Memorandum of Understanding and Referral for Parent-Child Visitation

Service Capacity: Pro Action operated Family Resource Centers (FRCs) do not provide direct supervision for Parent-Child visitation. They do offer, safe, neutral locations for non-custodial parents or family members to have unsupervised visitation with their children ages 0-5 or visitation supervised by another authorized individual.

Set up much like a family room or child care center, FRCs promote play and exploration in spaces filled with books, art supplies, science projects, dress-up clothes and other developmentally appropriate toys that parents and children can play with together. Also on hand is information about community resources, and about a variety of parenting questions such as potty training or how to handle behavior problems.

FRC staff and contract agents possess extensive experience, education and/or certification in early childhood, parenting education or other relevant topical areas. They capably provide a range of supports parents may need to foster their child’s healthy development. Supplemental supports include:

Formal parenting education series using evidence informed curricula
Informal one-to-one parenting information and guidance
Information about and referral to other community resources
Child developmental screenings

Restrictions: Because the Family Resource Center staff are not providing direct visitation supervision the following limitations apply.

Staff do not monitor or document conversations occurring between the parents, children or other family members engaged in the visitation.
The Family Resource Centers are “drop-in” centers where parents/caregivers and children arrive and stay together. Therefore, except in the instance of an adult threatening the safety or well-being of their child or other in the center, staff will not monitor or intervene with arrivals or departures.
All Family Resource Centers participants are required to sign in upon arrival and out upon departure. Therefore, documentation of attendance is the only information that could be supplied to the LDSS or Family Court.
Because our sites are located in school district owned facilities, they cannot accommodate visitations for parents/caregivers with sex offender status, those who have an Order of Protection against them by a student in the school district, or from whom there is any potential of violent behavior.

Referral: Please complete the form below.

Referral Form
Parent-Child Visitation at
Pro Action Operated Family Resource Centers

Family Name *

Center Family Referred To: *

Addison – (Jennie Mose FRC) Bath – (Bath Area FRC) Hornell – (Hornell FRC) Bradford (Mobile FRC) Greenwood (Mobile FRC) Prattsburgh (Mobile FRC) Pulteney (Mobile FRC) Wayland (Mobile FRC)

Type of Visitation (Center staff do not provide supervision. The name of the appointed supervisor is required.) *

Unsupervised Supervised*

Unsupervised - In the space below please indicate if you would like the center staff to talk with the family about any supplemental supports such as parenting education, community resources or developmental screenings. *

Name of Appointed Visitation Supervisor: *

Relationship of Supervisor to Family: *

Name of Referring Agency: *

Name of Person Referring Family: *

Phone Number *

Please enter a valid phone number.

Email

example@example.com

I have read and understand the service capacity and restrictions outlined in the Memorandum of Understanding regarding referral of families for visitation held at Pro Action operated Family Resource Centers. *

Signature of Person Referring Family Clear

Date of Referral: *

Date