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This document informs a man that he has been named as the birth father of a child and advises him of plans for the child to be adopted. The form describes how to be legally named the father of the child, whom to contact to obtain information about plans for the child, including pre-adoption birth registration information that may be available to the birth father and adopted child at age 18.  

Form required for licensed nursery schools to apply for operating grant funding.

Information to assist nursery schools in preparing an operating grant application.

This document provides detailed guidelines about zoning, building regulations, required paperwork and the process to obtain permits from the City of Winnipeg when seeking to occupy a space for use as a child care centre facility in Manitoba. 

The Adoption/Post Adoption unit uses this form to determine eligibility of adoptive parents for subsidy if they live north of the 53 parallel

The Adoption/Post Adoption unit uses this form to determine eligibility for subsidy to adoptive parents living north of the 53rd parallel without road access.

This form is used by the Adoption/Post Adoption unit to determine eligibility of adoptive parents for financial assistance who live south of the 53rd parallel.

A guide to the Online Child Care Registry for licensed child care facilities.

The Online Child Care Registry helps families find, and apply for a space in licensed Manitoba facilities. Register online to add your child(ren) to one or more wait lists and manage your contact information from one location. 

This document provides step-by-step information about how to create an account and use Manitoba's Online Child Care Registry, a tool that allows families to look for licensed child care and add their children to wait lists of licensed providers.

This document is a comprehensive guide for Maniotba licensed child care providers, to create an account on the online child care registry, to access and manage online waitlists and provide parents with necessary facility and program information.

Under sections 38 and 40 of The Child and Family Services Act an agency must get an order if they feel a child is in need of protection. This document explains the reasons whyy an order is necessary and contains all the material the Judge needs to hear.

Under sections 38 and 40 of The Child and Family Services Act an agency must get an order if they feel a child is in need of protection. This document explains the reasons whyy an order is necessary and contains all the material the Judge needs to hear.

This document is the template of an Order of Adoption that outlines the decision of a judge to grant an order of adoption based on material filed during a court hearing.  This legal document confirms that the application for an order of adoption has been filed and meets all applicable requirements of The Adoption Act.

This document is a template of an Order of Adoption that outlines the decision of a judge to grant an order of adoption based on material filed, oral evidence and submissions of counsel presented during a court hearing. This legal document confirms that the application for an order of adoption has been filed and meets all applicable requirements of The Adoption Act.

Policy regarding orthotics and orthopaedic footwear.

Preauthorization form for orthotics.

This document is an Outstanding Warrants Check form that must be completed by an EIA applicant/participant and Police Officer, according to the Manitoba Assistance Act.  

A letter template to be used by each Local Coordinator to inform Kindergarten parents about the implementation of the EDI.

This form is an agency form that a caseworker will have a parent sign to provide medical attention to their child while in care. If you need a copy of this form please go to your local CFS agency

The Parental/Legal Guardian Consent for Photographs form is used by the child and family services agency caseworker and the parent/legal guardian of a child. It gives permission for the caseworker to take a current photograph of the child for the child's file and is kept in the Child and Family Services Application. 

This form describes all the personal job plan activities that were completed by an EIA participant during a monthly reporting period. It is to be signed and submitted to EIA staff. 

This form is completed on every new participant that enters a program within the programs being evaluated under the MB FASD Strategy evaluation. This outcome data will be used to help improve programs as well as help identify how children/youth/adults/families are doing over time and determine what programs may be needed.

The program reimburses up to 4% of employer pension contributions.  All employees are eligible to join the pension plan as soon as it is set up.  For-profit child care centres are not eligible for funding.

This form is used to request personal health information from a hospital.

This form grants the consent of an EIA participant who is receiving Adult Probation Services for the use and disclosure of personal and personal health information, as part of joint planning to develop a Personal Plan.  The form must be signed by the participant and Province of Manitoba staff.

An agency uses this form when a child has an Order for Temporary Guardianship and  is still in need of protection requesting that another Order be made.This is a statutory regulated form embedded in The Child and Family Services Regulation

The agency believes that  a was, and is still, subjected to abuse. They are petitioning the court to receive guardianship of the child. This is a statutory regulated form embedded in The Child and Family Services Regulation

The agency believes that  a was, and is still in need of protection. They are petitioning the court to receive guardianship of the child. This is a statutory regulated form embedded in The Child and Family Services Regulation

This form is used to identify the children, dates of birth and their locations when apprehended and taken to a place of safety. It is an agency form and should be filled out by the caseworker.

This form is used when referring a child in care from one placement to another. It is filled out by the caseworker and contains information on the child and the reason for the referral. This is an internal record and is kept in the CIC file.

Social Services Appeal Board's policies and procedures of the appeal process. The purpose of this commission is to give Manitobans a fair, impartial and informal appeal process of decisions relating to various social services and programs.

This document is a detailed referral form required to apply to the Portable Housing Benefit - Mental Health Project. This form must be completed by a service provider on behalf of the EIA participant. 

Form requesting change in employment information for purposes of reassessment.

Form for Newcomers requesting additional information for benefit assessment.

Form to be completed to establish a private support agreement between a payer and debtor 

This document is a training request form made by an EIA recipient to study at the Neeginan Institute of Applied Technology (NIAT), including specific details about funding. 

Application and Guidelines on how to apply for Proposal Development Funding.

Protocol to ensure the smooth and positive transition of children with additional support needs into the school system.

This form must be completed in full in order to meet the requirement of notifying the Director of Child and Family Services of abuse allegations, per The Child and Family Services Act, Section 18(6) " Where an agency receives information that a child was or might have been abused by a person who provides work for or services to the agency or to a child care facility or other place where a child has been placed by the agency, the agency shall, in addition to carrying out its duties under subsection 18.4(1) and section 18.5, immediately report the matter to the director and the director shall investigate the matter and take such further steps as are required by this Act, prescribed by regulation, or as the director considers necessary.  This is an internal form that is filled out by agencies when reported abuse allegations.

This internal referral form for behaviour psychology services is completed by Community Service Workers at Children's disABILITY Services and Community Living disABILITY Services.

This form is used by child care centres to add, modify or remove employee information from facility employee records.

This record must be updated when there are any new residents, licensees, overnight or support staff in the home. 

When a youth is leaving the Child and Family Services System because they are approaching their 18th birthday, their caseworker must (if applicable) make a referral to independent living programs. The caseworker uses their agency form to make that referral. 

This document outlines types of funding support available to child care workers to help them plan for their retirement. Information is provided about eligibility and options for registered pension plans for full-and part-time child care workers, the matched registered retirement savings plan contributions and the long-term service recognition retirement benefit.

Registration by Adopted Adult for Adoptions Finalized in Manitoba form: An adoptee can fill out this form to request a search for information on their birth family. If a disclosure veto has not been received, the Manitoba Post-Adoption unit will provide information to the adoptee.

 This form allows an adoptive parent to share information on their adoptive child with their birth parents.

Form required by licensed child care facilities to register for access to the Child Care Online system.

This form is used by the Adoption/Post Adoption unit to allow for an adoptive parent to notify the birth family of the death of the adoptee

Refer to CMHA for the now defunct Parent Wellness Initiative (PWI)

New Key, Replacement, when lost, change of tenant or for contractors

The information on this form is required to determine the nature of your relationship with the adult you live with for the purpose of assessing eligibility for Employment and Income Assistance (EIA).

Under the Child and Family Services Act, Subsection 15(2) Financial information and maintenance agreement the agency shall request the parent or guardian to agrees to pay to the agency maintenance for the child in accordance with the regulations . This is the renewal form and must not  be changed other than by an amendment to the regulation. This is an agency form and is filled out by a case worker.

Form required by child care centres and nursery schools to apply to renew a licence.

Form required by family and group child care homes to apply to renew a licence.

Form required by an occasional child care centre to apply to renew a licence.

A voluntary placement agreement may not last more than 12 months and may be renewed to a maximum of 24 months. This is a statutory regulated form embedded in The Child and Family Services Regulation

Form required to apply for the Rent Assist benefit for people who are not receiving EIA benefits. To be completed by the applicant. 

Non-EIA Rent Assist Policy Manual

This form gathers information about rental arrangements made between a tenant who is an EIA participant and the landlord. 

Adult Abuse Registry form for completion by a peace officer to report the name of the accused and the details of the offence, in accordance with the regulations, to the registrar.

Not for Public Use. Application pursuant to Subsection 41(2) of The Adult Abuse Registry Act for access to the Adult Abuse Registry by a designated officer. Designated officer means an executive director appointed under The Vulnerable Persons Living with a Mental Disability Act, or a person specified with respect to any other designated Act (as defined in The Adult Abuse Registry Act).  

The Vulnerable Persons Living with a Mental Disability Act requires that if, after an investigation the executive director must provide a report about the matter to the adult abuse registry committee, in accordance with the regulations

The Vulnerable Persons Living with a Mental Disability Act requires that if, after an investigation the executive director must provide a report about the matter to the adult abuse registry committee, in accordance with the regulations

Not for Public Use.  This form is for a Peace Officer to provide the name of the person and the details of the offence to the Provincial Child Abuse Registry.  Where a person was found guilty, pleaded guilty to an offence involving the abuse of a child in a court in, or outside of Manitoba, the name of that person, the circumstances of the abuse and any sentence imposed must be reported for entry on the Child Abuse Registry.

This letter outlines the financial reporting requirements of licensed nursery schools.

This document is an application form to request an initial/extension of an exemption(s) to trained staff requirements, completed by ELCC licensed child care facilities as part of their staffing plan and noted as a condition on their facility license.

Request for information from MEP

This document is a list of requirements and responsibilities that must be met by the non-profit child care organization for funding to be received by Early Learning and Child Care Building Fund grant recipients.

This document summarizes the areas of compliance to be met (health, fire, zoning and building regulations) as well as child care licensing requirements, when constructing and/or renovating a space for use as a child care centre in Manitoba.

This form is completed by service providers of home shares (including agency supported home shares), mental health facilities, and facilities providing care for persons requiring support due to frailty or cognitive impairment related to aging during the annual review or renewal process.  By completing the form, the service provider declares whether, to the best of their knowledge, they as the service provider, any other persons providing residential care in the facility or any other adult (other than residents) residing in the facility, has been placed on the Adult Abuse Registry or is presently under investigation for an allegation of abuse or neglect.

This document provides clarification to Department of Families staff that paid and non-paid staff working in residential care facilities must be at least 18 years of age.

This form is completed by Residential Care Licensing staff as a supplement to the Inspection Checklist, which is completed during on-site inspections of facilities to record the results of a facility's compliance or non-compliance with licensing requirements.

This set of interview questions is asked to individuals applying to become host family home (i.e., Home Share) providers in order to assist the department in determining the individual's suitability to become a residential care provider.

This form, completed by a qualified physician, licensed prescriber, or dispensing pharmacist, authorizes residential care facility operators or staff employed by operators or agencies to administer non-prescription drugs to facility residents.

This form, completed by a residential care facility resident's attending physician and supervising agency, authorizes residential care facility operators or staff employed by operators or agencies to allow the resident to self-administer medications as directed by the physician, provided that the facility maintains an appropriate level of drug security to prevent unauthorized access and risks to others.

This form is completed by Residential Care Licensing staff as part of the application process for individuals who are interested in becoming a licensed care provider for the Community Living disABILITY Services program.  It provides information about the prospective care provider, such as their motivation to provide care, their personality, interests, and health, as well as information about their home, including its physical structure, other residents (if applicable), and sleeping accommodations.

This document outlines the standard communication skills and competencies required of service providers and staff responsible for providing care and supervision in residential care facilities.

This policy outlines the requirements, procedures and guidelines for service providers, persons providing residential care and adults residing in a residential care facility (other than those receiving accommodation, care and supervision) regarding Criminal Record Checks and Adult Abuse Registry checks.

This form is completed by service providers of home shares (including agency supported home shares), mental health facilities, and facilities providing care for persons requiring support due to frailty or cognitive impairment related to aging during the annual review or renewal process.  By completing the form, the service provider declares whether, to the best of their knowledge, they as the service provider, any other persons providing residential care in the facility or any other adult (other than residents) residing in the facility, has been charged with or investigated for any criminal or illegal activities.

This declaration form is completed by persons providing accommodation, care, or supervision in existing licensed or approved residential care facilities when there is a delay in obtaining a clear Adult Abuse Registry check.

This declaration form is completed by persons providing accommodation, care, or supervision in existing licensed or approved residential care facilities when there is a delay in obtaining a satisfactory Criminal Record Check.

This dental record form is completed by residential care facility operators or staff employed by operators or agencies for facility residents in instances where a record is required with respect to a resident's goals and treatment plan.  The facility must keep the record(s) on the resident's personal file.

This form is completed by residential care facility operators or staff employed by operators or agencies on a monthly basis to record fire drills conducted at residential care facilities, including the date and time of drills, evacuation times, exits used, participant information, problems encountered, and actions taken.

This checklist is completed by residential care facility operators or staff employed by operators or agencies on a monthly basis to record details of compliance or non-compliance with Residential Care Licensing fire safety requirements.

This form is completed by residential care facility operators or staff employed by operators or agencies to record details of accidents and incidents that involve residents of a residential care facility for reporting purposes.

This form is completed by Residential Care Licensing staff at the time of on-site inspections of facilities to record the results of a facility's compliance or non-compliance with licensing requirements.

This form is completed by residential care facilities or staff employed by operators or agencies and the receiving pharmacist when disposing unused, discontinued, or out-of-date narcotic or controlled drugs.  The facility must keep the form on file.

This form is completed by the agency/operator of a residential care facility when applying for the installation of life safety equipment through the Life Safety Initiative.  The form collects detailed information about the facility, the specific needs of residents, and the required equipment.

This form is completed by the registered owner(s) of a residential care facility and the contractor(s) responsible for installing approved life safety equipment at the facility after the installation is complete.  By completing the form, the registered owner(s) acknowledge that the work has been completed to their satisfaction, that the equipment is ready for use, and that the Department of Families is not responsible for the ongoing maintenance or removal of the equipment, while the contractor certifies that the equipment meets all municipal and provincial by-laws with respect to installation, safety and operation.

This letter, sent from the Department of Families to agencies or residential care facility operators who have successfully submitted three written quotes for the installation of required life safety equipment to the department for review, informs the agency or residential care facility operator that the department has approved Life Safety Initiative funding for the installation of the required equipment at the facility.

This document provides contractors who may be hired by agencies or residential care facility operators to install life safety equipment through the Life Safety Initiative with information regarding written quotes, installation requirements, and contractor responsibilities. 

This form, completed by the registered owner(s) of a residential care facility after a contractor has installed approved life safety equipment at the facility, authorizes the Department of Families to pay the full contract price (excluding GST) to the contractor on behalf of the registered owner(s).

This letter, sent from the Department of Families to agencies or residential care facility operators who have applied for funding through the Life Safety Initiative (LSI), informs the agency or operator that they have met the necessary requirements for LSI funding, and invites them to obtain three written quotes for the installation of the required  equipment at the facility and submit them to the department for review.

This medical record form is completed by residential care facility operators or staff employed by operators or agencies for facility residents in instances where a record is required with respect to a resident's goals and treatment plan.  The facility must keep the record(s) on the resident's personal file.

This form is completed by residential care facility operators or staff employed by operators or agencies on a monthly basis for each resident who received medication administration services.  The facility must maintain the form on each resident's personal file.

This form must be completed by residential care facility operators or staff employed by operators or agencies for each narcotic/controlled drug order for each resident, as applicable.  The facility must maintain a separate form each narcotic or controlled drug order on the resident's file.