OCFS-4001, Notice of Critical Decision Completed Form Examples and Samples

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Filled OCFS-4001 form based on case review notes

Source document used: Caseworker Progress Notes

Case Review Memorandum - March 14, 2026. Attending: Sarah Jenkins (Caseworker), Legal Dept. Subject: Permanent Plan for the Miller Children. Following the review of the current domestic environment, we have finalized our recommendation for the Miller household. For the record, the parents are James and Elena Miller, currently residing at 452 Maple Avenue, Apartment 3C, Syracuse, NY 13202. The children have been in temporary foster placement for 16 months. Despite significant efforts in family reunification services, the parents have failed to adhere to the court-ordered service plan. Therefore, the Agency has reached a critical decision to seek the termination of parental rights and move toward an alternative permanent home. This decision is effective as of April 1, 2026. We are prioritizing the children's stability over further reunification attempts. Caseworker Sarah Jenkins should be the primary contact for any procedural inquiries regarding this transition. She can be reached directly at 315-555-0198. For hearing-impaired stakeholders needing TDD assistance, please utilize the statewide line at 1-800-555-0122. We acknowledge that the logistics of this change will be difficult, and we have authorized additional support for the current foster parents during the transition period. The formal notice documentation should be prepared immediately to ensure all parties are served by the end of the business week. No further extensions will be granted to the parents' legal counsel.