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RESOURCE
MATERIALS FOR CPYP COUNTIES
Declaration of Intent to Maintain
Contact
This form was developed
by Cheryl Jacobson as part of Project Uplift/Adolescent Connections funded
by an Adoption Opportunity Grant received by Colorado. She attributes the
successfulness of utilizing the form to two factors: (1) it is very clear
to both the adolescent and the connection adult what the commitment will
entail, i.e., frequency of contacts, etc.; and (2) from "change theory" it
is known that if a person makes a formal written agreement then the
desired behavior is much more likely to happen.
Blank Form (MS WORD)
Completed
Sample 
Agency Self-Assessment Tool on Youth Permanency
This tool is designed to assist an
agency or state to reflect on youth permanency. We have designed the
questions a) to help assess current work and b) to trigger thinking about
people, organizations and methods that could be tapped to strengthen
family permanency for youth in the future.
Self-Assessment Tool (MS WORD)
County Data Collection Forms
Intake Form (MS WORD)
Progress Report (MS WORD)
Youth Permanency Consult Sheet
This tool is designed to be used as a framework for staffing or discussing cases on permanency. The tool assures that (1) information is shared in a concise way, (2) permanency is the focus of the discussion, (3) tentative permanency plans are set, and (4) specific next steps are set to forward the search for the youth's permanency.
Youth Permanency Consult Sheet (MS WORD)
Permanency Scale
- Youth has
no existing or potential lifelong connections
- Youth has
a potential lifelong connection but no commitment has been made
- Youth has
a lifelong connection to a caring adult AND caseworker has obtained a
signed agreement acknowledging this relationship
- A change
in legal status: adoption, guardianship, reunification, is in process
- Adoption,
guardianship, reunification has occurred
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