Standards for public agencies

2020 Edition

Adult Foster Care (PA-AFC) 4: Caregiver Recruitment and Assessment

The agency exercises due diligence when recruiting and approving caregivers to ensure a diverse group that is prepared to meet the needs of the service population.
2020 Edition

Currently viewing: ADULT FOSTER CARE (PA-AFC)



 Adult Foster Care (PA-AFC) programs support community-based living arrangements for adults in need of long term-services and supports, matching them with in-home caregivers.
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.
Self-Study EvidenceOn-Site EvidenceOn-Site Activities
  • Recruitment procedures
  • Caregiver/resource family assessment procedures
  • Copy of caregiver assessment tool
  • Procedures for caregiver background checks
  • Recruitment materials
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review caregiver records


PA-AFC 4.01

Recruitment involves key stakeholders including: 
  1. former and current service recipients and caregivers;
  2. workers;
  3. community leaders; and
  4. other agencies in the community.
NA The agency only approves ready-made matches, where there is a natural relationship between the caregiver and service recipient.


PA-AFC 4.02

Recruitment efforts are planned, implemented, and evaluated to ensure suitable caregivers are available for adults of varying abilities and varying levels of supervision upon entering care.


Planning should include a regular assessment of the qualities of caregivers needed, recruitment resources available, and recruitment goals. Evaluation of recruitment efforts should include the cost-effectiveness of activities and utilization of new caregivers.
NA The agency only approves ready-made matches, where there is a natural relationship between the caregiver and service recipient.


PA-AFC 4.03

Prospective caregivers are engaged in the recruitment process through: 
  1. awareness of the recruitment-to-placement timeline and available supports;
  2. timely, sensitive, personal, and culturally-responsive follow-up at each step of the process;
  3. personalized contact with existing caregivers; and
  4. accessible and inviting open houses, orientations, and training sessions.

Fundamental Practice

PA-AFC 4.04

In order to provide safe and consistent care, qualified personnel assess caregivers for: 
  1. personal characteristics;
  2. motivation for providing adult foster care;
  3. willingness to provide responsive care for the characteristics and needs of the population;
  4. willingness and ability to support the service recipient’s ties to family, peers, and community;
  5. family relationships and family functioning, including alternative providers for relief;
  6. mental and physical health;
  7. relevant strengths, skills, and experience;
  8. social support networks; and
  9. the home environment.


The caregiver assessment is a standardized process that meets all legal requirements. It should include an interview with all adults and children living in the home, including the identification of family roles as well as exploration and assessment of each person’s ability to contribute to the care of the individual. Household members should be interviewed separately to ensure each person feels comfortable to share freely. Agencies should identify who can be considered a caregiver and backup caregivers during this process.


Health assessments include the individual’s ability to perform lifts. While many service recipients may not require lifts, it is important for the agency to assess for it in case the agency receives an individual who does require lifts.

Fundamental Practice

PA-AFC 4.05

Resource family assessments are completed prior to placement, and are updated: 
  1. within two weeks of a reported change in home composition; and
  2. at least once annually.
Examples: Changes that may warrant a follow-up assessment include but are not limited to: 
  1. individuals who move in or out of the house; 
  2. death or debilitating illness of a caregiver; or 
  3. legal proceedings affecting the family such as eviction or divorce.


PA-AFC 4.06

To ensure resource families can provide safe and consistent care: 
  1. all adults in the home receive criminal background and sex offender registry checks prior to placement in accordance with applicable federal and state law; and
  2. three non-relative references are provided.
NA The agency only provides support to ready-made matches.
Examples: Agencies may have more flexibility to make exceptions around certain non-violent criminal or civil background histories for ready-made matches who are otherwise determined to be appropriate caregivers. Each situation can be assessed on a case-by-case basis.