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Free Ny Adoption Form in PDF

The New York Adoption Form (LDSS-0857) is an essential document issued by the New York State Office of Children and Family Services designed for individuals or families interested in adopting a child. This comprehensive form collects vital information regarding prospective adoptive parents, including personal, household, and preference details related to a future child's age, sex, ethnicity, and any special needs they may be equipped to support. Purposefully crafted, it facilitates the state's process in matching children with suitable adoptive families, ensuring the best possible outcomes for children in need of a loving home.

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The journey to adopt a child in New York State is detailed and rigorous, aimed at ensuring the best interests of the child are met through the meticulous application process outlined in form LDSS-0857 (Rev. 4/2011) by the New York State Office of Children and Family Services. This detailed form serves as the initial step for prospective parents to express their interest and willingness to adopt, encompassing a wide array of information that includes personal identification, home environment, demographic details, and preferences in the child they wish to adopt. It goes beyond basic information, delving into specifics such as the prospective parents' ethnicity, religion, languages spoken at home, and even the presence of family pets. The form recognizes the diverse nature of children in need of adoption, providing options for sex, age range, ethnicity, primary and secondary language, and religion of a child, as well as readiness to adopt children with special needs, including medical, educational, developmental, or mental health care requirements. The willingness to adopt sibling groups and legally "at-risk" children are also factors considered, reflecting the form’s thorough approach in aligning the needs of children with the capabilities and desires of prospective parents. Additionally, it includes procedural avenues for appeals through state administrative hearings if an application faces rejection or undue delay, ensuring fairness and transparency in the adoption process. This careful and comprehensive screening process substantiated through the LDSS-0857 form underscores New York State’s commitment to creating conducive environments for the flourishing of children through adoption.

Ny Adoption Sample

LDSS-0857 (Rev. 4/2011)

NEW YORK STATE

OFFICE OF CHILDREN AND FAMILY SERVICES

REGISTRY NUMBER

APPLICATION TO ADOPT

APPLICATION DATE

(For Official Use Only)

PART I

Family Adoption Registry Information

PROSPECTIVE PARENT’S NAME (Last, First, MI)

DATE OF BIRTH

ETHNICITY CODE

RELIGION CODE

MM, DD,

PROSPECTIVE PARENT’S NAME (Last, First, MI)

DATE OF BIRTH

ETHNICITY CODE

RELIGION CODE

MM, DD, YY

HOME ADDRESS (No., Street, Apt.)

CITY/TOWN

COUNTY

STATE

ZIP CODE

HOME TELEPHONE NUMBER

EMPLOYMENT TELEPHONE NO. (Prospective Adoptive Parent)

(

)

(

)

(

)

FAMILY’S PRIMARY LANGUAGE CODE

FAMILY’S SECONDARY LANGUAGE CODE

FAMILY’S PET:

E-Mail Address:

NOTE: Select ALL acceptable characteristics. You may choose more than one entry in each area.

Sex Male, Female, Either

Age:

Under 2

2-5

6-7

8-9

10-13

Over 13

Ethnicity Code:

Primary Language Code:

Secondary Language Code:

Religion Code:

ETHNICITY CODE

(FOR CHILD AND PARENTS)

LANGUAGE CODE

(FOR CHILD AND PARENTS)

AA	Black or African American	ASI	Indian	AI	Nat Am Lan	KM	Cambodian
AAC	Caribbean	ASJ	Japanese	AL	Albanian	KR	Korean
AAH	Haitian	ASK	Korean	AR	Arabic	LA	Laotian
AAN	Native African	ASX	Other - Asian	BN	Bengali	MU	Multiple
AAX	Other - Black or African American	HP	Hispanic	BS	Bosnian	NI	NigeranIbo
AL	Alaskan Native	ML	Multiple	CC	Cantonese	PJ	Punjabi
AM	American Indian	PI	Native Hawaiian/Pacific Islander	CF	Fujianese	PL	Polish
AS	Asian	WH	White	CH	ChnseOther	PR	Portuguese
ASC	Chinese	XNR	Not Reported	CM	Mandarin	PT	Patois
	RELIGION CODE			CR	HaitnCreol	RO	Romanian
	(FOR CHILD AND PARENTS)			CZ	Czech	RS	Russian
AT	African Religion	IS	Muslim/Islamic	EN	English	SC	SerboCroat
BA	Baptist	JW	Jehovah's Witness	ET	Ethiopian	SI	Amer Sign
BP	Other Protestant	LU	Lutheran	FA	Farsi	SL	Braille
BU	Buddhist	ME	Methodist/Wesleyan	FL	Fulani	SP	Spanish
CJ	Jewish	MO	Mormon	FO	Filipino	TL	Tagalog
CS	Christian Science	NA	Native American	FR	French	UK	Unknown
CT	Chinese Traditional	OC	Other Christian	GK	Greek	UR	Urdu
DE	Other Eastern	PE	Pentecostal	GR	German	VT	Vietnamese
EN	None/Secular	PR	Presbyterian	GU	Gujarati	YI	Yiddish
EP	Episcopal/Anglican	RC	Catholic	HI	Hindi	XX	Other
FP	No Preference	RO	Russian Orthodox	HW	Hebrew
GO	Greek Orthodox	UN	Unknown	IT	Italian
HI	Hindu	UU	Unitarian/Universal	JP	Japanese
		XX	Other	KH	Khmer

If you will consider a child with special needs and individual needs check ALL appropriate choices in the boxes below:

CATEGORIES OF CHILD NEEDS

Medical/Physical Needs

Educational/Learning Needs

Mental Health Needs

Developmental Delay Needs

MILD

MODERATE

SEVERE

Would You Be Willing to Accept a Legally “At Risk” Child?

YESNO

Would You Be Interested in Adopting a Sibling Group?

YESNO

LDSS-0857 (Rev. 4/2011)

NEW YORK STATE

OFFICE OF CHILDREN AND FAMILY SERVICES

FAMILY CERTIFICATION INFORMATION

PART II

Are you currently an approved adoptive parent?

Yes

If yes, please provide approval date:

NAME OF AGENCY

CONTACT PERSON

TELEPHONE NUMBER

( ) -

AGENCY ADDRESS (NO., STREET, APT.)

CITY/TOWN

COUNTY

STATE

ZIP CODE

IF YOU DO NOT HAVE A COMPLETED HOMESTUDY AND WOULD LIKE TO BEGIN THE HOMESTUDY PROCESS, PLEASE GIVE COMPLETE INSTRUCTIONS FOR REACHING YOUR HOME:

FOR OFFICIAL USE ONLY

HOME STUDY STATUS
1. In Process	2. Completed Favorable	3. Completed Unfavorable	4. Discontinued

GENERAL FAMILY INFORMATION

PART III

(To be completed by applicant)

IS THERE A FOSTER CHILD FREED FOR	DO YOU WISH TO ADOPT WHAT IS THE CHILD’S FULL NAME?
ADOPTION CURRENTLY LIVING IN YOUR HOME?	THIS CHILD?

Yes

CHILD’S DATE OF BIRTH

DATE OF PLACEMENT

CURRENT MARRIAGE INFORMATION

CURRENT MARRIAGE PLACE

STATUS

PROSPECTIVE PARENT

DATE

CITY

STATE

CURRENT MARRIAGE PLACE

STATUS

PROSPECTIVE PARENT

DATE

CITY

STATE

LDSS-0857 (Rev. 4/2011)

	PREVIOUS MARRIAGE INFORMATION

	PREVIOUS MARRIAGE PLACE				HOW TERMINATED

PROSPECTIVE PARENT		DATE	CITY	STATE
		DATE	CITY	STATE

	PREVIOUS MARRIAGE PLACE				HOW TERMINATED

PROSPECTIVE PARENT		DATE	CITY	STATE
		DATE	CITY	STATE

	LIST ALL HOUSEHOLD MEMBERS

FULL NAME		DATE OF BIRTH	RELIGION	RACE	RELATIONSHIP
		MM/DD/YYYY
1.					Self
2.
3.
4.
5.
6.
7.
8.

NOTE: If your application is rejected or if your application has not been acted upon within six months of filing by the completion of an adoption study, you may request a State administrative hearing. The hearing must be requested within 60 days after the date of rejection or failure to act.

NOTE: At such hearings, you will have the right to be represented by counsel or other representative to produce witnesses and other evidence on your behalf, to request the issuance of subpoenas, to cross-examine witnesses testifying against you, and to examine all evidence presented against you. If you wish to request a hearing, address your request to:

New York State Office of Children and Family Services

Special Hearings

52 Washington Street, Room 322 North

Rensselaer, New York 12144

NOTE: Social Services Law 424-a requires the authorized agency receiving this application to check with the New York State Register of Child Abuse and Maltreatment to determine whether an adoptive applicant and any person over 18 who resides in the home is the subject of an indicated report of child abuse and maltreatment.

NOTE: Social Services Law 378-a requires the authorized agency to complete a criminal history record check for a prospective adoptive parent or any other person over the age of 18 who is currently residing in the home.

NOTE: If you have acknowledged your willingness to adopt a handicapped or hard-to-place child, your name will be placed ion a Statewide computer file with the New York State Office of Children and Family Services only for the purpose of matching you with available children.

SIGNATURE OF PROSPECTIVE PARENT

DATE

SIGNATURE OF PROSPECTIVE PARENT

DATE

Note: Applicant should retain copy of application

LDSS-0857 (Rev. 42011)

INSTRUCTIONS FOR COMPLETING

APPLICATION TO ADOPT FORM

PART I: Family Adoption Registry Information: All prospective adoptive parents who express a willingness to adopt handicapped or hard-to-place children shall be listed on the Family Registry in the Adoption Album Our Children, Our Families. The information entered into the Family Adoptive Registry System is based on the information provided on the Application to Adopt Form. The registry will allow caseworkers to match the applicant’s profile with children photo listed in The Adoption Album – Our Children, Our Families. Consequently, prospective families will receive consideration based only upon the information contained on the application (i.e. if an applicant indicates a willingness to consider a severely handicapped child). Therefore the applicant will need to ensure the information provided in this registration accurately reflects the applicant’s adoption preferences.

Prospective Parent’s Name: The full name (last, first, middle initial) of the prospective adoptive parent(s). It is possible to list a single parent. Two-parent households must list both parents.

Parent’s DOB: Provide the date of birth (MM/DD/YYYY) of the prospective adoptive parent(s).

Parent’s Ethnicity: Enter parent’s ethnicity. Use ethnicity code from coding guide at the bottom of application.

Parent’s Religion: Enter parent’s religion. Use religion code from coding guide at the bottom of application.

Home Address: Provide the street address of the primary residence.

City/Town: Provide the city/town of the primary residence.

County: Provide the county of the primary residence

State: Provide the state of primary residence.

Zip Code: Provide the zip code of primary residence.

E-Mail: Provide an e-mail address if you have one.

Home Telephone: Provide telephone number including area code of primary residence.

Employment Telephone: Provide prospective parent’s employment telephone number including area code at place (s) of employment.

Family Primary and Secondary Language: Enter the code of the family’s primary and secondary language Use language code from the coding guide at the bottom of the application.

Family Pet: Indicate the type of family pet (as appropriate).

Sex: Indicate with an “E” (Either), “M” (Male), “F”(Female) the sex of the child desired.

Age Indicate with an “X” the appropriate age ranges of child(ren) desired. One or more or all age ranges may be selected. The system will only search the age ranges indicated.

Child’s Ethnicity: Enter ethnicity(ies) of the child(ren) prospective adoptive parent(s) is interested in adopting. Use ethnicity code from coding guide at the bottom of the application.

Child’s Primary and Secondary Language: Enter the code of the child’s primary and secondary language. Use primary and secondary language code form the coding guide at the bottom of the application.

Child’s Religion: Enter religion of the child(ren) prospective adoptive parent(s) is interested in adopting. Use religion code from coding guide at the bottom of the application.

Special Needs: Indicate with an “X” in the appropriate field the willingness of prospective adoptive parent(s) to accept a child with special needs. If a disabled child is not desired, leave this section blank. The system will only search to the degree of disability indicated. Please review the following definitions and examples of the categories of child needs and an explanation of the levels of severity. This is a framework intended to assist caseworker’s to assist matching prospective parents with children available for adoption. It is not the standard for determining rate of payment. Social Services districts establish special exceptional rates in accordance with 18 NYCRR 427.6

LDSS-0857 (Rev. 4/2011)

CATAGORIES OF CHILD NEEDS

Medical/Physical Needs: This category includes children with specific medical/physical needs that may require an additional level of care beyond that normally given at the child’s age level. This category includes children that may display some of the following medical problems that range from acute to chronic and/or terminal illness: a child who experiences respiratory problems ranging from asthma to reactive airway disease or skin conditions that range from eczema to those that require surgical/medical intervention; children with physical disabilities that impair the use of vision, hearing and mobility; and children with neurological problems that range from seizure disorders to different levels of cerebral palsy. This section will include infants that require additional medical intervention as well as some children who have gastrointestinal medical needs, and children who experience a wide range of allergy conditions. Additionally, children with genetically inherited conditions such as Down’s syndrome, Fetal Alcohol Syndrome, Tourettes and sickle cell disease will be included in this section.

Educational/Learning Needs: This category includes children with educational/learning needs ranging from educational support to diagnosed learning disabilities. Examples will include visual/receptive/auditory processing difficulties, dyslexia and educational delays. In addition children may require special educational intervention.

Mental Health Needs: This category includes children with mental/emotional disorders ranging from experiencing acting-out behavioral and emotional problems to having been adjudicated Persons in Need of

Supervision (PINS), and Juvenile Delinquents. Further examples of mental health needs include those children exhibiting some of the following behaviors low-frustration tolerance, early sexual activity, sexually acting-out behavior, enuresis, encopresis, and cruelty to animals. Also included are children who exhibit these additional issues: resistance to adult authority, have difficulty with their peers, runaway behavior, school absence and or discipline issues, diagnosed attention problems including Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder, substance abuse sleep disorders, and theft and gang activity. Children who are physically aggressive, violent and destructive will be noted here.

Developmental Delay Needs: This category includes children whose developmental needs range from receptive/ expressive language, fine/gross motor skills, social adaptations, and self-help skills to those needing intensive assistance in self-help skills and assistance towards achieving independent living. Also included in this section are children who have temporary developmental delays or more permanent deficits.

EXPLANATION OF MILD, MODERATE AND SEVERE LEVELS

Mild:

Medical/Physical Needs: - Child has a condition(s) which require non-acute medical attention such as: visual or hearing impairments, allergies, asthma, controllable epilepsy or follow-up conditions which have been surgically corrected such as open heart surgery.

Educational/Learning Needs - Child is slightly behind in one or more subjects but attends regular school classes. Child may have some minor learning disabilities.

Mental Health Needs: - Child has a diagnosed condition that may mildly impair their ability to function such as an adjustment or attachments disorder. Child is generally emotionally stable but may be facing a situation (disruption, new foster home) that has created a temporary emotional stress and may be addressed. Child has or has had a problem controlling their behavior, usually associated with a specific incident such as a disruption.

Developmental Needs: - Child has a mild delay in development and may be receiving speech, occupational or physical therapy.

Moderate:

Medical/Physical Needs: - Child that has a moderate level of cerebral palsy, cleft defects which have not yet

been surgically treated, sickle cell disease if severe complications are not present, partial impairment of normal movement, diabetes, heart defects which can be repaired, spina bifida without the most severe complications.

Educational/Learning Needs: - Child is 2 to 3 years behind in subjects and receiving resource room help or other special tutoring aside from being in the regular classroom.

Mental Health Needs: - Children with one of the described conditions requiring on going intervention services and a higher level of supervision and or treatment. Child is experiencing emotionally related problems that may interfere with child’s school performance or interaction with others. Child has a history of acting out causing problems in school and in interpersonal relationships.

Developmental Needs: - Child needs assistance with skills of daily living. Child is receiving early intervention services for significant lags in speech, fine/gross motor skills.

LDSS-0857 (Rev. 4/2011)

Severe:

Medical/Physical Needs: - Children with Spina Bifida with severe complications, muscular dystrophy, cerebral palsy with severe retardation and or paralysis, total paralysis, cystic fibrosis, blindness, total deafness, and terminal illnesses.

Educational/Learning Needs: - Children diagnosed as learning disabled or mentally retarded that are in special classroom settings.

Mental Health Needs: - Children who are schizophrenic, autistic and /or who act out destructively such as a fire- setter or a serious suicide risk. Children that are seriously emotionally disturbed, are in residential treatment, are receiving intensive therapy, or are in emotionally handicapped classroom settings. Children who exhibit severe acting-out and/or violent behavior. Children on medication to control their behavior.

Developmental Needs: - Children with severe mental retardation. Children receiving intensive therapy to obtain skills of daily living, children needing extensive supervision for daily functioning.

Accept Child who is “Legally At Risk”: Indicate with an “X” if applicant is willing to accept a child who is legally at risk. Detailed below, are two definitions associated with Legally At Risk.

The child’s birth parents have not terminated their parental rights and/or surrendered the child. Therefore, the child may not become available for adoption. (Note: This definition is appropriate for the recruitment and placement of children.)

A child is freed for adoption and there are potential legal impediments to the completion of the adoption including, but not limited to: a) there is a pending appeal of the termination of parental rights; b) there is a putative father who is claiming to be a person whose consent to the adoption is required; c) there is a conditional surrender where the surrender limits or restricts who the adoptive parent can be; and d) the child’s immigration status. (Note: This definition is appropriate for matching and searching photo-listed children with families registered in the Family Adoption Registry)

PART II: FAMILY CERTIFICATION INFORMATION: This section will provide the agency with the family’s current certification and license adoption information.

Certified/Licensed Adoptive Parent: Indicate yes or no applicant is currently certified/licensed as an adoptive parent. If no, leave blank. If yes, complete the following:

Approval Date: Please provide the date on which the family was approved as adoptive parents

(MM/DD/YYYY)

Name of Agency: Provide the full name of the adoption agency that certified the family as an adoptive family.

Contact Person: Provide both the first and last name of the district/agency official who will serve as the contact for this application in reference to inquiries from other districts/agencies or state offices.

Phone: Provide the business telephone number of the contact person.

Agency Address: Provide the street/address of the agency.

City/Town: Provide the city/town of the agency

County: Provide the county of the agency.

State: Provide the name of the state.

Zip Code: Provide the zip code.

Instructions to the home: If the applicant does not have a completed home study and would like the agency to conduct a home study, please provide detailed instructions for reaching the home.

LDSS-0857 (Rev. 4/2011)

PART III: GENERAL FAMILY INFORMATION (To be completed by applicant): Information collected in this section will allow the agency to begin the approval process for your family.

Is there a foster child freed for adoption currently living in your home? Indicate yes or no if a foster child is currently living in your home and the foster child’s parent’s rights have been terminated.

Do you wish to adopt this child? Indicate yes or no if your family intends to adopt the foster child currently living in your home.

What is the child’s name? Provide the foster child’s complete name (First, Last, Middle Initial). Child’s Date of Birth? Provide the date of birth (MM/DD/YYYY) of the foster child.

Date of Placement: Indicate the date (MM/DD/YYYY) on which the foster child was placed in your home.

Current Marriage Information: Provide current marriage information by indicating the following:

Prospective Parent’s:

Prospective Parent’s name;

The date of the current marriage;

City and State in which the current marriage took place; and

Status

Prospective Parent’s:

Prospective Parent’s name;

The date of the current marriage;

City and State in which the current marriage took place; and

Status

Previous Marriage Information: Provide previous marriage information by indicating the following:

Prospective Parent’s:

Prospective Parent’s name;

The date of the previous marriage;

City and State in which the previous marriage took place; and

How the previous marriage was terminated.

Prospective Parent’s:

Prospective Parent’s name;

The date of the previous marriage;

City and State in which the previous marriage took place; and

How the previous marriage was terminated.

List All Household Members: Indicate every member of the household by providing the following information: (Begin by indicating yourself first):

Name: Provide the full name of each household member (First, Last, Middle Initial);

Date of Birth: Provide the date of birth (MM/DD/YYYY) of each household member.

Religion: Indicate the religion of each household member.

Race: Indicate the race of each household member

Relationship: Provide the relationship of each household Signature Prospective Parent(s): Provide signature

Date: Provide the date the prospective parent(s) signs the application.

⇩ Ny Adoption

File Overview

Fact Name	Description
Form Identification	The form used for Adoption Application in New York is designated as LDSS-0857 (Rev. 4/2011).
Governing Body	The New York State Office of Children and Family Services is the governing body responsible for the oversight of this form’s application process.
Purpose of the Form	The form is utilized by prospective adoptive parents to apply for the adoption of a child or children, indicating preferences and willingness to adopt children with specific needs.
Special Considerations	Applicants can express their willingness to adopt children with special needs, including medical/physical, educational/learning, mental health, and developmental delay needs.
Legal and Administrative Provisions	In case of application rejection or lack of action within six months of filing, applicants have the right to request a State administrative hearing within 60 days following the decision or inaction.

Ny Adoption: Usage Guidelines

Filing the New York State Adoption Form is a pivotal step in the journey to becoming an adoptive parent, leading towards creating a new family unit. It's essential to accurately complete this form to ensure a smooth process and to best match prospective parents with a child whose needs they are prepared to meet. Here are detailed steps to help guide you through each part of the form, minimizing errors and improving your understanding of the process.

Part I: Family Adoption Registry Information
- Enter the full name (last, first, middle initial) of the prospective adoptive parent(s). For two-parent households, both names must be listed.
- Provide the date of birth (DD/MM/YYYY) for each prospective adoptive parent.
- Select the appropriate ethnicity code for parent(s) using the guide provided at the bottom of the application.
- Choose the religion code that matches the belief system of the prospective parent(s), referring to the coding guide.
- Fill in the complete home address, including city/town, county, state, and zip code.
- Indicate your home and employment telephone numbers, including area codes.
- Specify the family's primary and secondary language codes from the provided guide.
- Note the type of family pet, if applicable.
- Mark the desired child's sex, age range(s), ethnicity, primary and secondary language, and religion using the appropriate codes and indicators.
- Identify any special needs categories you are open to and indicate the level of severity for each that you are willing to consider.
Part II: Family Certification Information
- Indicate whether you are currently an approved adoptive parent; if yes, provide the approval date.
- Fill in the contact information of the agency, including the name of the agency contact person, their telephone number, and address.
- Provide detailed directions to your home if you're starting the home study process.
Part III: General Family Information
- Indicate whether there is a foster child freed for adoption currently living in your home and if you wish to adopt this child.
- Provide current and previous marriage information if applicable, including the date and place of the current marriage, as well as how any previous marriage was terminated.
- List all household members, including their full names, dates of birth, religions, races, and relationships to the prospective adoptive parent(s).
Review all parts of the application to ensure accuracy and completeness.
Sign and date the application in the designated spaces at the end of the form. Each prospective parent must sign.
Retain a copy of the application for your records.

Once the application is filled out and submitted, it will be reviewed by the relevant authorities to ensure it meets all necessary criteria for adoption. Prospective parents should prepare for the next steps, which include a home study process, attending adoption training sessions, and participating in meetings with social workers. These steps are vital in assessing the readiness and suitability of prospective adoptive parents to provide a stable and loving home to a child. Timeliness, honesty, and patience throughout this process will contribute significantly to a smoother adoption journey.

FAQ

What is the purpose of the LDSS-0857 form?

The LDSS-0857 form, issued by the New York State Office of Children and Family Services, is an application to adopt designed to gather comprehensive information about the prospective adoptive parent(s). It collects details on the adoption preferences, including the characteristics of the child or children they are willing to adopt, such as age, sex, ethnicity, primary and secondary language, and religion. Additionally, it inquires about the willingness to adopt children with special needs or siblings. This form facilitates the matching process between prospective parents and children in need of a forever family.

Who should complete the LDSS-0857 form?

This form should be completed by individuals or couples residing in New York State who are interested in the adoption process. It is pertinent both for those who are just beginning to explore adoption and for approved adoptive parents looking to provide a home to more children. It is especially important for applicants to be thorough and honest in their answers to ensure the best possible match between them and a child or children.

How does one indicate the characteristics of the child they wish to adopt?

In Part I of the form, prospective parents are asked to select all acceptable characteristics of the child they wish to adopt, including sex, age, ethnicity, language, religion, and whether they would consider a child with special needs. This section allows families to express their openness to a variety of child profiles and helps caseworkers in finding suitable matches based on these preferences.

Can single parents fill out the LDSS-0857 form?

Yes, single parents interested in adoption are encouraged to complete the form. It is designed to capture information from either individual applicants or couples. For a single parent, it's important to provide comprehensive personal information and adoption preferences, just as couples would.

What information is required about current and previous marriages?

In parts of the application, individuals are asked to provide information regarding their current marital status and any previous marriages, including how previous marriages were terminated. This information helps the agency understand the family dynamics and ensure that all legal aspects of the adoption process are addressed.

What happens if the application is rejected or not acted upon?

If an application is rejected or has not been acted upon within six months, the applicant may request a State administrative hearing. This must be done within 60 days after notice of the rejection or failure to act. At the hearing, applicants have rights, including representation by counsel, producing evidence, and examining evidence presented against them.

Is it necessary to undergo a home study process before completing the LDSS-0857 form?

While the LDSS-0857 form is an essential part of the adoption application process, it does not necessarily have to be filled out after a home study is completed. However, prospective parents should be in the process of having a home study done or be willing to begin the process, as it is a crucial step in becoming approved to adopt.

How are special needs defined in the form?

The form categorizes child needs into four areas: medical/physical, educational/learning, mental health, and developmental delays, with definitions for mild, moderate, and severe levels of each category. This classification helps applicants better understand what needs they feel prepared to manage, ensuring that children are placed in the most supportive and capable homes.

Common mistakes

When completing the New York Adoption Form (LDSS-0857), applicants often encounter a few common pitfalls that can delay the adoption process. Understanding these mistakes is crucial to ensure a smooth adoption journey. Here are five common mistakes people make:

Omitting Information: One of the most frequent errors is leaving sections of the form blank. Every field is designed to help the Office of Children and Family Services match children with the most suitable families. If an applicant fails to fill out parts of the form, such as the "Family’s Primary Language Code" or specifics about the "Categories of Child Needs" they are open to, this omission can slow down the matching process or lead to a less accurate matching.
Misinterpretation of Codes: The form uses specific codes to classify ethnicity, religion, and language, among other variables. Misinterpreting these codes can lead to incorrect submission of preferences or information. For example, incorrectly specifying an "Ethnicity Code" or "Religion Code" might misrepresent the family’s cultural or religious background, affecting the match with a child.
Not Indicating Flexibility: Many applicants select very narrow criteria for the child they wish to adopt, especially in the section concerning the "Sex," "Age," and "Special Needs" of the child. While it’s important to know your limits, showing no flexibility can significantly reduce the chances of being matched with a child. For instance, marking only one age group or specifying "NO" willingness to consider a child with any form of special needs might limit the options unnecessarily.
Incorrect Contact Information: Providing outdated or incorrect contact information, such as home, employment telephone numbers, or an incorrect email address, can delay the communication process. The agency needs accurate information to reach out to potential adoptive parents for updates or further necessities.
Failure to Consider Legal Implications: Not fully understanding the legal implications of adopting a "Legally 'At Risk' Child" or the requirements for becoming "an approved adoptive parent" can lead to complications down the line. Applicants need to thoroughly read the instructions and notes provided in the form, including those about the requirement for a home study, criminal history record check, and the process for adoption study completion.

By avoiding these common mistakes and thoroughly reviewing the form before submission, prospective parents can facilitate a smoother adoption process. Additionally, it’s advisable for applicants to consult with a legal advisor or the adoption agency for clarification on complex sections of the form. Keeping these tips in mind will help ensure that your application is accurate and complete, bringing you one step closer to welcoming a new family member.

Documents used along the form

When navigating the adoption process in New York, a variety of documents and forms beyond the initial LDSS-0857 Application to Adopt form are necessary. These documents help ensure that all legal, social, and health aspects of the adoption process are thoroughly considered and appropriately documented. They contribute to a comprehensive evaluation of the prospective adoptive family's suitability and preparedness to adopt, fostering the best possible outcome for the child or children involved.

Home Study Report: A detailed report prepared by a licensed agency, providing an assessment of the prospective adoptive family's home environment, lifestyle, health, financial stability, and suitability to adopt.
Child Abuse and Maltreatments Check (SCR): A mandatory check for all household members over the age of 18 to ensure the safety of the adoptive environment.
Criminal Background Check: A thorough criminal history check required for all prospective adoptive parents and any household members over the age of 18.
Medical Forms: Health assessments of the prospective adoptive parents and any household members, including recent physical exams and immunization records.
Financial Statement: Documentation providing a detailed overview of the family's financial status to assess the ability to financially support an adopted child.
References: Letters of recommendation from non-family members who can attest to the applicant's character, parenting ability, and the suitability to adopt.
Birth Certificates: Copies of birth certificates for all members of the prospective adoptive family.
Marriage Certificate or Divorce Decrees: Legal documents verifying the marital status of the prospective adoptive parent(s), where applicable.
Petition to Adopt: A formal legal document filed with the court requesting the approval of the adoption. This is completed after the child has been placed in the prospective home and before the adoption is finalized.
Post-Placement Reports: Reports conducted after the child is placed with the adoptive family, evaluating the adjustment of the child and family to the adoption.

Each of these documents plays a crucial role in the adoption process, collectively ensuring thorough vetting and preparation of prospective adoptive families. This meticulous process is designed to protect the best interests of the child and establish a foundation for a successful adoption. It represents a commitment to creating and supporting healthy, loving families through adoption.

Similar forms

The New York Adoption Form shares similarities with a Foster Care Application in how it gathers detailed information about prospective caregivers and their environment. Both forms collect comprehensive family demographic data, including names, addresses, employment information, household languages, and preferences about the child or children they aim to care for, such as age, sex, ethnicity, and religion. This process ensures a suitable and supportive environment for the child, taking into account the need to match specific preferences and requirements, including the willingness to adopt children with special needs or siblings, mirroring the structured effort to understand the foster or adoptive home’s potential support system.

Comparable to the adoption application, a Home Study Evaluation aims to assess the suitability of the prospective adoptive parent's home environment. The evaluation discusses the family's lifestyle, childcare experience, financial situation, and reasons for adopting, similar to sections of the adoption form that require information on current and previous marriages, household members, and the family’s pet ownership. Both documents are crucial in the decision-making processes that prioritize the child’s welfare, ensuring the home is safe and the family is prepared for the unique challenges of adoption.

The adoption form also parallels the functionality of a Visa or Immigration Application, especially in sections that record personal and demographic details such as ethnicity, languages spoken, and religious beliefs. Both types of applications require detailed personal information to assess eligibility and compatibility—a critical process for ensuring the prospective environment is conducive to the individual's (or child’s) successful integration, whether it be into a new country or family unit.

Similarly, the adoption form reflects aspects of a Job Application, particularly in how applicants must represent their qualifications—their suitability to adopt. Like job applicants highlighting their skills and experiences relevant to the position they desire, prospective adoptive parents must provide a thorough background, including their ability to meet the needs of a child. Sections regarding previous marriage information, employment details, and the preference for adopting children with specific needs underline the importance of evaluating an applicant’s readiness and capability, akin to assessing a candidate’s fit for a job role.

Lastly, the adoption form is akin to Medical Records, especially regarding the sections that deal with a child’s potential medical or physical needs. Just as medical records contain detailed information about a patient’s health history and specific needs for proper care and treatment, the adoption form’s requirement for prospective parents to indicate their willingness and capability to care for children with varying levels of medical, educational, or mental health needs ensures that the well-being of the child remains the paramount concern. This careful matching process is fundamental to ensuring the prospective adoptive parents are well-equipped to provide for the child's needs.

Dos and Don'ts

Do ensure all information is accurate and true. It's important to meticulously check the details you provide on the form, including your name, address, employment info, and the characteristics of the child you're interested in adopting. Accurate information helps facilitate a smoother adoption process.

Don't forget to specify your preferences regarding the child's age, sex, ethnicity, and special needs. The form provides options to select the characteristics you are willing to accept in a child. Being honest and clear about your preferences aids in finding the best match for your family.

Do include all household members and their details as required. The form asks for information about everyone living in your house to ensure a safe and supportive environment for the adopted child.

Don't overlook the legal requirements, such as the background check. The form mentions the need for a criminal history record check for anyone over the age of 18 living in the household. This is a crucial step in the process to ensure the child's safety.

Do indicate whether you are willing to adopt a child with special needs or a sibling group. Being open to such possibilities can increase your chances of making a life-changing difference in the lives of children who may find it harder to get adopted.

Don't ignore the instructions for providing a complete path to your residence if you haven't completed a home study yet. This information is essential for the home study process, which assesses your suitability as an adoptive parent.

Do sign and date the form correctly. Both prospective parents (if applicable) must sign the form to validate the information provided. This is a legal document, and your signature is a mandatory requirement.

Don't submit the application without reviewing it for completeness and accuracy. Missing or inaccurate information could delay the process or affect your application's approval.

Do retain a copy of the application for your records. It's important to have your own copy of the completed form for future reference. This can be helpful if there are any questions or follow-up required during the adoption process.

Misconceptions

Understanding the New York State Adoption Form (LDSS-0857) is crucial for families considering adoption. However, several misconceptions often cloud people's understanding of the process. Here are ten common misunderstandings:

Only married couples can adopt: Single individuals are also eligible to adopt, as the form allows for a single prospective parent’s information.
Prospective parents must share the same ethnicity or religion as the child: The form includes a wide array of ethnicity and religion codes for both the child and parents, highlighting the agency’s flexibility and inclusiveness.
The adoption form is only for young children: Prospective parents can express their openness to adopting children of various age ranges, including teenagers.
Prospective parents must be fluent in English: The form accommodates families with primary and secondary language codes, indicating that language barriers can be addressed.
Only people with no children can adopt: Families with existing children can adopt, as indicated by the section detailing household members.
Adopting a child with special needs requires medical training: The form categorizes child needs by mild, moderate, and severe, not demanding medical expertise from adoptive parents but rather willingness and capability to provide care.
The process excludes those who rent their homes: Home ownership is not specified as a criterion, focusing instead on the stability and safety of the living environment.
Applicants must be employed: While the form asks for employment telephone numbers, there is no direct statement that unemployment disqualifies prospective parents, emphasizing the overall ability to provide a supportive environment.
There is no recourse if an application is rejected: The form explicitly offers the right to request a state administrative hearing if an application is rejected or not acted upon within six months.
Applicants with pets are not eligible: The form inquiries about family pets, indicating that the presence of pets in the home is considered within the context of the adoption process rather than a disqualifying factor.

By addressing these misconceptions, prospective adoptive families can better understand the adoption process in New York State and feel more confident as they proceed with their application. It's essential to closely review the LDSS-0857 form and consult with adoption professionals for guidance tailored to specific circumstances and questions.

Key takeaways

Filling out and using the New York Adoption Form, LDSS-0857, is a crucial step for prospective adoptive parents in the state of New York. This comprehensive document not only serves as your formal application to adopt but also plays a pivotal role in how the New York State Office of Children and Family Services (OCFS) assesses your eligibility and matches a child to your family. Pay close attention to the following key takeaways to ensure a smooth process:

The form requires detailed information about the prospective parent(s), including names, dates of birth, employment information, and home addresses. Make sure all information is current and accurately reflected to avoid delays.
Sensitivity to the child’s background is pivotal. The form includes sections to specify the child’s desired sex, age, ethnicity, primary and secondary languages, and religion. Reflecting on these preferences deeply ensures that you are matched with a child whose needs you are prepared to meet.
Be prepared to discuss your willingness to adopt a child with special needs. The form asks you to indicate your openness to adopting children with varying degrees of medical, physical, educational, learning, mental health, and developmental needs. Being honest about your capacity to meet these needs is essential for a successful adoption.
Legal and procedural readiness is a must. The process as outlined includes steps for legal approval, home study status, and opportunities for appeal. Understanding the process, including the rights to a state administrative hearing if the application is rejected or not acted upon within six months, helps manage expectations.

Note: Ensure that every section of the form is filled carefully. Incomplete or inaccurate information can delay the adoption process. Most importantly, consider that each detail you provide will be used to match a child with your family, making it essential to approach this task with thoughtfulness and accuracy.

Finally, adhere to the state's legal requirements, including checks with the New York State Register of Child Abuse and Maltreatment and a criminal history record check for any prospective adoptive parent and anyone over 18 residing in the home. Showing preparedness for these steps signals your readiness for the adoption journey ahead.

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