Standards for Canadian organizations

2020 Edition

Family Foster Care and Kinship Care (CA-FKC) 13: Treatment Foster Care

Children with significant emotional, behavioural, medical, or developmental needs receive structured treatment within a therapeutic family setting that promotes well-being, family connections, and community integration.
NA The organization does not provide treatment foster care services.
2020 Edition




Children in Family Foster Care and Kinship Care live in safe, stable, nurturing, and often temporary family settings that best provide the continuity of care to preserve relationships, promote well-being, and ensure permanency.
Note: Organizations providing Foster Care Home Services only will complete CA-FKC 13.07 and CA-FKC 13.09 only. 
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice Standards.
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice Standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted; however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions, procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations and training; or
  • Active client participation occurs to a considerable extent.
Practice requires significant improvement, as noted in the ratings for the Practice Standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • Several client records are missing important information; or
  • Client participation is inconsistent. 
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice Standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or 
  • Documentation is routinely incomplete and/or missing.      
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Treatment planning and review procedures
  • Criteria for selection of treatment foster parents
  • Worker contact procedures
  • Table of contents of treatment model training for staff and treatment foster parents
  • Discharge procedures
  • Formal agreements with therapeutic facilities and/or providers that serve children and families in the program
  • On-call schedule for treatment foster care programs for previous six months
  • Documentation tracking treatment foster parent completion of required training
  • Training curricula for treatment foster parents


  • Interviews may include:
    1. Program director
    2. Parents
    3. Treatment team members
    4. Treatment foster parents
    5. Children and youth
  • Review case records
  • Review treatment foster parent records

CA-FKC 13.01

Treatment foster services are delivered by individualized treatment teams that include: 
  1. family members; 
  2. treatment foster parents; 
  3. local child welfare agency workers;
  4. treatment foster care program personnel, including the program supervisor, case managers, and clinicians or clinical consultants;
  5. education representatives or personnel; and
  6. a range of specialized providers, as appropriate to children's emotional, behavioural, medical, and/or developmental needs.


The treatment team should include at least one worker or contract employee, in addition to the supervisor, who has an advanced degree in social work or a related field and at least two years of professional experience working with children with specialized treatment needs.
NA The organization provides Family Foster Care Home Services only.
Examples: Depending on the needs of children, specialized providers may include, but are not limited to: behaviour support specialists; nurses and physicians; psychiatric nurses and psychiatrists; and rehabilitation therapists. 

CA-FKC 13.02

Preliminary treatment plans developed prior to placement identify:
  1. diagnoses;
  2. strategies to ensure children’s adjustment to treatment families; and
  3. short-term goals for the first 30 days of out-of-home care.
NA The organization provides Family Foster Care Home Services only.

CA-FKC 13.03

Within 30 days of placement, treatment teams develop individualized, comprehensive treatment plans that: 
  1. identify, incorporate, and build on children’s strengths and assets;
  2. specify diagnoses and presenting problems that prompted the referral to treatment foster care or were identified during assessment;
  3. address needs in major developmental areas; 
  4. specify short- and long-term therapeutic interventions; and
  5. address stressors in the children's environment that are trauma reminders or contribute to their emotional or behavioural issues.
NA The organization provides Family Foster Care Home Services only.

CA-FKC 13.04

Treatment plans are:
  1. discussed weekly by the treatment team to coordinate an effective response to current issues or behaviours;
  2. reviewed monthly to evaluate progress towards treatment goals; and 
  3. officially updated every 90 days to evaluate progress and the continued need for treatment foster care.


Intervals for discussing treatment plans for medically fragile children should be set based on the intensity of the child’s ongoing needs.  
NA The organization provides Family Foster Care Home Services only.

CA-FKC 13.05

The organization coordinates and ensures the provision of needed therapeutic, rehabilitative, and support services, including specialized treatment services. 
NA The organization provides Family Foster Care Home Services only.
Examples: Needed services may include, but are not limited to:
  1. individual, family, and/or group therapy, 
  2. social skills groups, and 
  3. medical treatment. 
Providing formal and informal support to other service providers can help the organization maximize service benefits and best meet the specialized needs of the children in their program.

Fundamental Practice

CA-FKC 13.06

Formal relationships are established with: 
  1. mental health facilities, medical institutions including neonatal and pediatric facilities, and other rehabilitation service providers to ensure the availability of requisite medical and mental health services; and 
  2. a board-certified physician with experience appropriate to the level and intensity of service, and the needs of the population served, who assumes responsibility for medical elements of a program that serves children with acute medical needs.
NA The organization provides Family Foster Care Home Services only.
Examples: The board-certified physician can provide service as an employee, contractor, or through formal agreement. 

Fundamental Practice

CA-FKC 13.07

The organization selects treatment foster parents based on established criteria that include: 
  1. proven experience as resource parents, work experience in a setting such as a group home or residential center, or specialized training in treatment foster care; 
  2. three non-relative references; and 
  3. attainment of at least 21 years of age.

CA-FKC 13.08

Treatment foster parents assume primary responsibility for:
  1. implementing in-home treatment strategies;
  2. assisting children to understand treatment goals and interventions; 
  3. documenting children’s behaviours and progress in targeted areas; and
  4. acting as liaisons with clinical personnel.
NA The organization provides Family Foster Care Home Services only.

Fundamental Practice

CA-FKC 13.09

Treatment foster parents receive the support they need to carry out their role, including: 
  1. initial and ongoing training designed to help them assume their responsibilities;
  2. weekly contact by the assigned worker; 
  3. in-person contact every two weeks and more frequently when indicated; 
  4. on-call crisis intervention 24-hours a day, seven days a week; and 
  5. the availability of additional personnel and technical assistance, as needed.


Additional personnel should be available during critical or stressful periods, such as the time from the end of the school day until bedtime.

CA-FKC 13.10

Discharge reports are tailored to support the transition to the next home or program, and document:
  1. the course of treatment and treatment recommendations;
  2. the transfer of records and appointment information; and
  3. the nature, frequency and duration of aftercare services, when applicable.
NA The organization provides Family Foster Care Home Services only.