Level 5 Foster Home Care Submission Portal

Licensing agencies should utilize this portal to submit any documents related to Level 5 Foster Homes. Submission through this portal will securely send materials to the DCF Level 5 Panel.

Prior to submitting a Preapproval to Begin Child Specific Planning for Level 5 Foster Home (DCF-F-5177), a licensing agency or placing agency or supervising agency must confirm the following circumstances exist:

  • The child has behaviors or conditions that require a high degree of supervision and overnight awake care by program staff who rotate shifts within a 24-hour period.
  • The child will benefit from a home-like environment that has fewer children than a group home or residential care center for children and youth.
  • The child is expected to need long-term care or a similar care setting as an adult or has needs agreed to by the department.
  • All other community placement options have been investigated and determined to not be in the best interest of the child.

If a preapproval request has been approved, the licensing agency must submit the Initial Application for Certification and Child Placement (DCF-F-2559). If seeking to renew a Level 5 Foster Home, the licensing agency must submit the Renewal Application for Certification and Child Placement (DCF-F-5705).  If a certified Level 5 Foster Home is seeking to provide respite care to a child, the licensing agency must submit the Application for Providing Respite in Level 5 Foster Home (DCF-F-5527).

Please select the appropriate drop down and complete the applicable form for the form that is being submitted.
 

Submission of Application for Certification and Child Placement for a Level 5 Foster Home

The purpose of this portal is to submit the required information to the DCF Level 5 Panel to request certification of a Level 5 Foster Home. Supplemental supporting documents must be uploaded as an attachment.

Provider Name
Submitter Name
Application Type

Communication Attachments

Attachments for Each Child in a Level 5 Foster Home

Program Description Attachments

DCF-F-5710-E (R. 11/2025)

Submission of Incident Report in a Level 5 Foster Home

As a Licensing Agency, use this portal to report a serious incident under DCF 56.06. This satisfies the requirement under DCF 56.06(3) that states a licensing agency shall immediately notify the department exceptions panel of any serious incident reported in this section that is reported by a foster parent of a Level 5 foster home.

Provider Name
Submitter Name
Unlimited number of files can be uploaded to this field.
500 MB limit.
Allowed types: pdf, docx.
DCF-F-5718-E (N. 02/2024)

Submission of Pre-approval to Begin Child Specific Planning for a Level 5 Foster Home

The purpose of this portal is to notify the DCF Level 5 Panel that a placing agency is considering development of a Level 5 Foster Home for a specific child. The pre-approval form must be completed and subsequently approved by the DCF Level 5 Panel giving placing agencies approval to move forward with the application and planning process to develop a Level 5 Foster Home for a specific child.

Provider Name
Submitter Name

DCF-F-5177-E

DCF-F-5715-E (R. 11/2025)

Submission of Application for Child Specific Respite Services - Existing Level 5 Foster Home

The purpose of this portal is to notify the DCF Level 5 Panel that a Level 5 Foster Home is seeking to provide respite care for a foster child. This request must be approved by the DCF Level 5 Panel prior to the respite occurring. 

Provider Name
Submitter Name

DCF-F-5527-E

DCF-F-5716-E (R. 11/2025)