Respite Care Services
1200-500.40 | Revision Date: 7/1/2014


This policy guide describes the eligibility requirements and responsibilities for primary caregivers requesting respite care and outlines the procedure for approving respite care requests and processing service payment requests.

Table of Contents

Version Summary

This policy guide was updated from the 03/14/11 version, as part of the Policy Redesign, in accordance with the DCFS Strategic Plan. The title has been changed to “Respite Care Services”.


Respite Care Eligibility

The respite care program provides children with prearranged child care and temporary out-of-home care when caregivers are in crisis or when a caregiver is absent or incapacitated. It provides caregivers with substitute care and temporary relief from the responsibilities of foster parenting.

Respite Care Services allows caregivers to receive up to 72 continuous hours of respite care services one time per fiscal year (July 1 – June 30). 

Respite care services are available to the following out-of-home caregivers who are serving as paid, non-treatment foster care placements at the time of the expense:

  • Licensed foster parents
  • Relative caregivers
  • Relative legal guardians
  • Non-relative legal guardians
  • Non-finalized adoptive homes receiving Adoption Assistance Program (AAP) funding

The following out-of-home placements do not qualify for respite care services:

  • Group homes
  • Foster family agency placements
  • Non-foster care placements
  • Non-paid placements

If a court order with clear and specific language requires DCFS to pay for respite care, the child’s placement type does not matter and the 72 hour time limit may not apply.

Respite Care Providers

Respite care providers must be licensed foster parents who are willing and able to provide quality care and supervision, regardless of a child’s history and current emotional and behavioral status. Respite care providers receive reimbursement from DCFS at a flat rate of $3.00 per child, per hour. 

Respite care providers must meet the following guidelines:

  • Provider must be in good standing with DCFS and the Community Care Licensing (CCL) Division.
  • Provider must not have an administrative or investigative hold or be on “Do not use” or “Do not refer” status.
  • Population of the provider’s home, including the number of children receiving respite care, must not exceed CCL licensed capacity for the home.
  • All children living in the provider's home, ages eighteen (18) or younger, regardless of relationship to provider, are counted towards the licensed capacity total.
  • If planning to provide care for special needs children at the D or F-rate, provider must have taken the appropriate specialized training and be D-rate certified or F-rate approved.

Caregivers Requesting Respite Care

Requests for respite care services are voluntary and must be approved by the case-carrying CSW prior to respite care being provided. Caregivers requesting respite are responsible for finding their own respite care providers, for transporting children to and from respite care, and for providing respite care providers with any medications or special instructions, and all relevant information about the child’s health, behavior, special needs and visitation requirements.

Caregivers do not need to request that foster care payments be stopped during the time the child is in respite care.


Responding to a Respite Care Request

Case Carrying CSW Responsibilities

  1. Assess the respite care request, and inform the caregiver whether the request is appropriate according to respite care guidelines.
  2. If the respite care request is appropriate, inform the caregiver of the following:
    1. Respite care is limited to 72 hours per fiscal year, per child, at a rate of $3.00 per hour, with a maximum claim of $216.
    2. The caregiver is responsible for finding an approved, licensed respite care provider.
    3. Once a respite care provider is found, the caregiver must inform the CSW to determine if the care provider is appropriate.
    4. In the event of an emergency, the caregiver must notify the CSW by phone prior to receiving respite care services.
      1. For after-hours emergencies, the caregiver must call the Child Protection Hotline (CPH) at (800) 540-4000. 
      2. The CSW must document any emergency situation in the Contact Notebook.
  3. Once a respite care provider has been identified by the caregiver, confirm that the provider is a licensed foster parent in good standing by verifying the following:
    • Respite caregiver provider is in good standing with DCFS and CCL.
    • Respite caregiver’s home does not have an administrative and/or investigative hold or a “Do not use” or “Do not refer” status.
    • Confirm that the child is an appropriate age and sex for the respite caregiver to accept into his/her home.
    • Ensure that the respite care provider meets CCL and DCFS license capacity and is certified to meet the child’s special needs.
    • Review and verify the placement status (B-rate, D-rate, or F-rate) documented by the caregiver.
  4. Consult with SCSW prior to approving the respite care provider.
  5. If the identified respite care provider is approved, inform the caregiver of the approval and instruct the caregiver of the following:
    1. The primary caregiver is responsible for the transportation of the child.
    2. The caregiver must provide the respite care provider with the following:
      • Any information about the child’s health, behavior, special needs, and visitation orders.
      • The child’s Medi-Cal card, any medications, and/or special instructions pertaining to the child.
      • An emergency phone number and the phone number of the CSW.
    3. In the event of a crisis or emergency, the respite caregiver must notify the primary caregiver, the CSW, and the CPH at (800) 540-4000.
    4. Once respite care services have been provided, the caregiver or respite care provider must provide a signed letter to the CSW confirming that respite care services were provided.  The letter must specify the name, address, and license number of the respite care provider, as well as the name of the child, and the dates respite care was provided.
  6. Once respite services have been provided, complete the DCFS 5540 This graphic links to a form tutorial video., Special Payment Authorization Request.
  7. Obtain SCSW and ARA approval for the DCFS 5540.
  8. Once approval has been received, fax the following to the Special Payment Unit at (213) 637-2551:
    • Completed DCFS 5540
    • Signed letter from caregiver or respite care provider confirming that respite care services were provided and specifying the name of the child and dates that respite care was provided.
    • A letter/memo from the CSW justifying the reason for using respite care services.
    • If respite care was court ordered, the minute order with clear and specific language that orders DCFS to pay for respite care.

SCSW Approval

  • DCFS 5540

ARA Approval

  • DCFS 5540


LA Kids

DCFS 5540 This graphic links to a form tutorial video., Special Payment Authorization Request


0100-510.10, Capacity in a Relative/Nonrelative Extended Family Member/Foster Family Home or FFA Certified Home

0900-522.11, Specialized Care Increment (SCI) – F-Rate

0900-522.10, Specialized Care Increment (SCI) – D-Rate


Welfare and Institutions Code (WIC) Section 16501 – Defines, in part, child welfare services, service-funded activities, respite care and related regulations.