4430. Courtesy Supervision

Approval: Jennifer Strus, Assistant Secretary

Original Date: 2002

Revised Date: July 1, 2016

Policy Review: July 1, 2020


Courtesy supervision is provided for children in the care and custody of Children’s Administration (CA) when placement in another CA office service area is necessary. This policy establishes clear communication and service provision requirements for caseworkers sharing courtesy supervision cases in order to provide for the child’s safety, well-being and permanency needs.


This policy applies to Division of Children and Family Services (DCFS) caseworkers.


  1. All CA offices will provide courtesy supervision when requested by a sending CA office for a child in CA’s care and custody, and placed outside the sending office's area. Reasons for the child’s move from the sending office area include:
    1. A child and his or her parent or caregiver has moved.
    2. A permanent or other relative placement has been located.
    3. A specific need for specialized medical, emotional or educational services not available near the child's current placement .
    4. A specific need for placement in a specialized home or facility due to the child's behavior.
    5. A child and his or her siblings can be placed together.
    6. Compliance with state and federal Indian Child Welfare Act (ICWA) placement preference.  
  2. A shared planning or FTDM staffing must occur when requested by the sending or receiving caseworker.
  3. If there is a disagreement about an unmet need related to the child’s safety, well-being or permanency, the sending or receiving supervisor will request a meeting to occur between the offices as soon as possible.
  4. Conflicts will be resolved at the lowest level possible.  If the conflict is unresolved, the regional administrators (RAs) or their designees will work toward resolution.
  5. Sending courtesy supervision requests
    1. The caseworker must:
      1. Send a completed Courtesy Supervision Referral DSHS 10-459 to the gatekeepers in the sending and receiving regions within 72 hours when a child has moved or will be moving.
      2. For a planned placement move, conduct an FTDM. For an emergent placement move, notify a supervisor in the receiving office within 24 hours of the move and, if not already completed, request household safety inspection using DSHS 10-453.
      3. Update the placement in FamLink within 72 hours of a placement move.
      4. Provide and review the following information with the prospective caregiver prior to or at the time of placement:
        1. Child Information and Placement Referral form DSHS 15-300
        2. Placement Agreement Form DSHS 15-281
        3. Documentation about how to access medical, educational and behavioral treatment for the child.
      5. Verify the following information is in FamLink:
        1. Current court order.
        2. Placement Agreement DSHS 15-281, if completed.
        3. Home Study Request if completed.  If not, complete within 30 calendar days. See 5100. Completing the Home Study policy.
        4. Child Information and Placement Referral form DSHS 15-300 is signed by the caregiver or verified by email receipt.
        5. Information for completed background checks for all household members age 16 and older. Follow 6800. Background Checks.
        6. Extended Foster Care Participation Agreement DSHS 10-432, if applicable.
        7. Voluntary Placement Agreement DSHS 09-004B (located on the CA intranet), if applicable.
        8. Independent Living (ILS) Information, if applicable.
      6. Maintain primary assignment to the case and responsibility for service referrals, decision making and payment authorizations.
      7. Initiate service referrals when notified of an identified service need for the child.
      8. Update the receiving caseworker about progress and changes in case plan, court dates and invite to all Shared Planning meetings.
      9. Notify the caregiver of the court dates and invite to all Shared Planning meetings.
      10. If the placement disrupts, schedule a FTDM.
      11. Notify the receiving caseworker and supervisor if the child is moved.
    2. The sending regional gatekeeper or designee will verify information in FamLink upon receipt of a courtesy supervision request. See section in 7(vi). If the required information is incomplete, notify the sending caseworker and supervisor.  
  6. Receiving courtesy supervision requests
    1. The receiving regional gatekeeper or designee will review the Courtesy Supervision Referral Form DSHS 10-459  and assign in FamLink as soon as possible and no later than 72 hours of receiving the referral.
    2. The receiving caseworker will:
      1. Prior to placement:
        1. Complete Household Safety Inspection Form DSHS 10-453 for all unlicensed caregivers, if not already completed by the sending caseworker. Document the completion of this form in a case note and upload in the case file.  
        2. Identify and verify all individuals living in the home and assess for safety threats.
        3. Obtain the caregiver’s signature on the Placement Agreement Form DSHS 15-281, if not already signed, and upload in FamLink.
      2. After placement:
        1. Conduct monthly health and safety visits with the children and caregivers. A health and safety visit must occur within seven (7) calendar days of a placement move.
        2. If the child is determined to be unsafe:
          1. Remove the child from the placement.
          2. Make a report to intake when there is a new allegation of abuse or neglect on an open case.

          3. Notify the sending caseworker and discuss placement alternatives.

            Collaborate with the sending caseworker on case planning and decision making.

            Notify the sending caseworker of requests or need for services for the child or caregiver.

            Attend all shared planning and FTDM’s for children, including children in group care or Behavioral Rehabilitative Services, unless otherwise negotiated with the sending caseworker.

  7. If the placement is at risk of disruption, notify the sending caseworker to schedule a FTDM.