DCBS # _______________________ Date Child/Children Came Into Care: ______________________, 2___
Reason for Removal: _____________________________________________________________________________
_______________________________________________________________________________________________
Permanency Goal: _______________________________________________________________________________
_______________________________________________________________________________________________
Next Permanency Review Date: ______________________, 2___
Date Child/Children Will Be In Care 15 Months: ______________________, 2___
Child/Children Age Placement Site
_____________________________ ________ _____________________________________
_____________________________ ________ _____________________________________
_____________________________ ________ _____________________________________
_____________________________ ________ _____________________________________
Case Plan Goals
Mother: ________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Father: ________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Notes: ________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Citizen Foster Care Review Board
Interested Party Review
Case Summary
lex
et
justitia
C
O
M
M
O
N
W
E
A
L
T
H
O
F
K
E
N
T
U
C
K
Y
C
O
U
R
T
O
F
J
U
S
T
I
C
E
Date _______________________
Board ______________________
County _____________________
AOC-CFCRB-13
Rev. 10-12
Page 1 of 1
Commonwealth of Kentucky
Court of Justice www.courts.ky.gov
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