Georgia Department of Human Services Aging Services | Child Support Services | Family & Children Services APPENDICES Annual Report State Fiscal Year 2021 Table of Contents Appendix A Residential Child Care Licensing Annual Waivers Report 2021 APPENDIX A Residential Child Care Licensing Annual Waivers Report 2021 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 1 Child Placing Agency 12/10/2020 Cherish All God's Children, Inc. Agency Representative Joetta Jones Agency/Agency Representative's Address 133 Delwood Drive, McDonough, Georgia 30252 Agency/Agency Representative's Phone Number 404-996-8187 Rule # 290-9-2.04(9)(a) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No for the rule which states that the casework supervisor shall have the minimum of a master's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or other human service or behavioral science field. 1/7/2021 1. The staff member must receive monthly supervision from a master's level staff member. This supervision must include an evaluation of his/her job duties and responsibilities that shall be documented and maintained in his/her personnel file. 2. The staff member must obtain 24 hours of annual training related to the type of residents served by the agency. This training must be documented and maintained in his/her personnel file. 3. The agency must document an annual performance evaluation for the staff member completed by his/her supervisor that is documented and maintained in his/her personnel file. 4. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. 2 Child Placing Agency 12/18/2020 Faithbridge Foster Care, Kris Isom Inc. 4400 Northpoint Parkway, 678-690-7118 Suite 210, Alpharetta, Georgia 30022 290-9-2- The agency requested a waiver Approved No .07(5)(a)(9)(ii) for the rule which states children (V) over three years of age of different sexes do not share a bedroom. 1/7/2021 1. The agency must conduct monthly foster home visits to ensure the children's placement in this home is appropriate and does not pose a threat to the health and safety to any of the children in care. 2. The agency must ensure that the foster family provides 24-hour oversight and supervision during naptime and overnight hours by ensuring the family installs some type of monitoring system, such as a baby monitor as well as a divider to ensure privacy for each child. 3. The agency must develop service plans to address each child's emotional, educational, medical, social and developmental needs. 4. All updates and any changes to the family's home shall be documented in an amended home study evaluation and a copy shall be maintained in the foster parent's file. 5. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. Page 1 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 3 Child Placing Agency 1/15/2021 The Methodist Home of Beth Greene the South Conference, Inc. Agency/Agency Representative's Address 116 Pierce Avenue, Macon, Georgia 31204 Agency/Agency Representative's Phone Number 478-464-3025 Rule # 290-9-2.07(2) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 1/28/2021 1. The agency must conduct monthly foster home visits to ensure the home is appropriate and does not pose a threat to the health and safety to any of the children in care. These visits shall be documented and maintained in both the foster parent's file and the foster children's file. 2. The agency must develop a service plan to address the children's emotional, family, educational, medical, social and developmental needs. This plan shall be maintained in each foster child's file. 3. The agency must not allow children of different sexes over the age of three to share a bedroom. 4. All updates and any changes in the family's home must be documented in an amended home study evaluation and a copy maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. 4 Outdoor Child Caring Program 1/16/2021 NVW East, LLC Summer Hornbeck 311 North Main Street, Clayton, 414-737-0400 Georgia 30525 290-2-7.05(5) The facility requested a waiver for Approved No the rule which states campers shall have had a dental examination by a licensed dentist within six months prior to admission. 2/24/2021 1. The facility must document a dental history conducted by either a certified nurse practitioner or physician during the intake physical. In the absence of any reported or identifiable dental issues or pain, the resident may be admitted into the facility. If there are any reported issues by the resident, the resident may still be admitted into the facility; however, an appointment with a licensed dentist must be scheduled for the next available appointment or within 30 days. 2. All residents admitted into the facility must receive a dental examination from a licensed dentist within six months from the admission date. Dental appointment documents must be maintained in the resident's file. 3. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Outdoor Child Caring Programs. Page 2 of 44 # License Type Date Received Agency Name 5 Outdoor Child Caring Program 1/16/2021 NVW East, LLC Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report Agency Representative Agency/Agency Representative's Address Agency/Agency Representative's Phone Number Summer Hornbeck 311 North Main Street, Clayton, 414-737-0400 Georgia 30525 Rule # 290-2-7.05(7)(a) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The facility requested a waiver for Approved No the rule which states that the intake summary shall include a current (within one year) evaluation by a licensed psychiatrist or psychologist. 2/24/2021 1. The facility must ensure all residents admitted into the facility receive a psychological or psychiatric evaluation within two weeks of admission. This evaluation shall assess the resident for the appropriateness of participating in an Outdoor Child Caring Program. Documentation of this evaluation must be maintained in the resident's file. 2. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Outdoor Child Caring Programs. 6 Outdoor Child Caring Program 1/16/2021 NVW East, LLC Summer Hornbeck 311 North Main Street, Clayton, 414-737-0400 Georgia 30525 290-2-7.14(1) The facility requested a waiver for Approved No the rule which requires camps to have a minimum of ten acres of land for the first 50 campers with an additional five acres for each additional camper. 2/24/2021 1. The facility shall be limited to a capacity of thirty residents for the first six months of operation. Afterward, the facility may increase its capacity quarterly by ten residents until a capacity of fifty has been reached. 2. The facility shall be limited to fifty residents at one time. 3. The facility must demonstrate current approval with the U.S. Department of Agriculture Forest at all times. 4. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Outdoor Child Caring Programs. 7 Outdoor Child Caring Program 1/14/2021 Second Nature Blue Ridge, LLC Laura Fuqua 236 File Street, Clayton, Georgia 30525 706-212-2037 290-2-7.05(5) The facility requested a waiver for Approved No the rule which states campers shall have a dental examination by a licensed dentist within six months prior to admission. Treatment shall be provided by the examining dentist. 2/24/2021 1. The facility must document a dental history conducted by either a certified nurse practitioner or physician during the intake physical. In the absence of any reported or identifiable dental issues or pain, the resident may be admitted to the field, however, an appointment with a licensed dentist must be scheduled for the next available appointment for within 30 days. All residents admitted to the program must receive a dental examination from a licensed dentist within six months of admission to the facility. All dental appointments must be documented and maintained in the resident's file. 2. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Outdoor Child Caring Programs. Page 3 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 8 Outdoor Child Caring Program 1/14/2021 Second Nature Blue Ridge, LLC Agency Representative Laura Fuqua Agency/Agency Representative's Address 236 File Street, Clayton, Georgia 30525 Agency/Agency Representative's Phone Number 706-212-2037 Rule # 290-2-7.05(6) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The facility requested a waiver for Approved No the rule which states Outdoor Child Caring Programs shall not accept a camper until a psychological or a psychiatric evaluation and an intake study has been made. 2/24/2021 1. All residents accepted and enrolled in the program must receive a psychological or psychiatric evaluation within two weeks of admission. This evaluation shall assess the resident for the appropriateness of participating in an Outdoor Child Caring Program. Documentation of this evaluation shall be documented and maintained in the resident's file. 2. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Outdoor Child Caring Programs. 9 Outdoor Child Caring Program 1/14/2021 Second Nature Blue Ridge, LLC Laura Fuqua 236 File Street, Clayton, Georgia 30525 706-212-2037 290-2-7.05(7)(a) The facility requested a waiver for Approved No the rule which states the intake summary shall include a current (within one year) evaluation by a licensed psychiatrist or psychologist. 2/24/2021 1. The facility must ensure that all residents accepted and enrolled in the program shall receive a psychological or psychiatric evaluation within two weeks of admission. This evaluation shall assess the resident for the appropriateness of participating in an Outdoor Child Caring Program. Documentation of this evaluation shall be documented and maintained in the resident's file. 2. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Outdoor Child Caring Programs. 10 Outdoor Child Caring Program 1/14/2021 Second Nature Blue Ridge, LLC Laura Fuqua 236 File Street, Clayton, Georgia 30525 706-212-2037 290-2-7.05(8) The facility requested a waiver for Approved No the rule which states that the outdoor child caring program intake process shall include a discussion regarding the placement with the camper and his/her parents or placement agency and it shall include a visit to the camp. 2/24/2021 1. The facility must ensure that the intake process includes a discussion of the program with both the resident and their parent/guardian. Any parent/guardian opting not to visit the camp as a part of the intake process must sign a waiver indicating that they do not wish to visit the camp. This visitation waiver must be documented and maintained in the resident's file. 2. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Outdoor Child Caring Programs. Page 4 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 11 Child Caring Institution 11/10/2020 George West Mental Health Foundation D/B/A Adolescent Program Skyland Trails Tonya Beckett Agency/Agency Representative's Address 2830 Dresden Drive, Atlanta, Georgia 30341 Agency/Agency Representative's Phone Number 470-823-6985 Rule # Reason for Waiver Approved Attorney Approval Yes/No Date 290-2-5- The facility requested a waiver for Approved No .05(8) the rule which states that a **Effective licensed child caring institution January 1, shall not provide room, board and 2021, this rule watchful oversight to more than was 16 residents on its premises. renumbered to 290-2-5- .05(6) as a result of amendments to the rules and regulations governing Child Caring Institutions. 2/24/2021 Conditions of Approval 1. The facility must limit its capacity to sixteen residents at one time for a period of six months without any adverse actions imposed upon them. After the six month period, the facility may increase its capacity to twenty-six residents at one time. 2. The facility must maintain a qualified director and human service professional. There must be at least one human service professional for every sixteen residents in care. 3. The facility must ensure that all staff members working directly with the residents are appropriately oriented and trained regarding the type of residents admitted into the facility. This orientation must be documented in the staff member's personnel file. 4. This waiver is contingent upon the facility demonstrating substantial compliance with the rules and regulations governing Child Caring Institutions. 12 Child Placing Agency 1/26/2021 National Mentor Healthcare, LLC D/B/A Georgia Mentor Valdosta Dr. Santoria Williams 2225 Bemiss Road, Suite C, 404-661-6709 Valdosta, Georgia 31602 290-9-2.04(7)(b) The agency requested a waiver Approved No for rule which states that the executive director shall have a minimum of a bachelor's degree and two years of administrative experience in the field of human services. 2/24/2021 1. The staff member must receive monthly supervision from a master's level staff member. This supervision must include an evaluation of his/her job duties and responsibilities and must be documented and maintained in his/her personnel file. 2. The staff member must complete at least 24-hours of annual training related to the type of children served by the agency and training on leadership and development. This training must be documented and maintained in his/her personnel file. 3. The staff member must receive an annual performance evaluation completed by his/her supervisor that is documented and maintained in his/her personnel file. 4. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. Page 5 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 13 Child Placing Agency 2/23/2021 Foster Love Ministries, Marci Bourland Inc. Agency/Agency Representative's Address 4520 New Jessup Highway, Brunswick, Georgia 31520 Agency/Agency Representative's Phone Number 912-275-0005 Rule # 290-9-2.04(9)(a) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No renewal for the rule which states that the casework supervisor shall have the minimum of a master's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or other human service or behavioral science field. 3/10/2021 1. The staff must receive quarterly supervision from the board president or a designee that must be documented and maintained in his/her personnel file. 2. The staff must obtain at least 24-hours of annual training related to the type of residents served by the agency as well as training on the writing of home study evaluations. This training must be documented and maintained in his/her personnel file. 3. The staff must receive an annual employee performance evaluation completed by the board president or a designee that is documented and maintained in his/her personnel file. 4. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. 14 Child Caring 2/24/2021 Institution Chris 180, Inc. Sherwood Sarah Ziegler 569 Sherwood Greens, Stone 404-564-3435 Mountain, Georgia 30087 290-2-5.08(3)(a) The facility requested a waiver for Approved No the rule which states the director shall possess either a bachelor's degree or a business degree from an accredited college or university in the area of social science, social work, childhood education, business or public administration or a related field plus four years of work experience in the field of childcare. 3/10/2021 1. The staff member must receive monthly supervision from his/her manager. This supervision must include an evaluation of his/her job duties and responsibilities which must be documented and maintained in his/her personnel file. 2. The staff member must obtain at least 32-hours of annual training related to the type of residents served by the facility. This training shall be documented and maintained in his/her personnel file. 3. The staff member shall receive an annual performance evaluation completed by his/her manager that shall be documented and maintained in his/her personnel file. 4. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Child Caring Institutions. Page 6 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 15 Child Caring 2/24/2021 Institution Chris 180, Inc. - DeKalb Sarah Ziegler Agency/Agency Representative's Address Agency/Agency Representative's Phone Number 2914 Cocklebur Trail, Decatur, 404-564-3435 Georgia 30034 Rule # 290-2-5.08(3)(a) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The facility requested a waiver for Approved No the rule which states the director shall possess either a bachelor's degree or a business degree from an accredited college or university in the area of social science, social work, childhood education, business or public administration or a related field plus four years of work experience in the field of childcare. 3/10/2021 1. The staff member must receive monthly supervision from his/her manager. This supervision must include an evaluation of his/her job duties and responsibilities which must be documented and maintained in his/her personnel file. 2. The staff member must obtain at least 32-hours of annual training related to the type of residents served by the facility. This training shall be documented and maintained in his/her personnel file. 3. The staff member shall receive an annual performance evaluation completed by his/her manager that shall be documented and maintained in his/her personnel file. 4. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Child Caring Institutions. 16 Child Caring 2/24/2021 Institution Chris 180, Inc. Gwinnett Sarah Ziegler 2552 Poplar Street, Snellville, 404-564-3435 Georgia 30078 290-2-5.08(3)(a) The facility requested a waiver for Approved No the rule which states the director shall possess either a bachelor's degree or a business degree from an accredited college or university in the area of social science, social work, childhood education, business or public administration or a related field plus four years of work experience in the field of childcare. 3/10/2021 1. The staff member must receive monthly supervision from his/her manager. This supervision must include an evaluation of his/her job duties and responsibilities which must be documented and maintained in his/her personnel file. 2. The staff member must obtain at least 32-hours of annual training related to the type of residents served by the facility. This training shall be documented and maintained in his/her personnel file. 3. The staff member shall receive an annual performance evaluation completed by his/her manager that shall be documented and maintained in his/her personnel file. 4. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Child Caring Institutions. Page 7 of 44 # License Type Date Received Agency Name 17 Child Caring 2/24/2021 Institution Chris 180, Inc. Stephenson Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report Agency Representative Sarah Ziegler Agency/Agency Representative's Address 505 Stephenson Road, Stone Mountain, Georgia 30087 Agency/Agency Representative's Phone Number 404-564-3435 Rule # 290-2-5.08(3)(a) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The facility requested a waiver for Approved No the rule which states the director shall possess either a bachelor's degree or a business degree from an accredited college or university in the area of social science, social work, childhood education, business or public administration or a related field plus four years of work experience in the field of childcare. 3/10/2021 1. The staff member must receive monthly supervision from his/her manager. This supervision must include an evaluation of his/her job duties and responsibilities which must be documented and maintained in his/her personnel file. 2. The staff member must obtain at least 32-hours of annual training related to the type of residents served by the facility. This training shall be documented and maintained in his/her personnel file. 3. The staff member shall receive an annual performance evaluation completed by his/her manager that shall be documented and maintained in his/her personnel file. 4. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Child Caring Institutions. 18 Child Caring 2/24/2021 Institution Chris 180, Inc. Ellenwood Sarah Ziegler 4489 Northwind Drive, Ellenwood, Georgia 30294 404-564-3435 290-2-5.08(3)(a) The facility requested a waiver for Approved No the rule which states the director shall possess either a bachelor's degree or a business degree from an accredited college or university in the area of social science, social work, childhood education, business or public administration or a related field plus four years of work experience in the field of childcare. 3/10/2021 1. The staff member must receive monthly supervision from his/her manager. This supervision must include an evaluation of his/her job duties and responsibilities which must be documented and maintained in his/her personnel file. 2. The staff member must obtain at least 32-hours of annual training related to the type of residents served by the facility. This training shall be documented and maintained in his/her personnel file. 3. The staff member shall receive an annual performance evaluation completed by his/her manager that shall be documented and maintained in his/her personnel file. 4. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Child Caring Institutions. Page 8 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 19 Child Caring 2/24/2021 Institution Chris 180, Inc. - Fulton Sarah Ziegler Agency/Agency Representative's Address Agency/Agency Representative's Phone Number 3686 Calmer Circle, East Point, 404-564-3435 Georgia 30344 Rule # 290-2-5.08(3)(a) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The facility requested a waiver for Approved No the rule which states the director shall possess either a bachelor's degree or a business degree from an accredited college or university in the area of social science, social work, childhood education, business or public administration or a related field plus four years of work experience in the field of childcare. 3/10/2021 1. The staff member must receive monthly supervision from his/her manager. This supervision must include an evaluation of his/her job duties and responsibilities which must be documented and maintained in his/her personnel file. 2. The staff member must obtain at least 32-hours of annual training related to the type of residents served by the facility. This training shall be documented and maintained in his/her personnel file. 3. The staff member shall receive an annual performance evaluation completed by his/her manager that shall be documented and maintained in his/her personnel file. 4. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Child Caring Institutions. 20 Child Caring 2/24/2021 Institution Chris 180, Inc. - Rock Shadow Sarah Ziegler 568 Rock Shadow Court, Stone Mountain, Georgia 30087 404-564-3435 290-2-5.08(3)(a) The facility requested a waiver for Approved No the rule which states the director shall possess either a bachelor's degree or a business degree from an accredited college or university in the area of social science, social work, childhood education, business or public administration or a related field plus four years of work experience in the field of childcare. 3/10/2021 1. The staff member must receive monthly supervision from his/her manager. This supervision must include an evaluation of his/her job duties and responsibilities which must be documented and maintained in his/her personnel file. 2. The staff member must obtain at least 32-hours of annual training related to the type of residents served by the facility. This training shall be documented and maintained in his/her personnel file. 3. The staff member shall receive an annual performance evaluation completed by his/her manager that shall be documented and maintained in his/her personnel file. 4. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Child Caring Institutions. Page 9 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 21 Child Placing Agency 3/1/2021 Families 4 Families, Inc. Allison Williams Agency/Agency Representative's Address Agency/Agency Representative's Phone Number 3915 Harrison Road, Suite 770-895-4776 500, Loganville, Georgia 30052 Rule # 290-9-2.07(2) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 3/17/2021 1. The agency must conduct bi-monthly foster home visits during the first six months of placement to ensure the children's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits must be documented and maintained in each foster child's file and the foster parent's file. 2. The agency must develop service plans to address each child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed quarterly during the first year of placement and documented and maintained in each foster child's file. 3. The agency will not allow children of different sexes over the age of three to share a bedroom. 4. All updates and any changes to the foster home shall be documented in an amended home study evaluation and a copy of the report shall be maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. 22 Child Placing Agency 3/4/2021 Community Connections, Inc. Kimberly Brown 2300 West Park Place Boulevard, Suite 114, Stone Mountain, Georgia 30087 770-465-9644 290-9-2.07(2) The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 3/25/2021 1. The agency must conduct monthly foster home visits during the first six months of placement to ensure the children's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits must be documented and maintained in each foster child's file and the foster parent's file. 2. The agency must develop service plans to address each child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed quarterly during the first year of placement and documented and maintained in each foster child's file. 3. The agency will not allow children of different sexes over the age of three to share a bedroom. 4. All updates and any changes to the foster home shall be documented in an amended home study evaluation and a copy of the report shall be maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 10 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 23 Child Placing Agency 3/4/2021 Families 4 Families, Inc. Allison Williams Agency/Agency Representative's Address Agency/Agency Representative's Phone Number 3915 Harrison Road, Suite 770-895-4776 500, Loganville, Georgia 30052 Rule # 290-9-2.07(2) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 3/25/2021 1. The agency must conduct monthly foster home visits during the first six months of placement to ensure the children's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits must be documented and maintained in each foster child's file and the foster parent's file. 2. The agency must develop service plans to address each child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed quarterly during the first year of placement and documented and maintained in each foster child's file. 3. The agency will not allow children of different sexes over the age of three to share a bedroom. 4. All updates and any changes to the foster home shall be documented in an amended home study evaluation and a copy of the report shall be maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. 24 Child Placing Agency 3/2/2021 Christian City, Inc. Tierra Harp 7501 Red Oak Road, Union City, Georgia 30291 770-336-6567 290-9-2- The agency requested a waiver Approved No .07(5)(a)(9)(ii) for the rule which states no child (IV) over one year of age shall sleep in a room with an adult. 3/26/2021 1. The agency must conduct monthly foster home visits to ensure the child's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits must be documented and maintained in the foster child's file and the foster parent's file. 2. The agency must develop a service plan to address the foster child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed per the agency's policies and procedures and documented and maintained in the foster child's file. 3. The agency will ensure that the foster child has an appropriate bed to sleep in and does not sleep in the bed with the foster parent. 4. The agency must ensure that the foster child is supervised at all times with other children and house pets. 5. All updates and any changes to the foster home must be documented in an amended home study evaluation report and a copy of the report shall be maintained in the foster parent's file. 6. The waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 11 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 25 Child Caring 3/16/2021 Institution Changing Lives Learning Center, LLC Sophia Jordan Agency/Agency Representative's Address 313 Henderson Street, Sandersville, Georgia 31082 Agency/Agency Representative's Phone Number 478-290-5296 Rule # 290-2-5.08(6)(c)2 Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The facility requested a waiver for Approved No the rule which states that any childcare worker shall be at least 21 years of age and possess a high school diploma or a general education diploma. 4/8/2021 1. The staff member must receive monthly supervision from the director and/or the human service professional that is documented and maintained in his/her personnel file. 2. The staff member must obtain 24-hours of annual training related to the type of residents served by the facility. This training must be documented and maintained in his/her personnel file. 3. The staff member must receive an annual employee performance evaluation completed by his/her supervisor that is documented and maintained in his/her personnel file. 4. The staff member's job duties are limited to the role of a child care worker. 5. This waiver is contingent upon the facility demonstrating substantial compliance with the rules and regulations governing Child Caring Institutions. 26 Child Placing Agency 3/25/2021 Uniting Hope 4 Children, Katherine Mays Inc. 1949 Highway 81, Suite 300, 770-317-0294 Loganville, Georgia 30052 290-9-2.07(2) The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 4/20/2021 1. The agency must conduct monthly foster home visits to ensure the home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits shall be documented and maintained in both the foster parent's file and the foster children's file. 2. The agency must develop a service plan to address the children's emotional, family, educational, medical, social and developmental needs. This plan shall be maintained in each foster child's file. 3. The agency must not allow children of different sexes over the age of three to share a bedroom. 4. All updates and any changes in the family's home must be documented in an amended home study evaluation and a copy maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 12 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 27 Child Placing Agency 3/31/2021 Choices for Life of Georgia, LLC Agency Representative Vivian Mann Agency/Agency Representative's Address 2200 North Patterson Street, Valdosta, Georgia 31602 Agency/Agency Representative's Phone Number 229-244-1707 Rule # Reason for Waiver Approved Attorney Approval Yes/No Date 290-9-2- The agency requested a waiver Approved No .07(5)(a)(9)(ii) for the rule which states children (V) over three years of age of different sexes do not share a bedroom. 4/20/2021 Conditions of Approval 1. The agency must conduct monthly foster home visits to ensure the child's placement in the home is appropriate and does not pose a threat to the health and safety of any of the children in care. 2. The agency must ensure that the foster family provides 24-hour oversight and supervision during overnight hours by ensuring the family installs some type of monitoring system, such as a baby monitor. 3. The agency must develop a service plan to address the foster child's emotional, educational, medical, social and developmental needs. 4. The agency will ensure that each foster child has an appropriate bed to sleep in and that children of the opposite sex do not share a bed. 5. All updates and any changes to the family's home shall be documented in an amended home study evaluation and a copy shall be maintained in the foster parent's file. 6. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. 28 Child Placing Agency 3/31/2021 It Is Well Foster Care, Bridgetta Sylvain 3 East Main Street, Suite 2A, 678-542-0011 Inc. Buford, Georgia 30518 290-9-2.04(9)(a) The agency requested a waiver Approved No for the rule which states the casework supervisor shall have the minimum qualifications of a master's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or other human service or behavioral science field. 4/20/2021 1. The staff member must receive monthly supervision from his/her supervisor. This supervision must include an evaluation of his/her job duties and responsibilities that shall be documented and maintained in his/her personnel file. 2. All home study evaluations and service plans completed by the staff member must be reviewed and signed off by a master's level staff member. 3. The staff member must complete at least 24-hours of annual training related to the type of children served by the agency, which includes training on writing home study evaluations and service plans. This training must be documented and maintained in his/her personnel file. 4. The staff member must receive an annual performance evaluation by his/her supervisor that is documented and maintained in his/her personnel file. 5. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. Page 13 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 29 Child Placing Agency 3/29/2021 National Mentor Dr. Santoria Healthcare, LLC D/B/A Williams Georgia Mentor - Athens Agency/Agency Representative's Address Agency/Agency Representative's Phone Number 185 Ben Burton Circle, Bogart, 404-661-6709 Georgia 30622 Rule # 290-9-2.04(9)(a) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No renewal for the rule which states the casework supervisor shall have the minimum qualifications of a master's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or other human service or behavioral science field. 4/22/2021 1. The staff member must receive monthly supervision from the director. This supervision must include an evaluation of his/her job duties and responsibilities that shall be documented and maintained in his/her personnel file. 2. All home study evaluations and service plans completed by the staff member must be reviewed and signed off by a master's level staff member. 3. The staff member must complete at least 24-hours of annual training related to the type of children served by the agency as well as training on writing home study evaluations and service plans. This training must be documented and maintained in his/her personnel file. 4. The staff member must receive an annual performance evaluation completed by his/her supervisor that is documented and maintained in his/her personnel file. 5. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. 30 Child Placing Agency 4/2/2021 National Youth Dr. Terri Jenkins Advocate Program, Inc. 315 West Ponce de Leon, Suite 661, Decatur, Georgia 30030 706-724-4387 290-9-2.07(2) The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 5/7/2021 1. The agency must conduct monthly foster home visits to ensure this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits shall be documented and maintained in the foster parent's file and each foster child's files. 2. The agency must conduct a monthly phone contact with the home for the first three months of placement to ensure the children are adjusting to the home and to ensure that the foster parents are not overwhelmed with three children under the age of three. 3. The agency must develop service plans to address each child's emotional, family, educational, medical, social and developmental needs. These plans shall be maintained in each foster child's file. 4. The agency will not allow children of different sexes over the age of three to share a bedroom. 5. All updates and any changes in the family make-up shall be documented in an amended home study report and a copy maintained in the foster parent's file and each foster child's file. 6. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. Page 14 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 31 Child Placing Agency 4/12/2021 Faithbridge Foster Care, Kris Isom Inc. Agency/Agency Representative's Address Agency/Agency Representative's Phone Number 4400 Northpoint Parkway, 678-690-7100 Suite 210, Alpharetta, Georgia 30022 Rule # 290-9-2.07(2) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 5/7/2021 1. The agency must conduct bi-monthly foster home visits to ensure this home is appropriate and does not pose a threat to the health and safety of any of the children in care. At least one of these visits must be conducted in the home.These visits shall be documented and maintained in the foster parent's file and the foster children's files. 2. The agency must develop service plans to address each child's emotional, family, educational, medical, social and developmental needs. These plans shall be maintained in each foster child's file. 3. The agency must not allow children of different sexes over the age of three to share a bedroom. 4. All updates and any changes in the family home must be documented in an amended home study report and a copy maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. 32 Child Placing Agency 4/13/2021 Faithbridge Foster Care, Kris Isom Inc. 4400 Northpoint Parkway, 678-690-7100 Suite 210, Alpharetta, Georgia 30022 290-9-2.07(2) The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 5/7/2021 1. The agency must conduct monthly foster home visits to ensure this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits shall be documented and maintained in the foster parent's file and the foster children's files. 2. The agency must develop service plans to address each child's emotional, family, educational, medical, social and developmental needs. These plans shall be maintained in each foster child's file. 3. The agency must not allow children of different sexes over the age of three to share a bedroom. 4. All updates and any changes in the family home must be documented in an amended home study report and a copy maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 15 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 33 Child Placing Agency 4/6/2021 Choices for Life of Georgia, LLC Agency Representative Sara Riley Agency/Agency Representative's Address 2200 North Patterson Street, Valdosta, Georgia 31602 Agency/Agency Representative's Phone Number 229-244-1707 Rule # 290-9-2.04(9)(a) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No renewal for the rule which states the casework supervisor shall have the minimum qualifications of a master's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or other human service or behavioral science field. 5/7/2021 1. The staff member must receive quarterly supervision from the director that must be documented and maintained in his/her personnel file. 2. The staff member must obtain 24-hours of annual training related to the type of residents served by the agency. This training must be documented and maintained in his/her personnel file. 3. The staff member shall receive an annual employee performance evaluation completed by the director that is documented and maintained in his/her personnel file. 4. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. 34 Child Placing Agency 4/14/2021 Families 4 Families, Inc. Allison Williams 3915 Harrison Road, Suite 770-895-4776 500, Loganville, Georgia 30052 290-9-2.07(2) The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 5/7/2021 1. The agency must conduct monthly foster home visits to ensure this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits shall be documented and maintained in the foster parent's file and the foster children's files. 2. The agency must develop service plans to address each child's emotional, family, educational, medical, social and developmental needs. These plans shall be maintained in each foster child's file. 3. The agency must not allow children of different sexes over the age of three to share a bedroom. 4. All updates and any changes in the family home must be documented in an amended home study report and a copy maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 16 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 35 Child Placing Agency 4/21/2021 Community Connections, Inc. Agency Representative Kimberly Boykin Agency/Agency Representative's Address 2300 West Park Place Boulevard, Suite 114, Stone Mountain, Georgia 30087 Agency/Agency Representative's Phone Number 770-465-9644 Rule # Reason for Waiver Approved Attorney Approval Yes/No Date 290-9-2- The agency requested a waiver Approved No .07(5)(a)(9)(ii) for the rule which states no child (IV) over one year of age shall sleep in a room with an adult. 6/9/2021 Conditions of Approval 1. The agency must conduct monthly foster home visits to ensure the child's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits must be documented and maintained in the foster child's file and the foster parent's file. 2. The agency must develop a service plan to address the foster child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed per the agency's policies and procedures and documented and maintained in the foster child's file. 3. The agency will ensure that the foster child has an appropriate bed to sleep in and does not sleep in the bed with the foster parent. 4. The agency must ensure that the foster child is supervised at all times with other children and house pets. 5. All updates and any changes to the foster home must be documented in an amended home study evaluation report and a copy of the report shall be maintained in the foster parent's file. 6. The waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. 36 Child Placing Agency 4/22/2021 Lookout Mountain Community Services TREK Program Mark Wattenbarger 1875 Fant Drive, Fort Oglethorpe, Georgia 30742 706-806-1205 290-9-2.07(2) The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 6/9/2021 1. The agency must conduct monthly foster home visits to ensure this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits shall be documented and maintained in the foster parent's file and the foster children's files. 2. The agency must develop service plans to address each child's emotional, family, educational, medical, social and developmental needs. These plans shall be maintained in each foster child's file. 3. The agency must not allow children of different sexes over the age of three to share a bedroom. 4. All updates and any changes in the family home must be documented in an amended home study report and a copy maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 17 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 37 Child Placing Agency 5/6/2021 Faithbridge Foster Care, Kris Isom Inc. Agency/Agency Representative's Address Agency/Agency Representative's Phone Number 4400 Northpoint Parkway, 678-690-7100 Suite 210, Alpharetta, Georgia 30022 Rule # Reason for Waiver Approved Attorney Approval Yes/No Date 290-9-2- The agency requested a waiver Approved No .07(5)(a)(9)(ii) for the rule which states children (V) over three years of age of different sexes do not share a bedroom. 6/9/2021 Conditions of Approval 1. The agency must conduct monthly foster home visits to ensure the child's placement in the home is appropriate and does not pose a threat to the health and safety of any of the children in care. 2. The agency must ensure that the foster family provides 24-hour oversight and supervision during overnight hours by ensuring the family installs some type of monitoring system such as a baby monitor. 3. The agency must develop a service plan to address the foster child's emotional, educational, medical, social and developmental needs. 4. The agency will ensure that each foster child has an appropriate bed to sleep in and that children of the opposite sex do not share a bed. 5. All updates and any changes to the family's home shall be documented in an amended home study evaluation and a copy shall be maintained in the foster parent's file. 6. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. 38 Child Placing Agency 5/6/2021 Murphy Harpst Agnetta Delancy Children's Center Specialized Foster Care 130 Grady Road, Rockmart, Georgia 30125 678-704-9291 290-9-2.04(9)(a) The agency requested a waiver Approved No for the rule which states that the casework supervisor shall have the minimum of a master's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or other human service or behavioral science field. 6/9/2021 1. The staff must receive monthly supervision from the director. This supervision must include an evaluation of his/her job duties and responsibilities that shall be documented and maintained in his/her personnel file. 2. All home study evaluations and service plans completed by the staff member must be reviewed and signed off by a master's level staff member. 3. The staff must complete at least 24-hours of annual training related to the type of children served by the agency as well as training on writing home study evaluations and service plans. This training must be documented and maintained in his/her personnel file. 4. The staff must receive an annual performance evaluation completed by his/her supervisor that is documented and maintained in his/her personnel file. 5. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. Page 18 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 39 Child Placing Agency 5/19/2021 Georgia Baptist Children's Homes & Family Ministry, Inc. Agency Representative Patricia Daniel Agency/Agency Representative's Address Agency/Agency Representative's Phone Number 9250 Hutchenson Ferry Road, 770-463-3800 Palmetto, Georgia 30268 Rule # 290-9-2.04(9)(a) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No for the rule which states that the casework supervisor shall have the minimum of a master's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or other human service or behavioral science field. 6/9/2021 1. The staff must receive monthly supervision from the director. This supervision must include an evaluation of his/her job duties and responsibilities that shall be documented and maintained in his/her personnel file. 2. All home study evaluations and service plans completed by the staff member must be reviewed and signed off by a master's level staff member. 3. The staff must complete at least 24-hours of annual training related to the type of children served by the agency as well as training on writing home study evaluations and service plans. This training must be documented and maintained in his/her personnel file. 4. The staff must receive an annual performance evaluation completed by his/her supervisor that is documented and maintained in his/her personnel file. 5. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. 40 Child Placing Agency 5/24/2021 Bethany Christian Services, Inc. Callie Chappell 6645 Peachtree Dunwoody 706-395-7038 Road, Atlanta, Georgia 30328 290-9-2.07(2) The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 6/21/2021 1. The agency must conduct monthly foster home visits to ensure this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits shall be documented and maintained in the foster parent's file and the foster children's files. 2. The agency must develop service plans to address each child's emotional, family, educational, medical, social and developmental needs. These plans shall be maintained in each foster child's file. 3. The agency must not allow children of different sexes over the age of three to share a bedroom. 4. All updates and any changes in the family home must be documented in an amended home study report and a copy maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 19 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 41 Child Caring 6/11/2021 Institution Foundation Group Home, Inc. Agency Representative Agency/Agency Representative's Address Steven Edmerson 827 Tallapoosa Street, Bremen, Georgia 30110 Agency/Agency Representative's Phone Number 770-537-0700 Rule # 290-2-5.08(3)(a) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The facility requested a waiver for Approved No the rule which states the director shall possess either a bachelor's degree or a business degree from an accredited college or university in the area of social science, social work, childhood education, business or public administration or a related field plus four years of work experience in the field of childcare. 7/12/2021 1. The staff member must receive quarterly supervision from the Board of Directors. This supervision must include an evaluation of his/her job duties and responsibilities which must be documented and maintained in his/her personnel file. 2. The staff member must obtain at least 32-hours of annual training which includes leadership and development training. This training shall be documented and maintained in his/her personnel file. 3. The staff member shall receive an annual performance evaluation completed by the Board of Directors that shall be documented and maintained in his/her personnel file. 4. The facility must maintain a qualified human service professional at all times. 5. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Child Caring Institutions. 42 Child Placing Agency 6/22/2021 National Youth Dr. Terri Jenkins Advocate Program, Inc. 315 West Ponce de Leon, Suite 661, Decatur, Georgia 30030 706-724-4387 290-9-2.07(2) The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 7/12/2021 1. The agency must conduct monthly foster home visits to ensure this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits shall be documented and maintained in the foster parent's file and the foster children's files. 2. The agency must develop service plans to address each child's emotional, family, educational, medical, social and developmental needs. These plans shall be maintained in each foster child's file. 3. The agency must not allow children of different sexes over the age of three to share a bedroom. 4. All updates and any changes in the family home must be documented in an amended home study report and a copy maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 20 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 43 Child Placing Agency 5/25/2021 Faithbridge Foster Care, Kris Isom Inc. Agency/Agency Representative's Address Agency/Agency Representative's Phone Number 4400 Northpoint Parkway, 678-690-7118 Suite 210, Alpharetta, Georgia 30022 Rule # 290-9-2.07(2) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No renewal for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 6/21/2021 1. The agency must conduct monthly foster home visits to ensure the home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits shall be documented and maintained in both the foster parent's file and each foster child's file. 2. The agency must develop a service plan to address each child's emotional, family, educational, medical, social and developmental needs. This plan shall be maintained in the foster children's file. 3. The agency must not allow children of different sexes over the age of three to share a bedroom. 4. All updates and any changes in the family's home must be documented in an amended home study evaluation and a copy maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. 44 Child Placing Agency 5/28/2021 Uniting Hope 4 Children, Katherine Mays Inc. 1949 Highway 81 South, Loganville, Georgia 30052 770-317-0294 290-9-2.07(2) The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 6/21/2021 1. The agency must conduct monthly foster home visits to ensure the home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits shall be documented and maintained in both the foster parent's file and each foster child's file. 2. The agency must develop a service plan to address the children's emotional, family, educational, medical, social and developmental needs. This plan shall be maintained in each foster child's file. 3. The agency will not allow children of different sexes over the age of three to share a bedroom. 4. All updates and any changes in the family's home must be documented in an amended home study evaluation and a copy maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 21 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 45 Child Placing Agency 6/15/2021 Uniting Hope 4 Children, Kayla Merritt Inc. Agency/Agency Representative's Address 1949 Highway 81 South, Loganville, Georgia 30052 Agency/Agency Representative's Phone Number 770-778-5789 Rule # 290-9-2.04(9)(a) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No renewal for the rule which states that the casework supervisor shall have the minimum of a master's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or other human service or behavioral science field. 7/12/2021 1. The staff member must receive monthly supervision from their supervisor. This supervision must include an evaluation of his/her job duties and responsibilities that shall be documented and maintained in their personnel file. 2. All home study evaluations and service plans completed by the staff member must be reviewed and signed off by a master's level staff member. 3. The staff member must complete at least 24-hours of annual training related to the type of children served by the agency which includes training on writing home study evaluations and service plans. This training must be documented and maintained in his/her personnel file. 4. The staff member must receive an annual performance evaluation completed by his/her supervisor that is documented and maintained in his/her personnel file. 5. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. 46 Child Placing Agency 6/17/2021 Uniting Hope 4 Children, Katherine Mays Inc. 1949 Highway 81 South, Loganville, Georgia 30052 770-317-0294 290-9-2.07(2) The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 7/12/2021 1. The agency must conduct monthly foster home visits to ensure the child's placement in this home is appropriate. These visits must be documented and maintained in both the foster parent's file and the child's file. 2. The agency must develop service plans to address the child's emotional, educational, medical, social and developmental needs. This plan shall be maintained in the foster child's file. 3. All updates and any changes to the family's home shall be documented in an amended home study evaluation and a copy shall be maintained in the foster parent's file. 4. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. Page 22 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 47 Child Caring 6/20/2021 Institution Changing Lives Learning Center, LLC Sophia Jordan Agency/Agency Representative's Address 313 Henderson Street, Sandersville, Georgia 31082 Agency/Agency Representative's Phone Number 478-290-5296 Rule # 290-2-5.08(6)(c)2 Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The facility requested a waiver for Approved No the rule which states that any childcare worker shall be at least 21 years of age and possess a high school diploma or a general education diploma. 7/12/2021 1. The staff member must receive monthly supervision from the director and/or the human service professional that is documented and maintained in his/her personnel file. 2. The staff member must obtain 24-hours of annual training related to the type of residents served by the facility. This training must be documented and maintained in his/her personnel file. 3. The staff member must receive an annual employee performance evaluation completed by his/her supervisor that is documented and maintained in his/her personnel file. 4. The staff member's job duties are limited to the role of a child care worker. 5. This waiver is contingent upon the facility demonstrating substantial compliance with the rules and regulations governing Child Caring Institutions. 48 Child Placing Agency 6/25/2021 Christian City, Inc. Michaela Guthrie 7501 Lester Road, Union City, 770-336-6566 Georgia 30291 290-9-2- The agency requested a waiver Approved No .07(5)(a)(9)(ii) for the rule which states children (V) over three years of age of different sexes do not share a bedroom. 7/12/2021 1. The agency must conduct monthly foster home visits to ensure the children's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. 2. The agency must ensure that the foster family provides 24-hour oversight and supervision during naptime and overnight hours by ensuring the family installs some type of monitoring system such as a baby monitor. 3. The agency must ensure that each foster child has an appropriate bed to sleep in and that children of the opposite sex do not share a bed. 4. The agency must develop service plans to address each child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed per the agency's policies and procedures and documented and maintained in each foster child's file. 5. All updates and any changes to the family's home shall be documented in an amended home study evaluation and a copy shall be maintained in the foster parent's file. 6. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. Page 23 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 49 Child Placing Agency 6/29/2021 Christian City, Inc. Agency Representative Tierra Harp Agency/Agency Representative's Address Agency/Agency Representative's Phone Number 7501 Lester Road, Union City, 770-336-6567 Georgia 30291 Rule # Reason for Waiver Approved Attorney Approval Yes/No Date 290-9-2- The agency requested a waiver Approved No .07(5)(a)(9)(ii) for the rule which states no child (IV) over one year of age shall sleep in a room with an adult. 8/2/2021 Conditions of Approval 1. The agency must conduct bi-monthly foster home visits to ensure the child's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits must be documented and maintained in the foster child's file and the foster parent's file. 2. The agency must develop a service plan to address the foster child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed per the agency's policies and procedures and documented and maintained in the foster child's file. 3. The agency will ensure that the foster child has an appropriate bed to sleep in and does not sleep in the bed with the foster parent. 4. The agency must ensure that all foster children's bedrooms are equipped with a monitoring system such as a baby monitor which allows for 24 hours of supervision, especially during overnight hours. 5. The waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. 50 Child Placing Agency 7/12/2021 Goshen Valley Foundation, Inc. D/B/A Goshen Homes Gabby Brumfield 505 Brown Industrial Parkway, 770-345-9535 Suite 200, Canton, Georgia 30114 290-9-2.07(2) The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 8/2/2021 1. The agency must conduct monthly foster home visits to ensure the child's placement in this home is appropriate. These visits must be documented and maintained in both the foster parent's file and the child's file. 2. The agency must develop service plans to address the child's emotional, educational, medical, social and developmental needs. This plan shall be maintained in the foster child's file. 3. All updates and any changes to the family's home shall be documented in an amended home study evaluation and a copy shall be maintained in the foster parent's file. 4. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. Page 24 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 51 Child Caring 7/16/2021 Institution North Georgia Angel House, Inc. Agency Representative Susan Worsley Agency/Agency Representative's Address 2260 Sam Nelson Road, Canton, Georgia 30114 Agency/Agency Representative's Phone Number 678-704-9291 Rule # Reason for Waiver Approved Attorney Approval Yes/No Date 290-2-5- The facility requested a waiver for Approved No .05(8) the rule which states no licensed **Effective child caring institution shall January 1, provide room, board and watchful 2021, this rule oversight to more than sixteen was (16) children on its premises. renumbered to 290-2-5- .05(6) as a result of amendments to the rules and regulations governing Child Caring Institutions. 8/2/2021 Conditions of Approval 1. The facility shall be limited to a capacity of twentyone (21) residents at one time. 2. The facility must maintain the staff to client ratio that's indicated per their Office of Provider Management placement contract. 3. The facility must maintain a qualified human service professional for every sixteen (16) residents in care. 4. The facility must ensure that all staff members working directly with residents have been appropriately oriented and trained regarding the type of residents served by the program. 5. This waiver is contingent upon the institution maintaining substantial compliance with the rules and regulations governing Child Caring Institutions. 52 Child Caring 7/16/2021 Institution Murphy Harpst Agnetta Delancy Children's Center Specialized Foster Care 740 Fletcher Street, Cedartown, Georgia 30125 678-704-9291 290-2-5.05(6)(a) The facility requested a waiver for Approved No the rule which states institutions with a valid child caring license issued on or before December 21, 2019, that includes authorization to place children in private foster homes where foster parents live, shall be required to obtain a child placing agency license no later than June 30, 2021. 8/23/2021 1. The facility must comply with the licensing process and meet all deadlines established by the application specialist. 2. The facility must report all complaints and incidents to the Residential Child Care Licensing Intake unit within the required timeframes. 3. The facility must ensure that they are operating in compliance with the rules and regulations governing Child Placing Agencies. 4. The facility must obtain their Child Placing Agency license by September 15, 2021. Page 25 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 53 Child Placing Agency 7/21/2021 Christian City, Inc. Agency Representative Tierra Harp Agency/Agency Representative's Address Agency/Agency Representative's Phone Number 7501 Lester Road, Union City, 770-336-6567 Georgia 30291 Rule # Reason for Waiver Approved Attorney Approval Yes/No Date 290-9-2- The agency requested a waiver Approved No .07(5)(a)(9)(ii) for the rule which states no child (IV) over one year of age shall sleep in a room with an adult. 8/23/2021 Conditions of Approval 1. The agency must conduct monthly foster home visits to ensure the children's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. 2. The agency must develop a service plan to address the foster child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed per the agency's policies and procedures and documented and maintained in the foster child's file. 3. The agency must ensure that each foster child has an appropriate bed to sleep. Foster children are not allowed to share a bed with the foster parent. 4. The agency will ensure that a partition or room divider is added to the foster parent's bedroom to allow for privacy and the child must get dressed in the bathroom or alone in the bedroom. 5. All updates and any changes to the family's home shall be documented in an amended home study evaluation and a copy shall be maintained in the foster parent's file. 6. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. 54 Child Caring 7/23/2021 Institution The Methodist Home for Robin Trantham Children and Youth 304 Pierce Avenue, Macon, Georgia 31204 478-751-2816 290-2-5.08(6)(b)1 The facility requested a waiver Approved No renewal for the rule which states that the human service professional shall possess a bachelor's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or a related field and either have two years of experience in the field of childcare or be supervised by another human service professional with a master's degree in one of the required disciplines. 8/23/2021 1. The staff member must receive monthly supervision from a master's level staff member that must be documented and maintained in his/her personnel file. The supervision must include a review of the assessments and service plans developed and written by the staff member. 2. The staff member must obtain 32-hours of annual training related to the type of residents served in the facility. This training must be documented and maintained in his/her personnel file. 3. The staff member must receive an annual performance evaluation completed by his/her supervisor and documented and maintained in his/her personnel file. 4. This waiver is contingent upon the institution maintaining substantial compliance with the rules and regulations governing Child Caring Institutions. Page 26 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative Agency/Agency Representative's Address 55 Child Caring 7/27/2021 Institution Liberty County Children's Home, Inc. D/B/A Gabriel's House Ranch James Osteen Jr. 6145 East Oglethorpe Highway, Midway, Georgia 31320 Agency/Agency Representative's Phone Number 912-884-4545 Rule # 290-2-5.09(2)(a) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The facility requested a waiver for Approved No the rule which states that a child under the age of six shall not be admitted to a child caring institution unless that child is a part of a sibling group with at least one of the siblings being six years of age or older and will reside at the institution. 8/23/2021 1. The facility will only admit residents under the age of six who are part of a sibling group. A separate waiver application must be submitted prior to the placement of any child under the age of six who is not a part of a sibling group. 2. The facility must maintain a homelike environment for residents in care and develop service plans that address their educational, medical, social and developmental needs. 3. The facility will not allow children of different sexes over the age of three years of age to share a bedroom. They must ensure that residents of different sexes are provided an individual crib or bed to sleep. 4. The facility must provide a living environment that is safe and appropriate for children under the age of six and ensure that appropriate supervision is maintained at all times. 5. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Child Caring Institutions. 56 Child Caring 7/27/2021 Institution Liberty County Children's Home, Inc. D/B/A Gabriel's House Ranch James Osteen Jr. 6145 East Oglethorpe Highway, Midway, Georgia 31320 912-884-4545 290-2-5.18(2)(a) The facility requested a waiver for Approved No the rule which states boys and girls shall sleep in separate sleeping areas. 8/23/2021 1. The facility will only admit residents under the age of six who are part of a sibling group. A separate waiver application must be submitted prior to the placement of any child under the age of six who is not a part of a sibling group. 2. The facility must maintain a homelike environment for residents in care and develop service plans that address their educational, medical, social and developmental needs. 3. The facility will not allow children of different sexes over the age of three to share a bedroom. They must ensure that residents of different sexes are provided an individual crib or bed to sleep. 4. The facility must provide a living environment that is safe and appropriate for children under the age of six and ensure that appropriate supervision is maintained at all times. 5. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Child Caring Institutions. Page 27 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 57 Child Placing Agency 7/30/2021 Health Connect of America, Inc. Agency Representative Nicole Aldred Agency/Agency Representative's Address 100 Glendalough Court, Suite E, Tyrone, Georgia 30290 Agency/Agency Representative's Phone Number 678-858-5653 Rule # 290-9-2.03(4), (5), 6(c), (7), 9(a,b,c,e) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a renewal Approved No for the waiver to operate as a forprofit agency. 8/23/2021 1. The agency must annually provide evidence that they remain registered to do business in the State of Georgia with an identified agent for service and that the agency is in good standing with Georgia's Secretary of State office. 2. The agency must not expand its scope of services as a Child Placing Agency beyond arranging foster care placements. The agency will not provide adoption services. 3. The agency leadership staff must meet quarterly to review and act upon all operational reports and evaluations of the agency. The agency must maintain a copy of these minutes and make them available to the licensing staff upon request. 4. The governing body shall meet at least annually to review and act upon all operational reports and evaluations of the Georgia program. A copy of these meeting notes shall be available to licensing staff upon request. 5. The agency will provide a copy of its annual financial audit report completed by a Certified Public Accountant to the licensing staff upon request. 6. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 28 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 58 Child Placing Agency 8/9/2021 Nightlight Christian Adoptions, Inc. Agency Representative Lexie Fowler Agency/Agency Representative's Address 2340 Prince Avenue, Suite B, Athens, Georgia 30606 Agency/Agency Representative's Phone Number 706-750-9119 Rule # 290-9-2.07(2) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 8/24/2021 1. The agency must conduct bi-monthly foster home visits to ensure each child's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits must be documented and maintained in each foster child's file and the foster parent's file. 2. The agency must develop a service plan to address each foster child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed per the agency's policies and procedures and documented and maintained in each foster child's file. 3. The agency will ensure that each foster child has an appropriate bed to sleep in and that children of the opposite sex do not share a bed. The agency will ensure that a partition or room divider is added to the foster children's bedroom to allow for privacy. 4. The agency must ensure the foster children's bedroom is equipped with a monitoring system such as a baby monitor to ensure 24-hours of supervision during overnight hours. 5. All updates and any changes to the foster home must be documented in an amended home study evaluation report and a copy of the report shall be maintained in the foster parent's file. 6. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. 59 Maternity 8/10/2021 Home Edify Teens Ministries, Inc. D/B/A Edify Teen Life Center Ruth Napoleon 39 Emmett Freeman Road, Senoia, Georgia 30276 770-685-5657 290-2-29.16(5) The facility requested a waiver for Approved No the rule which states a resident shall not remain in the home for more than eight weeks after delivery once the mother has been medically discharged. 9/13/2021 1. The facility must complete an updated assessment for each resident and her child. The assessment shall document any issues or concerns as it relates to the resident's developmental, social and emotional needs. The assessment shall also address the resident's educational and vocational skills, daily living skills and daycare needs, and discharge plans. 2. The facility shall document a 15-day Individual Service Plan for each resident. 3. The facility shall submit a change request form and the second chance home policies and procedures to the Residential Child Care Licensing Applications unit by September 30, 2021. 4. This waiver is contingent upon the facility maintaining substantial compliance with the rules and regulations governing Maternity Homes. Page 29 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative Agency/Agency Representative's Address 60 Child Caring 8/11/2021 Institution Broken Shackle Ranch, Lindsey Mae Cobb 1542 Francis Bridge Road, Inc. Davisboro, Georgia 31018 Agency/Agency Representative's Phone Number 478-331-6555 Rule # 290-2-5.08(6)(b)1 Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The facility requested a waiver for Approved No the rule which states that the human service professional shall possess a bachelor's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or a related field and either have two years of experience in the field of childcare or be supervised by another human service professional with a master's degree in one of the required disciplines. 9/29/2021 1. The staff member must receive monthly supervision from a master's level staff member that must be documented and maintained in his/her personnel file. The supervision must include a review of the assessments and service plans developed and written by the staff member. 2. The staff member must obtain 32-hours of annual training related to the type of residents served in the facility. This training must be documented and maintained in his/her personnel file. 3. The staff member must receive an annual performance evaluation completed by his/her supervisor and documented and maintained in his/her personnel file. 4. This waiver is contingent upon the institution maintaining substantial compliance with the rules and regulations governing Child Caring Institutions. 61 Child Placing Agency 8/12/2021 Care 4 All Children Services, Inc. Carla Simms 1174 McKendree Church 678-719-9677 Road, Suite 100, Lawrenceville, Georgia 30043 290-9-2.04(9)(a) The agency requested a waiver Approved No for the rule which states the casework supervisor shall have the minimum qualifications of a master's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or other human service or behavioral science field. 9/13/2021 1. The staff member must receive monthly supervision from his/her supervisor. This supervision must include an evaluation of his/her job duties and responsibilities that shall be documented and maintained in his/her personnel file. 2. All home study evaluations and service plans completed by the staff member must be reviewed and signed off by a master's level staff member. 3. The staff member must complete at least 24-hours of annual training related to the type of children served by the agency which includes training on writing home study evaluations and service plans. This training must be documented and maintained in his/her personnel file. 4. The staff member must receive an annual performance evaluation completed by his/her supervisor that is documented and maintained in his/her personnel file. 5. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. Page 30 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type 62 Child Placing Agency Date Received Agency Name Agency Representative 8/18/2021 Goshen Valley Foundation, Inc. D/B/A Goshen Homes Gabby Brumfield Agency/Agency Representative's Address Agency/Agency Representative's Phone Number 505 Brown Industrial Parkway, 770-435-9535 Suite 200, Canton, Georgia 30114 Rule # 290-9-2.07(2) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 9/13/2021 1. The agency must conduct monthly foster home visits to ensure the child's placement in this home is appropriate. These visits must be documented and maintained in both the foster parent's file and the child's file. 2. The agency must develop service plans to address the child's emotional, educational, medical, social and developmental needs. This plan shall be documented and maintained in the foster child's file. 3. All updates and any changes to the family's home shall be documented in an amended home study evaluation and a copy shall be maintained in the foster parent's file. 4. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. 63 Child Placing Agency 8/18/2021 Goshen Valley Foundation, Inc. D/B/A Goshen Homes Gabby Brumfield 505 Brown Industrial Parkway, 770-435-9535 Suite 200, Canton, Georgia 30114 290-9-2- The agency requested a waiver Approved No .07(5)(a)(9)(ii) for the rule which states children (V) over three years of age of different sexes do not share a bedroom. 64 Maternity 8/19/2021 Families First, Inc. - Erika Green Home Second Chance Home 2625 Jerome Road, College 678-598-4433 Park, Georgia 30349 290-2-29.21(4)(f) The facility requested a waiver for Approved No the rule which states each resident shall have adequate closet and drawer space for personal possessions in the room assigned. 9/13/2021 1. The agency must conduct monthly foster home visits to ensure the children's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. 2. The agency must ensure that the foster family provides 24-hour oversight and supervision during naptime and overnight hours by ensuring the family installs some type of monitoring system such as a baby monitor. 3. The agency must ensure that each foster child has an appropriate bed to sleep in and that children of the opposite sex do not share a bed. 4. The agency must develop service plans to address each child's emotional, educational, medical, social and developmental needs. These must be documented and maintained in the foster child's file. 5. All updates and any changes to the family's home shall be documented in an amended home study evaluation and a copy shall be maintained in the foster parent's file. 6. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. 9/29/2021 1. The facility staff must assess the resident's belongings and determine their storage needs. 2. The facility will utilize closet space and provide storage bins for each mother and her child based on the needs assessment. 3. This waiver is contingent upon the home maintaining substantial compliance with the rules and regulations governing Maternity Homes. Page 31 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 65 Child Placing Agency 8/25/2021 ENA, Inc. D/B/A NECCO Agency Representative Kristian Harper 66 Child Placing Agency 8/26/2021 National Mentor Healthcare, LLC D/B/A Georgia Mentor Columbus Joshua Salter Agency/Agency Representative's Address 120 North Oak Street, Valdosta, Georgia 31601 233 12th Street, Suite 521, Columbus, Georgia 31901 Agency/Agency Representative's Phone Number 229-415-7957 Rule # Reason for Waiver Approved Attorney Approval Yes/No Date 290-9-2- The agency requested a waiver Approved No .07(5)(a)(9)(ii) for the rule which states children (V) over three years of age of different sexes do not share a bedroom. 9/29/2021 Conditions of Approval 1. The agency must conduct monthly foster home visits to ensure the children's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. 2. The agency must ensure that the foster family provides 24-hour oversight and supervision during naptime and overnight hours by ensuring the family installs some type of monitoring system such as a baby monitor. 3. The agency must ensure that each foster child has an appropriate bed to sleep in and that children of the opposite sex do not share a bed. 4. The agency must develop service plans to address each child's emotional, educational, medical, social and developmental needs. The agency shall develop specific goals and objectives to assist the child in transitioning to sleeping in a separate room from his/her older sibling. 5. All updates and any changes to the family's home shall be documented in an amended home study evaluation and a copy shall be maintained in the foster parent's file. 6. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. 706-992-6263 290-9-2.04(9)(a) The agency requested a waiver Approved No renewal for the rule which states that the casework supervisor shall have the minimum of a master's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or other human service or behavioral science field. 9/29/2021 1. The staff member must receive monthly supervision from their supervisor. This supervision must include an evaluation of his/her job duties and responsibilities that shall be documented and maintained in their personnel file. 2. All home study evaluations and service plans completed by the staff member must be reviewed and signed off by a master's level staff member. 3. The staff member must complete at least 24-hours of annual training related to the type of children served by the agency which includes training on writing home study evaluations and service plans. This training must be documented and maintained in his/her personnel file. 4. The staff member must receive an annual performance evaluation completed by his/her supervisor that is documented and maintained in his/her personnel file. 5. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. Page 32 of 44 # License Type Date Received Agency Name 67 Child Placing Agency 8/30/2021 ENA, Inc. D/B/A NECCO Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report Agency Representative Agency/Agency Representative's Address Kaylene Kimsey 120 North Oak Street, Valdosta, Georgia 31601 Agency/Agency Representative's Phone Number 229-603-1644 Rule # 290-9-2.07(2) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 9/29/2021 1. The agency must conduct bi-monthly foster home visits to ensure the home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits shall be documented and maintained in both the foster parent's file and each foster child's file. 2. The agency must develop a service plan to address the children's emotional, family, educational, medical, social and developmental needs. This plan shall be maintained in each foster child's file. 3. The agency will not allow children of different sexes over the age of three to share a bedroom. 4. All updates and any changes in the family's home must be documented in an amended home study evaluation and a copy maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. 68 Child Placing Agency 9/13/2021 Bridge Builders Family Bianca Gouch and Children Services, Inc. 433 Cherry Street, Suite 18, Macon, Georgia 31201 478-960-7104 290-9-2.04(9)(a) The agency requested a waiver Approved No for the rule which states the casework supervisor shall have the minimum qualifications of a master's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or other human service or behavioral science field. 10/8/2021 1. The staff member must receive monthly supervision from his/her supervisor. This supervision must include an evaluation of his/her job duties and responsibilities that shall be documented and maintained in his/her personnel file. 2. All home study evaluations and service plans completed by the staff member must be reviewed and signed off by a master's level staff member. 3. The staff member must complete at least 24-hours of annual training related to the type of children served by the agency which includes training on writing home study evaluations and service plans. This training must be documented and maintained in his/her personnel file. 4. The staff member must receive an annual performance evaluation completed by his/her supervisor that is documented and maintained in his/her personnel file. 5. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. Page 33 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 69 Child Placing Agency 9/15/2021 Community Connections, Inc. Agency Representative Karen Jackson 70 Child Placing Agency 9/18/2021 Families 4 Families, Inc. Allison Williams Agency/Agency Representative's Address 2300 West Park Place Boulevard, Suite 114, Stone Mountain, Georgia 30087 Agency/Agency Representative's Phone Number 770-465-9644 Rule # Reason for Waiver Approved Attorney Approval Yes/No Date 290-9-2- The agency requested a waiver Approved No .07(5)(a)(9)(ii) for the rule which states children (V) over three years of age of different sexes do not share a bedroom. 10/8/2021 Conditions of Approval 1. The agency must conduct monthly foster home visits to ensure the children's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. 2. The agency must develop service plans to address each child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed per the agency's policies and procedures and documented and maintained in each foster child's file. 3. The agency must ensure that the foster family provides 24-hour oversight and supervision during naptime and overnight hours by ensuring the family installs some type of monitoring system such as a baby monitor. 4. The agency must ensure that each foster child has an appropriate bed to sleep. The agency will ensure that a partition or a room divider is added to the bedroom to allow for privacy. Each child must get dressed in the bathroom or alone in the bedroom. 5. All updates and any changes to the family's home shall be documented in an amended home study evaluation and a copy shall be maintained in the foster parent's file. 6. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. 3915 Harrison Road, Suite 770-895-4776 500, Loganville, Georgia 30052 290-9-2.07(2) The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 10/8/2021 1. The agency must conduct bi-monthly foster home visits to ensure the home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits shall be documented and maintained in both the foster parent's file and each foster child's file. 2. The agency must develop a service plan to address the children's emotional, family, educational, medical, social and developmental needs. This plan shall be maintained in each foster child's file. 3. During the monthly visits, the agency must ensure that respite care and other supports are available as needed for the foster parents. This information must be documented and maintained in the foster parent's file. 4. All updates and any changes in the family's home must be documented in an amended home study evaluation and a copy maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 34 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type 71 Child Placing Agency Date Received 9/9/2021 Agency Name Agency Representative Murphy Harpst Agnetta Delancy Children's Center Specialized Foster Care Agency/Agency Representative's Address 130 Grady Road, Rockmart, Georgia 30125 Agency/Agency Representative's Phone Number 678-704-9291 Rule # 290-9-2.07(2) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 10/8/2021 1. The agency must conduct bi-monthly foster home visits to ensure the home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits shall be documented and maintained in both the foster parent's file and each foster child's file. 2. The agency must develop a service plan to address the children's emotional, family, educational, medical, social and developmental needs. This plan shall be maintained in each foster child's file. 3. During the monthly visits, the agency must check in with the foster parents to determine what support systems are needed as it relates to caring for a large group of children. The agency should ensure that respite care and other supports are available as needed to minimize burnout of the foster parents. This information must be documented and maintained in the foster parent's file. 4. All updates and any changes in the family's home must be documented in an amended home study evaluation and a copy maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 35 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type 72 Child Placing Agency Date Received 9/9/2021 Agency Name Agency Representative Murphy Harpst Agnetta Delancy Children's Center Specialized Foster Care Agency/Agency Representative's Address 130 Grady Road, Rockmart, Georgia 30125 Agency/Agency Representative's Phone Number 678-704-9291 Rule # 290-9-2.07(2) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 10/8/2021 1. The agency must conduct bi-monthly foster home visits to ensure the home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits shall be documented and maintained in both the foster parent's file and each foster child's file. 2. The agency must develop a service plan to address the children's emotional, family, educational, medical, social and developmental needs. This plan shall be maintained in each foster child's file. 3. During the monthly visits, the agency must check in with the foster parents to determine what support systems are needed as it relates to caring for a large group of children. The agency should ensure that respite care and other supports are available as needed to minimize burnout of the foster parents. This information must be documented and maintained in the foster parent's file. 4. All updates and any changes in the family's home must be documented in an amended home study evaluation and a copy maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. 73 Child Placing Agency 8/30/2021 Health Connect of Crystal Porter America, Inc. - Dallas 168 North Johnson Street, Dallas, Georgia 30132 470-308-6150 290-9-2- The agency requested a waiver Approved No .07(5)(a)(9)(ii) for the rule which states no child (IV) over one year of age shall sleep in a room with an adult. 9/29/2021 1. The agency must conduct monthly foster home visits to ensure the children's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits must be documented and maintained in each foster child's file and the foster parent's file. 2. The agency must develop a service plan to address each foster child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed per the agency's policies and procedures and documented and maintained in each foster child's file. 3. The agency must ensure that each foster child has an individual bed or crib to sleep. Children are not allowed to share a bed with the foster parent. 4. The agency will ensure that a partition or room divider is added to the foster parent's bedroom to allow for privacy. 5. All updates and any changes to the foster home must be documented in an amended home study evaluation report and a copy of the report shall be maintained in the foster parent's file. 6. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 36 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 74 Child Placing Agency 8/30/2021 National Mentor Healthcare, LLC D/B/A Georgia Mentor Augusta Tracy L. Bush Agency/Agency Representative's Address Agency/Agency Representative's Phone Number 2828 Hillcreek Drive, Augusta, 706-868-5268 Georgia 30909 Rule # 290-9-2.07(2) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 9/29/2021 1. The agency must conduct monthly foster home visits to ensure the home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits shall be documented and maintained in both the foster parent's file and each foster child's file. 2. The agency must develop a service plan to address the children's emotional, family, educational, medical, social and developmental needs. This plan shall be maintained in each foster child's file. 3. During the monthly visits, the agency must check in with the foster parents to determine what support systems are needed. The agency must document and maintain this information in the foster parent's file. 4. All updates and any changes in the family's home must be documented in an amended home study evaluation and a copy maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. 75 Child Placing Agency 8/31/2021 Uniting Hope 4 Children, Katherine Mays Inc. 1949 Highway 81 South, Suite 770-317-0294 300, Loganville, Georgia 30052 290-9-2.07(2) The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 9/29/2021 1. The agency must conduct monthly foster home visits to ensure that each child's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits must be documented and maintained in each foster child's file and the foster parent's file. 2. During the monthly visits, the agency must check in with the foster parent to determine what support systems are needed as it relates to caring for a large group of children. The agency should ensure that respite care and other supports are available as needed to minimize burnout by the foster parent. This information must be documented and maintained in the foster parent's file. 3. The agency must develop a service plan to address each foster child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed per the agency's policies and procedures and documented and maintained in each foster child's file. 4. All updates and any changes to the foster home must be documented in an amended home study evaluation report and a copy of the report shall be maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 37 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type 76 Child Placing Agency Date Received 9/9/2021 Agency Name Agency Representative Goshen Valley Foundation, Inc. D/B/A Goshen Homes Gabby Brumfield Agency/Agency Representative's Address Agency/Agency Representative's Phone Number 505 Brown Industrial Parkway, 770-345-9535 Suite 200, Canton, Georgia 30114 Rule # 290-9-2.07(2) 77 Child Placing Agency 10/19/2021 National Mentor Crystal Smith Healthcare, LLC D/B/A Georgia Mentor - Macon 120-B Osigian Boulevard, Suite 478-333-2971 100, Warner Robins, Georgia 31088 290-9-2.04(9)(a) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 10/8/2021 1. The agency must conduct monthly foster home visits to ensure that each child's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. These visits must be documented and maintained in each foster child's file and the foster parent's file. 2. During the monthly visits, the agency must check in with the foster parent to determine what support systems are needed as it relates to caring for a large group of children. The agency should ensure that respite care and other supports are available as needed to minimize burnout by the foster parent. This information must be documented and maintained in the foster parent's file. 3. The agency must develop a service plan to address each foster child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed per the agency's policies and procedures and documented and maintained in each foster child's file. 4. All updates and any changes to the foster home must be documented in an amended home study evaluation report and a copy of the report shall be maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. The agency requested a waiver Approved No renewal for the rule which states that the casework supervisor shall have the minimum of a master's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or other human service or behavioral science field. 11/19/2021 1. The staff member must receive monthly supervision from their supervisor. This supervision must include an evaluation of his/her job duties and responsibilities that shall be documented and maintained in their personnel file. 2. All home study evaluations and service plans completed by the staff member must be reviewed and signed off by a master's level staff member. 3. The staff member must complete at least 24-hours of annual training related to the type of children served by the agency which includes training on writing home study evaluations and service plans. This training must be documented and maintained in his/her personnel file. 4. The staff member must receive an annual performance evaluation completed by his/her supervisor that is documented and maintained in his/her personnel file. 5. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. Page 38 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type 78 Child Placing Agency Date Received Agency Name Agency Representative Agency/Agency Representative's Address 10/26/2021 Abiding Love Adoption Agency, Inc. Carrie Murray Nellis 1700 Frederica Road, Suite 305, Saint Simons Island, Georgia 31522 Agency/Agency Representative's Phone Number 912-596-8778 Rule # 290-9-2.04(9)(a) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No renewal for the rule which states that the casework supervisor shall have the minimum of a master's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or other human service or behavioral science field. 11/19/2021 1. The staff member must receive quarterly supervision from the Board of Directors that must be documented and maintained in his/her personnel file. 2. The staff member must obtain at least 24-hours of annual training related to the type of residents served by the facility. This training shall be documented and maintained in his/her personnel file. 3. The staff member shall receive an annual performance evaluation completed by the Board of Directors that shall be documented and maintained in his/her personnel file. 4. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. 79 Child Caring 11/2/2021 Institution The Center for Children Steven Yarish & Young Adults, Inc. 2221 Austell Road, Marietta, 770-485-1661 Georgia 30008 290-2-5-.08 (6)(b)(1) The facility requested a waiver for Approved No the rule which states that the human service professional shall possess a bachelor's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or a related field and either have two years of experience in the field of childcare or be supervised by another human service professional with a master's degree in one of the required disciplines. 11/19/2021 1. The staff member must receive monthly supervision from a master's level staff member that must be documented and maintained in his/her personnel file. The supervision must include a review of the assessments and service plans developed and written by the staff member. 2. The staff member must obtain 32-hours of annual training related to the type of residents served in the facility. This training must be documented and maintained in his/her personnel file. 3. The staff member must receive an annual performance evaluation completed by his/her supervisor and documented and maintained in his/her personnel file. 4. This waiver is contingent upon the institution maintaining substantial compliance with the rules and regulations governing Child Caring Institutions. Page 39 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 80 Child Placing Agency 11/8/2021 ENA, Inc. D/B/A NECCO Agency Representative Lacey Stokes Agency/Agency Representative's Address 120 North Oak Street, Valdosta, Georgia 31601 Agency/Agency Representative's Phone Number 229-415-7957 Rule # Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval 290-9-2- The agency requested a waiver Approved No .07(5)(a)(9)(ii) for the rule which states children (V) over three years of age of different sexes do not share a bedroom. 12/17/2021 1. The agency must conduct monthly foster home visits to ensure the children's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. 2. The agency must develop service plans to address each child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed per the agency's policies and procedures and documented and maintained in each foster child's file. 3. The agency must ensure that the foster family provides 24-hour oversight and supervision during naptime and overnight hours by ensuring the family installs some type of monitoring system such as a baby monitor. 4. The agency must ensure that each foster child has an appropriate bed to sleep. The agency will ensure that a partition or a room divider is added to the bedroom to allow for privacy. 5. All updates and any changes to the family's home shall be documented in an amended home study evaluation and a copy shall be maintained in the foster parent's file. 6. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. 81 Child Placing Agency 11/15/2021 Chris 180, Inc. D/B/A Chris 180 - Adoption Services Erica Kaufman 1017 Fayetteville Road, Suite 404-564-4728 B, Atlanta, Georgia 30316 290-9-2- The agency requested a waiver Approved No .07(5)(a)6(v) for the rule which states that a screening for venereal disease for prospective foster parents and children 16 years of age and older living in a prospective foster home shall be completed. 11/19/2021 There are no imposed conditions for this waiver. Page 40 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 82 Child Placing Agency 11/18/2021 Uniting Hope 4 Children, Allie London Inc. Agency/Agency Representative's Address 1949 Highway 81 South, Loganville, Georgia 30052 Agency/Agency Representative's Phone Number 678-585-4686 Rule # Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval 290-9-2- The agency requested a waiver Approved No .07(5)(a)(9)(ii) for the rule which states children (V) over three years of age of different sexes do not share a bedroom. 12/17/2021 1. The agency must conduct monthly foster home visits to ensure the children's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. 2. The agency must develop service plans to address each child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed per the agency's policies and procedures and documented and maintained in each foster child's file. 3. The agency must ensure that each foster child has an appropriate bed to sleep and that children of the opposite sex do not share a bed. The agency will ensure that a partition or room divider is added to the foster children's bedroom to allow for privacy. 4. The agency must ensure the foster children's bedroom is equipped with a monitoring system such as a baby monitor to ensure 24-hours of supervision during overnight hours. 5. All updates and any changes to the family's home shall be documented in an amended home study evaluation and a copy shall be maintained in the foster parent's file. 6. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. 83 Child Placing Agency 11/18/2021 Creative Community Services, Inc. Charon Mathews 1650 Oakbrook Drive, Suite 770-469-6226 445, Norcross, Georgia 30093 290-9-2.04(9)(a) The agency requested a waiver Approved No renewal for the rule which states that the casework supervisor shall have the minimum of a master's degree from an accredited college or university in social work, psychology, childhood education, education counseling and psychology or other human service or behavioral science field. 12/17/2021 1. The staff member must receive monthly supervision from a master's level staff member. This supervision must include an evaluation of his/her job duties and responsibilities and must be documented and maintained in his/her personnel file. 2. The staff member must obtain 24-hours of annual training related to the type of residents served by the agency. This training must be documented and maintained in his/her personnel file. 3. The agency must document an annual performance evaluation for the staff member, completed by his/her supervisor, that is documented and maintained in his/her personnel file. 4. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. Page 41 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name Agency Representative 84 Child Placing Agency 11/29/2021 Families 4 Families, Inc. Allison Williams Agency/Agency Representative's Address Agency/Agency Representative's Phone Number 3915 Harrison Road, Suite 770-895-4776 500, Loganville, Georgia 30052 Rule # 290-9-2.07(2) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 12/17/2021 1. The agency must conduct monthly foster home visits to ensure that each child's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in the home. These visits must be documented and maintained in each foster child's file and the foster parent's file. 2. The agency must develop a service plan to address each foster child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed per the agency's policies and procedures and documented and maintained in each foster child's file. 3. During the monthly visits, the agency should ensure that respite care and other supports are available as needed for the foster parents. This information must be documented and maintained in the foster parent's file. 4. All updates and any changes to the foster home must be documented in an amended home study evaluation report and a copy of the report shall be maintained in the foster parent's file. 5. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 42 of 44 # License Type Date Received Agency Name 85 Child Placing Agency 11/30/2021 ENA, Inc. D/B/A NECCO Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report Agency Representative Sarah Carey Agency/Agency Representative's Address 120 North Oak Street, Valdosta, Georgia 31601 Agency/Agency Representative's Phone Number 229-415-7957 Rule # Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval 290-9-2- The agency requested a waiver Approved No .07(5)(a)(9)(ii) for the rule which states children (V) over three years of age of different sexes do not share a bedroom. 12/17/2021 1. The agency must conduct monthly foster home visits to ensure the children's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in care. 2. The agency must develop service plans to address each child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed per the agency's policies and procedures and documented and maintained in each foster child's file. 3. The agency must ensure that the each foster child has an appropriate bed to sleep and that children of the opposite sex do not share a bed. The agency will ensure that a partition or room divider is added to the foster children's bedroom to allow for privacy. 4. The agency must ensure the foster children's bedroom is equipped with a monitoring system such as a baby monitor to ensure 24-hours of supervision during overnight hours. 5. All updates and any changes to the family's home shall be documented in an amended home study evaluation and a copy shall be maintained in the foster parent's file. 6. This waiver is contingent upon the agency maintaining substantial compliance with the rules and regulations governing Child Placing Agencies. Page 43 of 44 Department of Human Services-Office of Inspector General-Residential Child Care Licensing-2021 Waiver-Variance Report # License Type Date Received Agency Name 86 Child Placing Agency 12/2/2021 Nightlight Christian Adoptions, Inc. Agency Representative Lexie Fowler Agency/Agency Representative's Address 2340 Prince Avenue, Suite B, Athens, Georgia 30606 Agency/Agency Representative's Phone Number 706-750-9119 Rule # 290-9-2.07(2) Reason for Waiver Approved Attorney Approval Yes/No Date Conditions of Approval The agency requested a waiver Approved No for the rule which states there shall be no more than six children under the age of 19 that may reside in a foster home. 12/17/2021 1. The agency must conduct bi-monthly foster home visits to ensure each child's placement in this home is appropriate and does not pose a threat to the health and safety of any of the children in the home. These visits must be documented and maintained in each foster child's file and the foster parent's file. 2. The agency must develop a service plan to address each foster child's emotional, educational, medical, social and developmental needs. The service plan meetings must be completed per the agency's policies and procedures and documented and maintained in each foster child's file. 3. The agency will ensure that each foster child has an appropriate bed to sleep and that children of the opposite sex do not share a bed. The agency will ensure that a partition or room divider is added to the foster children's bedroom to allow for privacy. 4. The agency must ensure the foster children's bedroom is equipped with a monitoring system such as a baby monitor to ensure 24-hours of supervision during overnight hours. 5. All updates and any changes to the foster home must be documented in an amended home study evaluation report and a copy of the report shall be maintained in the foster parent's file. 6. This waiver is contingent upon the agency demonstrating substantial compliance with the rules and regulations governing Child Placing Agencies. Page 44 of 44