Dss 5204-2026

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4.8 out of 5

143 votes

The document is a Kinship Care Comprehensive Assessment form designed to evaluate the suitability of a caregiver for a child placed in their care. It outlines specific requirements and indicators related to the caregiver's relationship with the child, ability to provide a nurturing environment, cooperation with parents and agencies, support for the child's recovery from abuse or neglect, and overall health status. The assessment must be completed within 30 days of placement and includes sections for comments, service needs, and signatures from both the caregiver and social worker.

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Click ‘Get Form’ to open the dss 5204 in the editor.
Begin by entering the Child’s Case Number at the top of the form. This is essential for tracking and reference.
Fill in the Case Name, County Case #, and Date fields accurately to ensure proper documentation.
In the Caregiver’s Name section, provide both names clearly. This identifies who is responsible for the child.
For each requirement listed, indicate 'Y' for Yes or 'N' for No based on your assessment of the caregiver's capabilities and environment.
Use the Comments/Service Delivery sections to elaborate on any specific observations or needs related to each requirement.
Ensure that both caregivers sign and date where indicated, confirming their agreement and understanding of their responsibilities.
Finally, have a social worker review and sign off on the document before submission to ensure compliance with agency standards.

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