PLACEMENT TERMINATION OF FOSTER CHILD - Los Angeles …
PLACEMENT TERMINATION OF FOSTER CHILDInstructions: Complete this form in duplicate, give original to Foster Caregiver at time of removal, retain copy in service case.Caregiver & Placement InformationCaregiver NamePlacement Street AddressCity/State/ZIPRemoval & Payment InformationDate of RemovalPayment Stop DateSignaturesCSWDateSCSWDateFoster Caregiver Date ................
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