CHILDREN’S FOSTER HOME RULES COMPLIANCE RECORDMichigan Department of Health and Human Services

Division of Child Welfare Licensing

Foster Home InformationHome Type License Number c Foster Family Home (1-4) c Foster Family Group Home (5-6)Home Name (Both people’s names in last name, first name format Telephone Number

Address (Number, Street, City, ZIP code Date(s) of Home Visit

Worker’s Name Telephone Number

Purpose of Visitc Original Licensing Visit c Renewal Licensing Visit c Annual Licensing Visitc Complaint Investigation (Specify rule) c Supervisory Visit (Specify rule)

PART 2 - APPLICATION AND LICENSINGRule 9201 Foster parent qualifications C N D(a) 18 years of age or older ............................................................. ccc(b) Good moral character ................................................................ ccc(c) Willingness to provide care ........................................................ ccc(d) Understanding of the care .......................................................... ccc(e) Willingness to learn how to provide care.................................... ccc(f) Time to provide care.................................................................... ccc(g) Have a defined legal source of income, and be capable of managing that

income, to meet the needs of the foster family .......................... ccc(h) Be of such physical health, mental, and emotional helth to assure

appropriate care of children ....................................................... ccc(i) Demonstrates ability to work with family .................................... ccc(j) Be of responsible character and be suitable and able to meet the needs of

children and provide for thier care, supervision, and protection ccc(k) Willingness and ability to comply with licensing rules ................ ccc(l) Reside in U.S. legally ................................................................. ccc

Rule 9202 Member of household qualifications(a) Be of good moral character and suitable to assure the welfare of children....................................................................................... ccc(b) Be in a state of physical, mental, and emotional health that will not impair

the care of a foster child ............................................................. ccc(c) Willing to accept a foster child into the home ............................. ccc(d) Be residing in the United States legally...................................... ccc(2) Any adult member of the household who provides care for foster children

shall also meet the qualificaiton specified in R 400.9201........... ccc

Rule 9203 OrientationAttended orientation before completing and submitting theapplication or transferring license .................................................... ccc

Rule 9204 Application submission(1) Application completed, signed, and submitted within

30 days....................................................................................... ccc(2) In a 2-caregiver household, both caregivers signed the

application .................................................................................. ccc

Rule 9205 Records check(1) The applicant provided all required signed releases at

time of original, including children who turn 18 years of agewhile living in home .................................................................... ccc

(2) Provides signed releases by the next working day ifanother adult moves in ............................................................... ccc

(3) Anyone within household identified on Central registry shallnot be licensed or reside in home .............................................. ccc

Statements which appear opposite each rule number are summaries and are not identical to the Administrative Rules for Foster Family Homes and Foster Family Group Homes.

CWL-3080 (Rev. 6-16) Previous edition obsolete. 1 C = Compliance N = Noncompliance D = Discussed

Rule 9206 Foster home evaluation C N D (a) Allow the agency access to the foster home for licensing and foster child

supervision purposes ................................................................. ccc(b) Truthfully assist the agency in determining all of the following:(i) Marital and family status and history ........................................... ccc(ii) Criminal convictions or arrests ................................................... ccc(iii) Educational history and any special skills and interests ............ ccc(iv) Employment history and current financial status ....................... ccc(v) Physical, mental, and emotional health ...................................... ccc(vi) History of substance abuse and treatment ................................ ccc(vii) Current substance abuse and current treatment ...................... ccc(viii) Parenting skills and attitudes toward children .......................... ccc(ix) Methods of discipline of children ............................................... ccc(x) Adjustment and special needs of the applicant’s own children .. ccc(xi) Strengths and weaknesses ....................................................... ccc(xii) Experiences with own parents and any history of out-of-home care ........................................................................................... ccc(xiii) Family’s perception of foster care ............................................ ccc(xiv) Reason for applying ................................................................. ccc(xv) Experience in providing regulated care .................................... ccc(xvi) Willingness to accept a foster child.......................................... ccc(xvii) Willingness to parent cross-racially or cross-culturally ........... ccc(xviii) Willingness and ability to give love and affection and accept child as member of household ............................................................ ccc(xix) Willingness to work with a foster child’s family ........................ ccc(xx) Understanding of/willingness to participate in concurrent planning................................................................. ccc(xxi) Social support system.............................................................. ccc(xxii) Spirituality or religious beliefs ................................................. ccc(xxiii) Safety and maintenance of the house and property .............. ccc(xiv) Assessment of neighborhood schools, community and available resouces ................................................................... ccc(xxv) Children preferred ................................................................... ccc(c) Provide the agency will all of the following(i) Three references ........................................................................ ccc(ii) Provided medical history ............................................................ ccc(iii) Provided required medical statements ...................................... ccc(iv) Provided past and/or current mental health treatments............. ccc

Rule 9207 Subsequent evaluationsA foster parent:(a) Allow the agency reasonable access to the foster home for licensing and foster child supervision purposed....................................... ccc(b) Provides any changes to information contained in the evaluations ................................................................................. ccc(c) Shares information on family functioning and interrelationships .. ccc(d) Provide a preference for receiving children in placement, including the

characteristics, age, sex, race, etchnic background, and number of children the foster parents would not wish to accept in placement............ ccc

CWL-3080 (Rev. 6-16) Previous edition obsolete. 2 C = Compliance N = Noncompliance D = Discussed

License Number

Rule 9301 Maintenance C N D(1) A foster parent shall ensure that the property, structure, premises, and furnishings of a foster home are constructed and mintained in a clean and safe condition and in good repair........................ ccc(2) A foster parent shall ensure that the property, structures, premises, and furnishings are adequately constructed and maintained to meet the needs of each foster child and each member of the household. .................... ccc(3) Animal safety, agency notification; licensed and vaccinated ...... ccc(4) Residential pool, spa, or hot tub water is clean, safe and

sanitary ...................................................................................... ccc(5) Children supervised at all times around any water activity ........ ccc(6) If there is a residential pool, spa, hot tub, pond, or other body of water on the premises, rescue equipment shall be available at all times. There shall be an alarm on any exterior door that leads directly to the pool, spa, hot tub, pond, or other body of water ................ ccc

Rule 9302 Heat, light, and ventilation(1) A foster parent shall ensure that the foster home heat, light, and ventilation

is adequate................................................................................. ccc(2) A foster parent shall ensure that the foster home windows and doors are screened if used for ventilation .................................. ccc

Rule 9303 Flame and heat-producing equipment;maintenance; inspection(1) A foster parent shall ensure that all of the following are maintained in safe condition:(a) Furnace ...................................................................................... ccc(b) Water heater .............................................................................. ccc(c) Fireplace..................................................................................... ccc(d) Pipes .......................................................................................... ccc(e) Radiators .................................................................................... ccc(f) Wood-burning stoves .................................................................. ccc(g) Other flame-producing or heat-producing equipment ................ ccc(2) Portable heating devices are not used in bedrooms .................. ccc

Rule 9304 Smoke detectors(1) An approved smoke detector is installed and

maintained as follows:(a) On each floor of the home, including the basement................... ccc(b) Between the sleeping area(s) and the rest of the home ............ ccc(c) Areas with flame or heat producing equipment .......................... ccc(2) An approved carbon monoxide detector is installed

and maintained as recommended .............................................. ccc

Rule 9305 Bathrooms; water supply; sewage disposal(1) The foster home has a minimum of 1 flush toilet, 1 washbasin that has warm and cold running water, and 1 bathtub or shower that has warm and cold running water, all of which shall be in working order ............................................................................. ccc(2) Water temperature from accessible outlets does not exceed

120 degrees fahrenheit .............................................................. ccc(3) Bathroom is accessible to a foster child requiring regular use

of a wheelchair .......................................................................... ccc(4) The water supply is from an approved source ........................... ccc(5) Sewage disposal is through a public system or in a manner

that is approved ......................................................................... ccc

Rule 9306 Bedrooms (1) Bedrooms comply with all of the following:(a) Allows for both rest and privacy and has access to adult supervision ........................................................................ ccc(b) Has 40 square feet of floor space per person ............................ ccc(c) Has space for the storage of clothing and personal belongings .................................................................................. ccc(d) Has a finished ceiling floor-to-ceiling permanently affixed walls and finished flooring ................................................................... ccc(e) Has a latchable door that leads directly to a means of egress... ccc(f) Has at least 1 outside window.................................................... ccc

PART 3. THE FOSTER HOME C N D(i) Is accessible to children and caregivers...................................... ccc(ii) Can be readily opened from inside the room.............................. ccc(iii) Is of sufficient size and design to allow for the evacuation ........ ccc(g) Does not contain:(i) Household heating equipment..................................................... ccc(ii) A water heater............................................................................. ccc(iii) A clothes washer ........................................................................ ccc(iv) A clothes dryer ........................................................................... ccc(2) None of the following is used as a bedroom:(a) A hall........................................................................................... ccc(b) A closet ....................................................................................... ccc(c) A stairway ................................................................................... ccc(d) A garage ..................................................................................... ccc(e) A shed ........................................................................................ ccc(f) A detached building ..................................................................... ccc(g) A space accessible only by a ladder, folding stairway, or

through a trapdoor ................................................................... ccc(3) A foster parent shall ensure that all bedding and sleeping equipment comply with all the following conditions:(a) All blankets shall be appropriate for the weather ....................... ccc(b) All bedding and equipment shall be in good repair and shall shall be cleaned and sanitized before being used by another person ........................................................................................ ccc(c) All bedding used by children shall be washed when soiled or weekly at a minimum ................................................... ccc(d) A clean pillow available for children 2 years of age and older.... ccc(e) Infants, birth to 12 months of age, shall rest or sleep alone in a CPSC compliant crib that meets needs of infant and the conditions of subdivision (f) of this rule ...................................... ccc(f) All cribs shall be equipped with all of the following:(i) A firm, tight-fitting mattress with a waterproof, washable covering...................................................................................... ccc(ii) No loose, missing, or broken hardware or slats ......................... ccc(iii) Not more than 2 3/8 inches between the slats ........................... ccc(iv) No corner posts over 1/16 inches high....................................... ccc(v) No cutout designs in the headboard or footboard ...................... ccc(vi) A tightly fitted bottom sheet shall cover the mattress with no additional padding placed between the sheet and mattress .............................................................................. ccc(g) An infant’s head shall remain uncovered during sleep ............... ccc(h) Soft objects, bumper pads, stuffed toys, quilts or comforters, and other objects that could smother a child shall not be placed with or under a sleeping infant .................... ccc(i) Blankets shall not be draped over cribs ..................................... ccc(j) Infant car seats, infant seats, infant swings, bassinets, highchairs, playpens, pack ‘n plays, collapsible cribs, collapsible play yards, waterbeds, adult beds, soft mattresses, sofas, beanbags or other soft surfaces are not approved sleeping equipment for children 24 months of age or younger ...................................................................................... ccc(k) Children 24 months or younger who fall asleep in a space that is not approved for sleeping shall be moved to approved sleeping equipment appropriate for their size and age .............. ccc(l) Appropriate number and types of beds/cribs available prior to licensure or a change in terms for children covered ...... ccc

Rule 9307 Exits(1) A foster parent shall ensure that there are 2 exits from each floor level used by a family member. A foster parent shall ensure that the exits are remote from each other and that 1 of the exits provides a direct, safe means of unobstructed travel to the outside at street or ground level .......................................... ccc(2) A window used as a second exit complies with all of

the following:(a) Is accessible to children and caregivers .................................... ccc(b) Can be opened from inside the room ......................................... ccc(c) Is of a size and design to allow for the evacuation ..................... ccc

CWL-3080 (Rev. 6-16) Previous edition obsolete. 3 C = Compliance N = Noncompliance D = Discussed

License Number

PART 3. THE FOSTER HOME (Cnt’d) C N D(3) If a family member occupies a level of a home that is above the second floor, then the building shall have 2 stairways to ground level, at least 1 of which shall provide a direct means of egress to the outside at ground level ............................................................... ccc

Rule 9308 Telephone(1) An operating telephone is available in the foster home.............. ccc(2) Emergency telephone numbers are within sight of the

telephone ................................................................................... ccc(3) Provide home telephone number to agency and inform agency within 24 hours of change.............................................. ccc

Rule 9309 Wheelchair accessThe foster home is accessible for providing care to a fosterchild requiring regular use of a wheelchair ...................................... ccc

Rule 9310 Smoking(1) No smoking inside home while children in placement................ ccc(2) No smoking inside vehicle while transportIng foster children..... ccc

PART 4. FOSTER CARE

Rule 9401 Child capacity; living arrangement(1) Both of the following apply tot he capacity of a foster home:(a) Not more than 8 children is 8 under 17 years of age ................ ccc(b) If concurrently licensed for child care, total number of children under 17 years of age, including children of foster parents, who live in or receive care in the foster home, shall not exceed 12. Comply with all applicable licensing rules for both foster homes and child care homes ..................... ccc(2) All of the following apply to infants:(a) No more than 2 children under age of 1 in home ....................... ccc(b) Children birth to 12 months of age shall sleep alone in a crib ..... ccc(c) An infant shall be placed on his or her back for resting and sleeping ...................................................................................... ccc(d) An infant unable to roll from stomach to back, and from back to stomach, when found facedown, shall be placed on their backs .......................................................................................... ccc(e) An infant who can easily turn over from his or her back to his or her stomach shall be initially placed on his or her back, but allowed to adopt whatever position he or she prefers for sleep ... ccc(f) For an infant who cannot rest or sleep on her/his back, the foster parent shall have written instructions, signed by a physician, detailing an alternative safe sleep position and/or other special sleeping arrangements for the infant .................... ccc(g) Foster parent shall maintain supervision and frequent monitoring of infant for signs of distress not exclusively via a baby monitor ........................................................................... ccc(4) Nonambulatory children sleep in bedrooms that have a means of exiting at ground level ................................................ ccc(5) A child does not share a bedroom with a non-parent adult unless all of the following conditions exists:(a) The child and adult are siblings of the same sex ....................... ccc(b) Foster siblings shared prior to age 18 ........................................ ccc(c) The child has a special medical need that requires adult attention ..................................................................................... ccc(6) A minor, 3 years of age or older, do not share a bedroom with a parent............................................................................... ccc(7) Children of the opposite gender, more than 5 years of age, do not share a bedroom ............................................................. ccc(8) Each child shall sleep alone in a bed sufficient to meet

functioning level, size, length and other needs of child ............. ccc(9) Resting or sleeping areas shall have adequate lighting to allow the foster parent to assess children.................. ccc

Rule 9402 Child placement C N D

(1) Each foster child falls within the approved placement specifications.............................................................................. ccc(2) The terms of the foster home license are followed .................... ccc(3) A foster parent shall receive a foster child for care only from the agency that certified the home or from another agency with the prior approval of the agency that certified the home..... ccc

Rule 9403 Foster parent dutiesFoster parents:(a) Cooperate with and assist in implementation of service plans... ccc(b) Fully disclose foster child progress and problems ..................... ccc(c) Provide written notification 14 calendar days before a foster

child is moved ............................................................................ ccc(d) Maintain a copy of the following agency policy:(i) Behavior management ................................................................ ccc(ii) Religion....................................................................................... ccc(iii) Communication .......................................................................... ccc(iv) Education................................................................................... ccc(v) Personal possessions ................................................................ ccc(vi) Allowance and money................................................................ ccc(vii) Clothing..................................................................................... ccc(viii) Emergencies ............................................................................ ccc(ix) Medical and dental care ............................................................ ccc(x) Substitute care ........................................................................... ccc(xi) Supervision ................................................................................ ccc(xii) Incident reporting ...................................................................... ccc(xiii) Hazardous materials ................................................................ ccc

Rule 9404 Behavior management(1) Each foster child’s behavior management plan is followed ........ ccc(2) A foster parent may use reasonable restraint to prevent a foster child from harming himself or herself, other persons, or property or to allow the child to gain control of himself or herself ............ ccc(3) Foster parent shall not use corporal punishment ....................... ccc

Rule 9405 ReligionFoster parents follow the agency’s religion policy ........................... ccc

Rule 9406 CommunicationFoster children can send and receive mail in accordance withthe agency’s communication policy ................................................. ccc

Rule 9407 EducationFoster parents implement the education or training plan of eachfoster child ....................................................................................... ccc

Rule 9408 Personal possessionsFoster parents follow the agency’s policy on personalpossessions ..................................................................................... ccc(a) A foster child’s possessions are provided to the child if the

child moves from the home ........................................................ ccc(b) Gifts and clothing purchased for the child remains the

property of the child.................................................................... ccc

Rule 9409 Allowance and money(1) Foster parent shall follow agency’s policy on allowance ............ ccc(2) Any money earned or received directly by child remains child’s

property ...................................................................................... ccc

Rule 9410 ClothingAll clothing child arrives with at foster home and all clothingpurchased while in care remains property foster child. ................... ccc

CWL-3080 (Rev. 6-16) Previous edition obsolete. 4 C = Compliance N = Noncompliance D = Discussed

License Number

PART 4. FOSTER CARE (Cnt’d)Rule 9411 Emergencies C N D(1) Foster parents follow agency approved written emergency

procedures for the following emergencies:(a) Fire ............................................................................................. ccc(b) Tornado ...................................................................................... ccc(c) Serious accident or injury ........................................................... ccc(2) Prompt evacuation of a person who needs assistance .............. ccc(3) Each member of the household and substitute care provider

including child is familiar with the emergency and evacuationprocedures ................................................................................. ccc

(4) Practice emergency evacuation procedure at least one timeevery four months ...................................................................... ccc

Rule 9412 Medical and dental care(1) The prescribed health plan for each foster child is followed ...... ccc(2) Foster parents follow approved protocols for medical care........ ccc(3) Medications are inaccessible to children unless medically

necessary .................................................................................. ccc(4) Prescription medication is given or applied as directed by a

licensed physician ..................................................................... ccc

Rule 9413 Substitute care; agency notification(1) Foster parents follow the agency’s substitute care policy .......... ccc(2) Foster parent ensure appropriate care and supervision ............ ccc(3) Identify primary substitute caregiver .......................................... ccc

Rule 9414 Unusual incident notification(1) Immediate notification of death of a foster child ......................... ccc(2) Immediate notification of removal or attempted removal of

foster child by any person not authorized .................................. ccc(3) Immediate notification if foster child is missing .......................... ccc(4) 24-hour notification after the foster parent knows of any of the

following:(a) Any illness resulting in inpatient hospitalization ......................... ccc(b) Any accident or injury requiring medical treatment .................... ccc(c) Foster child’s involvement with law enforcement ....................... ccc(d) Pregnancy of a foster child......................................................... ccc(e) Incidences of child-on-child abuse ............................................. ccc(f) Involvement with law enforcement by anyone in the home

pursuant to a criminal investigation .......................................... ccc

Rule 9415 Hazardous materials(1) Foster parents follow the agency’s hazardous materials

policy ......................................................................................... ccc(2) Securely store dangerous and hazardous materials, objects,

weapons, chemicals, medication, or equipment ........................ ccc(3) Firearms are subject to the following conditions:(a) Stored in a locked metal or solid wood gun safe, or .................. ccc(b) Trigger-locked and stored without ammunition in a locked area ............................................................................................ ccc(c) Ammunition shall be stored in a separate locked location.......... ccc(d) A handgun shall be registered. Documentation of the registration of the handgun shall be available for review ........... ccc

Rule 9416 Foster parent training(1) Foster parents attend training as required by the agency

foster parent training plan .......................................................... ccc(2) One household adult current in first aid certification .................. ccc

Rule 9417 Food and nutrition (1) Foster parents provide for the nutritional needs of each

foster child ................................................................................. ccc(2) Meals are nutritious, well-balanced, and of sufficient quantity ... ccc(3) Special diets are provided as prescribed ................................... ccc(4) Foster children eat with the other members of the household ... ccc(5) Foster children eat the same meals as other members of the

household .................................................................................. ccc

C N D

(6) Refrigeration is used for perishable foods.................................. ccc(7) Only pasteurized milk products are served to foster children .... ccc

Rule 9418 Foster child tasksFoster children perform only those routine tasks that are:(a) Within the child’s ability .............................................................. ccc(b) Are reasonable ........................................................................... ccc(c) Similar to those expected of other members of the household .. ccc

Rule 9419 RecreationFoster parents:(a) Encourage participation in activities ........................................... ccc(b) Provide a variety of indoor and outdoor recreational

activities ..................................................................................... ccc

Rule 9420 Transportation(1) Transportation done in safe and responsible manner ................ ccc(2) Transportation of members of the household is conducted as

required by state law ................................................................. ccc

PART 5. REPORTING and RECORD KEEPING

Rule 9501 Reporting suspected child abuse or neglect(1) A report is made immediately if physical or sexual abuse or

neglect is suspected .................................................................. ccc(2) If the abuse or neglect occurred in the foster home, the report

is made to:(a) The child protective services central intake unit ......................... ccc(b) The agency ................................................................................ ccc(3) A written report, as required by the agency is provided ............. ccc

Rule 9502 Reporting foster home changesA change in any of the following is reported by the next working day:(a) Employment status of a foster parent ........................................ ccc(b) Serious illness, injury, or death of a foster parent or member of the household................................................................................... ccc(c) Household composition .............................................................. ccc(d) Arrests and criminal convictions of a foster parent or member

of the household ........................................................................ ccc(e) Court-supervised parole or probation of a foster parent or

member of the household .......................................................... ccc(f) Admission to, or release from, a correctional facility, a facility, a hospital, or an institution for the treatment of an emotional, mental, or substance abuse problem of a foster parent or member of the household .......................................................... ccc(g) Counseling, treatment, or therapy on an outpatient basis for

an emotional, mental, or substance abuse problem of a foster parent or member of the household ................................ ccc

(h) Revocation or modification of drivers license ............................. ccc(i) Major changes or renovations of structure of home ................... ccc

Rule 9503 License application filing; agency notification(1) Agency is notified after filing an application for adult foster foster care or child care within 5 working days .......................... ccc(2) If licensed as adult foster care or child care, notify agency if change in terms of license....................................................... ccc

Rule 9504 Change of residence; agency notification A foster parent shall inform the agency of any change of residenceand submit an application for licensure at the new address notless than 4 weeks before a move .................................................... ccc

CWL-3080 (Rev. 6-16) Previous edition obsolete. 5 C = Compliance N = Noncompliance D = Discussed

License Number

PART 5. REPORTING and RECORD KEEPING (Cnt’d)

Summary of findings: (No Corrective Actions Plans [CAPs] are to be included in summary of findings; non-compliances are to be documented in the CAP docu-ment only.)

Licensing Recommendation (Include license action, age, sex, characteristics, and special needs of children best served, and maximum capacity)

Licensee Signature

Worker Signature

Date

Date

DateLicensee Signature

Authority: 1973 PA 116

The Michigan Department of Health and Human Services (MDHHS) does not discriminate against any individual or group because of race, religion, age, national origin, color, height, weight, marital status, genetic information, sex, sexual orientation, gender identity or expression, political beliefs or disability.

I understand that if I disagree with these findings, I may file a grievance. My signature on this form verifies that I have been given a copy of the form.

Rule 9505 Confidentiality C N D(1) Information obtained, and records maintained is kept

confidential ............................................................................. ccc(2) The requirements in subrule (1) of this rule shall not prohibit a foster parent from communicating with any person or organization that has a statutory privilege or any person representing the foster parent in a licensing or legal matter ........................................... ccc

Rule 9506 Record management(1) A record for each foster child in the home is maintained ........... ccc(2) The record contains all of the following:(a) Child’s name and date of birth ................................................... ccc(b) Any known history of abuse or neglect of the child .................... ccc(c) All known emotional and psychological problems of the child ............................................................................................ ccc(d) All known behavioral problems of the child ................................ ccc(e) Circumstances necessitating placement of the child ................. ccc(f) Any other known information to enable a stable, safe, and healthy environment ................................................................... ccc(g) Date of placement date of termination of placement and reasons for termination of placement ......................................... ccc

C N D(h) Name, address, and telephone number, including emergency telephone number of the agency and the agency’s social service worker who is currently assigned to the child............................. ccc(i) Name, address, telephone number of child’s physician and dentist......................................................................................... ccc(j) Written routine and emergency medical and surgical treatment consent ...................................................................... ccc(k) A report of the child’s medical history ..................................... ccc(l) Dates of, and reasons for, medical treatment of the foster

child ......................................................................................... ccc(m) Child’s behavior management and discipline plan .................... ccc(3) Each record is stored and maintained in a manner to prevent

unauthorized access or return documents to agency ................ ccc(4) When foster child moves from foster home, all records

returned to agency ..................................................................... ccc(5) Records provided by the child placing agency are returned

to the agency at closure ............................................................ ccc