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Transitional Plan for Adolescents DCP&P Form 5-43

This form provides a plan for adolescents who are placed out of home, to identify needed life skills, goals, and actions to achieve identified goals: 

  • When the adolescent is 14 years of age;
  • When and adolescent is entering into an Independent Living Program, Transitional Living Program, or Supported Housing Program;
  • Every six months, at a minimum, to re-evaluate status and progress; and
  • Within 90 days prior to closing the case.
  • Use the form in conjunction with the Casey Life Skills Assessment located at




Case Closing Forms

Notification: Services May Continue Beyond Age of Majority
, DCP&P Form 5-61, is used to provide official notice to the adolescent, that DCP&P will continue to provide services to him or her beyond the age of majority (from age 18 through age 21). The adolescent's case will remain open unless he or she a) wants the case to be terminated, or b) is not compliant with the criteria for continued services from DCP&P. The letter is sent under the signature of the Office Manager.

The assigned Permanency Worker meets with the adolescent to assess his or her needs, plan for his or her self-sufficiency, and begin his or her transition to adulthood. The Permanency Worker prepares the letter for signature by the Office Manager.


Termination of Services to Adolescent Client, DCP&P Form 5-62

This letter provides official notice to an adolescent in open case status, age 18-21, of the Division's intent to terminate his or her case, when the adolescent (age 18-21) requests his or her case be closed; refuses services; does not comply with policy (Provision of Services, II B 400); or reaches age 21. This letter advises the older adolescent that he or she may contact the Administrative Hearings Unit, if he or she disagrees with the agency's decision to terminate.

The Permanency Worker prepares the Termination Letter two months before the intended date of termination. Copies of the letter are also sent to parents/guardians, resource or para parents, a caring adult who will remain involved with the adolescent after DCP&P closes the case, and other involved individuals, as appropriate.


Adolescent Case Closing Checklist DCP&P Form 5-66

Use this form in conjunction with the DCP&P Form 5-66, Adolescent Case Closing Agreement, to present information to an adolescent between 16 to 21 years old for whom DCP&P does not have custody, when closing his or her case.  The worker obtains and makes copies of documents for the adolescent.

The form cannot be used and does not apply if DCP&P has custody of the adolescent or if the adolescent is receiving services based on child abuse/neglect.


Adolescent Case Closing Agreement, DCP&P Form 5-66

This form is used in conjunction with the DCP&P Form 5-67, Adolescent Case Closing Checklist. This agreement allows the Worker to review and document a discussion held with the adolescent about limitations on service eligibility, once his or her DCP&P case is closed. The form allows the adolescent to give a written explanation and documentation as to why he or she would like his or her DCP&P case closed. The form cannot be used/does not apply when DCP&P has custody of the child or when the adolescent is receiving services based on child abuse/neglect.