk Product
Protein
Vegetable 1
Vegetable 2
Bread
Fruit or Fruit Juice
1/2 cup
1 slice or 1 ounce
3/4 cup
1 1/2 ounces
1/4 cup
1/4 cup
1 slice
1/4 cup
Example Menu Following Meal Pattern
Breakfast or AM Snack
Milk
Cereal
Lunch
Milk
Roast Beef
New Potatoes
Spinach
Whole Wheat Bread
PM Snack
Orange Juice
GUIDELINES FOR INFANTS
Age of Baby
by Month
Breakfast
Lunch
Snack
Birth through 3
months
4-6 fluid ounces (fl.
oz.) formula (Ironfortified infant
formula)
4-6 fl. oz. formula
4-6 fl. oz. formula
4 months through
7 months
4-8 fl. oz. formula
4-8 fl. oz. formula
4-6 fl. oz. formula
0-3 tablespoons
(tbsp.) infant
Cereal * (optional)
0-3 tbsp. infant
cereal (optional)
0-3 tbsp. fruit and/or
vegetable (optional)
8 months through
11 months
6-8 fl. oz. formula or
whole milk
6-8 fl. oz. formula or
whole milk
2-4 fl. oz. formula, whole
milk, or fruit juice (Fullstrength fruit juice)
2-4 tbsp. infant
cereal
2-4 tbsp. infant
cereal and/or 1-4
tbsp. meat, fish,
0-1/2 slice bread or 0-2
crackers ** (optional)
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Child Rights
poultry, egg yolk, or
cooked dry beans or
peas, or 1-4 oz.
cottage cheese,
cheese food, or
cheese spread, or
1/2 to 2 oz. of
cheese
1-4 tbsp. fruit and/or
vegetable
1-4 tbsp. fruit and/or
vegetable
* Iron-fortified dry infant cereal
** Made from whole-grain or enriched meal or flour
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Refuge House Policies & Procedures
Child Rights
Subject
Applicable Standards
Date Board Approved
Preparation for Adult Living
6550
04/28/03; Changes Approved 3/07/06
The youth in the care of Refuge House, Inc. participate in the PAL program through The Transition Resource Action Center
(TRAC). The Refuge House case manager is responsible for referring an eligible youth to the program. The youth will be
referred to the program no later than their sixteenth birthday. The referral is made via the TRAC website
(http://www.traconline.org/refer_youth.html) or by calling 214-370-9300.
Certificates of completion and other information regarding PAL classes for youth in the care of Refuge House, Inc. can be
found in the child’s file.
Page 61 of 123
Refuge House Policies & Procedures
Child Rights
Subject
Applicable Standards
Date Board Approved
Policy on Child’s Contact with Biological Family, Including Siblings
1620.1,1620.2
04/28/03; Changes Approved 3/07/06
See Standard 3100.6, Children’s Rights. (Pg. 34)
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Refuge House Policies & Procedures
Substitute Care
Substitute Care Intake
Subject
Applicable Standards
Date Board Approved
Screening Procedures for Foster Parents and Child Care Staff
3100.2c
04/28/03; Changes Approved 3/07/06
See Standard 2320.1, Screening Program for Foster Parents, Child Care Staff. (Pg. 82)
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Substitute Care
Subject
Applicable Standards
Date Board Approved
Policy:
Sample Placement Agreement
3220.1
04/28/03; Changes Approved 3/07/06
Since placement will be done through DFPS, placement agreements will be used as provided by
DFPS:
Placement Authorization
Authorization for medical, dental and psychological care.
Page 64 of 123
Refuge House Policies & Procedures
Substitute Care Intake
Subject
Applicable Standards
Date Board Approved
Policy:
Written Notice to Parents/Managing Conservators
3220.2 Contract 14 A-B
04/28/03; Changes Approved 3/07/06
Refuge House will keep parents and managing conservators apprised of agency rules and
regulations at all times as required by the licensure standards.
Procedure:
1) Visits and Visitors
a. Overnight visitors of the child must be approved and documented in the child’s service
plan. If prior approval has not been obtained, the Case Manager must notify the
managing conservator and the Administrator for authorization before the visitor spends
the night in the home. This will be noted as an addendum to the service plan.
Appropriate foster parent-to-child ratios must be maintained in the home. The visitor
should provide vital information regarding whom to contact in case of an emergency.
b. Foster parents may have visitors in their home overnight. The Case Manager must be
notified of all such visitors in advance. Any concerns the Case Manager may have will
be discussed with the Administrator. Foster parent visitors must never sleep in the
same room or in the same bed with the foster children in the home. Foster parent
visitors may never provide supervision or be left alone with the foster children in the
home unless they have been officially approved and trained as the respite provider.
The managing conservator will be notified if a visitor exceeds three (3) weeks.
2) Gifts
a. Children are allowed to keep and use personal possessions and items received as gifts
as long as the possessions do not interfere with the safe and orderly operation of the
home, disrupt the home and activities, encourage delinquent sub-cultural values, or
appeal to the unique vulnerability of children to improper influence.
b. Money received as a gift is considered the child’s personal property and must be
accounted for separately from the agency’s funds or funds of the family with whom the
child is placed.
3) Mail and Telephone Calls
a. Children have the right to communicate with friends and family, on the telephone, and
by mail as approved by the treatment team and their managing conservator. Any
exceptions will be agreed upon by the managing conservator and treatment team,
explained to the child and documented in the child’s file with reasons for the
restrictions and guidelines for ending the restrictions.
b. If restrictions continue for more than one month and the child or the family continues
to request, a Level 1 Child-Placing Staff must evaluate the restriction(s) at least
monthly, the reasons must be explained to the child and documented in the child’s
file. If communication is limited for practical reasons (such as expense), limits must be
determined with the child and the managing conservator, and must be documented in
the child’s file.
4) Type and Frequency of Agency Reports
a. The Temporary Service Plan is completed within 72 hours of the time a child is place in
a Refuge House home. An Individual Service Plan is due within 30 days after a child’s
admission or transfer from another agency. The managing conservator will be mailed a
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Substitute Care Intake
copy of the Initial Service Plan as well as the Individual Service Plan upon final
completion and signature approvals obtained.
b. For children with basic needs, a service plan review must be conducted every six
months. For children who have therapeutic needs a quarterly service plan is conducted
90 days after the date of the individual service plan. All Service Plans are mailed to
the managing conservator (and parents where applicable) upon final completion and
signature approvals obtained.
c. All incidents involving the children are discussed with the Case Manager via phone by
the foster/adoptive or respite provider within two (2) hours of occurrence. The
managing conservator is notified by phone as soon as possible but no later than the
next business day. Documentation is faxed within 24 hours of the incident or the next
business day.
5) Discipline Policy
a. All children are kept free from any harsh, cruel, unusual, unnecessary, demeaning, or
humiliating discipline or punishment or from any form of physical punishment.
b. All discipline is consistent with Refuge House policies and foster parent training. It is
not physically or emotionally damaging to the child. It is individualized to meet the
child’s needs. Only adult caregivers may discipline a child.
c. Children are not denied food, mail, or family visits as punishment for their behavior.
Children are not threatened with loss of placement as a means of controlling behavior.
The reasons for any restriction of privileges or consequences for behavior are explained
to the child when the consequences are given.
d. Children attend school, counseling, and family visits regardless of other restrictions.
e. Personal restraint is limited to emergency use only.
f.
Foster parents do not use mechanical restraints, chemical restraints, or seclusion (see
policies on Discipline and Behavior Management).
6) Religious Training
a. At the time of the pre-placement visit, the foster/adoptive parent informs the child of
the foster/adoptive family’s plan for attending church, including the specific church,
frequency and duration.
b. The child is asked about their religious preferences. The child is advised that their
participation in religious activities is voluntary, however, required supervision may
limit options for the child during the foster family’s participation in religious activities.
c. The child is advised that should they choose, Refuge House will attempt to find another
foster home that can better meet their needs should any particular home’s religious
activities be objectionable for the child.
d. The child has a choice in their place of worship, subject to the availability of such
choices and appropriate supervision. If their religious preference is different that that
of the foster family, all attempts are made to honor the child’s religious preference.
e. Children in placement must never be bribed, intimidated, threatened or harassed into
attending any religious activity, services or counseling.
7) Visitation
a. All visits out of the home begin at the time designated by the managing conservator.
All requests for visits out of the home are approved in advance by the treatment team,
either as part of the child’s service plan or via special request submitted in advance of
the planned trip.
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b. Only approved persons may pick up a child.
c. A child will not be taken out of the region without permission from the treatment team
and the managing conservator. The managing conservator will need advance notice to
gain appropriate permission from the court.
d. The case manager must make note in their weekly logs to indicate that the child had an
overnight visit away from the home and how the child behaved during the visit , and
this note will become a permanent part of the child’s file.
e. The foster parent must provide emergency phone numbers and emergency information
so that emergency medical care can be obtained for the child, if needed.
f.
Medication and administration instructions are provided by the foster/adoptive parents
to the person the child is visiting, and medications must be given during the visit and
documented, if the child is on medication.
8) Travel
a. The managing conservator approves all planned travel, which are discussed and
documented in the Individual Service Plan (ISP). The following applies to those trips
not planned and documented in the ISP:

Foster/adoptive parents must notify the Case Manager of their travel plans for
any overnight trip. The following information must be provided:
o
The destination of the trips within Texas exceeding 48 hours, including
the full address
o
A phone number that may be utilized in the event of an emergency to
contact the foster/adoptive parents
o
The length of time the family will be gone
o
The method of transportation, i.e. car, plane, train, etc.

Foster/adoptive parents must obtain prior approval in order for children to
accompany them on any trip exceeding 48 hours.

Foster/adoptive parent traveling outside the region must provide 72 hours
notice for trips exceeding 48 hours to the Case Manager. The region includes
19 counties: Cooke, Grayson, Fannin, Wise, Denton, Collin, Hunt, Palo Pinto,
Parker, Tarrant, Dallas, Rockwall, Kaufman, Erath, Hood, Johnson, Somervell,
Ellis and Navarro.

Foster/adoptive parents will give the Case Manager at least three (3) weeks
notification of any tip that involves travel outside of Texas.

A Refuge House Case Manager will notify the managing conservator of the
foster/adoptive family’s travel plans and obtain the necessary written
approval.

If a child has a desire to attend camp or similar outings, the Case Manager will
supply the managing conservator with the necessary information in order for
written approval to be obtained.

The Case Manager and managing conservator will assess emergency travel on a
case-by-case basis.
OVERNIGHTS
REFUGE HOUSE WILL NOT ALLOW OVERNIGHT VISITS WITH ANY BIOLOGICAL FAMILY THAT IS
NOT COURT APPROVED.
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REFUGE HOUSE CASE MANAGER WILL OBTAIN APPROVAL FROM THE MANAGING CONSERVATOR
FOR OVERNIGHT VISITATION WITH PERSON(S) AS STATED IN CHILD’S ISP.
Page 68 of 123
Refuge House Policies & Procedures
Substitute Care Intake
Subject
Discharge/Removal of Children
3500 Contract 15 A.1 –2 & B
04/28/03; Changes Approved 3/07/06
Applicable Standards
Date Board Approved
Policy:
Refuge House supports the health, safety and well-being of a child at discharge to assure that
critical information is available to other agencies or individuals who may be responsible for later
care and treatment.
Procedure:
Non-Emergency Discharge
1) In the child’s best interest, if Refuge House can no longer meet the needs of the child, the
Case Manager will provide written notice to the managing conservator. The managing
conservator shall remove the child within not more than 30 days of written notice.
2) The child’s team is involved in the development of the discharge plan. This includes the child,
the parents or managing conservator, Level 1 Child-Placing Staff, professional consultants, and
the foster/adoptive parents. Participation in the discharge plan is documented in the child’s
file.
3) The Case Manager completes a discharge summary. The summary includes:

Services provided during care

Growth of the child and accomplishments made

Assessment of current needs

Recommendations for meeting these needs

Date of discharge

Reason for discharge

The name and relationship of the person(s) or agency to which the child was
discharged.

Aftercare recommendations (recommendations for further care or treatment
through a structured program).
4) The discharge plan is completed by the Case Manager and routed to the Executive Director and
Level One Child Placing Staff for approval. A signature and date sheet is provided to note
approval.
5) The Level 1 Child-Placing Staff reviews and signs the discharge summary three days before a
discharge is to occur. (If Refuge House is not given three days notice of a discharge the
summary will be completed and approved no later than the day of discharge). Documentation
of an emergency discharge is reviewed (by fax or email if necessary) within two hours of the
incident necessitating discharge.
6) A copy of the discharge summary goes with the child at discharge.
Emergency and Urgent Removal of Children
1) When a child exhibits behavior that is a danger to himself or to others and all methods of
interventions have been exhausted, it may be necessary to move the child to another more
appropriate setting. The Case Manager obtains written documentation by fax to the CPS Case
Worker. Plans will be made by CPS to transfer the child within 24 hours to a more secure
setting.
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
Substitute Care Intake
In such cases of harm to self or others, admission to a hospital or secure setting may be
necessary. Refuge House will provide the managing conservator with written notice
whether or not Refuge House shall accept placement of the child upon discharge from
the hospital or secure setting.
2) If a child consistently exhibits behavior that cannot be managed within the Refuge House
program and services, the Case Manager obtains written documentation from the treating
psychiatrist, psychologist, primary care physician, LMSW-ACP, or LPC of such. The
documentation is faxed to the CPS caseworker and a plan will be developed by CPS to remove
the child within two (2) working days.
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Refuge House Policies & Procedures
Substitute Care Intake
Subject
Subsequent Placements
3420
04/28/03; Changes Approved 3/07/06
Applicable Standards
Date Board Approved
When making subsequent placements Refuge House will go back through the initial placement process in
selecting an appropriate foster/adoptive family for the child(ren). The Child and Family Coordinator will
review information regarding the child and possible family placements will be identified. These families will
then be presented to the Level One Child Placing Staff and a placement decision will be made. The Child and
Family Coordinator will then contact the family and present as much information as is known regarding the
child, including but not limited to the child’s social, medical, psychological, and school history; known
behaviors issues; reason for original removal from the biological home; reason for the subsequent placement;
elements of the child’s service plan, any sibling and/or family visitation or contact; CPS caseworker and the
county the child was removed from. All efforts will be made to answer the family’s questions regarding the
child before a final decision is made.
Non-Emergency Subsequent Placements

Level One Child Placing Staff, Administrator, and Executive Director must approve
a planned subsequent placement before a child is moved from one placement to
another.

Written Approval from the managing conservator approving the subsequent
placement must be acquired and placed in the child’s file prior to moving a child
from one placement to another.

Refuge House will arrange for the child to have at least one pre-placement visit
with the family prior to the subsequent placement. The pre-placement visit will be
documented in the subsequent placement section of the child’s file.

Agency Staff must discuss the circumstances that made the move necessary with
the child, as appropriate to the child’s age and ability to respond orally and
behaviorally to such discussion. The discussion must take place prior to the move
and will be documented in the child’s file in the subsequent placement section.

The child’s understanding of, and response to the subsequent placement will be
documented in the child’s file in the subsequent placement section.

The family will be contacted within seven days of the placement to answer any
questions or concerns that have arisen. Refuge House case manager will work with
the family to resolve any concerns or issues that are identified at the seven day
follow up. Documentation of the seven-day follow up can be found in the Family
file.
Emergency Subsequent Placements

The Administrator must verbally approve the subsequent placement prior to the
child being moved to a new home.
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
Level One Child Placing Staff must approve the subsequent placement within 10
working days of the placement being made.

Agency Staff must discuss the circumstances that made the move necessary with
the child, as appropriate to the child’s age and ability to respond orally and
behaviorally to such discussion. The discussion must take place prior to the move
and will be documented in the child’s file in the subsequent placement section.

The child’s understanding of, and response to the subsequent placement will be
documented in the child’s file in the subsequent placement section.

The family will be contacted within seven days of the placement to answer any
questions or concerns that have arisen. Refuge House case manager will work with
the family to resolve any concerns or issues that are identified at the seven day
follow up. Documentation of the seven-day follow up can be found in the Family
file.
Page 72 of 123
Refuge House Policies & Procedures
Client Rights
Client Rights
Subject
Applicable Standards
Date Board Approved
Policy:
Appeal Process for Agency Clients
1500.3
04/28/03; Changes Approved 3/07/06
It is the policy of Refuge House to maintain sound decisions in accordance with policies and
procedures to assure the best interest of the children served.
Procedure:
A person becomes a client of Refuge House when the initial application to foster or adopt a child has
been completed and approved by the agency.
The individual should attempt to express his/her complaint/disagreement with the Case Manager
verbally. Every attempt will be made to immediately remedy the issue.
If the concern persists, the individual should contact the Administrator in writing. The written
appeal should include the basis for the concern, the parties involved, and the dates and times of the
occurrences. Individuals that are directly involved with the particular concern, as well as the
Administrator, will attempt to resolve the presenting issue. The response will be communicated
verbally and in writing within 10 working days of receipt of the concern. Specific reasons or policy
substantiating the decision with be cited in the response.
If the matter is not resolved following the Administrator’s response, the individual may send a copy
of the written appeal to the Executive Director. The Executive Director will respond within 10
working days verbally and in writing. The response will include specific reasons or policy
substantiating the decision.
The final appeal level within the agency is the Board of Directors. The individual may request in
writing a meeting with one board member and all individuals involved. A follow-up written
response will be sent within 10 working days of the meeting date. This will include specific reasons
or policy supporting the decision.
All attempts will be made to resolve the concerns at the lowest level. All clients will be informed of
their right to appeal at training.
Page 73 of 123
Refuge House Policies & Procedures
Problem Management
Problem Management
Subject
Applicable Standards
Date Board Approved
Policy:
Discipline and Behavior Management
1810.1, 1410.1-9, 1420, 1430, 1440 TAC 20.1001-20.1013 Contract 3.C
04/28/03; Changes Approved 3/07/06
Refuge House supports the use of the lease restrictive method(s) to intervene in crisis situations in
the management of problem behaviors of the children in foster care or an adoptive placement
prior to consummation. Individual program procedures will expound on these standards to more
effectively ensure these policies are understood and implemented appropriately by foster parents,
adoptive parents and respite providers.
Procedure:
1) Refuge House discipline policy strictly prohibits the use of physical discipline in any form.
Shouting, yelling, or the use of abusive or demeaning language in managing a child’s behavior is
prohibited. No child shall be subjected to cruel, harsh, unusual or unnecessary discipline. No
child shall be subjected to verbal remarks that belittle or ridicule the child or the child’s
family.
2) No child shall be denied food, mail, or visits with families as a form of punishment. Prohibited
methods of punishment also include physical punishment including forced physical exercise or
holding a physical position, punishment associated with toilet training, punishment associated
with the child’s basic diet, aversive procedures, and unproductive work.
3) Positive methods of behavior management shall be utilized to shape new behaviors and/or
decrease negative behaviors. These may include the use of positive behavior management
plans, behavioral guidelines, and the use of positive reinforcement.
4) No child shall be threatened with the loss of placement as a form of punishment, or as a threat
to manage the child’s behavior.
5) No child in care shall be placed in a locked room or dark secluded area where egress is not
possible as a form of punishment. The use of such rooms is forbidden.
6) No form or variation of any form of mechanical or chemical restraint may be used. Children in
need of mechanical or chemical restraint for their safety or the safety of others will be
hospitalized. Protective devices may only be used when prescribed by a physician.
7) Discipline must fit the needs of the individual child. The reason for any discipline or restriction
must be explained and made clear to the child. Only adult foster/adoptive or respite providers
may discipline a child.
8) If a child is restricted to a foster/adoptive home for more than 24 hours, the restrictions must
be recorded in the child’s record. “Restriction” means curtailment of a child’s normal
activities, except for school, chores and family visits. If a child is not allowed to leave the
home (except for school) but permitted normal recreation, etc., this is not considered
“restriction”.
9) Refuge House teaches foster parents parenting skills through a common sense approach as part
of on-going continuing education of the foster/adoptive parent. These principles include
effective praise, preventive teaching, corrective teaching, and teaching self-control. Through
the use of these tools foster/adoptive parents learn to prevent problems and deescalate
problems without physical intervention. Foster/adoptive parents are expected to apply these
concepts to their daily work with the children in their home. The Case Managers monitor the
application of these skills in the home through observation and discussion with the child and
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the foster/adoptive parent in one-on-one training with the foster/adoptive parents in the
home.
10) If the treatment team determines that a behavior modification plan is needed for a child, the
specifics of that particular child’s behavior modification plan must be outlined in the individual
service plan, and the foster/adoptive parents must be trained on the plan before the
implementation of the plan. Any deviations from the plan are agreed upon by the team and
documented in the child’s file.
11) Refuge House staff and/or foster/adoptive parents will not use seclusion or mechanical
restraint. Seclusion is defined to include blocking a doorway to prevent a child from exiting a
room. This is not the same as standing in the doorway to observe a child who is taking some
time out as long as the observer moves in the event that the child attempts to pass.
12) Refuge House staff and foster/adoptive parents and respite parents will be trained in the use
of behavioral intervention techniques to address crisis management prior to being responsible
for the care of children. This training must be provided as outlined in TAC 720.1012(a-d). all
foster/adoptive and respite parents having contact with the children must complete at least 4
clock hours annually of behavior interventions allowed by Refuge House. The training will be
competency based and will require participants to demonstrate skill competency. Annual
training will focus on reinforcing basic principles covered in the initial training and developing
and refining the foster/adoptive or respite parent’s skills.
13) Prior to a child’s admission to a foster/adoptive home, the Case Manager with the
foster/adoptive parent must explain to the child, based on their level of functioning and
comprehension, the policies and practices on the use of restraint. This explanation must
include who can use a restraint, the actions foster/adoptive and respite parents must first
attempt to defuse the situation and avoid the use of restraint, the kinds of situation in which
restraint may be used, the types of restraints authorized by Refuge House, when the use of
restraints must cease, what action the child must exhibit to be released from a restraint, and
the way to report an inappropriate restraint. This explanation must be documented in the
child’s record.
14) For each child in care, the treatment team must evaluate the use and effectiveness of behavior
intervention techniques as part of each child’s individual service plan, to be review at each
review period. The evaluation must focus on the frequency, patterns, and effectiveness of
specific behavior interventions; strategies to reduce the need for behavior interventions
overall; and specific strategies to reduce the need for use of personal restraint.
15) Personal restraint may only be used in emergency situations and may be used only to protect
the child from injury to self or others. Physical holding must not be used as a form of
punishment, as a substitute for effective treatment or programming, or for the foster/adoptive
parent or respite provider’s convenience. It may only be used as an absolute last resort for
crisis intervention. The child must be engaging in behaviors that meet one of the following
criteria:
a. Possible harm to self.
b. Possible harm to other.
c. Possible harm to significant property. (Significant property damage is defined as
damage to property that a responsible person would deem irreplaceable or that would
carry a significant replacement cost. A short personal restraint may be used to
intervene only to immediately prevent damage and only if less restrictive techniques
have been attempted and have failed.)
d. Child whose service plan describes situations the treatment team has approved as
requiring restraint in order to protect the child. Generally these will fall in the
categories listed above.
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16) Whenever possible a foster/adoptive parent or respite provider must attempt to use less
restrictive and intrusive behavior interventions as preventive measures and de-escalating
interventions to avoid the need for the use of restraint. The foster/adoptive parent or respite
provider must attempt and prove ineffective preventive, de-escalative, and less restrictive
techniques before the emergency use of restraint. Less restrictive measures include, but are
not limited to, quiet time and time out. Time out is defined as allowing the child a set amount
of time to calm down away from the other stimuli, such as going to his/her bedroom alone in
order to remove himself/herself from the situation which is causing agitation.
17) The amount of personal restraint used will be the minimal dictated by the situation. Examples
are pulling children apart who are fighting, holding the harm of a child who is throwing
something, use of basket holds, and full restraint, while full restraints involve taking a child to
the floor and then rolling them to the side, they will not involve taking a child down on their
stomach or placing weight on any of the joints or diaphragm. The adult is responsible to
support his or her own weight and is trained to do so. One of the main principles of these
techniques is maximum caring and minimal force.
18) The following interventions are not subject to the requirement in Standard G-1210.7 and
Appendix M, 720.1007 (a)(4), which address more than three (3) personal restraints of the same
child within a seven (7) day period.
a. Short personal restraints that last no longer than one (1) minute.
b. Short personal restraint used to intervene in a situation of imminent significant risk
when a child’s behavior is being restrained because of an external hazard and
foster/adoptive parent(s) or respite provider must protect the child, particularly a
young child, from immediate danger – for example, preventing a toddler from running
into the street or coming in contact with a hot stove. The restraint must end
immediately after the danger is averted.
c. Short personal restraint used as a physical response to intervene when a child under
the age of five (5) (chronological or developmental age) demonstrates disruptive
behavior, such as a tantrum in a public place. The physical response must be an
appropriate response to the disruptive behavior and efforts to de-escalate the behavior
must have failed. The restraint must end as soon as the disruptive behavior has been
de-escalated.
19) For children and adolescents ages 9-17 years, maximum time in a personal restraint must not
exceed one (1) hour. For children under age 9, a personal restraint must not exceed 30
minutes.
20) As soon as possible after personal restraint is started, the foster/adoptive parent(s) or respite
provider must explain to the child in restraint the behaviors the child must exhibit to be
released from the restraint or have the restraint reduced and permit the child to make
suggestions about what actions the foster/adoptive parent(s) or respite provider can take to
help the child de-escalate.
21) If the child does not appear to understand what action he must take to be released from the
restraint or have the restraint reduced, the foster/adoptive parent or respite provider must
attempt to re-explain it every 15 minutes until understanding is reached or the child is
released from the restraint.
22) The child must be released from personal restraint as soon as he/she is no longer a danger to
himself/herself or others. Should there appear to be any sign of danger to the child during the
restraint, i.e. distressed breathing, disorientation, change in level of consciousness, etc. the
restraint will be immediately terminated and emergency medical care will begin. Persons
restraining a child must insure that the child has the ability to communicate throughout the
restraint, i.e. deaf children who are limited to communication through sign must be able to
communicate in some manner that they are in distress either through sign or vocalization.
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23) The immediate goal is ending the restraint to utilize a programmatic intervention (i.e. giving
the child a cooling off period, listening to the child’s concerns, teaching self-control, using
rational problem solving techniques, and prompting skill previously taught to the child). Once
the restraint is removed, the child should be encouraged to transition into regular activities.
The child is to be observed for 15 minutes after a personal restraint has been used.
24) After a restraint, the foster/adoptive parent or respite provider is to provide the child with an
opportunity to discuss the situation which led to the need for restraint and the foster/adoptive
parent’s reaction to the situation privately as soon as possible and no later than 48 hours after
the release from the restraint. The purpose of the discussion is to allow the child to discuss
his/her behavior and the precipitating circumstances that constituted the emergency situation;
the strategies attempted before the use of the restraint and the child’s reaction to those
strategies; the restraint itself and the reaction to the restraint. All staff involved in the
personal restraint must make every effort to debrief concerning the incident.
25) After a personal restraint is used the foster/adoptive parent or respite provider will use a form
specifically designed for recording and reviewing restraints (Incident Report for Personal
Restraint of Children). Documentation includes:
a. Name of child
b. Description and assessment of the precipitating circumstances and the specific
behaviors, which continued to constitute the emergency situation.
c. Use of alternative strategies attempted before the use of personal restraint and the
child’s reaction to those strategies
d. Time the restraint began
e. Name of the foster/adoptive parent or respite provider participating in the restraint
f.
Specific restraint techniques used
g. De-escalating strategies employed during the restraint
h. Total length of time the child was restrained
i.
All attempts to explain to the child what behaviors were necessary for release from the
restraint
j.
Any injury the child sustained as a result of the incident or the use of restraint, and the
care or treatment provided
k. The actions of the foster/adoptive parent or respite provider took to facilitate the
child’s return to normal activities release from the restraint
l.
The child’s reaction to the opportunity to discuss the situation leading up to the need
for the personal restraint to include:
i. Date and time discussion was offered
ii. Date and time the discussion took place
iii. The actual discussion
iv. Foster/adoptive parent(s) or respite providers reaction to the situation
This form must be completed by the foster/adoptive parent or respite provider and the Case
Manager within 24 hours of the restraint and reviewed by the Treatment Direction,
Administrator and Executive Director. The report will be faxed to the managing conservator
within 24 hours or the next business day. The licensing representative will receive a copy of
the incident after an investigation has been completed if needed, unless a serious event
occurred, then notification is immediate. The original form will be placed in the child’s
record. A copy will be kept in a locked file in the office of the Executive Director.
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26) The foster/adoptive parent or respite provider will call the Case Manager to report the
restraint within two (2) hours of the incident. The Case Manager will ask questions of the
foster/adoptive parent regarding the possible injury to the child and may choose to speak to
the child directly. If the child is reporting any injuries as a result of the restraint, this will be
documented and the Case Manager will then determine the necessity of seeking medical care
of the child. If medical attention is obtained, physician’s orders will then be followed in the
care of the child.
27) The Case Manager will assure that an ISP review occurs if three (3) or more personal restraints
have occurred within a seven (7) day period. The review must be conducted as soon as
possible and no later than 30 days after the fourth personal restraint by the persons responsible
for the child’s service plan.
28) If there are more than three (3) reviews within a 90 day period, the child must be examined by
a licensed psychiatrist, a licensed psychologist, a licensed master social worker with advanced
clinical practice, or a licensed professional counselor. The professional conducting the exam
must make service plan recommendations regarding the use of restraint.
29) All reports of child death, suicide attempts, and incidents in which the child experiences
substantial bodily harm must include the complete documentation of any restraints which were
implemented within 48 hours prior to the incident.
30) The Behavioral Committee, a Quality review sub-committee, convenes every three (3) months
to evaluate the use of behavior therapy intervention techniques over the prior quarter. The
team consists, at a minimum, of the Administrator, Executive Director, Treatment Director,
and a Case Manager Supervisor. The purpose of the committee is to assess the success in the
development and maintenance of an environment that supports positive and constructive
behaviors on the part of children in care; safe, appropriate and effective use of any form of
physical restraint, and elimination or reduction of physical injuries and any other negative
impact of necessary restraints on the child’s behaviors or emotional development. The
Administrator will review data on all personal restraint incident reports monthly and provide a
report to the Executive Director. Trends will be noted in the following areas (but not limited
to these categories only):
a. Negative impact as a result of the use of a physical restraint including
i. Physical injuries – type and seriousness of injury
ii. Emotional, behavioral or social issues noted with the child due to restraint use.
b. Were alternative strategies used prior to the personal restraint?
c. Could the restraint possibly have been avoided?
d. Any trends noted with a particular foster/adoptive parent or respite provider?
e. Were de-escalating strategies properly used?
f.
Were actions taken in an attempt to return the child to normal activities?
g. Was the child given an opportunity to discuss the situations which lead to the need for
restraint? Did this occur within 48 hours?
h. Was the foster/adoptive parent or respite provider debriefed after using a personal
restraint?
i.
Did the treatment team meetings occur with all children who had three (3) or more
personal restraints within a seven (7) day period?
If trends are found needing urgent attention, the Administrator or Executive Director may call
a subcommittee meeting prior to three (3) months. The reviews will include a review of
Refuge House’s policies and procedures, including the training policy and curriculum. Areas
needing improvement will be identified and action plans developed. The subcommittee will
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report their findings and actions to the Quality Committee for final approval. Monitoring will
continue with action plans revised as necessary until goals and objectives are met. The results
of this evaluation will be made available to the Department of Family and Protective Services
as requested.
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Subject
Applicable Standards
Date Board Approved
Restraint Policy
1820.1
04/28/03; Changes Approved 3/07/06
See Standard 1810.1, Discipline and Behavior Management Policy (Pg. 47)
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Subject
Chemical Dependency
Applicable Standards
Date Board Approved
04/28/03; Changes Approved 3/07/06
Refuge House is open to taking youth with substance abuse issues if the right family is available and they
obtain at least five hours of on-going training specializing in substance abuse. If the family is licensed and a
child is already placed within the care of a home and the child is found to have a chemical dependency issue
that was not known at the time of placement, Refuge House will assess the family and if the family and the
agency both feel it is still a quality placement, Refuge House will ensure that the family receives at least five
hours of specific substance abuse training within a two week period of realizing the issue.
If a child with a substance abuse problem is in the care of Refuge House, the organization will ensure that an
assessment is done within a two-week period and that counseling be provided through a qualified substance
abuse counselor.
Refuge House will also see to it that the child attend AA meetings or NA meeting as required by the assessment
and/or the professional substance abuse counselor.
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Administration
Subject
Applicable Standards
Date Board Approved
Policy:
Informing Licensing Representative of Changes
1100.b.1
04/28/03; Changes Approved 3/07/06
Refuge House will provide Residential Child Care Licensing with updated information for routine
monitoring that will allow licensing staff to provide technical assistance and ensure ongoing
compliance with Minimum Standards.
Procedure:
1) Executive Director and/or Administrator will ensure that the licensing representative will be
given information regarding changes in agency personnel and professional staff. This will be
forwarded to the licensing representative within five business days of the change by fax, email
or mail.
2) Executive Director will ensure that reports of the verification of new homes and any changes in
the location, population served or other changes in foster/adoptive homes is on the Agency
Homes Report and in the home file. A copy of the Agency Home Report will be faxed, emailed
or mailed to the licensing representative the same day as the change.
3) Prior to any change in location of records or offices, the Executive Director will notify the
licensing representative for approval.
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Subject
Applicable Standards
Date Board Approved
Policy:
Evaluation for On-Going Compliance with Minimum Standards and
Documenting/Correcting All Non-Compliance
1100.b.4
04/28/03; Changes Approved 3/07/06
Refuge House will provide a formal process of monitoring foster/adoptive homes for compliance
with Minimum Standards and Guidelines of Child-Placing Agencies by the foster/adoptive parent.
Refuge House will define the methods to be used for documenting and correcting all noncompliance.
Procedure:
1) The Case Manager will visit each foster/adoptive home a minimum of two (2) times monthly
for homes with children who have levels of care at moderate or above. For homes with ONLY
basic level of care children the case manager will visit each foster/adoptive home a minimum
of once (1) monthly. The Case Manager will monitor the home for compliance with Minimum
Standards and Refuge House Policies and Procedures.
2) Case Manager uses a checklist itemizing licensing standards for review. Ten standards will be
reviewed with the family monthly and will be indicated on the checklist. The checklist is filled
out monthly with specific information regarding on-going compliance as gathered through
observation, review of child file and home file, on-site inspection of the home, and interviews
with the child. This information is submitted to the Level 1 Child-Placing Staff and Executive
Director monthly for review and commentary. The information is submitted by way of the
Foster Home Monthly Evaluation. A plan of correction is written for any areas of concern. A
copy of this report is given to the foster parent and placed in the foster parent’s file.
3) Case Manager completes a comprehensive evaluation on each foster/adoptive home a
minimum of once yearly. The evaluation includes feedback from a variety of consumers such
as foster child, foster parents, caseworkers, teachers and Refuge House staff. Review of home
files, training records, and child files are completed prior to an in-home observation. The
foster parents receive scores from Case Manager regarding their skill development in a variety
of areas as trained and consulted by Refuge House staff. A plan of correction is written and
signed by both Case Manager and the foster/adoptive parent(s) to address any area receiving a
less than satisfactory rating. A copy of both the evaluation and plan of correction is given to
the foster/adoptive parent(s) and placed in the file.
4) The Administrator or the Executive Director completes a quality assurance audit a minimum of
one time quarterly. This audit includes the frequency of written feedback to the foster parent,
the status of training hours completed per home, and evidence of home re-verification
information in the home files. The audit insures that foster home fields are up to date and
current with Minimum Standards. A copy of the audit is kept in the office of the Executive
Director.
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Subject
Applicable Standards
Date Board Approved
Policy:
Responding to Patterns of Non-Compliance with Minimum Standards
1100.b.4
04/28/03; Changes Approved 3/07/06
Refuge House will provide a formal process of addressing incidents of chronic or serious noncompliance with Minimum Standards and Guidelines of Child-Placing Agencies by the foster/adoptive
parent. This does not replace procedures for providing foster/adoptive parents with on-going
evaluation, training and written feedback for skill development.
Procedure:
When a foster/adoptive home is found to be non-compliant with Refuge House Policy or the DFPS
Minimum Standards and Guidelines of Child-Placing Agencies, the following procedure will be
followed:
1) The foster parent is notified in writing and a plan of correction is developed with the Case
Manager, Administrator, and Executive Director. The plan is reviewed and agreed upon with the
foster family.
2) If the plan of correction is not completed within the set timeframes and/or the same issue has reoccurred, the Executive Director may:
a) withhold up to 10% of the monthly per diem, which will be released to the foster family when
the goals established in the plan of correction are met
b) conduct an administrative review with the Administrator, Executive Director, Case Manager,
and foster family,
c) establish a new plan of correction,
d) establish a new timeline for the previous plan
3) The Administrator with the Executive Director may begin the disciplinary process, up to and
including removal of the foster child(ren) from the home, depending upon the nature and severity
of the violation.
4) If timelines for a revised plan of correction are not met and/or the same non-compliance has
reoccurred, the Executive Director may (as nature and severity of the violation warrant):
a) suspend child-placement in the home,
b) withhold up to 25% of the monthly per diem,
c) Conduct an administrative review in the office, requiring participation of Case Manager,
Administrator, Executive Director and foster parent.
5) Executive Director, in conjunction with the Administrator, may revoke the foster home verification
at any time as warranted by the nature and severity of the violation. In such instances, Refuge
House will cooperate with the managing conservator to move the child(ren) to a properly verified
home.
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Subject
Applicable Standards
Date Board Approved
Policy:
Decision Tree for Reporting and Investigating Allegations or Incidents
1100.b.5, 1100.b.7
04/28/03; Changes Approved 3/07/06
Refuge House will provide staff with the necessary information to know how to proceed when
critical and serious allegations/incidents are reported or observed.
Procedure:
1) Reporting to Residential Child Care Licensing Investigations
If the allegation or incident falls into one of the following, it must be reported to RCCL
Investigations or, if after normal business hours, the hotline at 1-800-252-5400.
a) Refuge House staff or foster/adoptive parent or anyone who makes the observation must
contact the Refuge House Case Manager immediately at Refuge House business office.
b) The incident report is completed by the Case Manager. Case Manager will notify the
Treatment Director, Administrator, Executive Director and Managing Conservator.
c) The Administrator is to inform the licensing representative by telephone upon knowledge of
the incident or the next business day.
d) A written report is faxed upon completion, but no later than 24 hours after the incident or
the next business day.
e) At any time, if the safety of the child is in question a safety plan will be formulated by
Case Manager, documented and approved by the Administrator, the Executive Director and
the Treatment Director. The safety plan is put into place immediately upon approval and
faxed to the licensing representative with the incident report.
f)
A copy of the incident report is placed in the child’s file and in a centralized, locked
investigation file in the office of the Executive Director.
g) Refuge House will not investigate serious incidents further without instruction to do so.
Definitions extracted from the Texas Family Code Section 261.401(a) (1, 2):
ABUSE – AN INTENTIONAL KNOWING, OR RECKLESS ACT OR OMISSION BY AN EMPLOYEE, VOLUNTEER, OR OTHER INDIVIDUAL
WORKING UNDER THE AUSPICES OF A FACILITY THAT CAUSES OR MAY CAUSE EMOTIONAL HARM OR PHYSICAL INJURY TO, OR THE
DEATH OF, A CHILD SERVED BY THE FACILITY AS FUTHER DESCRIBED BY RULE OR POLICY.
EXPLOITATION – THE ILLEGAL OR IMPROPER USE OF A CHILD OR OF THE RESOURCES OF A CHILD FOR MONETARY OR PERSONAL
BENEFIT, PROFIT, OR GAIN BY AN EMPLOYEE, VOLUNTEER, OR OTHER INDIVIDUAL WORKING UNDER THE AUSPICES OF A FACILITY
AS FURTHER DESCRIBED BY RULE OR POLICY.
1) “ABUSE” INCLUDES THE FOLLOWING ACTS OR OMISSIONS BY A PERSON:
a) MENTAL OR EMOTIONAL INJURY TO A CHILD THAT RESULTS IN A N OBSERVATLE AND MATERIAL IMPAIRMENT OF THE CHILD’S
GROWTH, DEVELOPMENT OR PSYCHOLOGICAL FUNCTIONING;
b) CAUSING OR PERMITTING THE CHILD TO BE IN A SITUATION IN WHICH THE CHILD SUSTAINS A METNAL OR EMOTIONAL INJURY
THAT RESULTS IN AN OBSERVABLE AND MATERIAL IMPAIRMENT IN THE CHILD’S GROWTH, DEVELOPMENT OR PSYCHOLOGICAL
FUNCTIONING;
c) PHYSICAL INJURY THAT RESULTS IN SUBSTANTIAL HARM TO THE CHILD, OR THE GENUINE THREAT OF SUBSTANTIAL HARM
FROM PHYSICAL INJURY TO THE CHILD, INCLUDING AN INJURY THAT IS AT VARIANCE WITH THE HISTORY OR EXPLANATION
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3)
Administration
GIVEN AND EXCLUDING AN ACCIDENT OR REASONABLE DISCIPLINE BY A PARENT, GUARDIAN, OR MANAGIN OR POSSESSORY
CONSERVATOR THAT DOES NOT EXPOSE THE CHILD TO A SUBSTANTIAL RISK OF HARM;
d) FAILUR TO MAKE A REASONABLE EFFORT TO PREVENT AN ACTION BY ANOTHER PERSON THAT RESULTS IN PHYSICAL INJURY
THAT RESULTS IN SUBSTANTIAL HARM TO THE CHILD;
e) SEXUAL CONDUCT HARMFUL TO A CHILD’S MENTAL, EMOTIONAL, OR PHYSICAL WELFARE;
f) FAILURE TO MAKE A REASONABLE EFFOR TO PREVENT SEXUAL CONDUCT HARMFUL TO A CHILD;
g) COMPELLING OR ENCOURAGING THE CHILD TO ENGAGE IN SEXUAL CONDUCT AS DEFINED BY SECTION 43.01, PENAL CODE;
h) CAUSING, PERMITTING, ENCOURAGING, ENGAGING IN, OR ALLOWING THE PHOTOGRAPHING, FILMING OR DEPICTING OF THE
CHILD IF THE PERSON KNEW OR SHOULD HAVE KNOWN THAT THE RESULTING PHOTOGRAPH, FILM, OR DEPICTION OF THE
CHILD IS OBSCENE AS DEFINED BY SECTION 43.21, PENAL CODE, OR PORNOGRAPHIC;
i) THE CURRENT USE BY A PERSON OF A CONTROLLED SUBSTANCE AS DEFINED BY CHAPTER 481, HEALTH AND SAFETY CODE,
IN A MANNER OR TO THE EXTENT THAT THE USE RESULTS IN PHYSICAL, MENTAL, OR EMOTIONAL INJURY TO A CHILD; OR
j) CAUSING, EXPRESSLY PERMITTING, OR ENCOURAGING A CHILD TO USE A CONTROLLED SUBSTANCE AS DEFINED BY CHAPTER
481, HEALTH AND SAFETY CODE.
“DEPARTMENT” MEANS THE DEPARTMENT OF FAMILY AND PROTECTIVE SERVICES.
“DESIGNATED AGENCY” MEANS THE AGENCY DESIGNATED BY THE COURT AS RESPONSIBLE FOR THE PROTECTION OF THE CHILDREN.
Definitions extracted from the Texas Family Code Section 261.401(a)(3):
NEGLECT – A NEGLIGENT ACT OR OMISSION BY AN EMPLOYEE, VOLUNTEER, OR OTHER INDIVIDUAL WORKING UDNER THE AUSPICES
OF A FACILITY, INCLUDING FAILURE TO COMPLY WITH AN INDIVIDUAL TREATMENT PLAN, PLAN OF CARE, INDIVIDUALIZED SERVICE
PLAN, THAT CAUSES SUBSTANTIAL HARM OR PHYSICAL INJURY TO, OR THE DEATH OF, A CHILD SERVED BY THE FACILITY
DESCRIBED BY RULE OR POLICY.
“NEGLECT” INCLUDES:
(A) THE LEAVING OF A CHILD IN A SITUATION WHERE THE CHILD WOULD BE EXPOSED TO A SUBSTANTIAL RISK OF PHYSICAL OR MENTAL
HARM, WITHOUT ARRANGING FOR THE NECESSARY CARE FOR THE CHILD, AND THE DEMONSTRATION OF AN INTENT NOT TO
RETURN BY A PARENT, GUARDIAN, OR MANAGING OR POSSESSORY CONSERVATOR OF THE CHILD;
(B) THE FOLLOWING ACTS OR OMISSIONS BYA PERSON;
i)
PLACING A CHILD IN OR FAILING TO REMOVE A CHILD FROM A SITUATIONS THAT A REASONABLE PERSONA WOULD REALIZE
REQUIRES JUDGMENT OR ACTIONS BEYOND A CHILD’S LEVEL OF MATURITY, PHYSICAL CONDITION, OR MENTAL ABILITIES AND
THAT RESULTS IN BODILY INJURY OR A SUBSTANTIAL RISK OF IMMEDIATE HARM TO THE CHILD;
ii) FAILING TO SEEK, OBTAIN, OR FOLLOW THROUGH WITH MEDIACL CARE FOR A CHILD, WITH THE FAILURE RESULTING IN OR
PRESENTING A SUBSTANTIAL RISK OF DEATH, DISFIGUREMENT, OR BODILY INJURY OR WITH THE FAILURE RESULTING IN AN
OBSERVABLE AND MATERIAL IMPAIRMENT TO THE GROWTH, DEVELOPMENT, OR FUNCTIONING OF THE CHILD;
iii) THE FAILURE TO PROVIDE A CHILD WITH FOOD, CLOTHING, OR SHELTER NECESSARY TO SUSTAIN THE LIFE OR HEALTH OF
THE CHILD, EXCLUDING FAILURE CAUSED PRIMARILY BY FINANCIAL INABILITY UNLESS RELIEF SERVICES HAD BEEN OFFERED
AND REFUSED; OR
iv) PLACING A CHILD IN OR FAILING TO REMOVE THE CHILD FROM A SITUATION IN WHICH THE CHILD WOULD BE EXPOSED TO A
SUBSTANTIAL RISK OF SEXUAL CONDUCT HARMFUL TO THE CHILD; OR THE FAILURE BY THE PERSON RESPONSIBLE FOR A
CHILD’S CAREE, CUSTODY OR WELFARE TO PERMIT THE CHILD TO RETURN TO THE CHILD’S HOME WITHOUT ARRANGING FOR
THE NECESSARY CARE FOR THE CHILD AFTER THE CHILD HAS BEEN ABSENT FROM THE HOME FOR ANY REASON, INCLUDING
HAVING BEEN IN A RESIDENTIAL PLACEMENT OR HAVING RUN AWAY.
If an employee, contractor, foster/adoptive parent or respite provider, based upon objective facts and
reasonable inferences drawn from those facts, has a reasonable suspicion that another persona is in
violation of this policy, then that person under reasonable suspicion will be subject to investigation.
Anyone who refuses to cooperate with the investigating body will be subject to discipline, up to and
including possible discharge or revocation of verification. Conviction of an employee or foster/adoptive
parent for abuse will result in immediate termination of that employee or revocation of verification as
appropriate. Any employee who knowingly “looks the other way” or fails to report abuse will be
terminated immediately. Foster/adoptive parents will no longer be verified by Refuge House, Inc. All
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Administration
reports of abuse will be written on an Incident Report Form. When the report is completed, it should be
given to the employee’s immediate supervisor or Case Manager, as appropriate. Employees and
foster/adoptive parents will also sign a form acknowledging their responsibilities for reporting abuse and
neglect upon hire.
The following are defined as serious incidents:
1. Any incident where there are indications that a child in care may have been abused or
neglected as defined by the Texas Family Code.
2. Abusive activity among children in care:
a. Non-consensual sexual activity between children of any age
b. Consensual sexual activity between children where there is a significant difference in size,
age or developmental level of the children
c. Child-to-child behavior that results in observable physical injury and causes material
impairment
3. Abusive treatment by a foster/adoptive parent or respite provider including:
a. A slap on the face;
b. Sexually oriented verbalizations;
c. Exposing the anus, breast, or any part of the genitals;
d. Inappropriate kissing;
e. Providing sexually suggestive materials to a child other than that used for appropriate sex
education or counseling;
f.
Touching a child in inappropriate ways;
g. Providing drugs or alcohol to a child.
4. Engaging in sexual activity in view of or in the presence of children.
5. Incidents resulting in critical injury or permanent disability of a child. A “critical injury” is
defined as any life-threatening injury or one that results in hospital intensive care or the need
for life-resuscitation methods. It includes any injury this is labeled as “critical” by qualified
medical personnel.
6. Child death regardless of cause
7. Any attempt by a child to take his own life, using means or methods capable of causing serious
injury or means or methods that the child believes capable of causing serious injury.
8. Incidents or injuries that require medical treatment
9. Injury as a result of a personal restraint – Note: Any serious incident report of an injury as a
result of a short personal restraint that is made to Licensing must include documentation of the
restraint and the precipitating circumstances and specific behaviors which led to the restraint.
10. Runaways
11. Commission of a crime
12. Unauthorized and unsupervised possession of a firearm
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The following allegations/incidents will not be reported to the Refuge House, Inc. licensing
representative until after an internal investigation is completed:

Suicide ideation

Sexual activity – consensual or acting out (not falling into the above serious incident category)

Personal restraint – no injury

Property Damage or Theft (non-criminal)

Illness Requiring Treatment

Drug or Alcohol Abuse
The Incident Report form will be completed by the Case Manager and/or On-Call Staff. The Case
Manager will then notify the Treatment Director, Administrator and Executive Director for review and
approval. The managing conservator will also be notified by the Case Manager. A copy of the Incident
Report will be faxed to the Managing Conservator within 24 hours or the next business day. The
original incident report will be placed in the appropriate file. A copy will be placed in a locked file in
the Executive Director’s office.
2) Internal Investigations
When an internal investigation is in process, no new child placements will occur with the foster/adoptive
family until the issues have been investigated and resolved. The Incident Report form will be turned in to
the Administrator and an Internal Investigator will be assigned. An Internal Investigation Form will be
completed and signed by the investigator, the Level 1 Child-Placing Staff, Administrator and Executive
Director. The plan of correction will be formulated to address the finding. A corrective action plan will be
written by the Case Manager and Internal Investigator. The Administrator and Executive Director approve
the plan. The Administrator will report the results to the licensing representative within 30 days of the
incident being investigated. A copy of the report will be placed in both the appropriate file and a locked
central file located in the office of the Executive Director.
All reports to Licensing of child death, suicide attempts, and incidents in which a child experiences
substantial bodily harm must include the complete documentation of any emergency medications,
restraints, and/or seclusions which were implemented within 48 hours prior to the incident.
The Administrator will also assign internal investigations for the following issues:
a) When requested by the Case Manager, Treatment Director, Executive Director, managing conservator
and/or the licensing representative.
b) When there is any reason to be concerned about the care of children.
3) Plans of Correction
A plan of correction will be written when any investigation or audit, internal or external reveals concerns
regarding staff or foster parent practices with children. The plan will be attached to investigations,
notification of finding from licensing, and a copy of both will be placed in the appropriate audit file and
will be scheduled for review as specified in the plan. Each plan shall include the following:
1) A statement explaining the nature of the problem and the standard violated
2) Specific guidelines for resolving the problem both for the specific situation and the agency in
general
3) Criteria for completion
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4) Timelines for completion
5) Signatures and dates of all pertinent persons
4) Reports to the Board of Directors
All serious allegations/incidents will be forwarded to the President of the Board of Directors from the
office of the EXECUTIVE DIRECTOR monthly.
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Administration
Subject
Applicable Standards
Date Board Approved
Policy:
Incident Reports
1910
04/28/03; Changes Approved 3/07/06
Refuge House will provide the foster/adoptive parents with specific instructions for writing
incident reports and determining which incidents are serious incidents and to provide a procedure
for reporting
Procedure:
1) Incident reports are to be written for instances of destruction of property, theft or runaway behavior,
major behavioral problems, use of personal restraint, * extreme cursing, verbal or physical threats to
foster/adoptive parents, staff or peers, suicidal threats (attempts or approximations), non-consensual
or consensual sexual activity, criminal behavior, drug or alcohol abuse, incidents or injuries that
require medical treatment, illness requiring emergency medical treatment, unauthorized possession of
a firearm and at the instruction of the Case Manager, Treatment Director, Administrator or Executive
Director. Incident reports must also be written for any incidents that result in critical injury or
permanent disability to a child. *There is a separate form for the use of restraint.
2) Incident reports must also be written when there are indications that a child in care may have been
abused or neglected. This includes any type of abusive treatment by a foster/adoptive or respite
parent, including non-accidental caregiver action, which if chronic or intensified, could cause
substantial harm to a child. Examples include: a slap to the face, sexual verbalizations, exposing the
anus, breast, or any part of the genitals, inappropriate kissing, engaging in sexual activity in view or in
the presence of children, provision of sexually oriented material to a child other than that used for
appropriate sex education or counseling, touching a child in inappropriate ways, or providing drugs or
alcohol to a child.
3) Each report must include the date and time of the occurrence, the individuals involved, and/or
children involved, the nature of the incident, and the surrounding circumstances.
4) Incidents are discussed with the Case Manager by phone within two (2) hours of the occurrence. The
case manager dealing with the issue must complete all incident reports. Whenever an injury occurs, an
injury report and incident report will need to be written. The Case Manager is to complete the written
reports within 24 hours.
5) For incidents that are rated serious, (any suspected abuse or neglect, abusive behavior by
foster/adoptive parents, abusive activity among children in care including non-consensual sexual
activity or consensual sexual activity between children when there is a significant difference in size,
age or developmental level of the children, suicide attempts, runaways, criminal activity, unauthorized
use or possession of a firearm, incidents or injuries that require medical treatment including critical
injury or permanent disability, child death regardless of cause, and injury as a result of a personal
restraint) the Case Manager will complete the Incident Report form after receiving a telephonic report
from the foster/adoptive parent or respite provider. The report will be immediately forwarded to the
Treatment Director, Administrator and Executive Director for review and signature.
6) The Administrator will then notify Residential Child Care Licensing during normal working hours or the
hotline at 1-800-252-5400 with a follow-up phone call the next business day.
7) The Administrator will receive follow-up instructions from Residential Child Care Licensing
Representative or the Executive Director including assignment of an internal investigation and
corrective action plans, if needed. Internal investigations must be completed and forwarded to the
licensing representative within 30 days of the initial report.
8) The Administrator will forward all written documentation of serious incidents to the Residential Child
Care Licensing within 24 hours or the next business day.
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9) The Case Manager will notify the managing conservator by telephone, fax or email at the time of
occurrence and forward a written report within 24 hours or one working day.
10) The completed incident report forms will be kept in the child or family file, as appropriate, with a
copy kept in a locked file in the office of the Executive Director.
11) Monthly foster home reviews will include a summary of foster family incidents to identify opportunities
for improvement and set action plans. The Case Manager will also review and discuss incident reports
specific to the child at monthly face-to-face meetings.
12) All incident reports will be reviewed for patterns and trends monthly by the Administrator and again
quarterly. Any trends noted will be discussed at the quarterly Quality Assurance Meeting. Action plans
will be reviewed and agreed upon. The Administrator and/or Executive Director may call a meeting at
any time a trend is noted and prompt action is needed.
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Administration
Subject
Applicable Standards
Date Board Approved
Policy:
Foster Family Annual Evaluation of Quality
1100.b.6, 1100.b.7
04/28/03; Changes Approved 3/07/06
Refuge House will provide high quality services for children placed in the foster/adoptive program,
and will further develop professionalism among staff and the foster/adoptive parents, maintain
good working relationships with our clients, and will uphold the values and ethics of Refuge House.
Procedure:
Components of Evaluation
Pre-Evaluation Training
In order to enhance the foster/adoptive parents understanding of and comfort with the evaluation process, a
pre-evaluation training to present the philosophy, history and evaluation procedures in place at Refuge House
will be provided during the first year of working with Refuge House. This training will be documented in the
foster/adoptive parents’ file.
Consumer Evaluations
Consumer evaluation includes feedback from persons who have regular contact with the child placed in Refuge
House’s foster/adoptive program and knowledge of the services provided by the foster/adoptive parents.
Examples would include the child, their families, caseworkers, administrators, and staff members. Consumer
lists will be compiled for all foster/adoptive homes twice each year. Consumers will be contacted by mail or
by phone for response to the consumer questionnaire. Feedback will be placed in the home file to be shared
with the foster/adoptive parent(s) by the Case Manager and reviewed with major evaluations.
Preparation for In-Home Evaluation
The Case Manager, who has been trained in the evaluation process, will visit the foster/adoptive home to
conduct the in-home portion of the evaluation. Children’s files will be reviewed and audited prior to this visit.
Documentation of services completed by the foster/adoptive parent(s) will be reviewed at this time. The
home file will be reviewed, as well as feedback given by the Case Manager, Administrator and Executive
Director in the last six months and the consumer feedback received in preparation for this review.
In-Home Evaluation
The Case Manager will visit the home for a minimum of two hours to assess implementation of key elements of
the Common Sense Parenting techniques and skills. During the course of the visit, the child will be privately
interviewed to discuss their satisfaction with services provided by the foster/adoptive parents. The Case
Manager will also be testing the understanding of the child regarding his treatment program and a foster parent
practice form will be completed to document issues regarding children’s rights. A copy of this report, signed
by the child, will be placed in the child’s file.
The Case Manager will observe the teaching and counseling skills of the foster/adoptive parents as well as
relationships with the child attending.
Immediately following the In-Home visit, the Case Manager will complete the Evaluation Feedback Form. The
Case Manager will type up the agreed upon scores and feedback.
Scheduling
Each child admitted to the Refuge House program has a service plan review at 30 days and a quarterly service
plan review every 90 days thereafter for children with levels of care moderate and above and every six months
for basic level of care children. When a new home is opened the quarterly service plan reviews will occur 4
months after the placement of the first child in the home and every 3 months thereafter. All children
admitted to the home will be placed on this same cycle for review. These reviews take place in the home with
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the child and significant persons in the treatment of the child invited to attend. Major evaluations will take
place in conjunction with these reviews. When the first child is placed in the home, the Case Manager will
schedule the In-Home evaluation (at either 4 months or 7 months depending on available resources) and the
post-evaluation conference (2-7 working days after the evaluation). The annual evaluation will take place at
either 10 or 13 months depending on the scheduling of the first major evaluation. Evaluations will then occur
every 12 months annually thereafter.
The Case Manager will score the foster/adoptive parents on their implementation and demonstration of the
Key Elements of providing foster/adoptive care. The report will indicate whether or not the foster/adoptive
parent(s) has met criteria. The report will include a plan of correction written by the Case Manager. This plan
will review areas that need improvement, set specific goals, and define methods for accomplishing the goals.
A follow up time will be designated. If all goals have not been met by the next quarterly review, the in-home
portion of the evaluation will repeat at that time. The automatic follow up time for the first major evaluation
will be the first annual evaluation. The first year of service as a foster/adoptive parent is considered a training
year.
Post-Evaluation Meeting
The post-evaluation meeting will be pre-scheduled to take place between 2 and 10 days after the in-home
visit. The Case Manager will be prepared to provide generous amounts of effective praise and encouragement
to the foster/adoptive parent(s) as well as constructive feedback. This conference is perhaps the single most
significant aspect of the procedure. It is during this time that any plan of correction is agreed upon. Each
participant should sign the Evaluation Feedback Form whether or not there is a corrective plan.
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Subject
Applicable Standards
Date Board Approved
Governing Body’s Responsibilities
1200.1, 1200.5
04/28/03; Changes Approved 3/07/06
Refuge House, a Christian 501 (c) 3 non-profit corporation, provides foster care and adoption services to at-risk
children. Children are placed with carefully selected and well-trained families by Refuge House.
The Board of Directors is the governing body of Refuge House. The Board is also responsible for the overall
programs of Refuge House. The Board is also responsible for reviewing and approving the policies and
procedures of the agency. The Board will review and approve the strategic plan to ensure that an effective
plan is implemented, monitored and supported. The Board ensures that Refuge House functions according to
the provisions of the plan and the policies approved.
The Board is comprised of a minimum of three (3) members in accordance with the by-laws of the corporation.
The Executive Director reports directly to the Board and is responsible for the overall operation of the agency’s
programs.
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Fiscal Accountability
Fiscal Accountability
Subject
Applicable Standards
Date Board Approved
Policy:
Budget
1310.1, 1320.2
04/28/03; Changes Approved 3/07/06
Demonstrate fiscal accountability standards by showing projected expenses and projected income
by category. To show that Refuge House is able to meet the expenses of providing services with
sufficient funds to complete services for initial months as a startup and ability to complete services
for all current clients on an on-going basis.
Procedure:
See appendix for the Budget and Rationale.
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Fiscal Accountability
Subject
Applicable Standards
Date Board Approved
Policy:
Reserve Funds
1320.3
04/28/03; Changes Approved 3/07/06
Provide documentation of available credit at least equal to operating costs for the first 3 months of
operation
Procedure:
See appendix for a copy of the bank statement and deposit slip.
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Reports and Records
Reports and Records
Subject
Applicable Standards
Date Board Approved
Runaways
1910.3
04/28/03; Changes Approved 3/07/06
Policy:
Procedure:
1.
If a youth is found to be gone without permission and their whereabouts are unknown, then
consider the following:
1.
Have you searched thoroughly, i.e., under the beds, in closets, in the car, in the trunk,
in the attic or basement? If so, and if any of the following apply, call the police
immediately. Give accurate information to the police in order to expedite a search.
Be sure to get a report number for your incident report. Notify the Case Manager and
begin a neighborhood search yourself if the child ran away from home
 The child is not old enough to be safe for more than 10-15 minutes on the street.
The child does not know the way home. The child does not know your address or
phone number.
 The child is under age 11.
 The child is on medications that might be crucial to his/her physical well being
should the child not return before medication time.
 The child is mentally or physically challenged.
 The child could possible be suicidal or homicidal. The child is impulsive and not
thinking clearly. The child has a history of placing him/herself in a position to be
victimized.
2.
If none of the above are a concern for this child, then continue through the following
questions:
 Does this child have a history of running away, and if so, what has the child done in
the past on runaway?
 Have you called friends or family where you might suspect the child to run?
 Do you know for sure the circumstances of their runaway? For example, do you
know if the child is alone, was this runaway planned or unplanned, do you really
know anything about the situation?
 Would the child expect you to know they are missing at this time? (i.e., the child
doesn’t usually get home from school until 4:00p.m., the school reported the child
absent after lunch, it is only 3:30 p.m. now)
2.
Call the Case Manager to report the suspected runaway. Report with as much detail as possible
the information above. Together you will make a decision of when to call in a runaway report,
however you will not wait for more that one hour. At this time, you will also notify the
managing conservator by phone. Residential Child Care Licensing is to be notified as per policy
and licensing standards.
3.
An incident report will be completed by the foster/adoptive parent and reviewed by the Case
Manager. The runaway police report number is to be recorded on the incident report. The
Case Manager will fax with the written report to the managing conservator within 24 hours of
the next business day.
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4.
The Case Manager will contact the managing conservator to discuss possible discharge of the
child from the program if needed. Documentation of this process will be completed at this
time.
5.
If the child returns to the home from runaway status without being detained by another agency
(such as a juvenile detention facility), the foster/adoptive parent should contact the staff
immediately. Staff will then readmit the child to the program and contact the managing
conservator to advise of such action. If, however, the child is detained by another agency, the
managing conservator will be required to pick up the child from the agency.
6.
If a child returns to the home, the foster/adoptive parents will inventory child’s belongings and
check pockets, socks, etc., for cigarettes, contraband, money, and/or food. The child should
take a shower, eat, and receive the consequences.
7.
If the child should require any medical attention while he/she is on runaway status and has
been dismissed from the program, the foster/adoptive parent may not grant permission for
such medical service. They may act as a “friend” of the child and assist medical personnel in
contacting the managing conservator for permission.
8.
If the child does not return within 5 days, the child’s belongings are to be taken up, bagged,
marked, and placed in the clothing storage closet or given to a DFPS caseworker.
9.
Children will be dismissed according to the decision of the DFPS caseworker. If the caseworker
wishes to hold the bed for more than the number of days payable in our contract, Refuge
House will require a written agreement signed by the caseworker’s supervisor in order to hold
the bed.
10.
Foster parents will notify the Case Manager of the child’s return. When it is determined by the
foster/adoptive parent and the staff that it is the intent of the child to remain at the home,
the police are to be notified of the child’s return.
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Required Material
Required Material
Subject
Applicable Standards
Date Board Approved
Policy:
Fee Policy
1310.3
04/28/03; Changes Approved 3/07/06
Refuge House will maintain clear, concise fees and clearly define the services that are covered by
the fees
Policy Statement:
Refuge House only accepts children from DFPS and all fees will be based on the Contractual
Agreement between DFPS and Refuge House. Refuge House will pay fees to families based on the
Fee Schedule provided.
If Refuge House enters into other contractual arrangements with private or public entities, a fee
policy will be developed at that time.
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Structure of a Child Placing Agency
Structure of a Child Placing Agency
Subject
Applicable Standards
Date Board Approved
Policy:
Level 1 Child Placing Staff Services
1100.b.2
04/28/03; Changes Approved 3/07/06
Refuge House Assures that the Level 1 Child-Placing Staff is available to agency staff, foster and
adoptive homes to make decisions required of the position. Decisions will be documented in the
agency records in a timely manner.
Procedure:
1) General Availability
a) Level 1 Child-Placing Staff will be physically present at the office three (3) times weekly
and available as needed.
b) Level 1 Child-Placing Staff will be available 24 hours a day by cell phone, pager and/or
home phone.
c) All Level 1 Child-Placing Staff will maintain a fax machine in their home to increase
flexibility and for easy access to documents needed for decision making.
d) All Level 1 Child-Placing Staff will have secure Internet email accessible from any webenabled computer for non-urgent updates.
2) Matching Process Prior to Admission
a) The Intake Staff will receive an intake call. Written and verbal information about the child
will be gathered, presented to and/or faxed to the Level 1 Child-Placing Staff for potential
placement approval. Initial intake is completed and approved by the Level 1 Child-Placing
Staff.
b) The Intake Staff will have a telephonic or face-to-face discussion in the office with the
Level 1 Child-Placing Staff. The strengths of each family will be discussed in relationship
to the child’s needs.
c) Home studies of the prospective families are forwarded to the managing conservator who
identifies a family or families that best meet the needs of the child. Selection is based
upon mutual consent of the managing conservator and Refuge House staff based upon the
available data provided.
d) Once all paperwork is collected, and the potential foster family has expressed interest the
Child and Family Coordinator will get final approval from the Level 1 Child-Placing Staff to
move forward with the placement.
*In an emergency situation, the home study may be sent after placement has occurred.
During the emergency admission process the potential families are contacted and given
information about the child in order to complete the matching process.
3) Admission Process
a) Subsequent to the selection of a foster family, the intake study is approved by the Level 1
Child-Placing Staff.
b) Level 1 Child-Placing Staff will review the child’s completed file and sign the following
within 24 hours:
i) Justification Form
ii) Individual Service Plan (temporary)
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iii) Any Communication Restrictions
4) Child Ongoing Care
a) Weekly Clinical Meeting
i)
Review/discuss foster child progress
ii) Review/sign foster parent progress notes
b) Review/sign the temporary individual service plans within 24 hours of completion
c) Level 1 Child-Placing Staff participation in quarterly and Treatment Team meetings
d) Level 1 Child-Placing Staff review/approval of communication restrictions
e) Monthly review of continuing communication restrictions
5) Discharge
a) Level 1 Child-Placing Staff reviews/signs discharge summary three (3) days prior to actual
discharge or date of emergency discharge.
b) Emergency discharge documentation reviewed within two (2) hours of the incident
c) Subsequent placement due to disruption of the home will be discussed, documented by
Case Manager and signed by the Level 1 Child-Placing Staff prior to any action. In such
cases, the matching process previously listed would begin again.
6) Family Monitoring
a) Level 1 Child-Placing Staff reviews and approves foster and adoptive homes studies.
Review and sign foster family file and foster parent verification checklist prior to admitting
children into the home. In urgent situations fax approval may be obtained via telephonic
review/consultation until an original signature is obtained.
b) Level 1 Child-Placing Staff reviews and approves in writing all 40 hours of pre-service
observation by foster, adoptive and respite families.
c) Level 1 Child-Placing Staff reviews and approves documentation of monthly
foster/adoptive home visits and necessary action plans.
d) Level 1 Child-Placing Staff provides final approval for verification/re-verification of
foster/adoptive file and annual evaluations.
e) Level 1 Child-Placing Staff approves respite families after review of file documentation.
f)
Reviews occur within one week of completed routine documentation, 24 hours for urgent
finding by the Level 1 Child-Placing Staff.
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Structure of a Child Placing Agency
Subject
Applicable Standards
Date Board Approved
Policy:
Agency Homes Meet Minimum Standards
1100.b.3
04/28/03; Changes Approved 3/07/06
Refuge House assures that foster families have completed and met all necessary criteria based on
Minimum Standards and Guidelines as set forth by DFPS prior to being deemed completely ready to
accept a child for care.
Procedure:
1) Foster parent’s and respite provider’s physical, mental and emotional health must be stable in
order to assume parenting responsibilities. This is assessed through the home study process
with attention to each individual’s overall well being. The interview and evaluation process
conducted in the home provides information to support stability in every area of each
individual’s life.
2) All foster parents, family members and employees in direct contact with children are screened
for tuberculosis as recommended by medical professionals prior to having foster children in
care. A copy of the negative report is filed in the foster family file.
3) A written agreement between Refuge House, Inc. and each foster family is signed as a final
step in verification. The original is placed in the foster family file and a copy given to the
foster family for their personal records. The agreement is updated annually.
The written agreement contains all elements as specified in the Minimum Standards and
Guidelines for Child-Placing Agencies, Appendix F 1200 & 1300. See Refuge House, Inc. Foster
Parent Agreement Standard 3620.6.
4) Foster parents and Refuge House home care staff are well prepared and trained to work with
the children placed in their care.
See Foster Parent Training Requirements Standard 2410.1.
5) The Foster Parent Verification Checklist is used to track the necessary documentation needed
in order to show completion by the foster family of all requirements. The foster family file and
verification checklist is reviewed for completeness by the Level 1 Child-Placing Staff and signed
to indicate readiness to receive foster children into their care.
See Foster Parent Checklist and Definitions
Updated 3/2006
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Personnel Policies
Personnel Policies
Subject
Applicable Standards
Date Board Approved
Policy:
Personnel Qualifications and Responsibilities
2320.1
04/28/03; Changes Approved 3/07/06
Foster Parents will be able to comprehend and benefit from training. The will have the
capabilities to meet the needs of the children in all areas of care.
Procedure:
Foster parent applicants who possess a high school diploma or GED will satisfy the requirement for mastery of
basic learning abilities and skills. For individuals who do not have a high school diploma or GED, competencies
will be assessed through participation in the pre-service training process. An assessment will be made through
review of the required written autobiography and the PRIDE homework. Learning skills will be evaluated
throughout the training process and documented on the Proficient Documentation Form. This evaluation will
take place during the pre-service training process and will ensure that potential foster parents or staff are able
to benefit from training process and will ensure that potential foster parents or staff are able to benefit from
training and have the competencies to meet the needs of the children in care in areas such as health,
education, discipline and behavior management.
Updated 3/2006
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Personnel Policies
Subject
Applicable Standards
Date Board Approved
Job Descriptions
2100.2
04/28/03; Changes Approved 3/07/06
Job descriptions attached:
 Executive Director
 Administrator
 Level One Child Placing Staff/Intake
 Level One Child Placing Staff/Home Developer
 Treatment Director
 Office Manager
 Recruiter/Trainer
 Case Manager Supervisor
 Case Manager/Case Worker
 Child and Family Coordinator
Updated 3/2006
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Job Description for the Executive Director
RESPONSIBILITIES:


To maintain confidentiality and other responsibilities listed in governmental laws and regulations, as
well as Policies and Procedures.
Under the direct supervision of the Board of Directors:
 Establish goals and action (business) plans for execution of mission.
 Oversee marketing including needs assessments, and funding mechanisms.
 Make presentations to agencies, churches, organizations and community leaders.
 Oversee the financial plan.
 Give final approval of foster family agreements.
 Approve all business and professional contracts.
 Coordinate contract services with DFPS and other child placing agencies.
 Inform the licensing representative of any plans to move location of records or office.
 Provide support and supervision for employees designated in the organizational chart.
 Participate in quality assurance meetings.
 Be present for all internal and external on-site audits.
 Report to the Board of Directors regarding the above responsibilities and readjust in accordance with
feedback.
QUALIFICATIONS:


Be a person of demonstrated integrity, maturity, and sound judgment, capable of establishing and
maintaining a sound administrative structure and a providing leadership for the staff and board, in
developing programs and services in accordance with recognized standards and the regulations of the
appropriate public regulatory agencies; and have the ability to interpret the purpose and mission of the
agency to the board of directors, to the staff, and to the public.
It is recommended that the agency executive should have four years of experience with a social agency
(two years of which much have been in an administrative or supervisory capacity).
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Job Description for the Administrator
An Administrative position
Under the Supervision of the Level One Child-Placing Staff
RESPONSIBILITIES:
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Supervise case management Supervisors and monitor progress of children in association with RH Staff;
Supervise the development of individual service plans for children placed in therapeutic foster care
homes;
Responsible for the oversight of all submissions to YFT
Supervise the development of service plan addendums;
Supervise contract consultants including clinical review of assessments and progress notes;
Review Case Management progress notes;
Review Foster Parent progress notes;
Participate in weekly clinical meetings and agency administrative meetings;
Monthly review of Incident Reports;
Chairperson for the quarterly Behavioral Quality Sub-committee meeting;
Prepare the quarterly agency Quality Assurance Committee information for review;
Inform the licensing representative of any changes regarding personnel and professional staff;
Inform the licensing representative of the verification of new homes and any changes in location,
population served and other changes in foster/adoptive homes;
Provide staff and foster/adoptive parent training and development.
Interpret agency programs and services to the public and referral agencies;
Maintain confidentiality and other responsibilities listed in government laws and regulations, as well as
Policies and Procedures;
Protect children’s rights;
Inform the licensing representative of all incidents as defined by process;
Participate in internal investigations of incidents as defined by process;
Participate in internal investigations of incidents as needed;
Advocate children’s files, family files, training records, and other information for quality assurance, staff
feedback, and in preparation for external auditors;
Represent Refuge House in the community by attending committee meetings;
Available on-call for supervisory issues;
Keep informed regarding all Refuge House policies, procedures and licensing requirements and to
support the same.
Create a Monthly Newsletter.
Assist the Executive Director on all other issues regarding Refuge House
QUALIFICATIONS:
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Bachelor’s Degree in a behavioral science or related field, and at least two years experience working
within the child placing arena and one year of supervisory experience.
Excellent writing skills
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Excellent communication skills
Organizational skills
Relationship development skills
Knowledge and interest in family dynamics and keeping families together
Job Description for the Level 1 Child-Placing Staff/ Intake
Under the Supervision of the Administrator and Executive Director
RESPONSIBILITIES:
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Approve admissions of children into the child-placing program;
Approve foster and adoptive homes for a child’s initial and any subsequent placements;
Approve the discharge of a child from a home;
Approve casework duties, including review and approval of the foster/adoptive home study, verification
and ongoing management;
Professional supervision of less qualified or experienced staff, including planning for staff development
and corrective action in regard to child-placing decisions;
Supervise development and approval of 72 hour service plans
Approve communication restrictions written in a child’s service plan, including monthly review and
continued authorization of continued need of such restrictions;
Attend clinical and departmental meetings;
Representing in the community by attending committee meetings if needed;
To keep informed regarding all policies, procedures, and licensing requirements and to support the same;
Review monthly and annual foster home reviews
Keep the EXECUTIVE DIRECTOR employee issues
And any other project or assignment give by the Executive Director and or the Administrator
QUALIFICATIONS:
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Master’s Degree in social work or a human service field from an accredited college or university and at
least two years of supervised child-placing experience. The degree must include the following:
a minimum of nine credit hours in graduated level courses that focus on family and individual function
and interaction, and
at least 350 hours of formal, supervised field placement or practicum with a social service or human
services agency, OR
Master’s Degree in human services field and at least three years of supervised child-placing experience
Excellent writing skills
Excellent communication skills
Organizational skills
Relationship development skills
Knowledge and interest in family dynamics and keeping family together
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Job Description for the
Level 1 Child-Placing Staff/Home Developer
Under the Supervision of the Administrator
And Executive Director
RESPONSIBILITIES:
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Conduct all home studies within the agency
Assist the Executive Director in deciding if the family should be licensed with the agency.
Approve respite providers that come into the agency
Professional supervision of less qualified or experienced staff,
Supervise the recruiter/trainer
Assist in staff and foster/adoptive parent training, development, and evaluation;
Attend clinical and departmental meetings;
Conduct a quarterly quality assurance audit to ensure each foster/adoptive home file is current and in
compliance with minimum licensure standards;
Representing in the community by attending committee meetings;
To keep informed regarding all policies, procedures, and licensing requirements and to support the same;
Keep the EXECUTIVE DIRECTOR informed regarding all serious issues and issues of non-compliance
such as criminal history.
And any other project or assignment give by the Executive Director and or the Administrator
QUALIFICATIONS:
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Master’s Degree in social work or a human service field from an accredited college or university and at
least two years of supervised child-placing experience. The degree must include the following:
a minimum of nine credit hours in graduated level courses that focus on family and individual function
and interaction, and
at least 350 hours of formal, supervised field placement or practicum with a social service or human
services agency, OR
Master’s Degree in human services field and at least three years of supervised child-placing experience
Excellent writing skills
Excellent communication skills
Organizational skills
Relationship development skills
Knowledge and interest in family dynamics and keeping family together
Updated 3/2006
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Job Description for the Treatment Director
An Administrative position
Under the Supervision of the Administrator and
Executive Director
RESPONSIBILITIES:
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Monitor progress of children in association with Administrator;
Supervise the development of individual service plans for children placed in therapeutic foster care
homes;
Responsible for the oversight and supervision in the development of the child’s diagnostic assessments
(Intake Study, all Individual Service Plans) involving all service levels provided by Refuge House;
Supervise the development of service plan addendums;
Participate in Monthly clinical meetings and agency administrative meetings;
Monthly review of Incident Reports;
Interpret agency programs and services to the public and referral agencies;
Maintain confidentiality and other responsibilities listed in government laws and regulations, as well as
Policies and Procedures;
Protect children’s rights;
Participate in internal investigations of incidents as defined by process;
Participate in internal investigations of incidents as needed;
Advocate children’s files, family files, training records, and other information for quality assurance, staff
feedback, and in preparation for external auditors;
Represent Refuge House in the community by attending committee meetings;
Available on-call for supervisory issues;
Keep informed regarding all Refuge House policies, procedures and licensing requirements and to
support the same.
QUALIFICATIONS:
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Master’s Degree in a behavioral science or related field, and at least two years experience working with
having problems of adaptation
Excellent writing skills
Excellent communication skills
Organizational skills
Relationship development skills
Knowledge and interest in family dynamics and keeping families together
Updated 3/2006
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Job Description for the Office Manager Director
Reports to the Executive Director
RESPONSIBILITIES:
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To maintain confidentiality and other responsibilities listed in governmental laws and regulations, as
well as Policies and Procedures.
Under the direct supervision of the Executive Director:
 Assist in the establishment of goals and action (business) plans for execution of mission.
 Assist and secure all business and professional contracts along with maintaining them.
 Coordinate contract services with DFPS and other child placing agencies.
 Provide support and supervision for employees designated in the organizational chart.
 Participate in quality assurance meetings and weekly staff meetings.
 Be present for all internal and external on-site audits and ensure the readiness of all files and staff.
 Develop office processes for work flow.
 Oversee all Respite and Payments within the agency
 Develop monthly reports that track attendance, money, respite etc.
 Order all office supplies
 Report to the Executive Director regarding the above responsibilities and readjust in accordance with
feedback.
 All other projects that might be assigned by the Executive Director or Board of Refuge House, Inc.
QUALIFICATIONS:
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Be a person of demonstrated integrity, maturity, and sound judgment, capable of establishing and
maintaining a sound administrative structure and a providing leadership for the staff and board, in
developing programs and services in accordance with recognized standards and the regulations of the
appropriate public regulatory agencies; and have the ability to interpret the purpose and mission of the
agency to the board of directors, to the staff, and to the public.
Updated 3/2006
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Job Description for the Recruiter/Trainer
Under the Supervision of the Level One Home Developer
And Executive Director
RESPONSIBILITIES:
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Recruitment of foster families (goal 5 per month)
Marketing of agency
Community presentations (goal 5 per month)
Training of foster families and Respite providers (2 full trainings per month)
Work in collaboration with the foster home assistant in obtaining all required paperwork
Coordinates all RH events such as Christmas parties, appreciation events, promotional events, etc.
Take all incoming calls concerning possible foster care
Develop and maintain a weekly DCTV slot to promote Foster care awareness and the need
Conduct one on-going training per quarter for all current foster families
And any other project or assignment give by the Executive Director and or the HR Director
QUALIFICATIONS:
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Bachelor’s degree
Excellent writing skills
Excellent communication skills
Organizational skills
Relationship development skills
Updated 3/2006
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Job Description for the Case Manager Supervisor
An Administrative Position
Under the Supervision of the Administrator
RESPONSIBILITIES:
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Carry a caseload of 9 to 14 children.
Supervise case managers
Conduct weekly staffings with Case managers
Ensure all case managers complete daily, weekly and monthly paperwork
Review and sign off on monthly foster home reviews
Review and sign off on all case manager logs per month
Review and sign off on all ISP’s
Manage all case managers work loads
Assign families to case managers
Conduct all internal investigations and review and sign off on all safety plans and non-compliance
issues.
Review all case manager notes
Maintain Confidentiality
Conduct quarterly quality assurance audits
Keep the Executive Director informed regarding all serious issues and issues of non-compliance.
Generate all monthly reports
Conduct semi-annual employee evaluations on case managers
Keep informed regarding all policies, procedures, and licensing requirements and support them.
Attend all clinical and departmental meetings.
Represent RH in the community by attending community meetings.
Train all incoming case managers and case aids
Protect children’s rights
Available on-call
Review foster parent logs at least quarterly
Assist in the development of policies
Maintain a schedule of all due dates, PPT meetings, and court hearings.
And other special projects as assigned by the Executive Director or Administrator.
QUALIFICATIONS:
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Bachelor’s Degree from an accredited college or university,
At least one year of experience in the field of Child Placement
Excellent writing skills
Excellent communication skills
Organizational skills
Relationship development skills
Knowledge and interest in family dynamics and keeping families together
Updated 3/2006
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Job Description for the Case Manager/Case Worker
Under the Supervision of the Case Manager Supervisor
And/or Administrator
RESPONSIBILITIES:
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Interview children for placement;
Write initial and individual service plans for children placed in therapeutic foster care homes;
Coordinate provision of medical, dental and therapy services to clients’
Prepare and organize the individual service plan review meetings;
Coordinate input to the treatment team members from outside consultants (psychiatrists,
psychologists, and social workers);
Assist in staff and foster/adoptive parent training and development;
Interpret agency programs and services to the public and referral agencies;
Maintain confidentiality and other responsibilities listed in government laws and regulations, as well as
Policies and procedures;
Review and supervise maintenance of complete and current records on each case in compliance with
Child-Placing Minimum Standards;
Protect children’s rights;
Participate in internal investigations as needed;
Advocate for foster/adoptive parents and children with other agencies as well as support staff;
Attend all PPT’s
Attend court hearings;
Keep foster/adoptive parents informed and hold them responsible for attendance of PPT’s and court
hearings as needed;
Attend ARD meetings as needed;
Visit all assigned foster/adoptive homes no less than twice monthly;
Interview all children privately regarding their satisfaction with placement;
Complete case management progress notes for each child each week;
Keep the Administrator, Case Manager Supervisor , Executive Director and Treatment Director informed
of all incidents as they occur.
Maintain communication with the managing conservator including individual service plans, routine and
serious occurrences.
Review incident reports, progress notes, therapists notes, and other children file documentation;
Audit children’s files, home files, training records, and other information for quality assurance, staff
feedback, and in preparation for external auditors;
Provide foster/adoptive parents with written information regarding the needed training hours, and
ongoing verification issues and collecting the same;
Develop the teaching, organizational, administrative, advocacy, and other professional skills of the
foster/adoptive parents on caseload;
Supervise child visits with biological families and providing feedback and recommendations to the DFPS
caseworker; testifying in court when required;
Participate in foster/adoptive parent training and evaluation;
Write the foster/adoptive evaluation feedback, scheduling and conducting the post-evaluation
conference;
Assist in preparing adoptive children for placement, preparing adoptive applicants for the process, and
conducting pre-and post-adoption assessments and services;
Attend weekly clinical meetings and departmental meetings;
Represent in the community by attending committee meetings;
Work on special projects as assigned by the Administrator or the Executive Director;
Serve in the on-call rotation for weekend coverage and for daily coverage as needed;
Keep informed of all policies, procedures, and licensing requirements and to support the same.
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Complete all Case Manager and Case Worker paperwork on time each month, Ensure the completion of
the foster families paper work,
Update the “unicentric” report weekly on all children and families.
Conduct placements that occur in your assigned caseloads during business hours and all placements if
on-call after hours.
Carry a caseload of anywhere from 9 to 12 children with Basic care children counting as .5. If you are a
caseworker. A case manager will carry anywhere from 19 to 23 children.
And other special projects as assigned by the Executive Director or administrator.
QUALIFICATIONS:
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Bachelor’s Degree from an accredited college or university,
Excellent writing skills
Excellent communication skills
Organizational skills
Relationship development skills
Knowledge and interest in family dynamics and keeping families together
Updated 3/2006
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Job Description for the Child and Family Coordinator
An Administrative Position
Under the Supervision of the Level 1 Child-Placing,
Administrator and Executive Director
RESPONSIBILITIES:
Work in conjunction with the Level 1 Child-Placing Staff in obtaining all information and paperwork
pertaining to the Certification of a foster family or respite provider
 Responsible for answering all incoming calls to the agencies
 Maintain records of all Fire and Health inspectors
 Schedule all training for families within Refuge House, re-service and all on-going trainings
 Maintain completion of and accuracy of all foster family files in compliance with auditing entities.
 Track all criminal requests of all foster families, respite providers, employees, and contractors.
 Assemble foster family and respite provider’s information packets.
 Field questions and or concerns from existing and or potential foster families.
 Conduct all references on all potent ional foster families and respite providers.
 Back- up case managers concerning all foster family and respite provider’s expiration dates.
 Create the agency home report and deliver it to the HR Director.
 Maintain the foster family and respite providers directory meaning current foster family, potential
foster families and those in the process
 Maintain the foster family and respite provider deficiency list.
 Maintain a weekly status report of incoming families
 Maintain a monthly status report of all current foster families and respite providers.
 Upon the completion and approval from the Level one staff will need to issue the foster family and or
respite provider a license.
 Develop a quarterly Refuge House, Inc. News letter
 Assist the child service coordinator with monthly CPS packets, which includes but is not limited to
coping, assembling, and preparing the CPS packets. (Possible hand delivery may be required)
 Assist the case managers in securing respite for the foster families as needed.
 And other special projects as assigned by the Executive Director or Administrator.
 Work in conjunction with the Level 1 Child-Placing Staff in obtaining all information and paperwork
pertaining to the placements of children.
 Maintain the CPS directory which consists of CPS contacts ( cps workers, each county eligibility
workers, billing, Licensing, contract managers etc.) there positions, phone numbers (both office and
cell), addresses, fax numbers and e-mail information.
 Maintain a professional services directory consisting of name , address, phone numbers both office and
cell, office contracts, e-mail, and fax numbers for the following professionals: therapists, doctors,
dentists, psychiatrists, psychologists, Neurologists, Speech therapists, ECI workers, school contacts,
Therapy 2000, etc.
 Maintain open beds report and distribute to the CPS placement offices and all Refuge House employees
weekly
 Responsible for the family files of the children to be made and kept up with at each new placement.
 Maintain the file drawer for the CPS packets and their delivery.
 Responsible for creating and tracking all treatment referrals all the way to completion. (therapy,
psychological, ECI, psychiatry etc.)
 Ensure that all Medicals and dentals accrue on time according to all auditing entities.
 Create and maintain a tracking chart for new placements
 Ensure and track all YFT expiration dates and make sure all children are sent into YFT according to the
appropriate due dates given by the different auditing entities.
Updated 3/2006
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Ensure that all monthly paperwork is received and complete by the according deadlines.
Assist case managers with child files as needed
Assist in answering the phones when needed.
Assist with the Monday night Psychiatry appointments. Making sure they are scheduled and in order.
Arrange and schedule all Psychological of the children with Treehouse or another entity within the time
frame given by the auditing entities.
Make sure all TB tests and shot records are current before handing off the file to the case manager.
Responsible for Sending out a letter and recording that letter in the child’s file to ECI within the first
three days of placement.
And other special projects as assigned by the Executive Director or HR Director.
QUALIFICATIONS:
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Bachelors degree in a social service field.
Excellent writing skills
Excellent communication skills
Organizational skills
Relationship development skills
Knowledge and interest in family dynamics and foster parenting
Updated 3/2006
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Subject
Employee Time Policy
Applicable Standards
Date Board Approved
04/28/03; Changes Approved 3/07/06
Employee Time Policy
1.
2.
3.
4.
Employees are required to be available by cell phone between the hours of 8am and 5pm.
The Employee who is on call is required to answer the on call phone 24 hours a day, 7 days a week- no
exceptions!
Employees are expected to be in the office or signed out to a home visit or other work related
appointment no later than 10am.
- To sign out you must call and speak to the Office Manager. You must be able to tell
him/her where you will be, how long you expect to be there and when you will return
to the office.
When employees are in the office and must leave for a home visit or other work related appointment
he/she must sign out so that other office staff and personnel will know where to find him/her if it is
needed.
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To sign out you must state where you will be, how long you expect to be there and
when you will return to the office.
If your plans change you must call into the office and have someone else sign you out
so that your whereabouts can be accounted for at all times.
5. Employees must either be in the office or signed out to a home visit or other work related appointment
between the hours of 10am to 5pm daily (Monday through Friday).
6. Employees will be allowed to “flex” their time if he/she has had a home visit or other work related
appointment late at night or into the evening. However, employees must be in the office NO LATER than
12pm. He/she must also call the office by 10am to have the office manager sign him/her out for
“flextime” if this is the case.
- This should not be an every day occurrence. Be wise when you are scheduling your
home visits. If this privilege is abused it will be stopped.
- This is a good time for you to schedule your medical/dental or other personal
appointments. Remember if it is not work related do not use work time to do it!
7. All time off and “flex time” must be approved by an employee’s immediate supervisor. Pay for time off
can only be approved by the Executive Director by way of the employee’s immediate supervisor.
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Updated 3/2006
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Subject
Applicable Standards
Date Board Approved
Volunteers
2100.3 and 2100.4, 3100.2a, 3100.2c
04/28/03; Changes Approved 3/07/06
Refuge House as a start up agency will not be utilizing volunteers. The use of volunteers will be reassessed
when the agency reaches a point of serving 15 children. The policy will then be submitted for approval if this
type of personnel is deemed appropriate.
Updated 3/2006
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Subject
Applicable Standards
Date Board Approved
Policy:
Screening Program
3100.2a, and 3100.2c, 110073b Contract 16 G
04/28/03; Changes Approved 3/07/06
Refuge House foster families will be well prepared and have the ability emotionally and physically
to live with and provide support and guidance to children with therapeutic needs.
Procedure:
1) The initial criteria to be considered a foster parent includes the following:
a. Complete application and interviews. Refuge House conducts extensive interviews with
adult children, children in the home, extensive reference interviews and other
diagnostic tools for increasing the success of potential foster parents. This process
allows the person interviewing to assess all of the areas addressed in the Minimum
Standard and Guidelines for Child Placing Agencies regarding completion of the home
study. Applicants are generally seen by all of the following persons: Administrator,
Level 1 Child Placing Staff, person completing the home study interviews, pre-service
trainers, and Executive Director. The Foster Home Developer makes the final visit to
the potential foster home.
b. Must have a high school diploma or G.E.D. or meet Refuge House’s proficiency criteria
and provide documentation of such.
c. Must be at least 21 years old, as indicated on birth certificate.
d. Must be a U.S. Citizen, permanent resident, or qualified alien.
e. Must be responsible, mature, healthy adults capable of meeting the needs of children
in care.
f.
Must profess to be a Christian and be willing to sign the Refuge House Statement of
Faith.
g. Must be tolerant of all racial, ethnic, religious, and educational backgrounds as
indicated during the home study process. All barriers to tolerance will be discussed
during the home study process, and any preferences will be documented in the file.
Must be wiling to receive and successfully complete 40 hours of training prior to the
home being verified as well as a one (1) hour orientation class.
h. Must have adequate room to house a child in a manner that allows him/her privacy and
meets licensing standards. Bedrooms must of 80 square feet for one child alone.
Bedrooms must have 40 square feet per child for foster homes and 50 square feet per
child for foster group homes when multiple children share the same room. Each child
must have his/her own bed and a place to store their belongings. This will be
ascertained during the home study process.
i.
Updated 3/2006
Must submit to a criminal background check, and CAPS check. Refuge house will meet
the licensing standards regarding criminal histories of foster/adoptive parents. In some
cases, Refuge House may be more conservative in our decisions regarding the selection
of foster/adoptive parents than is required by licensing standards. For example, a drug
screen and driving record checks are not required, but may be requested by Refuge
House staff at our discretion. Drug screen results (if applicable) must be negative for
illegal substances, and driving record results (if applicable) must meet eligibility
requirements for insurance purposes. Must have a car and a telephone as verified
during the home study process.
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Personnel Policies
Must be able to transport (or make transportation arrangements for) children to all
appointments, school functions, office visits, birth parent visits, counseling, respite,
etc. This will be discussed and agreed upon during the home study process.
k. Must have at least one parent at home to supervise a child when a child is home (e.g.
after school, vacations, school suspensions, etc.) or make other arrangements for the
child approved in advance by the Case Manager. This will be discussed and agreed
upon during the home study process.
l.
Must be willing to work closely and cooperatively with a treatment team in learning to
carry out the treatment parenting procedures within prescribed guidelines. This may
include scheduling in-home visits of the Case Manager for one to two hours duration as
frequently as once a week and no less than once each month.
m. Must be willing to keep prescribed, orderly records documenting incidents, progress of
the child, doctor visits, fire drills, allowance, clothing purchases, etc. (taking
approximately two to three hours per week, on average).
n. Refuge House foster care program requires that other children are not in your home for
daycare (licensed or unlicensed). Our children require more than the usual amount of
attention, and a parent who has dealt with a house full of children all day may not be
able to adequately meet their needs. In addition, the parent needs to be free enough
from responsibilities to take the child to appointments as noted elsewhere in this
document.
o. Foster/adoptive parents currently licensed with another agency will need to talk with
their agencies and advise the agency of their plan to transfer agencies. The
foster/adoptive parents will sign a release that allows Refuge House to secure records
from the other agency and begin a background investigation. A conference with the
other agency and the foster/adoptive parent will be requested to discuss the strengths
and weaknesses of the foster/adoptive parent and the children in the home. When all
licensing requirements have been met and a time is agreed upon with the other agency
for transfer, the other agency must close the foster/adoptive home officially and
Refuge House is allowed to open the home the following day. At any time during this
process, Refuge House has the right, as does the foster/adoptive parent, to stop this
process.
2) The criteria for licensing the foster/adoptive home includes the following:
a. Satisfactorily completing the Pre-service Training including orientation, PRIDE training,
CPR, First Aid, Psychotropic Medications, and Behavior Management.
b. Complete and have returned a clear criminal record and CAPS check.
c. Complete and have returned a negative drug screen and driver’s record check (if
requested).
d. Have an approved Home Study as outlined in the Minimum Standards and Guidelines for
Child Placing Agencies, and Refuge House policies and procedures.
e. Meet Fire Prevention and Environmental Health requirements, according to licensure
regulations. Gas inspections are required for group homes. A water test is needed if
well water is used.
f.
Provide other items, including the following:
i. A floor plan of the home showing the size of each room in terms of exact
measurements.
ii. Fire escape plan to be posted in the home.
iii. Verification of auto liability insurance that meets the requirements spelled out
in the foster parent contract.
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iv. Records of natural children’s immunizations.
v. T.B. test for all occupants of the house two years or older.
vi. Records of required animal vaccinations (if applicable).
vii. Copy of Birth Certificate.
viii. Signed and notarized DFPS Affidavit.
ix. Copy of marriage license (if foster/adoptive parents are a couple).
x. Copy of divorce decree (if applicable)
xi. Copy of death certificate (if applicable).
xii. Copy of Social Security card.
xiii. Copy of Driver’s License.
xiv. Copy of high school diploma.
xv. Signed copy of Refuge House Statement of Faith.
xvi. Signed copy of Refuge House confidentiality, appeal procedure, and reporting
abuse and neglect policies, and agreement to comply with Minimum Standards.
xvii. A minimum of three (3) reference letters.
xviii. Documentation of homeowner’s or renter’s liability insurance.
xix. Documentation of emergency plan.
xx. Documentation of Medical/Dental plan.
xxi. A list of area schools.
xxii. Signed agency agreement.
g. The decision to verify a foster/adoptive home is made only after every step is
completed and can be stopped at any time any member of the team has serious
concerns regarding the appropriateness of verifying the home. Refuge House will
ensure that all agency homes meet applicable minimum standards prior to verification.
The Level 1 Child-Placing Staff will verify that each home has completed all items on
the Foster Parent Verification Checklist before the verification is finalized. Applicants
will be notified immediately if a decision has been made not to pursue verification.
The applicant may also stop the process at any time they are uncomfortable about
proceeding.
3) The criteria/screening for staff/child-care staff
a. Complete application and interviews. Refuge House conducts extensive interviews with
potential staff/child-care staff. This process allows the person interviewing to assess
appplicant. Applicants are generally seen by Executive Director.
b. Must have a high school diploma or G.E.D. or meet Refuge House’s proficiency criteria
and provide documentation of such.
c. Must profess to be a Christian and willing to sign the Refuge House Statement of Faith.
d. Must be tolerant of all racial, ethnic, religious, and educational backgrounds.
e. Must submit to a criminal background check, and CAPS check. Refuge house will meet
the licensing standards regarding criminal histories of staff/child-care. In some cases,
Refuge House may be more conservative in our decisions regarding the selection of
staff/child-care than is required by licensing standards. For example, a drug screen
and driving record checks are not required, but may be requested by Refuge House
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staff at our discretion. Drug screen results (if applicable) must be negative for illegal
substances, and driving record results (if applicable) must meet eligibility requirements
for insurance purposes. Must have a car and a telephone as verified during the
application process.
f.
Must be able to provide their own transportation and show proof of automobile
insurance.
g. Provide other items, including the following:
i. Annual T.B. test
ii. Signed and notarized DFPS Affidavit.
iii. Copy of Social Security card.
iv. Copy of Driver’s License.
v. Copy of high school diploma, GED or college degree.
vi. Signed copy of Refuge House Statement of Faith.
vii. Signed copy of Refuge House confidentiality, appeal procedure, and reporting
abuse and neglect policies, and agreement to comply with Minimum Standards.
viii. A minimum of three (3) reference letters.
ix. Signed employment agreement.
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Index of Standards
1100.b.1.................................................................................................................................................................................... 56
1100.b.2.................................................................................................................................................................................... 74
1100.b.3.................................................................................................................................................................................... 76
1100.b.4.............................................................................................................................................................................. 57, 58
1100.b.5.................................................................................................................................................................................... 59
1100.b.6.................................................................................................................................................................................... 66
1100.b.7.............................................................................................................................................................................. 59, 66
1200.1 ....................................................................................................................................................................................... 68
1200.5 ....................................................................................................................................................................................... 68
1310.1 ....................................................................................................................................................................................... 69
1310.3 ....................................................................................................................................................................................... 73
1320.2 ....................................................................................................................................................................................... 69
1320.3 ....................................................................................................................................................................................... 70
1400.2 ......................................................................................................................................................................................... 3
1410.1-9 .................................................................................................................................................................................... 49
1420 ........................................................................................................................................................................................... 49
1430 ........................................................................................................................................................................................... 49
1440 ........................................................................................................................................................................................... 49
1500.3 ....................................................................................................................................................................................... 48
1620.1 ................................................................................................................................................................................. 36, 39
1620.2 ................................................................................................................................................................................. 36, 39
1630 ........................................................................................................................................................................................... 36
1710.2 ....................................................................................................................................................................................... 34
1810.1 ....................................................................................................................................................................................... 49
1820.1 ....................................................................................................................................................................................... 55
1910 ........................................................................................................................................................................................... 64
1910.3 ....................................................................................................................................................................................... 71
1920.6 ....................................................................................................................................................................................... 35
1920.7 ....................................................................................................................................................................................... 35
1920.8 ....................................................................................................................................................................................... 35
2100.2 ....................................................................................................................................................................................... 78
2100.3 ....................................................................................................................................................................................... 85
2100.4 ....................................................................................................................................................................................... 85
2320.1 ....................................................................................................................................................................................... 77
2410.0 ......................................................................................................................................................................................... 6
3100.2a ........................................................................................................................................................................... 5, 85, 86
3100.2b ....................................................................................................................................................................................... 9
3100.2c ..................................................................................................................................................................... 5, 40, 85, 86
3100.2d ..................................................................................................................................................................................... 10
3100.3 ................................................................................................................................................................................... 6, 24
3100.5 ....................................................................................................................................................................................... 25
3100.6 ....................................................................................................................................................................................... 36
3220.1 ....................................................................................................................................................................................... 41
3220.2 ....................................................................................................................................................................................... 42
3420.1 ....................................................................................................................................................................................... 26
3500 ........................................................................................................................................................................................... 46
3620.6 ....................................................................................................................................................................................... 29
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