2022 Edition

Adult Foster Care (CA-AFC) 8: Placement Monitoring and Reassessment

Placement monitoring ensures continuity of service and care and timely adjustments to the placement when challenges arise.

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Adult Foster Care (CA-AFC) programs support community-based living arrangements for adults in need of long term-services and supports, matching them with in-home caregivers.
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions, procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • Active client participation occurs to a considerable extent.
Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • Several client records are missing important information; or
  • Client participation is inconsistent. 
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or 
  • Documentation is routinely incomplete and/or missing.      
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Procedures for placement monitoring and reassessment
  • Procedures for responding to complaints or problems
  • Tools for placement monitoring and reassessment
  • Schedule of home visits
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records

Fundamental Practice

CA-AFC 8.01

Placement monitoring procedures include: 
  1. a frequency schedule of in-person visits made to the home;
  2. assignment of responsibility for ensuring services are being accessed and are appropriate and satisfactory;
  3. annual health status reports, either provided by the qualified personnel or documentation by the caregiver’s and service recipient’s primary care physicians;
  4. documentation to be provided by the caregiver, and
  5. responsiveness to any complaints or problems that may develop.


Regarding element (c) health status reports should be completed annually, on a schedule, and after every medical emergency or significant change in functioning.


CA-AFC 8.02

Qualified personnel meet with the caregiver and service recipient at least annually to conduct formal placement reassessments and: 
  1. within five working days of a precipitating event;
  2. when there is a significant change in the individual’s status or circumstances, or a new issue arises; and
  3. within 48 hours of notification when a hospital or institutional discharge is imminent.


CA-AFC 8.03

Placement reassessment includes: 
  1. conditions of the home environment;
  2. changes in baseline functioning status of the service recipient, including increased needs;
  3. community integration, including frequency of the individual engaging in community activities and ability to access community activities independently; and
  4. changes in the household make up.


CA-AFC 8.04

Caregivers and case workers develop a system of documentation and communication regarding: 
  1. completion of ADLs and IADLs;
  2. the service recipients physical, mental, and emotional status within the household;
  3. medication; and
  4. services utilized.

Fundamental Practice

CA-AFC 8.05

Case workers regularly monitor the placement and: 
  1. have a schedule of caregiver documentation review; and
  2. communicate with other service providers to assess service participation and effectiveness.