Private Organization Accreditation

Sweetser, a Maine non-profit agency operating since 1828, provides comprehensive mental and behavioral health and substance abuse treatment services. Statewide, it serves around 15,000 consumers a year, including children, adults, and families in outpatient, office-based, and residential settings.


Children's Foundation of Mid America

James W. Thurman, President/CEO

Children’s Foundation of Mid America has been accredited through COA since 1983. The process of accreditation ensures that we meet or exceed the highest standards in the industry.
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Child Protective Services protect children from abuse and neglect and increase child well-being and family stability.

PA-CPS 11: Child Placement

Children in need of out-of-home care are referred to a foster care, kinship care, or residential program that can meet their needs for safety, permanency, stability, and well-being in a culturally-competent manner.

Note: An agency that provides emergency placements must document efforts made to meet the standards given the emergency nature of the placement.

NA The agency does not place or refer children for out-of-home care.

Rating Indicators
Full Implementation, Outstanding Performance
A rating of (1) indicates that the agency's practices fully meet the standard and reflect a high level of capacity.  
  • All elements or requirements outlined in the standard are evident in practice, with rare or no exceptions; exceptions do not impact service quality or agency performance. 
Substantial Implementation, Good Performance
A rating of (2) indicates that an agency's infrastructure and practices are basically sound but there is room for improvement. 
  • The majority of the standards requirements have been met and the basic framework required by the standard has been implemented.  
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality or agency performance.  
Partial Implementation, Concerning Performance
A rating of (3) indicates that the agency's observed infrastructure and/or practices require significant improvement.  
  • The agency has not implemented the basic framework of the standard but instead has in place only part of this framework.   
  • Omissions or exceptions to the practices outlined in the standard occur regularly, or practices are implemented in a cursory or haphazard manner. 
  • Service quality or agency functioning may be compromised.   
  • Capacity is at a basic level.
Unsatisfactory Implementation or Performance
A rating of (4) indicates that implementation of the standard is minimal or there is no evidence of implementation at all.  
  • The agency’s observed service delivery infrastructure and practices are weak or non-existent; or show signs of neglect, stagnation, or deterioration.  
Please see Rating Guidance for additional rating examples. 

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    • Placement Procedures
    • A description of services:
      1. available out-of-home care services;
      2. the level of care assessment process; and
      3. supports and services provided to children that experience multiple placements
No On-Site Evidence
    • Interview:
      1. Supervisors
      2. Relevant personnel
    • Review case records

  • PA-CPS 11.01

    All information available from intake, screening, assessment, and placement history are considered to identify the most family-like, least restrictive type of out-of-home care suitable to provide for the child’s safety, permanency, stability and well being.

    Research Note: Research has identified many factors that can impact placement decisions including: age, race, reason for placement, placement history, and presence of behavior problems or disabilities. Research suggests that despite the availability of information on a child’s psychosocial functioning, workers base placement decisions on labels and the reason for entering care. Researchers recommend use of clinical judgment, assessment information, and standardized tools to identify and consider the factors that indicate a child is at greater risk of disruption to determine the most suitable out-of-home placement. Some literature suggests the agency monitor decision making for inappropriate biases.

  • PA-CPS 11.02

    Children are placed according to their best interests in the most family-like and familiar setting possible: 

    1. with siblings; 
    2. with kin; or 
    3. with families or in residential settings within reasonable proximity to their family and home community. 

    Interpretation: Unless it is contrary to the well-being of a child, agencies are required to make reasonable efforts to place siblings together and policy requires that preference be given to kin. If a child is not placed in a manner consistent with the specified options, the reason is documented in the case record. 

    Research Note: Literature suggests that children placed in close proximity to relatives are less likely to disrupt and more likely to have regular visitation with parents.

  • PA-CPS 11.03

    Indian children are placed according to the placement preferences specified in the Indian Child Welfare Act as applicable.

    Interpretation: An agency that has responsibility for placing an Indian child should work closely with the child’s tribe to identify placement options within the tribal community. Families from all tribes to which the child has ties should be considered as placement options.

    Research Note: The Indian Child Welfare Act requires that preference be given to foster placements in the following order: (1) a member of the child’s extended family; (2) other members of the child’s tribe; (3) foster homes licensed, approved, or selected by the child’s tribe; and (4) an institution approved by an Indian tribe or operated by an Indian agency. As evidence of compliance with these placement preferences, a record of each placement must be maintained by the state in which the placement was made. These records are made available upon request of the United States Secretary of Interior or the Indian child’s tribe.

  • PA-CPS 11.04

    The agency prevents placement changes through coordinated placement planning that:

    1. ensures children and families are aware of the placement process and receive support and information throughout; 
    2. provides  all legally permissible information about children’s characteristics, behaviors, histories, and permanency goals to prospective residential settings or resource families; 
    3. arranges opportunities for children and parents to meet prospective resource families when possible; 
    4. responds proactively to challenges associated with placement and assesses the need for services and supports; and 
    5. facilitates workers’ abilities to spend more time with children, families, and/or resource parents after a new placement or when challenges arise.

    Research Note: The trauma of separation and placement moves can be partially minimized through a sensitive and responsive placement process. Effective placement planning requires sharing of information to promote equal involvement in the process and to allow all parties to do their job well. Birth and resource families need information about the process, visitation, decision making timeframes and expectations for involvement in meetings and ongoing communication.

  • PA-CPS 11.05

    Children’s level of care is reviewed regularly and placement changes occur to support their best interests and permanency goals.

    Interpretation: The agency should make every effort to prevent any placement change that is not in the best interest of the child and his or her permanency goals. Placement changes that support children’s best interests and permanency goals may include moving from a foster home to an adoptive home, moving from foster care to kinship foster care or other moves that bring children closer to family or community.

    Research Note: Significant research has demonstrated the correlation between placement instability and negative child outcomes including poor academic performance and social and emotional difficulties. Regardless of a child’s prior history of maltreatment or behavioral challenges, these negative outcomes increase following placement disruptions.

  • PA-CPS 11.06

    Children, families, and resource families receive additional support during placement changes that includes: 

    1. sufficient advanced notice prior to a placement change; 
    2. formalized discussions of the reasons for a placement move or disruption, each parties’ feelings about the change, and as needed, interventions to address the reasons for the change;
    3. reassessment of children’s needs in advance or at the time of the change, and identification of a resource family or other placement setting that can best achieve safety, well-being, and permanency; and
    4. referral to additional services or supports.

    Interpretation: Whenever possible notice should be provided at least 14 days in advance of a placement move. 

    Interpretation: When the agency is working with Indian children and families, tribal representatives must be involved in placement decisions and moves for Indian children in care.

  • FP
    PA-CPS 11.07

    When youth are in care past the age of 18, shared living agreements are developed at the time of placement, or upon youths’ birthdays, to promote independence, clarify new roles, and establish mutually agreed upon expectations.

    Interpretation: In many states foster care services have been extended to youth until age 19, 20, or 21. In a developmentally appropriate manner, every youth over 18 should be engaged in a conversation, that is formally documented, that explores and determines the mutual expectations and responsibilities of the living arrangement now that they are not a minor.

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