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FOSTER PARENT RENEWAL EVALUATION Date Completed: Parent’s Name: 1. Have there been any changes in household membership since the last year? 2. Have there been any changes in employment, work schedules of any family member since last relicensing? Yes If yes, please describe the changes: 3. What parenting issues are you most comfortable dealing with when caring for foster children? (Examples: chemical dependency, bedwetting, physical or emotional disabilities, etc.) 4. What parenting issues are you uncomfortable dealing with when caring for foster children? 5. Please describe your as a foster 6. Please describe your weaknesses as a foster parent: 7. Has your family experienced any losses or trauma this past year? How were they addressed? 8. Do you have any foster children at this time? No Yes List the foster children/respite you have had this past year in your home. Put an * by names of children currently in your home or current respite. Name Age Date of Placement Social Worker ---PAGE BREAK--- 9. Has each provider completed the required 12 hours of training for foster parenting?____No ____Yes If No, please explaining some of the barriers to completing the requirements. 10. Do you feel that all members of your family understand the rules of confidentiality with regard to Sharing private information about a child or his/her family? ____Yes If No, please explain: 11. Do you feel that you have a good working relationship with placement workers/agency? ____Yes If No, how do you feel this could be 12. Any other comments, concerns or suggestions: Topics to cover: ___Confidentiality ___Supervision ___Mandating reporting ___Incident reporting 01/2016