Form Soc 818nmd - Relative Or Nonrelative Extended Family Member Caregiver Assessment - Nonminor Dependent Page 5

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STATE OF CALIFORNIA – HEALTH AND HUMAN SERVICES AGENCY
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
Nonminor Dependent Name:
Case Number:
_____
Caregiver Name: __________________________________________________________________________________
19. The (prospective) caregiver agrees to allow the nonminor dependent access to information
about vocational and postsecondary educational options and emancipation programs. If
requested by the nonminor dependent, the (prospective) caregiver agrees to assist the
nonminor dependent with information about career requirements and salary; internet career
searches; community sponsored career, volunteer or internship events and opportunities; and,
THP-Plus, THP-Plus Foster Care, and supervised independent living placements (SILPs).
[§893179(c)]
[
] Yes [
] No
Comments:
Additional Comments:
SOC 818NMD (1/12)
Relative or Nonrelative Extended Family Member
Required-No Substitute Permitted
Caregiver Assessment - Nonminor Dependent
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