• Coordinated Family Support (CFS)

    CFS Provider Quarterly Reporting Tool
  • CFS Quarterly Report Completed on (Date)
     - -
    2 digit month, 2 digit day, 4 digit year

  • CFS is for adults who live in the family home. The outcome of CFS should provide equitable access to services and supports which reduce disparity while flexibly tailoring the service to the individual and their family through the multiple stages of life from transition through aging. CFS will be provided in a manner which is respectful of the culture, ethnicity, and linguistic preferences of the individual and their family. A CFS Plan of Action shall not replace or duplicate any regional center service coordination, generic service or other regional center funded service that the individual and their family are receiving.

  • Directions:
    The CFS provider is to update the progress only on items for which a CFS Plan of Action has been developed. The progress report should include actions taken and outcomes achieved towards the overall goal(s). If an individual is receiving direct support through CFS in components #1 and/or #7, please note the actions taken and progress made in transitioning the direct support to a more permanent service within the 90-day period. This progress report must be submitted on a quarterly basis by the CFS provider to the regional center Service Coordinator of the individual served.

  • 1. Identifying and providing supports necessary to successfully reside in the family home

  • Is there a CFS Plan of Action

  • 2. Providing assistance and training for the individual and their family in navigating comprehensive services and supports that are tailored to meet their unique needs, including creating pathways to overcoming barriers to accessing generic and other
    resources

  • Is there a CFS Plan of Action

  • 3. Providing additional information or resources on the individual’s diagnosis and identified supports

  • Is there a CFS Plan of Action

  • 4. Coordinating consistency in training across providers specific to the needs of the individual and their family

  • Is there a CFS Plan of Action

  • 5. Assisting with scheduling of service delivery including medical and other appointments

  • Is there a CFS Plan of Action

  • 6. Identifying transportation options or services

  • Is there a CFS Plan of Action

  • 7. Identifying backup providers/supports and providing those backup supports when the plan fails

  • Is there a CFS Plan of Action

  • 8. Providing futures planning for the individual, including those living with aging caregivers

  • Is there a CFS Plan of Action

  • 9. Providing training to the individual which maximizes their independence

  • Is there a CFS Plan of Action

  • 10. Other - need that has been identified within the scope of the service, but not identified in Items #1-9 above

  • Is there a CFS Plan of Action
  • Should be Empty: