RAINBOWVALLEY*2835 G Street*Merced, Ca. 95340

FOSTER PARENT AGREEMENT

NAME OF CHILD / DOB / DOP
FOSTER PARENTS / PHONE
ADDRESS / CITY
Anticipated duration

The agency will pay per month for room and board, clothing, personal needs, recreation , transportation, education, incidental, and supervision. Payment will be made by the 10th of the month following placement, with subsequent payments to be made monthly.

Special Problems: See background information in file.

AGENCY AGREES TO:

/ FOSTER PARENTS AGREE TO:
  1. Provide the foster parent with knowledge of the background and needs of the child necessary for effective care. This may include a social work assessment, medical reports, educational assessment, and identification of special needs when necessary. This information shall be made available to foster parents within 30 days from the date of placement.
  2. Develop a plan for the child and share pertinent aspects with the foster parents.
  3. Involve the foster parents in future planning for the child. The plan will be reviewed every three months.
  4. Assist the child in his/her use of foster care.
  5. Assist in the maintenance of the child’s constructive relationship with parents and other family members.
  6. Provide procedure for grievances of foster parents.
  7. Maintain contact with the child and foster parents at least twice a month.
  8. Inform foster parents if the child has any tendencies toward dangerous behavior.
  9. Provide Medi-Cal card or other medical coverage at time of placement 30 days unless child has had such within 6 months and information is available.
  10. In cooperation with foster parents, arrange for visiting by parents or relatives.
  11. Provide assistance with emergencies. Telephone Numbers for after hours or weekends: 388-2040
  12. Provide parent training and support services.
  13. Give prior notice of at least 7 days if removal of child is desired, unless the child is physically or psychologically endangered; court ordered removal; signed waiver obtained from foster parent.
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  1. Provide this child with the nurturance, care, clothing, and training suited to his/her needs.
  2. Develop an understanding of the responsibilities, objectives and requirements of RainbowValley in regard to the care of the child.
  3. Recognize the Agency’s responsibility for planning for this child, as given by the court or the parent(s), and recognize any limitations.
  4. Increase their knowledge and ability to care for this child.
  5. Encourage the child’s relationship with his parents and relatives, and to cooperate in visiting arrangements.
  6. Not to use corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including but not limited to: interference with the daily living functions, such as eating, sleeping, or toileting; or withholding shelter, allowance, visits from parents, home visits, clothing, medication or aids to physical functioning, or threat of removal. To use constructive alternative methods of discipline.
  7. Maintain this child’s home files in an accurate, up-to-date manner. Keep information regarding this child and family confidential.
  8. Accept this child’s special problems as given above in my care. To immediately notify RainbowValley of significant changes in his/her health, behavior, or location.
  9. GiveRainbowValley prior notice of at least 7 days if removal is requested, unless it is agreed upon with the agency that less time is necessary. Assist the agency in carrying out termination of placement in a smooth manner.
  10. Conform to the certification and licensing requirements.
  11. Provide state agencies access to documentation.
  12. Notify RainbowValley if this child and/or your family is to be away from your residence for more than 72 hours.
  13. Attend foster parent training classes and be available for consultation concerning the child at least once a week unless other arrangements are agreed upon.
  14. Cooperate with the agency in designing, implementing, supporting any treatment plans for the education, emotional, social, psychological, and emancipation needs of the child.

I have read the foregoing and agree to meet these requirements. The terms of this agreement shallremain in force until changed by mutual agreement of both parties or the child is removed.

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RainbowValley Social Worker Foster Mother's Signature

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Date Foster Father's Signature