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Get WI DCF-F-CFS2142 2010-2024

DEPARTMENT OF CHILDREN AND FAMILIES Division of Safety and Permanence STAFF CONTINUING EDUCATION AND TRAINING RECORD CHILD WELFARE PROGRAMS Use of form Use of this form is voluntary however completion of this form will facilitate the licensing inspection process and help ensure compliance with the continuing education requirements outlined in DCF 52. 12 5 f 2. and 52. 12 5 h DCF 54. 03 3 DCF 57. 17 2 i and DCF 59. 04 1 c 2. of the Wisconsin Administrative Codes. Personally identifiable information gathered on this form will be used only for identification purposes. Personal information you provide may be used for secondary purposes Privacy Law s. 15. 04 1 m Wisconsin Statutes. Instructions The form shall be completed by the staff person initialed by the trainer whenever feasible and placed in the employee file for examination by the licensing specialist. Enter the data in chronological order and use a new form for each continuing education year. Attach all supporting documentation* Name Staff Person Position Training Year Employment Date Hours Worked Per Week to Date / Time DCF-F-CFS2142 R* 04/2010 Training Subject Name Trainer Total Hours Trainer s Initials. 12 5 f 2. and 52. 12 5 h DCF 54. 03 3 DCF 57. 17 2 i and DCF 59. 04 1 c 2. of the Wisconsin Administrative Codes. Personally identifiable information gathered on this form will be used only for identification purposes. Personally identifiable information gathered on this form will be used only for identification purposes. Personal information you provide may be used for secondary purposes Privacy Law s. 15. 04 1 m Wisconsin Statutes. Personal information you provide may be used for secondary purposes Privacy Law s. 15. 04 1 m Wisconsin Statutes. Instructions The form shall be completed by the staff person initialed by the trainer whenever feasible and placed in the employee file for examination by the licensing specialist. Instructions The form shall be completed by the staff person initialed by the trainer whenever feasible and placed in the employee file for examination by the licensing specialist. Enter the data in chronological order and use a new form for each continuing education year. Attach all supporting documentation* Name Staff Person Position Training Year Employment Date Hours Worked Per Week to Date / Time DCF-F-CFS2142 R* 04/2010 Training Subject Name Trainer Total Hours Trainer s Initials. 12 5 f 2. and 52. 12 5 h DCF 54. 03 3 DCF 57. 17 2 i and DCF 59. 04 1 c 2. of the Wisconsin Administrative Codes. Personally identifiable information gathered on this form will be used only for identification purposes. Personal information you provide may be used for secondary purposes Privacy Law s. 15. 04 1 m Wisconsin Statutes. Personally identifiable information gathered on this form will be used only for identification purposes. Personal information you provide may be used for secondary purposes Privacy Law s. 15. 04 1 m Wisconsin Statutes. Instructions The form shall be completed by the staff person initialed by the trainer whenever feasible and placed in the employee file for examination by the licensing specialist. .

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