Family Partnership Agreement

Family Services
Including: Family Partnership Plan,
Goal Sheets, Family Assessment,
• Step 1
– Fill out 1st half of Family Partnership Plan BEFORE
Home Visit
• Step 2
– Prepare referrals and follow-up for Visit based on
questions above
• Step 3- Complete Follow Ups to questions on FPP
– Enter these as part of the FPA contact note
• Step 4- Complete Family Assessment w/family
– You can use either the MKV, Needs or Health items to
create a GOAL.
• ALL items identified MUST have a referral
• Highlighted questions if identified could be large concerns
for family
Review Assessment
• Step 5- Develop Goal Sheet
– Family only has to have 1 goal
– Goal sheet MUST be completely filled out
• These will be reviewed by a team end of October
• For objectives you won’t use-simply mark thru
with one line.
• Must have a time line to complete
• Don’t forget the bottom of the Goals sheet
– Resources
– Remember this is for the parents to remember their Goal!
• All items identified must have a referral
BEFORE end of October
• Provide referrals with greatest need first
(start with 5’s)
• Step 5-Use referral form
Referral Form
(top half of form goes in brown folder)
Referral Form—
(bottom half of form goes to parent to give to agency)
• Once you finish everything…check these boxes!
Staple or paper clip everything together.
• Step 6-Enter FPA in Child Plus
– Family Services
• Family Services Information-Scroll to Bottom
• Needs Assessment = Family Assessment
Completed – yes
Date – date completed
Valid Until – HS (May 31) EHS (Aug 31)
Needs Services – mark according to answers
Received Agency Social Services – mark according to answers (has the
family has received any agency services i.e WIC, Housing, SPARTAN, Weatherization, Utility
Assistance, CHAMPS, CCS, Workforce, Family Planning, CLASS, Health Services/Home Health
f) Additional Community Services Needed – mark according to answers
(does the family need additional services outside of SPCAA)
g) Referred to Another Agency – did you refer the family to an any
agency for services.
In family goal setting process-yes or no
Family Partnership Agreement-Yes
Effective dates-date completed to End of school
Family Partnership Notes- “SEE FPA Contact Note”
– Family Services
• Events
– Note must contain
– Assessment Score
– Follow Up to MKV, Enrollment Need, Health items (if
not Goal)
– Strengths (identified on Family Assessment 1-3’s)
– Family Goal & Objectives
• Each referral must be an ACTION
• Place FPP/Family Assessment/Goal Sheet/Referrals
(stapled or paper clipped) in Child Plus

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