Intake Form

HomeIntake Form

Alba Care ServicesBecome a Foster Parent, Foster Care

Name
First Last
Phone
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship Status*
*
I am at least 21 years of age*

Have you lived in a state other than California in the last five years?*
Please identify each state you've resided in below:
Have you or any other adult living in your home been arrested or investigated by CPS?*
What was the reason and in what county?
Do you have a daycare license?*
How many children does your license allow you to care for?

Have you ever been certified or RFA approved with another FFA or with the County?*
Did you have any investigation(s)? If so, please explain below:
Can you and partner complete RFA Orientation and Pre-approval training?*

Can you provide 10 years of driving records?*
Do you own a vehicle?*
Are you currently employed?*
Are you self-employed?*
How will provide proof of income?*
- Pay Stubs
- SSI Statements
- Income Taxes
- Bank Statements

What type of home do you live in?*
How many stories is your home?*
Number of bedrooms?*
Please enter a number from 1 to 20.
How many people live in the home?*
Please enter a number from 1 to 20.
Do you own a swimming pool or jacuzzi?*
Do any of the windows at home have bars?
The home has space for:*
- Children
- Infants