Children & Family Services Training Center

ND Quality Assurance

The goal of the child welfare system is to promote, safeguard, and protect the overall well-being of children, to intervene on behalf of abused and neglected children, and to work with children and families to ensure that every child has a permanent, safe, and nurturing environment in which to achieve their maximum potential. ND Children and Family Services (CFS) utilizes the Quality Assurance (QA) Unit to conduct case reviews as one tool to ensure that child welfare services achieve these outcomes and support the state’s ongoing quality improvement efforts. The information from the reviews is used to assess how the state’s child welfare system is functioning, rather than focusing on any individual worker or agency.

Round 4 Children & Family Service Reviews (CFSR)

The QA Unit completed our first-ever state-led CFSR Case Review between October 2024 and March 2025, and the state received its R4 CFSR Final Report in August 2025. While the report noted many areas of growth and strength, the state did not meet any of the federal measures. North Dakota must complete a Performance Improvement Plan (PIP). The initial plan must be submitted by October 31, 2025. Once approved, the state will have two years to complete the activities outlined in the plan.

North Dakota will also develop a PIP Measurement Plan, and the QA Unit will be responsible for conducting the case reviews in accordance with that plan. There are new monitoring requirements, and we want to be ready when the time comes. Results from the reviews conducted since April suggest the 4-month review event proposal is not the right fit for North Dakota. Thus, we will return to review events occurring every six months. New to the R4 PIP Measurement Plan approach is the introduction of “Item-Only/Exclusion” case reviews. In this type of review, only certain aspects of practice subject to specific case review items are reviewed. This is to ensure that a sufficient pool of cases has been examined to assess performance and increase confidence that improvements are related to specific improvement activities.

We appreciate everyone’s patience, collaboration, and hard work as we find a more efficient process for the state. If you or your staff have questions, please contact Leanne Miller at lemiller@nd.gov.

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

This page contains information for agencies participating in a QA Case Review to prepare for the review and know what to expect when the case is actually reviewed.

25B 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 March 2026. During the first quarter (Oct – Dec), we will conduct thirty-five (35) full reviews. During the second quarter (Jan – Mar), six (6) foster care cases will be reviewed as well as Item-Only reviews. Because not all cases apply to all items, we cannot determine in advance how many Item-Only reviews will be required. Progress will be closely monitored throughout the review event. Our target is to have a minimum of thirty-three (33) applicable cases for each item that will eventually be tracked in our measurement plan.
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 this event is 3/1/25 to the date the case is reviewed or closed (whichever happens first).

North Dakota has shifted to a shorter ‘PUR”. Instead of a 12 – 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 five (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.

Please look at the FC & IH case checklists below to help gather case file documents.

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 seven (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.

- 25B Statewide Message
- 25B QA Unit Outreach Map

Reference Documents

Foster Care Case File Checklist *great resource
In-Home Case File Checklist *great resource
Genogram Resource
Key Case Participant Interview Guide
Glossary Reference **New 02.24**
Onsite Review Instrument **Updated 2.25**

Case Preparation Documents

*Most Case Preparation Documents are encouraged, but not required.

CPS Case Narrative-SFN 993
Foster Care Case Narrative-SFN 995 11.23
Foster Care Supervisory Questionnaire-SFN 997
In Home Services Case Narrative-SFN 996
In Home Supervisory Questionnaire-SFN 998
Adoption Summary-SFN 992 **Required for Applicable Cases** 11.23