Children's Group Care Application

(Click here for a description of the Children's Group Care program.)

Instructions for Children's Group Care application.

(children’s group care, revised 3/00)

1. Complete the enclosed children's application, pages 1 - 4.
   Fill in all blanks where applicable.
2. Have a psychological evaluation completed which must include the following (or equivalent):
   1. A standard test of intelligence (i.e., WISC or Stanford-Binet)
   2. A test of academic achievement (i.e., WRAT or California Achievement Test)
   3. A personality description (i.e., Rorschach, T.A.T.)
   4. A personality inventory (California Test of Personality/Bell Adjustment Inventory)
3. Obtain a treatment summary (referral to another physician) from the child’s physician.
4. Copies of divorce papers or any other legal documentation that proves legal custody of the child must be sent with application.
5. Mail all of the above information plus any other data that might help in a placement evaluation to:

NOTE: AFTER REVIEW OF THE APPLICATION YOU WILL BE CONTACTED WITH FURTHER INSTRUCTIONS REGARDING PLACEMENT. SEE PLACEMENT PROCEDURES BELOW.

PLACEMENT PROCEDURES

(children’s group care, revised 3/00)

After the application has been evaluated and placement approved you will be contacted and a placement date agreed upon.

STEP ONE - PREPARATION
The following will be needed at time of placement:

1. A certified copy of the birth certificate (hospital certificates are not acceptable).
2. An original Social Security card for the child.
3. Bring school withdrawal papers and school records, if possible.
4. A dental examination.
5. A tuberculosis test (with a “negative” result).
6. Immunization records.
7. Five signed insurance claim forms.

STEP TWO - MEDICAL EXAMINATION
As soon as possible call Family Practice to set up an appointment for the day of placement. Family Practice Associates (ph. 830-896-4711) is located at Medical Arts Plaza, 220 Wesley Dr., Kerrville, Texas. Dr. John D. Davis is first choice of physicians and Dr. William O’Donnell is the alternative. Be prepared to pay for a physical examination. Transfer of medications and treatment will be done at this time.

STEP THREE - PLACEMENT
Note: Legal guardian(s) must be present for placement.

1. Medina Children’s Home is located on Texas Highway 16 about 17 miles south of Kerrville and 7 miles north of Medina.
2. Upon arrival on campus please stop at the Administration Building (at the flag pole) and contact the Financial Office. The $300 for startup costs and the first month's support (as agreed upon) will be paid at this time.
3. You will be directed to the Chaney Social Services Center where placement procedures will continue.
4. Guardians will accompany the child to the cottage where the child will live. You will have the opportunity to meet the house parents before making your farewells to the child.

Click here to apply online for Group Care using secure submission.

Click here for a printable Group Care application form.

You will need the free Adobe Acrobat Reader to view/print this form. 
If you don't already have Acrobat Reader, click here to get it.