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Dss 5295-2026

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  1. Click ‘Get Form’ to open the dss 5295 in the editor.
  2. Begin by filling in the Agency Name and Visit Date at the top of the form. This information is crucial for record-keeping.
  3. Select the Placement Type by checking the appropriate box: Family Foster Care, Therapeutic Foster Care, Kinship Care, or Other.
  4. For each child or sibling group being visited, enter their First Name, Last Name, Age, and Permanent Plan. Ensure accuracy as this data is vital for ongoing assessments.
  5. List any other children in the home by noting their gender, age, and status (adoptive, birth, foster). This helps provide a complete picture of the household dynamics.
  6. In the 'Items to Cover' section, review priorities from previous visits and discuss topics such as child behaviors and household changes. Use our platform's comment feature to jot down notes during your conversation.
  7. Complete follow-up activities identified during your visit and ensure that all necessary signatures are obtained before finalizing the document.

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Related links

DSS-5295-v2.pdf

NORTH CAROLINA MONTHLY PERMANENCY PLANNING CONTACT RECORD (For all Out of Home Placements) DSS-5295 (Rev. 05/2021) Child Welfare Services. Type: Foster Care

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Division of Social Services Interstate Compact on the

NC county agencies can utilize the DSS 5295: Monthly Permanency Planning Contact Record to document monthly supervision for the ICPC placement supervision

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