ContractAdoption Subsidy Agreement • September 2nd, 2013
Contract Type FiledSeptember 2nd, 2013Adoption SubsidyProvider Name: Contract Number: Pre-Site QA Check (LastName/Date): Post-Site QA Check (LastName/Date): Date of Tool Revision: 10/24/2012 Requirements AuthorityCFOP 175-71, Chapter 6 and Attachment I and 2 to Chapter 6 Child's Last Name First Initial Date Initial Adoption Assistance Agreement is Signed Date of Final Judgement of Adoption Order Provider Operating Procedure If the provider is using its own operating procedure, the procedure meets the requirements of CFOP 175-71 and is approved by DCF? (If "No", then provide details in notes section.) Add any additional items to the tool based on provider procedures. Att. I term that provider may have its own operating procedures and Att I fed funding term that provider must follow CFOP 175-71. I. Generic Documentation - Applies to all subsidy files Documentation that child may not return home.TPR Order on All Parents is present in the child's record OR signed relinquishment by parents OR any special documentation