Georgia Department of Human Resources

AGREEMENT

County Department of Family and Children Services

Case Number:

Made the / day of / , / between
(Date) / (Month) / (Year)
(Foster Father),
(Foster Mother),
Hereinafter referred to as the “Foster Parents” and the / County
Department of Family and Children Services, herein referred to as the “County Department
WITNESSETH, that the Foster Parents and the County Department, in consideration of the following mutual obligations, agree as follows:
THE COUNTY DEPARTMENT AGREES:
1.
To place one or more children, hereinafter referred to as “the children”, in the home of the Foster Parents for temporary care as determined appropriate;
2.
To place said children only with mutual agreement of Foster Parents and County Department;
3.
To reimburse the Foster Parents the current foster care per diem for the care and support of the children;
4.
To furnish, within prescribed limits and in compliance with agency policy and resources, clothing, medical care, dental care, and other incidentals for children while in the home of the Foster Parents;
5.
To visit monthly with Foster Parents and children and to provide general supervision, information, and assistance related to the welfare of the child;
6.

To make arrangements with Foster Parents for visits of children in the Foster Parent’s home or other places with birth / legal parents, relatives, or other persons or for contacts by telephone or mail;

7.
To provide Foster Parents with all relevant information pertaining to the child when he/she is place, utilizing Form 469, Foster Child Information Sheet;
8.

To invite Foster Parents to provide input in the development of the six-month reviews;

9.
To provide Foster Parents with Form 149, Notification to Foster Parents of Intent to Petition for Termination of Parental Rights, when such intent is determined. Should rights be terminated on one or both parents, to provide Foster Parents with Form 150, Foster Parent Affidavit for Consideration of Adopting Foster Child Currently in Home and Form 151, Foster Parent Notification of Decision Regarding Adopting Foster Child Currently in Home, with respect to submitting an application to adopt. To notify Foster Parents ten days in advance of any anticipated removal of a child from their home, unless the child’s safety necessitates immediate removal or unless waived by mutual agreement.
(Continued)
(Continued)
11.
To notify Foster Parents of required ongoing parent development training and to provide / arrange training.
12.

To provide Foster Parents with contact arrangements with County Department after hours to emergency purposes.

THE FOSTER PARENTS AGREE:
1.
To maintain a foster home for provision of temporary care for children placed with then through the County Department of Family and Children Services;
2.
To observe strictly the confidentiality guidelines as defined by the County Department;
3.
To accept no child or adult for day care, foster care or personal care except through the knowledge of and approval of the County Department;
4.
To provide input for the six-month review and to support the plan developed during the review; to assist the County in returning the children to a permanent placement as determined by the review;
5.
To be supportive of County Department staff visits with the children, while the children are in the Foster Parents’ home;
6.
To abide by defined County Department policy guidelines, including discipline policy;
7.
To take all reasonable precautions to protect the children from unsafe or unsanitary living conditions and physical, mental, emotional, or sexual abuse;
8.
To report immediately to the County Department any change of address, sickness of the children or other member of the family, accident to the children, or change in the number of people living in the home of Foster Parents; to not administer medications or treatment except on medical advice;
9.
To treat the children with the same love and respect afforded other members of their family;
10.
To notify the County Department whenever out-of-town trips for 3 days or less are taken; trips for more than 3 days require the county department’s written authorization;
11.
To notify the County Department in the event that alternate placement arrangements are needed for the child (e.g., Foster Parents leave town);
12.
To allow contacts with birth/ legal parents, relatives, or other persons by visits in the home of the Foster Parents, by telephone or by mail when such plans have been agreed upon between the Foster Parents and the County Department; to permit contacts only by prior arrangement with the County Department;
13.
To give the County Department at least two weeks to make other placement arrangements if the Foster Parents request that the children be removed from their home;
14.
To release the children to the County Department upon its request in accordance with the agreed plan or following the resolution of a grievance;
15.
To submit prescribed invoices on children’s monthly expenses in a timely manner;
16.
To participate in ongoing parent development training, as required and/or needed.
That the objects of this Agreement are conditional upon personal evaluation of the Foster Parents, and, for this reason, the duties and obligations of the Foster Parents under this Agreement are not assignable or transferable to anyone under any circumstances, except with the written consent of the County Department and
That violation of any of these provisions may constitute grounds for termination of the Agreement.
WHEREFORE, the Foster Parents and the County Department, by its duly authorized agent, have set their hands and seals to this Agreement on the day and year above written.
NOTARY PUBLIC / FOSTER FATHER

ADDRESS

CITY, STATE, AND ZIP CODE

NOTARY PUBLIC

/ FOSTER MOTHER

ADDRESS

CITY, STATE, AND ZIP CODE
NOTARY PUBLIC / REPRESENTATIVE OF THE
COUNTY DEPARTMENT OF FAMILY AND CHILDREN SERVICES

FC_38 Agreement Between Foster Family And County DFCS (Revised 09/06) Page 1of 3