The composition of the Respite Care Provider case file should include the following:

Forms Section (Yellow)

• Application to Provide Respite Care, CS-RC-1
• Respite Care Provider Approval, CS-RC-3
• Foster Respite Care Provider Checklist, CS-RC-2
• Respite Provider Evaluation/Payment Invoices, CD-111
• Resource Parent Discipline Agreement, CD119
• Safe Sleep Practices, CD-117
• Notification of Hazards, CD-101, if applicable

HIPAA (White)

Correspondence (White)

• Letters to Respite Provider Family
• Any other written correspondence (including business e-mail)

Training (Buff)

• Training record screens (this is only applicable to the Elevated Needs Level B Respite Providers who are required to complete eight (8) hours of Elevated Needs Level B respite training.)

Contracts (Yellow)

• Cooperative Agreement for the Purchase of Respite Care Services with the Children’s Division, CM-10
• Cooperative Agreement for the Purchase of Respite Care for Elevated Needs Level B Foster Parents, CM-9

OHI Reports (Pink)

The cover sheet should include:

• Case Name
• Date of Report
• Incident Number
• Expungement Date

Narrative (Blue)

• Dictate when a family is awarded or renewed a cooperative agreement for respite care services.
• Record background screenings were completed
• Record all home visits and meetings with Respite Resource family
• Record when training notices for Elevated Needs Level B Respite Providers have been mailed
• Record when Elevated Needs Level B Resource Provider has participated in training
• Record any cooperate agreement or qualifications concerns noted and action taken
• Document closing narrative

Placed Inside and attached to the front flap of the file folder:

• Placement Report for Foster Home Record, CD104

Memoranda History:

CD09-07, CD10-20, CD14-17, CD15-75, CD18-16