ATTACHMENT A
Report on State Eligibility State
| Date Completed: | ACYF Staff Completing Report: |
STATE
I. STATE AGENCY LEVEL REVIEW
The State ( ) has ( ) has not met all section 427(a) requirements at the State level for FY 1981.
Comment:
The State ( ) has ( ) has not met all section 427(a) requirements at the State level for FY 1982.
Comment:
STATE
II. CASE RECORD SURVEY SUMMARY
FY 1981
Number of case records surveyed
Major safeguards were not met in case records.
Less than 13 of 18 protections were met in case records.
CASE RECORD SURVEY:
|
( ) Acceptable ( ) Conditionally Acceptable ( ) Unacceptable |
FY 1982
Number of case records surveyed
Major safeguards were not met in case records.
Less than 13 of 18 protections were met in case records.
CASE RECORD SURVEY:
|
( ) Acceptable ( ) Conditionally Acceptable ( ) Decision Withheld |
Determination of State Eligibility Under Section 427 of the Social Security Act
SUMMARY AND RECOMMENDATIONS
|
A. Inventory of Children in Foster Care Recommendations: |
Met ( ) |
Not Met ( ) |
|
B. Statewide Information System Recommendations: |
( ) | ( ) |
|
C. Case Review System Recommendations: |
Met ( ) |
Not Met ( ) |
|
D. Reunification and Permanent Placement Services Recommendations: |
( ) | ( ) |
|
E. Pre-placement Preventive Services Recommendations: |
( ) | ( ) |
FINDINGS
FY 1981
-
1. The findings of the verification review indicate the State of
( ) is, ( ) is conditionally, ( )
is not in compliance with the requirements of section 427(a).
-
Add some sentence as item 4 below
FY 1982
-
The findings of the verification review indicate the State of
( ) is, ( ) is conditionally, in
compliance with the requirements of section 427(a); Decision withheld pending further review ( ).
- The findings of the verification review indicate the State
of
( ) is, ( ) is conditionally, ( ) is not
in compliance with the replacement preventive service requirements of section 427(b). Decision withheld pending further review ( ).
| Regional Program Director |
Date | Review Team Leader Unit Supervisor |
Date |
Attachments:
Attachment B - State
Agency Administrative Review
Attachment C
- Case Record Survey
Attachment
D - Policy Guidance for Certain Section 427 Requirements
Attachment E - Case Record Sample Survey for Section 427 of the
Social Security Act (SSA) Eligibility Determination
