Annual & Alternate Year Relicensing Paperwork

To open a pdf version of the form, click on "PDF"; to open a Word version of the form, click on "Word".
  • Adult Foster Care (AFC) and Community Residential Settings (CRS) Home Safety Checklist (DHS-16-193581 4/18) (PDF)
  • Adult Foster Care Initial/Relicensing/Alternate Year Data Sheet (71980-234 12/16) (Word) (PDF)
  • Adult Foster Care Program Plan (71980-247 1/19) (Word) (PDF)
  • Adult Foster Care Program Plan (DHS-16-181480 8/18) (PDF)
  • Certificate of Compliance - Workers' Compensation (PDF)
  • Evaluation of Agency by Adult Foster Care Provider (71980-12a 11/10) (Word) (PDF)
  • Family Child Care, Family Foster Care, and Community Resident Settings License Applicant Privacy Rights (72000-2 7/17) (Word) (PDF)
  • Family Systems Licensing Application - Family Adult Foster Care (AFC)/Family Adult Day Services (FADS)/Alternate Overnight Supervision Technology (AOST) (DHS-16-180907 5/1/17) (PDF)
  • Foster Home In Use (71980-19 4/12) (Word) (PDF)
  • Program Abuse Prevention Plan (PAPP)-AFC (71980-53 4/9/12) Portrait view (Word) (PDF)
  • Program Abuse Prevention Plan (PAPP)-AFC and CRS (DHS-16-180922 6/12/15) Landscape view (Word) (PDF)