Families / All Categories

This form is completed by 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.
Department/Crown:Families
Category:Families
This form, completed by individuals who are interested in becoming a licensed or approved residential care facility operator as part of the application process, verifies the physical structure of the facility, including the number of rooms, number of storeys, heating, water and sewage, and bedroom dimensions. 
Department/Crown:Families
Category:Families
This form is completed by residential care facility operators or staff employed by operators or agencies for each resident who takes PRN (i.e., as required) medications ordered by a physician.   The facility must maintain the form on each resident's personal file.
Department/Crown:Families
Category:Families
This form, completed and maintained by residential care facility operators or staff employed by operators or agencies, is kept on each residential care facility resident's personal file.  The form records information about the resident such as identifying information, medical contacts, financial information, and critical information.
Department/Crown:Families
Category:Families
This form, completed by residential care facility operators or staff employed by operators or agencies in facilities with more than eight residents and kept on file for a period of at least three months, records necessary variations to the facility's weekly menu.
Department/Crown:Families
Category:Families
This policy outlines the process for conducting Residential Care Occupancy Risk Assessments in shift-staffed residential care facilities operating under a letter of approval.  The policy also applies to host family homes (i.e., home shares) as best practice.
Department/Crown:Families
Category:Families
This orientation checklist is completed by residential care facility operators or staff employed by operators or agencies.  Residential Care Licensing requires operators to provide each employee with an orientation to residential care standards, policies, procedures, and routines using this form (or form in a similar format).  The operator must retain the form on each individual's personnel file.
Department/Crown:Families
Category:Families
This form, completed by residential care facility operators or staff employed by operators or agencies in facilities with more than eight residents and kept on file for a period of at least three months, is the weekly menu plan for the facility.
Department/Crown:Families
Category:Families
This document provides information to parents and guardians of children open to Children's disABILITY Services about when their child goes on an outing with a department-managed respite provider. This guide includes an activity plan that requests input from families to help plan outings.
Department/Crown:Families
Categories:Application, Families
This form is to be used by service providers to give feedback on how their programming is working for the FASD population they serve.
Department/Crown:Families
This document decribes the requirements for supervision of napping infants in Manitoba's licensed early learning and child care facilities.
Department/Crown:Families
Categories:Families, Licence
The Supports Intensity Scale (SIS) is an assessment tool, completed in the form of an interview with the individual and members of their support network, that the Community Living disABILITY Services (CLDS) program uses to determine how often eligible participants need support, what type of supports they need, and how much support they need in areas of daily life.
Department/Crown:Families
The tax release form grants permission from an EIA applicant/participant for Revenue Canada to release Income Tax information to the Department of Families for the purpose of information verification.  
Department/Crown:Families
The Teen Services Network hosts an annual professional development day. This form allows participants to register for the event. It is updated annually to reflect the date and location and is sent around to potential registrants via email approximately 3 months prior to the event. 
Department/Crown:Families
Under the Manitoba Strategy, a Regional Team is a committee, coalition, or group made up of various multi-system stakeholders whose goal is to provide public awareness and education, and incorporating specialized training for team members to address the issue of sexual exploitation in any or all its forms regionally and provincially. This document is used to inform their strategic plans.
Department/Crown:Families
Category:Families
This form is an agency form and is used when a child is being transported for family trips, visits to birth families or travel for sporting events. The caseworker locates the form in the CFSA system and downloads it on the agency letterhead.
Department/Crown:Families
Category:Families
Volume 2(1) contains provincial policies and standards with respect to the development, operation and licensing requirements of emergency group care facilities, including the administrative procedures by which licences are issued, maintained, renewed and cancelled. The forms in this manual are not for public use. This is only used once approval for a license has been given.  The information in this standard manual is also contained in Volume 2 Child and Family Services Standards Manual Facility Standards.
Department/Crown:Families
Categories:Application, Families

The use of voluntary placement as a short term measure is consistent with an agency's duty to provide family guidance, counselling, supervision and other services to families for the protection of children.  This form is located within the Child and Family Services Information System for agency use.  This is a statutory regulated form embedded in The Child and Family Services Regulation

Department/Crown:Families
Category:Families
The signing of a voluntary surrender of guardianship by guardian (VSG) agreement has the same legal effect as a permanent order of guardianship under subsection 45(1) of The Child and Family Services Act. It permanently terminates all parental rights and obligations for the child after 21 days from the date of signing (see subsection 16(10) of the Act). This is a statutory regulated form embedded in The Child and Family Services Regulation
Department/Crown:Families
Category:Families
The signing of a voluntary surrender of guardianship by mother (VSG) agreement has the same legal effect as a permanent order of guardianship under subsection 45(1) of The Child and Family Services Act. It permanently terminates all parental rights and obligations for the child after 21 days from the date of signing (see subsection 16(10) of the Act). This is a statutory regulated form embedded in The Child and Family Services Regulation.
Department/Crown:Families
Category:Families

The signing of a voluntary surrender of guardianship (VSG) agreement has the same legal effect as a permanent order of guardianship under subsection 45(1) of The Child and Family Services Act. It permanently terminates all parental rights and obligations for the child after 21 days from the date of signing (see subsection 16(10) of the Act). This is a statutory regulated form embedded in The Child and Family Services Regulation.

Department/Crown:Families
Category:Families
Under The Vulnerable Persons Living with a Mental Disability Act, certain requirements must be met before a substitute decision maker for a vulnerable person can be appointed. Use this form to request withdraw of an application for the appointment of a substitute decision maker. 
Department/Crown:Families
Categories:Application, Families
Under The Vulnerable Persons Living with a Mental Disability Act, certain requirements must be met before a substitute decision maker for a vulnerable person can be appointed.  Use this schedule to list all the real and personal property of a vulnerable person. 
Department/Crown:Families
Categories:Application, Families
Under The Vulnerable Persons Living with a Mental Disability Act, certain requirements must be met before a substitute decision maker for the vulnerable person can be appointed. Use this form (schedule B to E) to apply for appointment as emergency/temporary substitute decision maker. 
Department/Crown:Families
Categories:Application, Families

This template is for the creation of a bond to ensure that a substitute decision maker for property performs the duties and exercises the powers of a substitute decision maker as set out in The Vulnerable Persons Living with a Mental Disability Act and regulations.

Department/Crown:Families
Category:Families
Under The Vulnerable Persons Living with a Mental Disability Act, certain requirements must be met before a substitute decision maker for a vulnerable persnon can be appointed. for an individual. Use this form to apply for a variation of an appointment of a substitute decision maker. 
Department/Crown:Families
This warrant entitles a peace officer to apprehend and return a child in care to their placement if they run away. This is a statutory regulated form embedded in The Child and Family Services Regulation. It I s a form that would only be filled out by a CFS agency and/or a peace officer.
Department/Crown:Families
Category:Families
The Warrant allows peace officers to enter these premises, by force if necessary, and to search for the child and if the child appears to be in need of protection, to apprehend the child and to take the child to a place of safety, or take other steps to protect the child. This is a statutory regulated form embedded in The Child and Family Services Regulation.
Department/Crown:Families
Category:Families
This is an application form requesting an EIA Intake Appointment.  Staff at Welcome Place (Settlement Services) help the applicant to complete this form and then send it to EIA Programs on their behalf.  An appointment date will be set and then sent back to the staff at Welcome Place (Settlement Services) who will share this information with the applicant.
Department/Crown:Families
You have a choice between two shelter rates: a base rate for your family size plus the actual amount you pay for utilities (called the Utilities Excluded Shelter Rate) or a higher amount that stays the same regardless of what you pay for utilities (called the Utilities Included Shelter Rate.)
Department/Crown:Families
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