Dfps Form J-800-2838 - Request For Exemption From Regulation Page 5

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J-800-2838
New June 2014
SECTION G: CHILD OR SIBLING GROUP PLACED BY DFPS
Is DFPS the managing conservator of the child or sibling group?
No
Yes
Did DFPS place the child or sibling group in your home?
No
Yes
SECTION H - FOOD DISTRIBUTION PROGRAM
Complete this section if you are requesting an exemption based on meeting the requirements for being a food
distribution program under 40 TAC §745.129(6).
Does your program serve an evening meal to children who are two years old or older?
No
Yes
Is your program operated by a nonprofit food bank located in a nonprofit, religious, or educational facility for no more
than two hours a day on regular business days?
No
Yes
SECTION I - EMERGENCY SHELTER: HUMAN TRAFFICKING
Complete this section if you are requesting an exemption based on meeting the requirements for being an
emergency shelter for victims of human trafficking under DFPS under 40 TAC §745.129(7).
No
Yes
Does your shelter operate as a child care facility that must have a license from DFPS?
No
Yes
Is your shelter operated by a nonprofit organization?
No
Yes
Does your shelter provide shelter and care for no more than 15 days to youth who are alleged victims of human
trafficking (as defined in Penal Code §20A.02) and are 13-17 years old?
No
Yes
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