CHILD'S SERVICE PLAN Initial Plan Initial Service Plan / Intake Study / Initial Assessment Report OVERVIEW A. Genera l: Religio Date This Plan n Completed Date of Next Review Note: This plan has been reviewed based on this child's special strengths and needs. Services have been planned to meet the child's needs. Worker Who Completed Form B. Long-Range Goal For Permanency (See last page for definitions.) Permanency Goal Projected Date for Achieving Permanency Estimated Length of Stay in Substitute Care If there is a discrepancy between the estimated length of stay in substitute care and the projected date of permanency, explain: C. Concurrent / Alternative Goal for Permanency (See last page for definitions.) INTAKE HISTORY A. Initial Child History B. Initial Family/Genetic History RESULTS OF INITIAL ASSESSMENTS / PROGRESS SINCE REMOVAL Caregiver observations about child's personality, behavior, special interests, and talents CHILD'S SERVICE PLAN Initial Plan Basic needs All children in placement have basic needs. They require food, shelter, and clothing; routine medical and dental care; safe, stimulating, and nurturing home environments; and friendships and recreational activities appropriate to their ages. FPS expects each child's caregiver to meet the child's basic needs without specifically identifying those needs in the case plan. Specific needs Social and Emotional Needs Educational Needs Developmental Needs Medical and Dental Needs Special Physical Needs Psychological/Intellectual/Mental Health Needs Recreation, Community Interaction, Religious Needs Appropriateness and Safety of Placement / Expected Outcomes Progress/Efforts Made Toward Permanency Visitation/Contacts Summary Child's Culture Heritage Discharge Planning Relationship Issues High Risk Behaviors Emergency Conditions FPS has determined that one of the following emergency conditions continues to exist for this case and, therefore, services continue to be necessary: 1. A child is at risk of abuse or neglect, as determined by FPS; 2. A child has been removed from his/her home and placed in FPS care; or 3. A child formerly in FPS care is at-risk of being returned to FPS care. PLANS Plans to address Permanency Specific needs CHILD'S SERVICE PLAN Initial Plan Plans to Address Social and Emotional Needs Plans to Address Educational Needs Plans to Address Developmental Needs Plans to Address Medical and Dental Needs Plans to Address Special Physical Needs Plans to Address Psychological/Intellectual/Mental Health Needs Plans to Address Recreation, Community Interaction, Religious Needs Plans to Address Safe and Proper Care / Expected Outcomes Plans to Address Future Visitation / Contacts Plans for Preserving Child's Cultural Heritage Discharge Planning Plans to Address Relationship Issues Plans to Address High Risk Behaviors Supervision / Special Actions Behavior Management (Discipline) The child's discipline must suit the child's age, circumstances, and developmental needs. Methods of discipline may include: establishing routines, setting reasonable limits, modeling appropriate behavior, offering choices, giving explanations. repeating instructions, taking ''time-out'', enforcing or permitting logical or natural consequences, and reinforcing desired behavior. Physical punishment is not permitted. Additional strategies for managing the child's behavior are specified below. Travel The child may travel to participate in normal activities (examples: church, school events). Any trips that last more than 48 hours must be approved in advance by the child's worker. Trips outside the state or country must be approved in advance by the child's worker and by the court.The child must be restrained in a car safety seat or seat belt, whichever is required by law based on the child's age. Additional stipulations regarding the child's travel are specified below. Support Services to the Caregivers Identify the support services to be provided to the caregiver to help them meet the CHILD'S SERVICE PLAN Initial Plan child's needs and to ensure that the child receives safe and proper care. Include the planned frequency of worker visits to the child and to the caregiver's home. INVITED PARTIES AND PARTICIPATION INFORMATION NAM RELATIONSHIP TO E CASE DATE OF NOTIFICATION TYPE OF NOTIFICATION DATE COPY GIVEN DATE OF PARTICIPATION EXPLANATION IF NO PARTICIPATION BY CHILD, MOTHER, FATHER OR CAREGIVER INFORMATION NOT AVAILABLE: If information was not availab

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