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The NY Adoption Form, officially known as LDSS-0857, is a critical document that prospective adoptive parents must complete when seeking to adopt a child in New York State. This form collects essential information regarding the applicants, including their names, dates of birth, ethnicities, and religious backgrounds, which help create a comprehensive profile. The form also captures details about the family's home address, contact numbers, and primary and secondary languages, ensuring that relevant caseworkers have a complete understanding of the family’s background. Additionally, prospective parents are asked to indicate their preferences for the child they wish to adopt, including age, sex, and ethnicity. There’s also a section for parents to express their willingness to accept children with special needs, alongside the specific challenges those children may face. Furthermore, the application prompts families to provide information about their current and previous marriages, household members, and any foster children currently living in their home. Completing this form accurately is crucial as it directly affects the matching process and overall adoption journey. Understanding what is required on this application can simplify the intricacies of adopting and help families prepare for what lies ahead.

Ny Adoption Example

LDSS-0857 (Rev. 4/2011)

 

 

 

 

 

 

 

NEW YORK STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OFFICE OF CHILDREN AND FAMILY SERVICES

 

 

 

 

 

REGISTRY NUMBER

 

 

 

APPLICATION TO ADOPT

 

APPLICATION DATE

(For Official Use Only)

 

 

 

 

(For Official Use Only)

 

 

 

 

 

 

 

PART I

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Family Adoption Registry Information

 

 

 

 

 

PROSPECTIVE PARENT’S NAME (Last, First, MI)

 

 

 

 

DATE OF BIRTH

YY

ETHNICITY CODE

 

RELIGION CODE

 

 

 

 

 

 

 

 

 

MM, DD,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROSPECTIVE PARENT’S NAME (Last, First, MI)

 

 

 

 

DATE OF BIRTH

ETHNICITY CODE

 

RELIGION CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MM, DD, YY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOME ADDRESS (No., Street, Apt.)

 

 

 

 

CITY/TOWN

COUNTY

 

 

STATE

ZIP CODE

 

 

 

 

 

 

 

 

HOME TELEPHONE NUMBER

EMPLOYMENT TELEPHONE NO. (Prospective Adoptive Parent)

 

EMPLOYMENT TELEPHONE NO. (Prospective Adoptive Parent)

(

)

-

(

 

)

-

 

 

(

 

 

)

-

 

 

 

FAMILY’S PRIMARY LANGUAGE CODE

FAMILY’S SECONDARY LANGUAGE CODE

FAMILY’S PET:

 

E-Mail Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

@

 

 

NOTE: Select ALL acceptable characteristics. You may choose more than one entry in each area.

Sex Male, Female, Either

Age:

 

Under 2

 

2-5

 

6-7

 

8-9

 

10-13

 

Over 13

Ethnicity Code:

Primary Language Code:

Secondary Language Code:

Religion Code:

ETHNICITY CODE

(FOR CHILD AND PARENTS)

LANGUAGE CODE

(FOR CHILD AND PARENTS)

AA

Black or African American

ASI

Indian

AI

Nat Am Lan

KM

Cambodian

AAC

Caribbean

ASJ

Japanese

AL

Albanian

KR

Korean

AAH

Haitian

ASK

Korean

AR

Arabic

LA

Laotian

AAN

Native African

ASX

Other - Asian

BN

Bengali

MU

Multiple

AAX

Other - Black or African American

HP

Hispanic

BS

Bosnian

NI

NigeranIbo

AL

Alaskan Native

ML

Multiple

CC

Cantonese

PJ

Punjabi

AM

American Indian

PI

Native Hawaiian/Pacific Islander

CF

Fujianese

PL

Polish

AS

Asian

WH

White

CH

ChnseOther

PR

Portuguese

ASC

Chinese

XNR

Not Reported

CM

Mandarin

PT

Patois

 

RELIGION CODE

 

 

CR

HaitnCreol

RO

Romanian

 

(FOR CHILD AND PARENTS)

 

CZ

Czech

RS

Russian

AT

African Religion

IS

Muslim/Islamic

EN

English

SC

SerboCroat

BA

Baptist

JW

Jehovah's Witness

ET

Ethiopian

SI

Amer Sign

BP

Other Protestant

LU

Lutheran

FA

Farsi

SL

Braille

BU

Buddhist

ME

Methodist/Wesleyan

FL

Fulani

SP

Spanish

CJ

Jewish

MO

Mormon

FO

Filipino

TL

Tagalog

CS

Christian Science

NA

Native American

FR

French

UK

Unknown

CT

Chinese Traditional

OC

Other Christian

GK

Greek

UR

Urdu

DE

Other Eastern

PE

Pentecostal

GR

German

VT

Vietnamese

EN

None/Secular

PR

Presbyterian

GU

Gujarati

YI

Yiddish

EP

Episcopal/Anglican

RC

Catholic

HI

Hindi

XX

Other

FP

No Preference

RO

Russian Orthodox

HW

Hebrew

 

 

GO

Greek Orthodox

UN

Unknown

IT

Italian

 

 

HI

Hindu

UU

Unitarian/Universal

JP

Japanese

 

 

 

 

XX

Other

KH

Khmer

 

 

If you will consider a child with special needs and individual needs check ALL appropriate choices in the boxes below:

CATEGORIES OF CHILD NEEDS

Medical/Physical Needs

Educational/Learning Needs

Mental Health Needs

Developmental Delay Needs

MILD

MODERATE

SEVERE

Would You Be Willing to Accept a Legally “At Risk” Child?

YESNO

Would You Be Interested in Adopting a Sibling Group?

YESNO

LDSS-0857 (Rev. 4/2011)

NEW YORK STATE

OFFICE OF CHILDREN AND FAMILY SERVICES

FAMILY CERTIFICATION INFORMATION

PART II

Are you currently an approved adoptive parent?

Yes

No

If yes, please provide approval date:

MM

DD

YY

NAME OF AGENCY

CONTACT PERSON

TELEPHONE NUMBER

( ) -

AGENCY ADDRESS (NO., STREET, APT.)

CITY/TOWN

COUNTY

STATE

ZIP CODE

IF YOU DO NOT HAVE A COMPLETED HOMESTUDY AND WOULD LIKE TO BEGIN THE HOMESTUDY PROCESS, PLEASE GIVE COMPLETE INSTRUCTIONS FOR REACHING YOUR HOME:

FOR OFFICIAL USE ONLY

HOME STUDY STATUS

 

 

 

1. In Process

2. Completed Favorable

3. Completed Unfavorable

4. Discontinued

GENERAL FAMILY INFORMATION

PART III

(To be completed by applicant)

IS THERE A FOSTER CHILD FREED FOR

DO YOU WISH TO ADOPT WHAT IS THE CHILD’S FULL NAME?

ADOPTION CURRENTLY LIVING IN YOUR HOME?

THIS CHILD?

Yes

No

 

Yes

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CHILD’S DATE OF BIRTH

 

 

 

 

 

 

 

 

 

DATE OF PLACEMENT

 

 

 

 

 

 

 

 

MM

DD

YY

 

 

MM

 

DD

 

YY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CURRENT MARRIAGE INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CURRENT MARRIAGE PLACE

 

 

 

 

STATUS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROSPECTIVE PARENT

 

 

 

 

DATE

 

 

 

 

CITY

 

STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CURRENT MARRIAGE PLACE

 

 

 

 

STATUS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROSPECTIVE PARENT

 

 

 

 

DATE

 

 

 

 

CITY

 

STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LDSS-0857 (Rev. 4/2011)

 

PREVIOUS MARRIAGE INFORMATION

 

 

 

 

 

 

 

 

 

 

 

PREVIOUS MARRIAGE PLACE

 

 

HOW TERMINATED

 

 

 

 

 

 

 

 

PROSPECTIVE PARENT

 

DATE

 

CITY

STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PREVIOUS MARRIAGE PLACE

 

 

HOW TERMINATED

 

 

 

 

 

 

 

 

PROSPECTIVE PARENT

 

DATE

 

CITY

STATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LIST ALL HOUSEHOLD MEMBERS

 

 

 

 

 

 

 

FULL NAME

 

DATE OF BIRTH

RELIGION

RACE

RELATIONSHIP

 

 

MM/DD/YYYY

 

 

 

1.

 

 

 

 

Self

2.

 

 

 

 

 

3.

 

 

 

 

 

4.

 

 

 

 

 

5.

 

 

 

 

 

6.

 

 

 

 

 

7.

 

 

 

 

 

8.

 

 

 

 

 

NOTE: If your application is rejected or if your application has not been acted upon within six months of filing by the completion of an adoption study, you may request a State administrative hearing. The hearing must be requested within 60 days after the date of rejection or failure to act.

NOTE: At such hearings, you will have the right to be represented by counsel or other representative to produce witnesses and other evidence on your behalf, to request the issuance of subpoenas, to cross-examine witnesses testifying against you, and to examine all evidence presented against you. If you wish to request a hearing, address your request to:

New York State Office of Children and Family Services

Special Hearings

52 Washington Street, Room 322 North

Rensselaer, New York 12144

NOTE: Social Services Law 424-a requires the authorized agency receiving this application to check with the New York State Register of Child Abuse and Maltreatment to determine whether an adoptive applicant and any person over 18 who resides in the home is the subject of an indicated report of child abuse and maltreatment.

NOTE: Social Services Law 378-a requires the authorized agency to complete a criminal history record check for a prospective adoptive parent or any other person over the age of 18 who is currently residing in the home.

NOTE: If you have acknowledged your willingness to adopt a handicapped or hard-to-place child, your name will be placed ion a Statewide computer file with the New York State Office of Children and Family Services only for the purpose of matching you with available children.

SIGNATURE OF PROSPECTIVE PARENT

 

DATE

 

SIGNATURE OF PROSPECTIVE PARENT

 

DATE

Note: Applicant should retain copy of application

LDSS-0857 (Rev. 42011)

INSTRUCTIONS FOR COMPLETING

APPLICATION TO ADOPT FORM

PART I: Family Adoption Registry Information: All prospective adoptive parents who express a willingness to adopt handicapped or hard-to-place children shall be listed on the Family Registry in the Adoption Album Our Children, Our Families. The information entered into the Family Adoptive Registry System is based on the information provided on the Application to Adopt Form. The registry will allow caseworkers to match the applicant’s profile with children photo listed in The Adoption Album – Our Children, Our Families. Consequently, prospective families will receive consideration based only upon the information contained on the application (i.e. if an applicant indicates a willingness to consider a severely handicapped child). Therefore the applicant will need to ensure the information provided in this registration accurately reflects the applicant’s adoption preferences.

Prospective Parent’s Name: The full name (last, first, middle initial) of the prospective adoptive parent(s). It is possible to list a single parent. Two-parent households must list both parents.

Parent’s DOB: Provide the date of birth (MM/DD/YYYY) of the prospective adoptive parent(s).

Parent’s Ethnicity: Enter parent’s ethnicity. Use ethnicity code from coding guide at the bottom of application.

Parent’s Religion: Enter parent’s religion. Use religion code from coding guide at the bottom of application.

Home Address: Provide the street address of the primary residence.

City/Town: Provide the city/town of the primary residence.

County: Provide the county of the primary residence

State: Provide the state of primary residence.

Zip Code: Provide the zip code of primary residence.

E-Mail: Provide an e-mail address if you have one.

Home Telephone: Provide telephone number including area code of primary residence.

Employment Telephone: Provide prospective parent’s employment telephone number including area code at place (s) of employment.

Family Primary and Secondary Language: Enter the code of the family’s primary and secondary language Use language code from the coding guide at the bottom of the application.

Family Pet: Indicate the type of family pet (as appropriate).

Sex: Indicate with an “E” (Either), “M” (Male), “F”(Female) the sex of the child desired.

Age Indicate with an “X” the appropriate age ranges of child(ren) desired. One or more or all age ranges may be selected. The system will only search the age ranges indicated.

Child’s Ethnicity: Enter ethnicity(ies) of the child(ren) prospective adoptive parent(s) is interested in adopting. Use ethnicity code from coding guide at the bottom of the application.

Child’s Primary and Secondary Language: Enter the code of the child’s primary and secondary language. Use primary and secondary language code form the coding guide at the bottom of the application.

Child’s Religion: Enter religion of the child(ren) prospective adoptive parent(s) is interested in adopting. Use religion code from coding guide at the bottom of the application.

Special Needs: Indicate with an “X” in the appropriate field the willingness of prospective adoptive parent(s) to accept a child with special needs. If a disabled child is not desired, leave this section blank. The system will only search to the degree of disability indicated. Please review the following definitions and examples of the categories of child needs and an explanation of the levels of severity. This is a framework intended to assist caseworker’s to assist matching prospective parents with children available for adoption. It is not the standard for determining rate of payment. Social Services districts establish special exceptional rates in accordance with 18 NYCRR 427.6

LDSS-0857 (Rev. 4/2011)

CATAGORIES OF CHILD NEEDS

Medical/Physical Needs: This category includes children with specific medical/physical needs that may require an additional level of care beyond that normally given at the child’s age level. This category includes children that may display some of the following medical problems that range from acute to chronic and/or terminal illness: a child who experiences respiratory problems ranging from asthma to reactive airway disease or skin conditions that range from eczema to those that require surgical/medical intervention; children with physical disabilities that impair the use of vision, hearing and mobility; and children with neurological problems that range from seizure disorders to different levels of cerebral palsy. This section will include infants that require additional medical intervention as well as some children who have gastrointestinal medical needs, and children who experience a wide range of allergy conditions. Additionally, children with genetically inherited conditions such as Down’s syndrome, Fetal Alcohol Syndrome, Tourettes and sickle cell disease will be included in this section.

Educational/Learning Needs: This category includes children with educational/learning needs ranging from educational support to diagnosed learning disabilities. Examples will include visual/receptive/auditory processing difficulties, dyslexia and educational delays. In addition children may require special educational intervention.

Mental Health Needs: This category includes children with mental/emotional disorders ranging from experiencing acting-out behavioral and emotional problems to having been adjudicated Persons in Need of

Supervision (PINS), and Juvenile Delinquents. Further examples of mental health needs include those children exhibiting some of the following behaviors low-frustration tolerance, early sexual activity, sexually acting-out behavior, enuresis, encopresis, and cruelty to animals. Also included are children who exhibit these additional issues: resistance to adult authority, have difficulty with their peers, runaway behavior, school absence and or discipline issues, diagnosed attention problems including Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder, substance abuse sleep disorders, and theft and gang activity. Children who are physically aggressive, violent and destructive will be noted here.

Developmental Delay Needs: This category includes children whose developmental needs range from receptive/ expressive language, fine/gross motor skills, social adaptations, and self-help skills to those needing intensive assistance in self-help skills and assistance towards achieving independent living. Also included in this section are children who have temporary developmental delays or more permanent deficits.

EXPLANATION OF MILD, MODERATE AND SEVERE LEVELS

Mild:

Medical/Physical Needs: - Child has a condition(s) which require non-acute medical attention such as: visual or hearing impairments, allergies, asthma, controllable epilepsy or follow-up conditions which have been surgically corrected such as open heart surgery.

Educational/Learning Needs - Child is slightly behind in one or more subjects but attends regular school classes. Child may have some minor learning disabilities.

Mental Health Needs: - Child has a diagnosed condition that may mildly impair their ability to function such as an adjustment or attachments disorder. Child is generally emotionally stable but may be facing a situation (disruption, new foster home) that has created a temporary emotional stress and may be addressed. Child has or has had a problem controlling their behavior, usually associated with a specific incident such as a disruption.

Developmental Needs: - Child has a mild delay in development and may be receiving speech, occupational or physical therapy.

Moderate:

Medical/Physical Needs: - Child that has a moderate level of cerebral palsy, cleft defects which have not yet

been surgically treated, sickle cell disease if severe complications are not present, partial impairment of normal movement, diabetes, heart defects which can be repaired, spina bifida without the most severe complications.

Educational/Learning Needs: - Child is 2 to 3 years behind in subjects and receiving resource room help or other special tutoring aside from being in the regular classroom.

Mental Health Needs: - Children with one of the described conditions requiring on going intervention services and a higher level of supervision and or treatment. Child is experiencing emotionally related problems that may interfere with child’s school performance or interaction with others. Child has a history of acting out causing problems in school and in interpersonal relationships.

Developmental Needs: - Child needs assistance with skills of daily living. Child is receiving early intervention services for significant lags in speech, fine/gross motor skills.

LDSS-0857 (Rev. 4/2011)

Severe:

Medical/Physical Needs: - Children with Spina Bifida with severe complications, muscular dystrophy, cerebral palsy with severe retardation and or paralysis, total paralysis, cystic fibrosis, blindness, total deafness, and terminal illnesses.

Educational/Learning Needs: - Children diagnosed as learning disabled or mentally retarded that are in special classroom settings.

Mental Health Needs: - Children who are schizophrenic, autistic and /or who act out destructively such as a fire- setter or a serious suicide risk. Children that are seriously emotionally disturbed, are in residential treatment, are receiving intensive therapy, or are in emotionally handicapped classroom settings. Children who exhibit severe acting-out and/or violent behavior. Children on medication to control their behavior.

Developmental Needs: - Children with severe mental retardation. Children receiving intensive therapy to obtain skills of daily living, children needing extensive supervision for daily functioning.

Accept Child who is “Legally At Risk”: Indicate with an “X” if applicant is willing to accept a child who is legally at risk. Detailed below, are two definitions associated with Legally At Risk.

The child’s birth parents have not terminated their parental rights and/or surrendered the child. Therefore, the child may not become available for adoption. (Note: This definition is appropriate for the recruitment and placement of children.)

A child is freed for adoption and there are potential legal impediments to the completion of the adoption including, but not limited to: a) there is a pending appeal of the termination of parental rights; b) there is a putative father who is claiming to be a person whose consent to the adoption is required; c) there is a conditional surrender where the surrender limits or restricts who the adoptive parent can be; and d) the child’s immigration status. (Note: This definition is appropriate for matching and searching photo-listed children with families registered in the Family Adoption Registry)

PART II: FAMILY CERTIFICATION INFORMATION: This section will provide the agency with the family’s current certification and license adoption information.

Certified/Licensed Adoptive Parent: Indicate yes or no applicant is currently certified/licensed as an adoptive parent. If no, leave blank. If yes, complete the following:

Approval Date: Please provide the date on which the family was approved as adoptive parents

(MM/DD/YYYY)

Name of Agency: Provide the full name of the adoption agency that certified the family as an adoptive family.

Contact Person: Provide both the first and last name of the district/agency official who will serve as the contact for this application in reference to inquiries from other districts/agencies or state offices.

Phone: Provide the business telephone number of the contact person.

Agency Address: Provide the street/address of the agency.

City/Town: Provide the city/town of the agency

County: Provide the county of the agency.

State: Provide the name of the state.

Zip Code: Provide the zip code.

Instructions to the home: If the applicant does not have a completed home study and would like the agency to conduct a home study, please provide detailed instructions for reaching the home.

LDSS-0857 (Rev. 4/2011)

PART III: GENERAL FAMILY INFORMATION (To be completed by applicant): Information collected in this section will allow the agency to begin the approval process for your family.

Is there a foster child freed for adoption currently living in your home? Indicate yes or no if a foster child is currently living in your home and the foster child’s parent’s rights have been terminated.

Do you wish to adopt this child? Indicate yes or no if your family intends to adopt the foster child currently living in your home.

What is the child’s name? Provide the foster child’s complete name (First, Last, Middle Initial). Child’s Date of Birth? Provide the date of birth (MM/DD/YYYY) of the foster child.

Date of Placement: Indicate the date (MM/DD/YYYY) on which the foster child was placed in your home.

Current Marriage Information: Provide current marriage information by indicating the following:

Prospective Parent’s:

Prospective Parent’s name;

The date of the current marriage;

City and State in which the current marriage took place; and

Status

Prospective Parent’s:

Prospective Parent’s name;

The date of the current marriage;

City and State in which the current marriage took place; and

Status

Previous Marriage Information: Provide previous marriage information by indicating the following:

Prospective Parent’s:

Prospective Parent’s name;

The date of the previous marriage;

City and State in which the previous marriage took place; and

How the previous marriage was terminated.

Prospective Parent’s:

Prospective Parent’s name;

The date of the previous marriage;

City and State in which the previous marriage took place; and

How the previous marriage was terminated.

List All Household Members: Indicate every member of the household by providing the following information: (Begin by indicating yourself first):

Name: Provide the full name of each household member (First, Last, Middle Initial);

Date of Birth: Provide the date of birth (MM/DD/YYYY) of each household member.

Religion: Indicate the religion of each household member.

Race: Indicate the race of each household member

Relationship: Provide the relationship of each household Signature Prospective Parent(s): Provide signature

Date: Provide the date the prospective parent(s) signs the application.

Form Characteristics

Fact Name Details
Form Purpose The LDSS-0857 form is used to apply for adoption in New York State.
Governing Laws This form is governed by New York Social Services Law, particularly Sections 424-a and 378-a, which require background checks.
Family Registry Prospective parents who wish to adopt may be listed in the Family Adoption Registry, aiding children with special needs or specific characteristics.
Special Needs Option The form includes a section where applicants can indicate their willingness to adopt children with special needs, allowing tailored child matching.

Guidelines on Utilizing Ny Adoption

Filling out the NY Adoption form is an important step in the adoption process. Careful attention to detail will ensure a smoother experience. Once you complete the form, it will be submitted for review. Be prepared to provide additional documentation as required.

  1. Obtain the form: Download or collect the NY Adoption form (LDSS-0857) from the New York State Office of Children and Family Services website.
  2. Fill out Part I: Enter your full name (last, first, middle initial) and date of birth for yourself and any additional prospective parents.
  3. Provide ethnicity and religion: Refer to the provided coding guide to choose the appropriate codes for your ethnicity and religion.
  4. Complete your address information: Include your home address, city/town, county, state, and zip code.
  5. Include contact information: Provide your home telephone number, and if applicable, the employment telephone numbers for both prospective parents.
  6. Language details: Fill in the primary and secondary languages spoken in your household using the designated codes.
  7. Describe family pets: Provide details about any pets in the home.
  8. Indicate child preferences: Select characteristics such as sex, age, ethnicity, language, and religion preferences for the child you wish to adopt.
  9. Special needs considerations: Check any applicable boxes if you are willing to adopt a child with special needs, and specify the type of needs.
  10. Part II - Family Certification Information: Indicate your approval status and provide the name and telephone number of your agency contact if applicable.
  11. Fill out Part III - General Family Information: Answer questions regarding current and previous marriage statuses and list all household members, including their details.
  12. Review and double-check: Carefully go over the completed form to ensure all sections are filled out accurately and completely.
  13. Sign and date: Both prospective parents must sign and date the application before submission.
  14. Submit the form: Send the completed form to the appropriate agency, ensuring you retain a copy for your records.

What You Should Know About This Form

What is the NY Adoption form LDSS-0857 and who needs to complete it?

The NY Adoption form, specifically the LDSS-0857, is an application to adopt children in New York State. This form must be completed by prospective adoptive parents who wish to initiate the adoption process. It collects vital information about the adoptive parents, their family structure, preferences regarding the child to be adopted, and other pertinent details. Anyone looking to adopt a child must provide accurate and complete information to facilitate a successful match with a child in need of a family.

What information is required from prospective adoptive parents on this form?

Prospective adoptive parents need to provide detailed personal information, including names, dates of birth, ethnicity, religion, and contact details such as home and employment phone numbers. Additionally, the form asks about preferences concerning the child's sex, age, ethnicity, and language skills. It also inquires whether the applicants are open to adopting children with special needs and if they are willing to accept groups of siblings. Each section of the form is designed to ensure caseworkers can find the best possible match between children and families.

How can I indicate my willingness to adopt children with special needs?

On the adoption form, there is a specific section that allows prospective adoptive parents to indicate their openness to adopting a child with special needs. Applicants must check all appropriate boxes that apply to their willingness to accept medical, educational, mental health, or developmental needs. This clear communication helps caseworkers understand which children may be best suited for a particular family, improving the odds of a successful placement.

What happens after I submit the NY Adoption form?

After submitting the form, the authorized agency will review it to ensure all necessary information is included. If everything is in order, the next steps in the adoption process can begin, which often includes a home study. This process evaluates the family’s living conditions and parenting suitability. It’s important to note that the agency must also conduct background checks, including a review of any potential child abuse or maltreatment reports, as well as a criminal history check. Prompt submission of the form can minimize waiting times and facilitate quicker progress through the adoption process.

Can I adopt a child who is already in my home as a foster child?

Yes, the adoption form allows for the application to adopt a child who is currently a foster child residing in your home. It’s essential to indicate their name and date of birth on the form, as well as the date of placement in your home. If the foster child has been freed for adoption, this information will streamline the process, making it easier to transition them into a permanent family environment.

What should I do if my application is rejected?

If your application to adopt is rejected or not acted upon within six months, you have the right to request a State administrative hearing. This request must be made within 60 days of the rejection or inaction. During the hearing, you can present your case, bring witnesses, and have legal representation if desired. The process allows you to contest the decision while ensuring the rights of prospective adoptive parents are respected and upheld throughout the adoption process.

Common mistakes

Completing the New York Adoption form can seem straightforward, but many prospective adoptive parents make common mistakes that can delay the process. One frequent error involves providing incomplete information about the prospective parent's background. The form requires details such as full names, dates of birth, and ethnicity codes. Omitting or miswriting any of this information can lead to a rejection of the application or cause significant processing delays.

Another mistake concerns the indications of willingness to accept a child with special needs. When filling out the section related to this, applicants sometimes forget to mark all applicable choices. If a family is open to adopting a child with specific medical, educational, or emotional challenges, it is crucial to indicate this clearly. Failing to do so may limit the prospective matches with available children who fit the family’s adoption preferences.

Addressing the dependents in a household is also essential. Many applicants neglect to list all household members, including their relationships and relevant information. For the application to be accurately assessed, every individual residing in the home should be accounted for, as this information is vital for ensuring a suitable match between the prospective adoptive parents and the child.

An additional oversight involves misunderstanding the language requirement sections. It is critical that applicants provide accurate primary and secondary language codes. Misinterpreting which code to use or failing to include this information can lead to complications during the matching process, as language is an important factor in successful adoptions.

Finally, one notable error occurs when prospective parents misread the instructions regarding previous marriages or certifications. The form requires detailed information about any past marriages and their outcomes. Not disclosing this information or failing to provide the necessary details could result in rejection. Ensuring that every part of the form is completed accurately is essential for a smooth adoption process.

Documents used along the form

When navigating the adoption process in New York, several forms and documents are frequently required alongside the NY Adoption form (LDSS-0857). Each of these documents plays a critical role in ensuring a comprehensive representation of the prospective parent and their suitability for adoption.

  • Homestudy Report: This report evaluates the living conditions and readiness of the adoptive family. It provides insights into the family’s dynamics, background, and the environment in which a child would be placed.
  • Background Check Forms: These forms are necessary for conducting criminal history checks. All adults residing in the home may be required to submit their information for review to ensure a safe environment for the adopted child.
  • Financial Disclosure Statement: This document outlines the financial status of the adoptive parents, including income, expenses, and overall financial health. It helps authorities assess the family's ability to provide for a child.
  • Medical Examination Records: Adoptive parents often need to provide medical records that confirm their health status. This ensures that they can meet the physical demands of parenting.
  • Consent Forms: If there are other individuals involved in the adoption, such as a biological parent, consent forms may be required to secure permission for the adoption process.
  • Adoption Agency Application: This application is submitted to the adoption agency managing the process. It details the family's profile and preferences regarding the child they are looking to adopt.
  • Parenting Classes Completion Certificate: Many agencies recommend or require prospective adoptive parents to complete parenting classes. The certification serves to demonstrate the family's commitment to preparing for a child's needs.
  • Child Preference Survey: This survey allows the adoptive parents to outline their preferences regarding the child’s age, gender, special needs, and background, guiding agency matching efforts.
  • Post-Adoption Support Plan: This plan outlines how the family intends to support the adopted child post-placement, including any therapy or resources they may seek to ensure a smooth transition.

The adoption process is complex and requires careful attention to detail. Each document is essential for ensuring that both the adoptive parents and the child are well matched, creating a stable and nurturing environment for the new family members.

Similar forms

The New York Adoption form, LDSS-0857, has similarities to various other documents related to family, guardianship, and caregiving matters. Here is a list of ten documents that share common features with the adoption form:

  • Foster Care Application: Like the adoption form, this application collects personal information about prospective caregivers, including details about their home, family structure, and willingness to care for children with special needs.
  • Guardianship Petition: This document requests a court to appoint a guardian for a minor, containing similar information about the prospective guardian's identity, background, and ability to provide a stable environment for the child.
  • Child Placement Agreement: This agreement outlines the arrangement for placing a child in a new home, requiring information about the caretaker’s background, including employment and familial details similar to the adoption form.
  • License Application for Child Care Providers: This application must be completed by individuals wanting to run a child care center. It involves submitting background checks and details about the caretakers, reflecting the need for comprehensive information as seen in the adoption form.
  • Home Study Report: This report is created after evaluating a family’s suitability for fostering or adopting a child and includes personal details, living conditions, and assessments akin to the information requested in the adoption form.
  • Safety Assessment Form: Like the adoption form, this document evaluates the safety and suitability of a living environment for a child, asking for information about the household, potential hazards, and the caregiver's capacity to provide a safe space.
  • Child Welfare Case Plan: This plan outlines the steps for improving a child's living situation, including detailed descriptions of the family's background and the services needed for the child, reflecting some of the family-oriented elements found in the adoption application.
  • Emergency Contact Form: This form gathers essential personal information, including contacts and medical history, similar to the data requested in the adoption process, focusing on the child's safety and well-being.
  • Health History Questionnaire: This document collects medical histories and insurance information relevant to children, much like the medical and developmental needs sections of the adoption form.
  • Educational Needs Assessment: This assessment reviews a child's learning requirements and may include demographic information about the family, paralleling the descriptions in the adoption application concerning educational and developmental needs.

Each of these documents serves to gather vital personal and familial information, ensuring that the needs of children are prioritized in the adoption or caregiving process.

Dos and Don'ts

Completing the New York Adoption Form is an important step in the adoption process. To ensure a smooth experience, here’s a guide on what to do and what to avoid:

  • Do: Provide accurate and complete information in all sections of the form. This includes names, birth dates, and contact details.
  • Do: Double-check the coding guides for ethnicity, languages, and religions. Using the correct codes helps avoid misunderstandings later.
  • Do: Be honest about your willingness to adopt children with special needs. This helps caseworkers match you with the right child.
  • Do: Review your application carefully before submission. Errors or incomplete sections can delay the process.
  • Do: Attach any necessary supporting documents required by the agency, such as your approved home study.
  • Don't: Leave any sections blank unless specifically indicated. Missing information can lead to rejection of your application.
  • Don't: Forget to keep a copy of your completed application for your records. It’s essential for future reference.

Following these tips will help you navigate the adoption form with greater confidence. Each step brings you closer to welcoming a child into your home.

Misconceptions

  • Misconception 1: The Ny Adoption form can be completed hastily without careful consideration of details.
  • This is incorrect. Each section of the form is crucial for matching prospective parents with children. Inaccurate or incomplete information may lead to delays or rejection of your application.

  • Misconception 2: Only families with specific preferences are encouraged to adopt.
  • In reality, the Ny Adoption form allows for a range of preferences, including age, ethnicity, and special needs. All families are invited to express their willingness to adopt, regardless of strict criteria.

  • Misconception 3: Submitting the adoption form guarantees a match with a child.
  • This is misleading. While filling out the form is a vital step, matching with a child depends on various factors, including the availability of children that fit the criteria specified in your application.

  • Misconception 4: The application process is solely a formality with no impact on the outcome.
  • This is untrue. The details provided in the application are essential for determining eligibility and preferences. They play a significant role in the overall adoption process and potential outcomes.

  • Misconception 5: Information on the application is disregarded once it is submitted.
  • In fact, submitted information becomes part of a registry used by caseworkers for making matches. Therefore, accuracy and completeness are imperative for successful outcomes in the adoption process.

Key takeaways

Filling out the New York Adoption Form, known as LDSS-0857, is a crucial step for prospective adoptive parents. Below are key takeaways to consider when completing and utilizing this form.

  • Ensure to fill out all required sections completely and accurately to avoid delays in the adoption process.
  • Provide the full names, dates of birth, and relevant ethnicities of all prospective parents listed on the form.
  • List the primary and secondary languages spoken in the household using the respective codes provided on the coding guide.
  • Select all acceptable characteristics for the child being sought, including sex, age range, ethnicity, and any specific needs.
  • If applicable, indicate willingness to adopt a child with special needs by checking the appropriate boxes on the form.
  • Be aware of the process for requesting a State administrative hearing in case of application rejection or inaction.
  • Include information about all household members, including their names, dates of birth, religions, races, and their relationship to the prospective parents.
  • Consult the coding guide for accurate entries regarding ethnicity and religion to ensure alignment with the State's classification.
  • Understand that your information will be used to match with available children through the Family Adoption Registry, prioritizing accuracy in your profile.
  • Retain a copy of the completed application for your records, as this will aid in tracking your application status in the future.

This summary presents crucial elements to keep in mind while completing the NY Adoption Form, facilitating a smoother adoption process.