Link to State of North Dakota

 

County Social Service Agency Responsibilities 660-05-25-10

(Revised 3/1/09 ML 3177)

View Archives

 

 

The County Social Service Agency is responsible to:

  1. Upon request of a license application, provide the following to potential Adult Family Foster Care providers:
  1. North Dakota Century Code Chapter 50-11
  2. North Dakota Administrative Code Chapter 75-03-21
  3. Qualified Service Provider/Adult Family Foster Care Provider Handbook
  4. The Following Sections of the North Dakota Department of Human Service Chapter 660-05:
  5. Section 05-20 Licensing
  6. Section 05-20-15 Application for License
  7. Section 05-20-15-05 Additional Information/Verifications
  8. Section 05-20-20 Renewal of an AFFC License
  9. Section 05-25-05 Applicant Responsibilities
  10. Section 05-30-05 Standards for Providers
  11. Section 05-30-05-05 General Practices – AFFC Providers
  12. Section 05-30-10 Standards for Respite Care Providers and Substitute Caregivers
  13. Section 05-30-10-05 General Practices for Respite Care Providers and Substitute Caregivers
  14. Section 05-30-15 Standards for Service Delivery/Allowable Tasks
  15. Section 05-30-20 Standards for the Licensed Home
  16. Section 05-30-25 Standards for Sanitation
  17. Section 05-30-30 Standards for Safety
  18. Section 05-30-35 Standards for Meals and Nutrition
  19. Section 05-30-40 Standards for Insurance
  20. Section 05-30-45 Standards for Preadmission Information and House Rules
  21. Section 05-30-50 Standards for Record Keeping
  22. Section 05-30-55 Standards for Provider Termination of Care
  23. Section 05-30-60  Standards for Voluntary Termination of License
  24. Section 05-35 Complaints
  25. Section 05-60 Allowable Tasks/Activities
  26. Section 05-60-05 Client out-of-Home with Foster Care Provider
  27. Section 05-60-10 Employment Outside of the Home
  1. SFN 1013, “Application to Provide Adult Family Foster Care”
  2. SFN 800, “Fire Safety Self Declaration”
  3. SFN 823, "Family Evacuation Disaster Plan"
  4. Adult Family Foster Care Background Check Packet including:
  5. Information Sheet
  6. SFN 467, “Personal Authorization for Criminal Record Inquiry”
  7. SFN 466, “Background Check Address Disclosure”
  8. Two fingerprinting cards, if required
  1. Conduct a licensing assessment with the applicant. Completing SFN 669, “Initial Licensing Study-Adult Family Foster Care,” to determine compliance with policies, rules, and state laws relating to adult family foster care.  
  2. Request letters of reference (see Forms Appendix for example) from individuals identified on the application form, or interview individuals and document substance of the interview. Three letters of reference (or documented interviews) are required for initial licensure. Individual references must be non-relatives and have knowledge of the applicant’s ability to provide care to older individuals and/or individuals with disabilities. If the applicant currently holds an Adult Family Foster Care license, letters of reference must be included in the provider’s record.
  3. Review all information pertaining to the application for a license for accuracy and completeness and forward to the respective regional Human Service Center. Qualified service provider application and background check paperwork will be sent to the Aging Services Division Office for processing. Include a recommendation as to whether a license should be issued and, if license is not recommended, provide justification. Indicate the number of individuals the provider will be licensed to care for, not to exceed four individuals.
  4. If an applicant or current provider resides on an Indian reservation or military base, facilitate completion of SFN 915, “Adult Family Foster Care Affidavit of Standard of Compliance in Lieu of License” (Section 05-20-10).
  5. For license renewal, contact the provider to discuss license renewal and provide the required renewal paperwork. Assist provider in completion of paperwork if warranted. Complete SFN 1031, “Re-Licensing Study - Adult Family Foster Care." Review all renewal documentation for accuracy and completeness. Qualified service provider enrollment renewal paperwork will be sent to the Aging Services Division Office for processing. Forward completed paperwork to the respective regional Human Service Center at least 30 days prior to the expiration of the current license. Provide justification if initial licensure or license renewal is not recommended.  Indicate the number of individuals the provider will be licensed to care for, not to exceed four individuals.
  6. Report immediately to the Human Service Center and the Division any changes that affect the ability of the provider to provide service.
  7. Upon receipt of a request to change the number of individuals listed on the AFFC license, notify the Regional Human Service Center representative. If there is a request to increase the number of individuals listed on the license, complete a home inspection to insure the home meets the standards for an increase. Make recommendation to the Regional Human Service Center for the increase and to issue a corrected license to the provider.
  8. Evaluate compliance with policies, rules, and state law through on-site inspections, review of records, and interviews with the resident(s), provider, and caregivers.
  9. Receive complaints and consult with appropriate Human Service Center staff regarding investigation. (Section 05-35)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Return to DHS Policy Manuals Homepage

[Disclaimer]

Get Adobe Reader