Form Rfa 09e - Notice Of Action And Exclusion Order Page 5
Download a blank fillable Form Rfa 09e - Notice Of Action And Exclusion Order in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form Rfa 09e - Notice Of Action And Exclusion Order with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4
5Cause of Action Reference Page
Instructions: Copy and paste one or more of the below applicable
causes of action into page 1 below the statutory citation to W&IC 16519.61.
(Note: Citations are from Written Directives, Version 4.1. You must update citations
from the Written Directives version that was applicable at the time of the incident(s) at issue).
An adult residing in or regularly present in the home was denied a criminal record exemption or had an existing
exemption rescinded due to a conviction for an exemptible crime [Writ. Dir. §§ 6-03A, 6-03B, 10-01(b)].
An adult residing in or regularly present in the home was denied a criminal record exemption or had an existing
exemption rescinded due to a conviction for a non-exemptible crime [Writ. Dir. §§ 6-03A, 6-03B, 10-01(b)].
Failure to comply with or pass the background checks assessment relating to child abuse or neglect history,
criminal history that did not result in a conviction, a prior administrative action or other history [Writ. Dir. §§ 6-03A,
6-03B, 10-01(b)].
Engaging in conduct that poses a risk or threat to the health and safety, protection, or well-being of a child or
nonminor dependent or other individual [Writ. Dir. §§ 6-03A, 10-01(b)].
Violation of a child or nonminor dependent’s personal rights, or failure to ensure a child or nonminor dependent is
accorded personal rights [Welf. and Inst. Code § 16001.9; Writ. Dir. §§ 10-01, 11-08, 11-09, 11-10, 11-11,
11-14, 11-15].
Failure to act as a reasonable and prudent parent or failure to provide care and supervision as required [Welf. and
Inst. Code §§ 362.04 and 362.05; Writ. Dir. §§ 10-01(b), 10-03, 11-12, 11-13].
Failure to comply with reporting requirements [Writ. Dir. § 11-06].
Failure to meet Resource Family applicant/parent qualifications [Writ. Dir. §§ 5-02, 5-03, 6-07(b), 9-02].
Failure to meet or comply with home environment assessment standards [Writ. Dir. §§ 6-02, 11-01, 11-02, 11-03].
Failure to cooperate or comply with the application process, with applicant requirements, with ongoing
requirements to maintain approval, or making false or misleading statements to the County or Department to
obtain or maintain resource family approval [Writ. Dir. §§ 5-02, 5-03, 6-06, 8-01, 9-02, 10-01(b), 11-15].
Failure to meet Resource Family caregiver criteria or permanency criteria as determined in a psychosocial or risk
assessment [Writ. Dir. §§ 6-04, 6-05, 6-07(b), 10-01(b)].
Failure to complete required pre-approval or post-approval training [Writ. Dir. §§ 6-06, 8-01, 11-19].
Failure to maintain or provide records for a child or nonminor dependent as required
[Writ. Dir. § 10-01(b), 11-06].
Engaging in acts of financial malfeasance, including but not limited to, improper use or embezzlement of the
money or property of a child or nonminor dependent or fraudulent appropriation for personal gain of money or
property, or willful or negligent failure to provide services [Writ. Dir. § 10-01(b)(5), 11-08].
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Rfa 09b - Notice Of Action To Individual Regarding Resource Family Approval Criminal Record Exemption Decision
Legal
Form Na 1261 - Notice Of Action - Form And Instructions - For Group Homes, Short-term Residential Treatment Centers, Foster Family Agencies, Transitional Housing Placement-plus Foster Care And Transitional Housing Placement Program
Legal
Related Categories
Parent category: Legal