Form 04KI004E, Placement Provider Information, is a component of the case plan and is provided to the child's out-of-home placement provider. The form includes the most recent information available about the child required by Section 1-7-104 of Title 10A of the Oklahoma Statutes, but is not limited to, available information regarding:
(1) demographic information;(2) the child's strengths, needs, and general behavior;(3) circumstances necessitating the child's placement;(4) type of custody and child's previous placement;(5) pertinent family information including, but not limited to: (A) names of family members who are and who are not, by court order, allowed to visit the child; and(B) the child's relationship to family that might affect placement;(6) known and important life experiences and relationships that may significantly affect the child's feelings, behavior, attitudes, or adjustment;(7) whether third-party insurance coverage may be available to the child;(8) education history including present grade placement, last school attended, and special strengths and weaknesses. OKDHS assists the foster parent with the child's school admittance and enrollment and obtaining the child's school records;(9) known or available medical history including, but not limited to: (E) psycho-social information; and(F) the name of the child's last doctor, if known; and(10) sufficient medical information regarding the child to enable the placement provider to care for the child safely and appropriately, including, but not limited to: (A) any medical or psychological conditions;(B) diseases, illnesses, accidents, allergies, or congenital defects;(C) the child's SoonerCare card or information on other third-party insurer, if any; and(D) immunization history.Okla. Admin. Code § 340:75-6-40.2
Added at 18 Ok Reg 3067, eff 7-12-01; Amended at 24 Ok Reg 1044, eff 6-1-07; Amended at 27 Ok Reg 1092, eff 3-26-10 (emergency); Amended at 27 Ok Reg 1865, eff 7-1-10; Amended at 30 Ok Reg 389, eff 7-1-13