Exit

ILP New Provider Self-Assessment Instrument

 
 100% of survey complete.
Independent Living Program (ILP) Provider applicants are required to complete this online agency self-assessment prior to submitting the New Provider Application to the Office of Provider Management. The assessment is intended to provide applicants with a framework of elements that are critically important in the provision of out-of-home care to children in the custody of DFCS. Completing the assessment should give your agency a sense of its current capacity to appropriately serve children and families at various Room Board and Watchful Oversight (RBWO) program designations. Additionally, the assessment should guide your agency's future development and service planning needs.

While affirmative answers to the items in the assessment does not guarantee approval as an RBWO provider, these items represent a portion of the prerequisite conditions for approval as a new provider. To determine all applicable provider requirements, please refer to the RBWO Minimum Standards document, located on the home page of www.gascore.com.

Please answer each question on the assessment, and click the "Done" button at the bottom of the document when you have completed the assessment. Once you click "Done, the assessment will be automatically submitted to the DFCS Office of Provider Management. Your agency is eligible to submit the remaining portions of the New Provider Application Package, once the assessment has been submitted. A representative from the Office of Provider Management will contact you once the completed application package is received.

Question Title

* 1. Please provide the following information:

Question Title

* 2. Choose the option from the following Current RBWO Provider Services Needs List that matches with the program designation and location of your agency's proposed new site and program:

Question Title

* 3. Describe the type(s) of youth for which the agency targets its services?

Question Title

* 4. If seeking a specialty designation, describe the prior experience, if any, the agency has with children needing the type of care required for the respective designation?

Question Title

* 5. Does the agency have a minimum of 50% of your agency’s starting operating capital to cover fixed expenses for at least six months? (Funds will be verified prior to contracting)

Question Title

* 6. Is the Owner and/or Program Director of your agency prior/existing DFCS Staff?  If so, what county/counties of employment and dates of employment.

Question Title

* 7. Is the Owner and/or Program Director of your agency prior/existing RBWO Staff? If so, what agency/agencies and dates of employment.

Question Title

* 8. Is the owner of your agency prior/existing foster parent? If so, what agency and/or county along with dates of approval.

Question Title

* 9. Is the Owner and/or Program Director of your agency prior/existing Sub Contractor with the Division? If so, what agency and program areas.

Question Title

* 10. Does the agency have a complete policy manual which includes all written agency policies and procedures based on the current RBWO Minimum Standards?

Question Title

* 11. Does your agency have a process in place to complete the following screenings on staff? (ie., Criminal Background checks, Safety Screening Checks, Pardons and Paroles, Sex Offender Registry and Department of Corrections.)

Question Title

* 12. Have all staff within your agency received all of the above-mentioned screenings?

Question Title

* 13. Does your agency have a policy addressing procedures to ensure that a CPS screening is completed on each staff member.

Question Title

* 14. Does the agency's behavior management policy reinforce the strict ban on the use of corporal punishment and have staff been trained on prohibited discipline and punishment?

Question Title

* 15. Will the agency ensure that the principles of trauma-informed practice are incorporated into staff on-going training?

Question Title

* 16. What behavioral management training will be utilized for staff?

Question Title

* 17. Does the agency's staff meet the minimum eucational and work experience requirements according to the RBWO Minimum Standards?

Question Title

* 18. Does the agency have a policy and written procedure for accepting evening and weekend placements?

Question Title

* 19. Do all of the agency's staff have current Office of Investigative Services (OIG)Fitness Determination Letters on file?

Question Title

* 20. Does the agency ensure that annual continuing education training requirements for staff is met?

Question Title

* 21. Does the agency have telephones and computers with internet access to assure that DFCS is able to communicate with the provider as needed, and by telephone, 24 hours per day, seven days per week?

Question Title

* 22. Does your agency have a policy on Reasonable and Prudent Parenting Standards (RPPS) to include training of staff. 

Question Title

* 23. Is the agency prepared to participate in PAUSE calls, Family Team Meetings, Multi-Disciplinary Team Meetings, TRT and discharge planning meetings as requested if an RBWO contract is granted?

Question Title

* 24. What are your plans for community engagement? Is your community prepared to accept youth placed in foster care? Is so, how?

Question Title

* 25. What is the planned living arrangement?

T