SLEEPING ARRANGEMENTS ASSESSMENT (Rev. 9/08)

In accordance with OAC Rule 5101:2-7-05, I/we certify that any bedroom used for a foster child shall:

1.  Have at least one outside wall window. The window should be screened and capable of opening and closing, unless the room is provided with a ventilation system which provides fresh air;

2.  Accommodate no more than four children;

3.  Include storage space for personal belongings and closet or dresser space for clothing;

4.  Be safe, comfortable and provide reasonable privacy and access to adult supervision;

5.  Have floor to ceiling walls and a standard door;

6.  Have reasonable access to an unobstructed emergency exit;

7.  NOT be on a floor higher than the second floor or in a basement, unless approved in writing by a fire safety inspector;

8.  Be comparable in appearance to other bedrooms used by children in the home;

9.  Be approved by the agency prior to placement.

Further, I/we agree that:

1.  A foster child shall not share a bedroom with a child of the opposite sex, except when all children sharing the room are under the age of five, or when a foster child who is also a parent is sharing a room with her own child;

2.  A foster child over the age of one shall not share a bedroom with an adult without prior approval;

3.  Each foster child should be provided with a clean, comfortable, permanent mattress of his own;

4.  A bunk bed shall not be higher than two tiers. It shall be equipped with safety rails on the upper tier for a child under the age of ten or for any child whose physical, mental or emotional condition indicates the need for such protection;

5.  A child under the age of 6 is not permitted to sleep on the upper bunk of a bunk bed;

6.  Each foster child will be provided with clean bed linen at least once per week or more frequently if needed and that a child shall not be required to sleep on a bed soiled by urine or excrement.

7.  Unless there is a documented medical reason, a child over 2 years of age or 35” in height must be provided with a toddler bed or standard bed.

8.  Our home can not be certified for placement on the condition that beds will “be obtained” at a future date. Suitable and approved beds must be on location in the home for each child approved to be placed in the home.

Foster Parent/Applicant Signature / Date
Foster Parent/Applicant Signature / Date

The following documents the sleeping arrangements for all household members, how many and what type of bed is in each room as viewed by the assessor, and whether or not the room is approved for foster children.

Bedroom / Occupants / Floor / Number of Cribs / Number of Twins / Number of Doubles / Number of Bunks / Approved
Yes/No
1
2
3
4
5
Agency Representative / Date
Supervisor / Date