ND Quality Assurance

The goal of the child welfare system is to support and protect children, step in when a child is abused or neglected, and work with families to make sure every child has a safe, permanent, and loving place to grow. North Dakota Children and Family Services (CFS) uses the Quality Assurance (QA) Unit to complete case reviews as one way to check whether child welfare services are meeting these goals and to help the state keep improving.

While these reviews do provide information about individual cases, the main purpose is to look at results from many reviews to understand how the whole child welfare system is working. This helps guide ongoing quality improvement across the state.

This page provides information for agencies taking part in a QA Case Review, so they know how to prepare and what to expect when a case is reviewed.

Round 4 Children & Family Service Reviews (CFSR)

The QA Unit completed North Dakota’s first state-led CFSR Case Review from October 2024 through March 2025, and we received the final federal report in August 2025. The report highlighted many strengths and areas where the state is improving. However, North Dakota did not meet any of the required federal measures. Because of this, the state must create a Program Improvement Plan (PIP) to avoid financial penalties. We sent an initial plan to the Children’s Bureau on October 31, 2025.

In December, the Children’s Bureau released new guidance (Technical Bulletin 14), offering states a pilot option with modified requirements for PIPs. North Dakota has chosen to participate in this pilot. The TB 14 Pilot focuses on helping states increase the number of available homes for children in foster care—both licensed and unlicensed—while also reducing the total number of children in care. North Dakota’s plan is being developed with the CQI Council and is expected to be submitted in early summer 2026.

It’s important to know that QA Case Reviews will not be required under a TB 14 PIP. Still, North Dakota will continue ongoing case reviews as part of our commitment to continuous quality improvement.

The QA Case Reviews use the Round 4 Federal Onsite Case Review Instrument (OSRI) which is available at: www.cfsrportal.acf.hhs.gov/resources/round-4-resources/cfsr-round-4-instruments-tools-and-guides

If you or your staff have questions, please contact Leanne Miller at lemiller@nd.gov.

26B QA Case Review Highlights

Case Sampling and Outreach

• A random statewide sample will be utilized. We will then divide the sample according to the proportions found in each CQI Cross Zonal Team, ensuring a sufficient number of cases for the Metro area, much like we did previously. However, each QA Reviewer will be assigned to specific agencies to work within their own list throughout the review event.
• We will complete all case reviews by the end of September 2026. During the first quarter (Apr – Jun), we will conduct thirty-one (31) full reviews. During the second quarter (Jul – Sep), we will conduct at least twenty-eight (28) full reviews. No Item-Only reviews will occur during this measurement period. We aim to have twenty-four (24) in-home and thirty-five (35) foster care cases for a total of fifty-nine (59) cases reviewed.
• Case reviews will be staggered throughout the review period. We anticipate that each reviewer will complete two full case reviews per month. We will review in-home services cases first and then move to the foster care sample.
• The period under review (PUR) for the first quarter is 9/1/25 to the date the case is reviewed or closed (whichever happens first). The period under review (PUR) for the second quarter will start 12/1/25.
• North Dakota will continue to shift to a shorter ‘PUR”. Instead of a 12 to 15 month ‘lookback’ time for which practice is assessed, the state focuses on more recent practice, which will help the state better understand the impact of performance improvement efforts.

Case Files

• Access to case file documents will be needed sooner rather than later in this revised process. QA will utilize any case files located in a Zone’s SharePoint Child Welfare Files library.
• Agencies not utilizing SharePoint for their child welfare files will be given 5 business days to gather and submit case file documentation. This can be done by uploading the case files to the assigned TEAMS channel or emailing the files to the QA Reviewer. 

Case Related Interviews

• QA Reviewers will contact agencies to initiate the case outreach process as cases appear in the sample.
• The QA Reviewer will also contact relevant key case participants to determine if they are interested in participating in the review or if someone else can speak to their perspective. We may seek the assistance of the agency to reach a case participant. Once non-agency case participants have agreed to participate, the case will be secured for review. The QA Reviewer will coordinate interviews with the agency worker on a case-by-case basis.
• Interviews must be held within 7 business days of the case being secured.

Case Review Findings

• Once a case has been reviewed and has reached the approved and final status, agency personnel will receive a copy of the final report.
• After reviewing the final report, agencies can contact Leanne Miller, QA Manager, if there are questions about the case review results.

Reference Documents

Case Preparation Documents 

• Adoption Summary-SFN 992  **Required for Applicable Cases** 

Click to View Quality Assurance Microlearnings

Any Quality Assurance questions should be directed to the North Dakota Children and Family Services Quality Assurance Unit by email to: dhscfsqateam@nd.gov