WPC? 5M7MdD_Pvhk\ :9;+,arxs懽0f*M7oYmQU NI\[] ݎcU=?:|41tx妌:ZuakB_=|:^\tǽݤfUaWfkamfafaNI 0bZ 0bQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ B A 0V{ D5 D-333333 B D5 D5K B D5 B C B5  DM> B3 ASAVIN 2055DP PCL 60(hH  Z6Times New Roman RegularX($USUS.,  'USUS.,  _ XX  StateofKansas0 ` 0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#0p(#(#0p(#p(#0 (#(#0x (# (#CFS2014Ax(#x(# SocialandRehabilitationServices0  0h(#(#0h(#h(#0(#(#0p(#(#0p(#p(#0 (#(#0x (# (#June2000Fx(#x(# ChildrenandFamilyServices    h      p      x Page1of1#X AX =#(.3$ !USUS.,  (.3$ !USUS.,  TABLE Aဗ, _,( Backup3|xUTABLE D%TABLE B:TABLE E-TABLE C ? ],USUS., d  _   `     h      p ~(_}XX#X AX}~(_#   ` ~(_}XX A(:3]$ !USUS.,   d  ]+USUS., d  _   `     h      p      x    ` (:3]$ !USUS.,   d  d_^&Draw Object =8C HKKKK(.3$ !USUS.,  ZZZZ)!dxdx)!dxdxLevel 1Level 2Level 3Level 4Level 5  deeee)!dxdxmmmm)!dxdx doooo)!dxdx d d1Large Dashed dZZZZASingle Green!dxdx/Wavy Single  d\{  <<= 8C !USUS.,  _&!D%XX   CorrectiveActionPlan:ReportsInvolvingFacilities :   *kZ ddd Xdd Xdd X(#(#,Xdd ,dd ,dd ,dd ,dd ,dd ,Tdd ,dd ,,dd ,dd ,dd ,dd ,dd +   #X AX%&!D=#%XX ATo: +!6  + * 6  *From: +!6  + * 6  *Date: '6  ' +!6  +FacilityName: .$ H  . .$ H  .Telephone: .$ H  . .$ H  .Address: .$   . .$  .Address: .$  . .$  .City: *   *State: +!  +City: .$  . .$  .State:KS *   *ZIP: +!f,  + .$f,  .ZIP: .$f,   .+!f,    +#X AX%#&!D%XX A  *PZd dXdd Xdd dd dd dd dd Tdd Tdd ,dd ,dd dd dd dd kZ (#(#P,xdd +    #X AX%&!D#%XX ABasedoninformationgatheredintheinvestigationofabuseorneglectbySRS,youhavebeensubstantiatedasa ~D  perpetratorofanincidentoccurringinachildcarehomeorfacilitysubjecttoregulationbytheKansas 6  DepartmentofHealthandEnvironment.InaccordancewithSRSpolicy,youarebeingprovidedanopportunity   toacceptacorrectiveactionplandesignedtoavoidfurtherincidents.Failuretoacceptorsuccessfullycompletea l  correctiveactionplanwillresultinplacementofyournameonthechildabuseandneglectcentralregistryasa ^$  validatedperpetratorofabuseorneglect.Personslistedonthechildabusecentralregistryareprohibitedfrom   working,residing,orvolunteeringinafacilityregulatedbytheKansasDepartmentofHealthandEnvironment.#X AX% #&!D%XX A   ! #X AX%&!DM #&!D%XX AReasonforCorrectiveAction:  H" SRShassubstantiatedareportof򀀀(typeofmaltreatment)forthefollowing N# child(ren)placedinyourcare: $ *lod dxdd xZ(#(#l, dd , dd +  !% d! !J&d d! !J'd d! !p(d d!p)  d  CorrectiveActionNeeded:  l) *]Zd d dd dd o(#(#,dd ,'dd ,edd +  &zr8*r8 &#X AX%&!D #%XX ATaskorActionRequired: /z+z /#X AX%f#*XX APersonResponsibleto , CompleteTask#X AX*#%XX A /z|B-z /DateToBe . Achieved: $T/z $#X AX%h#&!D%XX A  0   1   2   : 3   : 4   : 5   !`6   !`7  !`8  Toindicateyouracceptanceofthisplan,pleasesignandreturnthisdocumenttoSRSby//.If b#(9 therearetaskswhichinvolveparticipationorservicesthroughagenciesotherthanSRS,pleaseprovide .$: documentationtoSRSregardingcompletion.Thisplanwillbemonitoredby________________,and $; youwillbenotifiedwhenadecisionhasbeenmaderegardinganyterminationofcorrectiveaction. %< #X AX%&!D%#%XX A SignaturesandDateRequired: #X AX%#&!D%XX A &X= *d ddd 'dd 'edd e]Z(#(#,edd , dd ,dd , dd +  J' >J'  Addressee:#X AX%&!Dx#&!D%XX A Z 't ?  $'t @Z $Date:#X AX%&!D#&!D%XX A Z 't A  $'t BZ $SRSStaff: Z )!C  $)!DZ $#X AX%&!D#&!D%XX ADate: Z )!E  $)!FZ $Other: Z n*4#G  $n*4#HZ $Date: Z n*4#I (n*4#J  Z (#X AX%&!DO#*XX ADistribution:0 ` 0 ` (#` (#Addressee0h (# (#FACTS(dataentry)0ph(#h(#File#X AX*e#*XX A0p(#p(##X AX*R#*XX A0 (#(#KDHE#X AX*#  @ j+0$J (# (#  XX A#X AX >#