Standards for public agencies

2020 Edition

Adult Foster Care (PA-AFC) 8: Placement Monitoring and Reassessment

Placement monitoring ensures continuity of service and care and timely adjustments to the placement when challenges arise.
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
  • Procedures for placement monitoring and reassessment
  • Procedures for responding to complaints or problems
  • Tools for placement monitoring and reassessment
  • Schedule of home visits
  • Interviews may include:
    1. Program director
    2. Relevant personnel
    3. Persons served
  • Review case records

Fundamental Practice

PA-AFC 8.01

Placement monitoring procedures include: 
  1. a frequency schedule of in-person visits made to the home;
  2. assignment of responsibility for ensuring services are being accessed and are appropriate and satisfactory;
  3. annual health status reports, either provided by the qualified personnel or documentation by the caregiver’s and service recipient’s primary care physicians;
  4. documentation to be provided by the caregiver, and
  5. responsiveness to any complaints or problems that may develop.


Regarding element (c) health status reports should be completed annually, on a schedule, and after every medical emergency or significant change in functioning.


PA-AFC 8.02

Qualified personnel meet with the caregiver and service recipient at least annually to conduct formal placement reassessments and: 
  1. within five working days of a precipitating event;
  2. when there is a significant change in the individual’s status or circumstances, or a new issue arises; and
  3. within 48 hours of notification when a hospital or institutional discharge is imminent.


PA-AFC 8.03

Placement reassessment includes: 
  1. conditions of the home environment;
  2. changes in baseline functioning status of the service recipient, including increased needs;
  3. community integration, including frequency of the individual engaging in community activities and ability to access community activities independently; and
  4. changes in the household make up.


PA-AFC 8.04

Caregivers and case workers develop a system of documentation and communication regarding: 
  1. completion of ADLs and IADLs;
  2. the service recipients physical, mental, and emotional status within the household;
  3. medication; and
  4. services utilized.

Fundamental Practice

PA-AFC 8.05

Case workers regularly monitor the placement and: 
  1. have a schedule of caregiver documentation review; and
  2. communicate with other service providers to assess service participation and effectiveness.