Form Cfs-323-B - Notice To Fictive Kin That A Child Has Been Taken Into Dcfs Custody
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1Arkansas Department of Human Services
Division of Children and Family Services
Notice to Fictive Kin that a
Child Has Been Taken into DCFS Custody
To:
Address:
From:
Phone:
Email:
Date:
Dear ________________________________,
You have been identified as an individual having a strong, positive, emotional tie to ________________________________ and a
positive role in ________________________________’s life. Pursuant to A.C.A. §9-28-107, this is your notice that this child is now
in the custody of the Arkansas Department of Human Services’ Division of Children and Family Services (DCFS). DCFS has
removed or is removing the above-named child from the home of _____________________________. We believe that relatives and
other individuals with whom a child shares a positive, meaningful relationship play an important role in a child’s life, especially a
child who must be temporarily cared for by someone other than a parent. Children do better when they can temporarily live with or
stay connected in other ways to people who know and care about them.
We are contacting you as someone who could offer services needed by ________________________________ and/or his or her
family such as offering a temporary home for or otherwise supporting _____________________________ by staying in contact while
he or she is in custody. In the next few days, I or someone from my agency will call you to review your options for helping to care for
________________________________.
If you would like to temporarily bring the child into your home, you may ask to become a Provisional Foster Parent. DCFS may
approve your home as a Provisional Foster Home after conducting (1) a health and safety check, which includes background checks,
and (2) a visual inspection of your home. Requesting to be considered as a possible Provsional Foster Home, does not guarantee that
you will be asked or approved to ulimtately serve as a Provisional Foster Home for ____________________________.
If your home is opened as a Provisional Foster Home, you may receive benefits if you qualify after the child is placed in your home,
such as Supplemental Nutrition Assistance Program (SNAP—formerly known as food stamps). DCFS may also provide daycare
assistance if appropriate. The child will receive medical insurance.
Within six months of becoming a Provisional Foster Home, you must meet all other foster home requirements including attending
foster parent training. If you are approved as a Regular Foster Home, DCFS will provide all services and supports available to every
child in foster care, such as monthly board payments for the child.
If you are not approved as a Regular Foster Home within six months of becoming a Provisional Foster Home, then one of the
following must take place: (1)You must receive permanent custody of the child, or (2) Your Provisional Foster Home must be closed
and the child must be removed.
If you are not able to provide a temporary home for ________________________________, there are other ways for you to stay
involved in his or her life and maintain important connections.
We will call you in the next few days to explore your options, but feel free to contact me sooner. My phone number and email address
are listed above. We need to communicate with you at your earliest convenience by phone, mail, email, or in person, to determine if
you are interested in (1) Participating in the care and placement of the child, (2) Becoming a foster parent, and/or (3) Visiting the
child. Contacting me will help ensure that you do not lose the opportunity to connect with ____________________________ now or
in the future.
Signature
CFS-323-B (R. 08/2015)
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