Adoption Home Study Checklist
ADOPTION HOME STUDY CHECKLIST
HOME STUDY INFORMATION
| Field | Information |
|---|---|
| Prospective Adoptive Parent(s) | [NAME(S)] |
| Home Study Provider | [AGENCY/SOCIAL WORKER NAME] |
| Provider License Number | [NUMBER] |
| Home Study Start Date | [DATE] |
| Target Completion Date | [DATE] |
| Type of Adoption | ☐ Domestic Infant ☐ Foster Care ☐ International ☐ Stepparent ☐ Relative |
| State of Residence | [STATE] |
SECTION I: DOCUMENTATION REQUIREMENTS
1.1 Identification Documents
| Document | Required | Obtained | Submitted | Verified |
|---|---|---|---|---|
| Birth certificate (each adult) | ☐ | ☐ | ☐ | ☐ |
| Driver's license or state ID | ☐ | ☐ | ☐ | ☐ |
| Social Security card | ☐ | ☐ | ☐ | ☐ |
| Passport (if international adoption) | ☐ | ☐ | ☐ | ☐ |
| Proof of citizenship/legal residency | ☐ | ☐ | ☐ | ☐ |
1.2 Marriage/Relationship Documents
| Document | Required | Obtained | Submitted | Verified |
|---|---|---|---|---|
| Marriage certificate | ☐ | ☐ | ☐ | ☐ |
| Domestic partnership certificate | ☐ | ☐ | ☐ | ☐ |
| Divorce decree(s) (all prior marriages) | ☐ | ☐ | ☐ | ☐ |
| Death certificate of former spouse | ☐ | ☐ | ☐ | ☐ |
| Annulment decree | ☐ | ☐ | ☐ | ☐ |
1.3 Financial Documents
| Document | Required | Obtained | Submitted | Verified |
|---|---|---|---|---|
| Last 3 years tax returns | ☐ | ☐ | ☐ | ☐ |
| Recent pay stubs (last 3 months) | ☐ | ☐ | ☐ | ☐ |
| Employer verification letter | ☐ | ☐ | ☐ | ☐ |
| Bank statements (last 3 months) | ☐ | ☐ | ☐ | ☐ |
| Investment/retirement account statements | ☐ | ☐ | ☐ | ☐ |
| Property deed or mortgage statement | ☐ | ☐ | ☐ | ☐ |
| Rental/lease agreement (if renting) | ☐ | ☐ | ☐ | ☐ |
| Debt documentation | ☐ | ☐ | ☐ | ☐ |
| Monthly budget/expense statement | ☐ | ☐ | ☐ | ☐ |
1.4 Insurance Documents
| Document | Required | Obtained | Submitted | Verified |
|---|---|---|---|---|
| Health insurance policy/card | ☐ | ☐ | ☐ | ☐ |
| Proof child can be added to policy | ☐ | ☐ | ☐ | ☐ |
| Life insurance policy | ☐ | ☐ | ☐ | ☐ |
| Homeowner's/renter's insurance | ☐ | ☐ | ☐ | ☐ |
| Auto insurance | ☐ | ☐ | ☐ | ☐ |
1.5 Medical Documents
| Document | Required | Obtained | Submitted | Verified |
|---|---|---|---|---|
| Physical exam (within 12 months) - Parent 1 | ☐ | ☐ | ☐ | ☐ |
| Physical exam (within 12 months) - Parent 2 | ☐ | ☐ | ☐ | ☐ |
| TB test results (all household members) | ☐ | ☐ | ☐ | ☐ |
| Mental health evaluation (if required) | ☐ | ☐ | ☐ | ☐ |
| Documentation of treatment (if applicable) | ☐ | ☐ | ☐ | ☐ |
| Fertility treatment records (if applicable) | ☐ | ☐ | ☐ | ☐ |
| Immunization records (if applicable) | ☐ | ☐ | ☐ | ☐ |
Medical Form Physician Statement:
The medical examination should address:
☐ Overall physical health
☐ Chronic conditions and treatment plans
☐ Mental health history
☐ Substance use history
☐ Life expectancy concerns
☐ Ability to parent a child
SECTION II: BACKGROUND CHECK REQUIREMENTS
2.1 Criminal Background Checks
| Check Type | Required | Completed | Cleared | Date |
|---|---|---|---|---|
| State criminal check - Parent 1 | ☐ | ☐ | ☐ | [DATE] |
| State criminal check - Parent 2 | ☐ | ☐ | ☐ | [DATE] |
| FBI fingerprint check - Parent 1 | ☐ | ☐ | ☐ | [DATE] |
| FBI fingerprint check - Parent 2 | ☐ | ☐ | ☐ | [DATE] |
| State check for other adults in home | ☐ | ☐ | ☐ | [DATE] |
| Additional state/local criminal checks required by governing law | ☐ | ☐ | ☐ | [DATE] |
Federal scope note: For approvals covered by a state's Title IV-E plan, 42 U.S.C. § 671(a)(20)(A) requires criminal-record procedures for each prospective foster or adoptive parent. The separate five-year lookback in § 671(a)(20)(B) concerns child-abuse and neglect registries, not criminal-record checks.
2.2 Child Abuse/Neglect Registry Checks
| Check Type | Required | Completed | Cleared | Date |
|---|---|---|---|---|
| Current state registry - Parent 1 | ☐ | ☐ | ☐ | [DATE] |
| Current state registry - Parent 2 | ☐ | ☐ | ☐ | [DATE] |
| All prior states (past 5 years) - Parent 1 | ☐ | ☐ | ☐ | [DATE] |
| All prior states (past 5 years) - Parent 2 | ☐ | ☐ | ☐ | [DATE] |
| Current/prior-state registry checks - other adults in home | ☐ | ☐ | ☐ | [DATE] |
Applicability note: Section 671(a)(20)(B) requires a state, before final approval of a prospective foster or adoptive parent, to check its own registry for the prospective parent and every other adult living in the home and to request registry checks from each other state where any such person resided during the preceding five years. This federal provision is a Title IV-E state-plan condition for foster/adoptive placement approvals; it is not a uniform federal checklist for every private, stepparent, relative, or intercountry adoption. Confirm the adoption type and all governing state, tribal, federal, agency, and court requirements with the licensed provider. Official text: https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section671&num=0&edition=prelim
States of Residence (Past 5 Years):
| State | Dates | Check Completed |
|---|---|---|
| [STATE] | [DATES] | ☐ |
| [STATE] | [DATES] | ☐ |
| [STATE] | [DATES] | ☐ |
2.3 Other Checks
| Check Type | Required | Completed | Cleared | Date |
|---|---|---|---|---|
| Sex offender registry check | ☐ | ☐ | ☐ | [DATE] |
| DMV/driving record | ☐ | ☐ | ☐ | [DATE] |
| Previous adoption/foster records | ☐ | ☐ | ☐ | [DATE] |
| Military records (if applicable) | ☐ | ☐ | ☐ | [DATE] |
SECTION III: WRITTEN STATEMENTS AND AUTOBIOGRAPHIES
3.1 Autobiographical Statements
Each prospective adoptive parent must provide:
☐ Personal History Statement - Parent 1
- Childhood and family of origin
- Education history
- Employment history
- Relationship history
- Previous marriages/partnerships
- Parenting experience
- Motivation to adopt
☐ Personal History Statement - Parent 2
- Same components as above
3.2 Relationship Statement (if couple)
☐ How you met
☐ History of relationship
☐ Strengths of relationship
☐ How you handle conflict
☐ Division of responsibilities
☐ Communication patterns
☐ Shared values and goals
3.3 Parenting Philosophy Statement
☐ Views on discipline
☐ Approach to education
☐ Religious/spiritual upbringing
☐ Cultural considerations
☐ Handling adoption-related issues
☐ Approach to discussing adoption with child
☐ Support for birth family connections (if open adoption)
SECTION IV: REFERENCES
4.1 Reference Requirements
Minimum typically required: 3-5 references (varies by state/agency)
| Reference Type | Name | Relationship | Contact | Letter Received |
|---|---|---|---|---|
| Personal Reference 1 | [NAME] | [RELATIONSHIP] | [PHONE/EMAIL] | ☐ |
| Personal Reference 2 | [NAME] | [RELATIONSHIP] | [PHONE/EMAIL] | ☐ |
| Personal Reference 3 | [NAME] | [RELATIONSHIP] | [PHONE/EMAIL] | ☐ |
| Professional Reference | [NAME] | [RELATIONSHIP] | [PHONE/EMAIL] | ☐ |
| Family Reference | [NAME] | [RELATIONSHIP] | [PHONE/EMAIL] | ☐ |
Note: References typically cannot be family members (unless family reference specifically required).
4.2 Reference Topics
References will typically be asked about:
☐ How long they've known you
☐ Your character and integrity
☐ Your relationship stability (if couple)
☐ Your interactions with children
☐ Your parenting abilities/potential
☐ Your home environment
☐ Any concerns about your ability to parent
SECTION V: HOME SAFETY INSPECTION
5.1 General Safety
| Item | Requirement | Compliant | Notes |
|---|---|---|---|
| Working smoke detectors | Every level/sleeping area | ☐ | |
| Carbon monoxide detectors | As required by code | ☐ | |
| Fire extinguisher | Accessible, not expired | ☐ | |
| First aid kit | Stocked and accessible | ☐ | |
| Emergency evacuation plan | Posted or documented | ☐ | |
| Emergency contact numbers | Posted near phone | ☐ |
5.2 Child Safety
| Item | Requirement | Compliant | Notes |
|---|---|---|---|
| Electrical outlet covers | All accessible outlets | ☐ | |
| Cabinet/drawer locks | For hazardous materials | ☐ | |
| Stair gates | Top and bottom (if stairs) | ☐ | |
| Furniture anchored | Tall furniture secured | ☐ | |
| Window guards/stops | Upper floor windows | ☐ | |
| Cord safety | Blind cords secured | ☐ | |
| Corner protectors | Sharp corners covered | ☐ |
5.3 Hazardous Materials
| Item | Requirement | Compliant | Notes |
|---|---|---|---|
| Medications | Locked or out of reach | ☐ | |
| Cleaning supplies | Locked or out of reach | ☐ | |
| Alcohol | Secured (if applicable) | ☐ | |
| Firearms | Unloaded, locked, separate from ammunition | ☐ | |
| Power tools | Secured | ☐ | |
| Sharp objects | Out of reach | ☐ | |
| Poisonous plants | Removed or inaccessible | ☐ |
5.4 Outdoor Safety (if applicable)
| Item | Requirement | Compliant | Notes |
|---|---|---|---|
| Pool/hot tub fencing | 4-foot fence with self-closing gate | ☐ | |
| Pool cover/alarm | If no fence | ☐ | |
| Deck/balcony railings | Secure, proper spacing | ☐ | |
| Yard fencing | Secure perimeter | ☐ | |
| Play equipment | Safe, age-appropriate | ☐ | |
| Toxic plants | Removed | ☐ |
5.5 Sleeping Arrangements
| Item | Requirement | Compliant | Notes |
|---|---|---|---|
| Dedicated bedroom or space | Age-appropriate | ☐ | |
| Bed/crib | Safe, meets current standards | ☐ | |
| Adequate space | Per licensing requirements | ☐ | |
| Temperature control | Comfortable | ☐ | |
| Window coverings | For privacy and safety | ☐ | |
| Smoke detector nearby | Working | ☐ |
5.6 Environmental Safety
| Item | Requirement | Compliant | Notes |
|---|---|---|---|
| Lead paint (pre-1978 homes) | Tested or treated | ☐ | |
| Radon | Tested (if applicable) | ☐ | |
| Mold | No visible mold | ☐ | |
| Water quality | Safe drinking water | ☐ | |
| HVAC system | Functional | ☐ | |
| Pest control | No infestations | ☐ |
SECTION VI: INTERVIEWS AND VISITS
6.1 Interview Schedule
| Interview Type | Date | Time | Location | Completed |
|---|---|---|---|---|
| Initial application review | [DATE] | [TIME] | [LOCATION] | ☐ |
| Individual interview - Parent 1 | [DATE] | [TIME] | [LOCATION] | ☐ |
| Individual interview - Parent 2 | [DATE] | [TIME] | [LOCATION] | ☐ |
| Joint interview (if couple) | [DATE] | [TIME] | [LOCATION] | ☐ |
| Interviews with children in home | [DATE] | [TIME] | [LOCATION] | ☐ |
| Interviews with other household members | [DATE] | [TIME] | [LOCATION] | ☐ |
| Home visit | [DATE] | [TIME] | [HOME] | ☐ |
| Follow-up visit (if needed) | [DATE] | [TIME] | [LOCATION] | ☐ |
6.2 Common Interview Topics
Be prepared to discuss:
☐ Your childhood and upbringing
☐ Relationship with your parents/family
☐ Your marriage/relationship history
☐ How you met your partner (if applicable)
☐ Your reasons for adopting
☐ Your fertility journey (if applicable)
☐ Your understanding of adoption
☐ How you will discuss adoption with your child
☐ Your parenting style and discipline approach
☐ Your support system
☐ Your religious/spiritual beliefs
☐ Your career and work-life balance
☐ How you handle stress and conflict
☐ Your expectations for the child
☐ Your openness to different children (age, race, special needs)
☐ Your plan for post-adoption contact (if applicable)
SECTION VII: TRAINING REQUIREMENTS
7.1 Pre-Adoption Training
| Training | Hours Required | Completed | Date | Certificate |
|---|---|---|---|---|
| Pre-adoption education | [HOURS] | ☐ | [DATE] | ☐ |
| CPR certification | [HOURS] | ☐ | [DATE] | ☐ |
| First aid certification | [HOURS] | ☐ | [DATE] | ☐ |
| Trauma-informed parenting | [HOURS] | ☐ | [DATE] | ☐ |
| Cultural competency training | [HOURS] | ☐ | [DATE] | ☐ |
| Transracial adoption training | [HOURS] | ☐ | [DATE] | ☐ |
| Special needs training | [HOURS] | ☐ | [DATE] | ☐ |
| State-specific requirements | [HOURS] | ☐ | [DATE] | ☐ |
7.2 Training Providers
| Provider | Program | Contact |
|---|---|---|
| [PROVIDER] | [PROGRAM NAME] | [CONTACT] |
| [PROVIDER] | [PROGRAM NAME] | [CONTACT] |
SECTION VIII: SPECIAL REQUIREMENTS
8.1 International Adoption (Hague Convention)
If adopting internationally, additional requirements under 8 CFR 204.311:
☐ USCIS Form I-800A (Application for Determination of Suitability to Adopt)
☐ Home study by Hague-accredited provider
☐ Biometric services appointment
☐ Home study approved by USCIS
☐ Additional country-specific requirements
8.2 Foster Care Adoption
☐ Foster parent licensing (if not already licensed)
☐ Resource family training (MAPP, PRIDE, GPS, or equivalent)
☐ Additional background checks per foster care requirements
☐ Understanding of subsidy/adoption assistance programs
8.3 Transracial/Transcultural Adoption
☐ Transracial adoption training completed
☐ Cultural competency assessment
☐ Plan for maintaining child's cultural heritage
☐ Diverse books, toys, and media
☐ Connection to cultural communities
SECTION IX: STATE-SPECIFIC REQUIREMENTS
California
- Licensed by California Department of Social Services
- Home study valid for 12 months (then update required)
- Must use licensed adoption agency or county adoption worker
- TB test required for all household members
- Minimum 10-year age difference not required for all adoptions
Texas
- Social study required under Texas Family Code Chapter 162
- Licensed child-placing agency or DFPS must conduct study
- Can be waived by judge in stepparent adoptions
- Valid for duration of adoption process
- Additional requirements for intercountry adoption
Florida
- Chapter 63, Florida Statutes requirements
- Preliminary home study before placement
- Licensed agencies or licensed social workers
- Home study valid for 12 months
- Update required if circumstances change
New York
- Home study by authorized agency or certified social worker
- Criminal background and child abuse clearances mandatory
- Stepparent adoptions may have abbreviated requirements
- 6-month residency requirement before filing
- Photo of each applicant required
SECTION X: HOME STUDY UPDATE REQUIREMENTS
10.1 When Updates Are Required
☐ Home study has expired (typically 12-24 months)
☐ Significant change in household (new person, someone moved out)
☐ Change of address
☐ Change in financial situation
☐ Change in health status
☐ Change in marital/relationship status
☐ Criminal charges or arrest
☐ Pregnancy or new child in home
☐ Other significant life changes
10.2 Update Tracking
| Change/Update | Date | Reported to Provider | Documentation |
|---|---|---|---|
| [CHANGE] | [DATE] | ☐ | ☐ |
| [CHANGE] | [DATE] | ☐ | ☐ |
SECTION XI: HOME STUDY COMPLETION
11.1 Final Steps
☐ All documents submitted
☐ All interviews completed
☐ Home inspection passed
☐ All training completed
☐ All background checks cleared
☐ References received and verified
☐ Medical clearances received
☐ Draft home study reviewed by applicants
☐ Final home study signed
☐ Home study approved
11.2 Home Study Approval
| Field | Information |
|---|---|
| Date Approved | [DATE] |
| Expiration Date | [DATE] |
| Social Worker Name | [NAME] |
| Supervisor Name (if required) | [NAME] |
| Agency Approval | ☐ |
11.3 Copies Distributed
☐ Copy to prospective adoptive parents
☐ Copy to adoption agency (if different from home study provider)
☐ Copy to attorney
☐ Copy to USCIS (if international)
☐ Copy to ICPC office (if interstate)
☐ Copy to court (when required)
SECTION XII: TIMELINE TRACKING
12.1 Typical Timeline
| Phase | Start Date | End Date | Status |
|---|---|---|---|
| Application submitted | [DATE] | [DATE] | ☐ Complete |
| Documents gathered | [DATE] | [DATE] | ☐ Complete |
| Background checks initiated | [DATE] | [DATE] | ☐ Complete |
| Training completed | [DATE] | [DATE] | ☐ Complete |
| Interviews scheduled | [DATE] | [DATE] | ☐ Complete |
| Interviews completed | [DATE] | [DATE] | ☐ Complete |
| Home inspection | [DATE] | [DATE] | ☐ Complete |
| Draft review | [DATE] | [DATE] | ☐ Complete |
| Final approval | [DATE] | [DATE] | ☐ Complete |
Note: Average home study timeline is 3-4 months, but can vary significantly.
SECTION XIII: COST TRACKING
| Item | Estimated Cost | Actual Cost | Paid |
|---|---|---|---|
| Application fee | $[AMOUNT] | $[AMOUNT] | ☐ |
| Home study fee | $[AMOUNT] | $[AMOUNT] | ☐ |
| Background check fees | $[AMOUNT] | $[AMOUNT] | ☐ |
| Training fees | $[AMOUNT] | $[AMOUNT] | ☐ |
| Medical exams | $[AMOUNT] | $[AMOUNT] | ☐ |
| Document fees | $[AMOUNT] | $[AMOUNT] | ☐ |
| Update fees (if applicable) | $[AMOUNT] | $[AMOUNT] | ☐ |
| TOTAL | $[AMOUNT] | $[AMOUNT] |
Typical range: $1,000 - $3,000 for home study alone
DOCUMENT CONTROL
| Version | Date | Author | Changes |
|---|---|---|---|
| 1.0 | 2026-01-25 | [NAME] | Initial version |
| 1.1 | 2026-07-22 | Ezel Templates | Corrected federal background-check scope and five-year registry lookback |
This checklist is provided for informational purposes only. Home study requirements vary significantly by state, adoption type, and provider. Work with a licensed home study provider and qualified adoption professionals for guidance specific to your situation.
About This Template
Family law covers the paperwork that shapes divorce, custody, child support, adoption, guardianship, and other family matters. These filings are emotional and high-stakes, and they also have to meet strict procedural rules for service, financial disclosure, and parenting plans. Clean, accurate paperwork keeps the focus on getting a workable outcome for the family instead of getting derailed by technical problems that delay hearings or force amended filings.
Important Notice
This template is provided for informational purposes. It is not legal advice. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Last updated: July 2026
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