CFS 403-2, Notice of Decision Completed Form Examples and Samples
Explore professional examples and samples of the CFS 403-2, Notice of Decision form. Learn how to accurately complete this child welfare document with our detailed, annotated case study examples.
CFS 403-2, Notice of Decision Example: Child Welfare Case Management
How this form was filled:
This example demonstrates how an AI can parse an internal case worker supervisor memo to automatically populate a formal CFS 403-2 Notice of Decision. The AI extracts key dates, addresses, and the legal rationale for case closure from unstructured prose, showing how automated systems improve accuracy and efficiency in regulatory compliance documentation.
Source document used: Case Worker Supervisor Memo
Memo to file: RE: Case Closure for the Martinez Family. Following our quarterly review meeting on January 12, 2026, we have determined that the foster care placement for the child, Mateo Martinez, can safely conclude. Mateo, who currently resides at 442 Maple Street, Springfield, IL 62704, has demonstrated significant stability. We are drafting the Notice of Decision today, January 14, 2026, to officially notify the family. The effective date for the transition to supervised home placement is February 1, 2026. This decision is based on the successful completion of the family reunification plan and the consistent positive progress reports from the school counselors. Specifically, per Rule 302.385 of the Illinois Administrative Code, we have satisfied all requirements for reunification. If there are any concerns regarding this change in status, please contact the lead caseworker, Sarah Jenkins, directly at 217-555-0199. For TDD assistance, please utilize our dedicated line at 217-555-0122. We want to ensure this transition remains as seamless as possible for the child; therefore, we are scheduling a follow-up visit for the third week of February to confirm the adjustments are holding up well. We have documented all findings in the central database under the primary case ID #88921-X.
Information used to fill out the document:
- Client Details: Mateo Martinez, 442 Maple Street, Springfield, IL 62704
- Notice Date: January 14, 2026
- Effective Date: February 1, 2026
- Decision Rationale: Successful completion of reunification plan per Illinois Administrative Code Rule 302.385
- Contact Info: Worker: Sarah Jenkins, Phone: 217-555-0199, TDD: 217-555-0122
What this filled form sample shows:
- Contextual entity extraction of address and contact information
- Normalization of date formats from narrative text
- Mapping legal citations to the appropriate form fields
- Filtering relevant case closure logic from procedural memo text
Form specifications and details:
| Form Number: | CFS 403-2 |
| Agency: | Department of Children and Family Services |
| Use Case: | Official notice of case status change/reunification |
| Compliance Standard: | Illinois DCFS Administrative Guidelines |
| Categories: | 403(b) forms |
| Created: | May 25, 2026 10:02 PM |