Adoption Agency Research Questionnaire

Agency Name: __________________________________ Date Contacted: __________________

Name/Title of the Person Spoken to: _____________________________________________________

Phone: _________________________ Ext. _________ E-Mail: __________________________________

How long has the agency been in business? ______________________________________________

How many adoptions has this agency facilitated? ________________________________________

How long (or how many adoptions) has the agency been facilitating adoptions in the

country of interest to you? _______________________________________________________________

What state does this agency operate out of? ______________________________________________

 Is this the same state in which the agency is licensed to perform adoptions and where

the agency is incorporated (or where they are registered as a non-profit organization)?

YES NO

 If yes, what is their license number? _______________________________________________

 If no, record information about their license and business incorporation or non-profit

status here:

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

 Who is the owner of the business? _________________________________________________

 Who is the Executive Director? _____________________________________________________

 Has the owner or Executive Director ever owned or operated an adoption agency in

another state? YES NO

© 2008 Dawn De Lorenzo

  If yes, in what state and what was the name of the agency and the reason the agency

is no longer in business? __________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

 Has the owner or Executive Director ever had their adoption agency license revoked

or requested to be surrendered?

YES NO

 For domestic adoption: What support services (legal advice, counseling) is offered to

the natural mother and natural father before, during, and after placing their child for

adoption?

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

 For International Adoption: Does the agency have Hague Accreditation, and if so,

what type? YES NO

________ Accredited

________ Temporary Accreditation (1 yr.)

________ Temporary Accreditation (2 yr.)

________ Approved For Profit Service Provider

 Is the agency a member any professional organizations?

____________________________________________________________________________________

____________________________________________________________________________________

© 2008 Dawn De Lorenzo

  What support or educational opportunities are available for Adoptive Parents
using this agency?

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

 Does the agency charge a different fee based on race, ethnicity, or gender?

YES NO

 Does the agency offer grants for adopting a child with special needs?

YES NO

 What post-placement support is available? ______________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

 Have any adoptions facilitated through this agency been disrupted?

YES NO How many? _________________

 Does the agency assist adoptive parents facing a disruption of a child adopted

through their agency? YES NO

If yes, in what manner is the family assisted? ______________________________________

________________________________________________________________________________________

________________________________________________________________________________________

____________________________________________________________________________

 Is the agency fiscally sound? You can check many non-profit organizations’

financial records at www.guidestar.com. Request the agency’s financial records

directly. Are they willing to disclose this information?

YES NO

© 2008 Dawn De Lorenzo

 Information Obtained Through My State Licensing Department

Contact Name: ______________________________________ Date: __________________

Phone/Ext. _________________________________________ Title: __________________

Have there been any complaints filed? YES NO

If yes, note the date(s), nature of the complaint, whether it was investigated, and the

outcome: ________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

__________________________________________________________________________________________

Client References
I urge you to get a minimum of five client references from the adoption agency you are
investigating. Ask for references that are recent, as an agency that once enjoyed a positive
reputation can quickly become one with numerous complaints. Request references from
clients in the program you are interested in as well as others. You want assurances that
the agency, in its entirety, conducts itself in a transparent and ethical manor that is
respectful of all members of the adoption triad.

Reference #1

Name: ________________________________ Phone: ___________________ Year Adopted: _________

Reference #2

Name: ________________________________ Phone: ___________________ Year Adopted: _________

Reference #3

Name: ________________________________ Phone: ___________________ Year Adopted: _________

Reference #4

Name: ________________________________ Phone: ___________________ Year Adopted: _________

Reference #5

Name: ________________________________ Phone: ___________________ Year Adopted: _________

© 2008 Dawn De Lorenzo

 WARNING SIGNS

 Is not forthcoming with information.

 Does not provide concrete information, but rather speaks in generalizations often

emphasizing a “special” or “privileged” relationship that enables the agency to

process adoptions faster or assures “healthier” children.

 Offering the referral of a child in a country that does not allow pre-identification of

a child. Will stress an “ends justify the means” mentality.

 Pressure to “sign up” quickly in order to “get a child”.

 Attempts to isolate you from the adoption community; urging you to stay off Yahoo

groups, blogs, or listservs.

 Has a contract with a gag clause.

 If you inquire about an issue or negative experience or report from another client

be leery if the agency speaks poorly about the client, sometimes going as far as

saying “They are crazy/ unrealistic/demanding/too sensitive, etc…”

 Operating their business in a state other than where they are licensed especially if

the only business address is a purchased “suite box” such as Mail Boxes Etc.

 Requests money to be wired to unknown individuals.

 Consistently uses language that is emotionally charged often calling into question

“how much you really want a child.”

 Heated debates on the internet in Yahoo groups and other arenas both in support

of the agency and against the agency. There should not be an extreme polarity in

opinions. Agencies should not pit clients against each other!

*REMEMBER: Choose an agency based on its reputation as a service provider NOT

based on a specific child you see in a photolisting. If any agency tries to make you

feel “indebted” to them for “getting a child for you” they are being manipulative!

© 2008 Dawn De Lorenzo

 Important Links and Resources

U.S. Department of State:

http://www.travel.state.gov/family/adoption/adoption_485.html

Rip Off Report:

http://www.ripoffreport.com

Adoption Agency Research Group:

http://groups.yahoo.com/group/AARD/

Ethica ~ A Voice for Ethical Adoption Placement:

www.ethicanet.org/

PACT ~ An Adoption Alliance

http://www.pactadopt.org/

Focus on Adoption: An Intercountry Adoption Advocacy Organization

http://www.focusonadoption.com/

PEAR ~ Parents for Ethical Adoption Reform

http://www.pear-now.org

Informed Adoption Advocates

http://www.informedadoptions.com

Full Contact List for the Attorneys General

http://www.naag.org/ag/full_ag_table.php

Smart Money Magazine Article: Ten Things Your Adoption Agency Won’t Tell You

http://www.smartmoney.com/tb/Jtyq.2FdE.3D

© 2008 Dawn De Lorenzo

 US State Licensing Specialists

Alabama Department of Human Resources Connecticut Department of Children and

Faye Wilson Families
50 North Ripley Street Thomas Dematteo
Montgomery, AL 36130 505 Hudson Street
Phone: (334) 242-9500 Hartford, CT 06106
Fax: (334) 242-0939 Phone: (860) 550-6306
E-mail: fwilson@dhr.state.al.us Fax: (860) 566-6726
URL: http://www.dhr.state.al.us E-mail: thomas.dematteo@state.ct.us

Alaska Department of Health and Social Delaware Department of Services for

Services Children, Youth and Their Families
Tracy Spartz-Campbell Cynthia Brown
PO Box 110630 Office of Child Care Licensing
130 Seward Street, Room 4F 1825 Faulkland Road -- Delaware Youth and
Juneau, AK 99811-0630 Family Center
Phone: (907) 465-3209 Wilmington, DE 19805
Fax: (907) 465-3397 Phone: (302) 892-5800
E-mail: Tracy_Spartz- Fax: (302) 633-5112
Campbell@health.state.ak.us E-mail: Cynthia.Brown@state.de.us
URL: http://www.hss.state.ak.us/ocs/ URL: http://www.state.de.us/kids/occl.htm

Arizona Department of Economic Security Delaware Department of Services for

Sybil Oliver Children, Youth and Their Families
Office of Licensing Certification & Regulation Maxine Travis
- Child Welfare Licensing Unit Office of Child Care Licensing
1951 West Camelback Road -- Suite 400 Barrett Building - 821 Silver Lake Blvd, Suite
Phoenix, AZ 85015 103
Phone: (602) 347-6340 Dover, DE 19904
Fax: (602) 336-9603 Phone: (302) 739-5487
Toll-Free: (888) 229-1814 Fax: (302) 739-6589
E-mail: soliver@azdes.gov Toll-Free: (800) 822-2236
E-mail: Maxine.Travis@state.de.us
Arkansas Department of Health and Human URL: http://www.state.de.us/kids/occl.htm
Services -- Division of Child and Family
Services District of Columbia Department of Health -
Debbie Roark Licensing and Regulatory Administration
Child Welfare Agency Licensing Unit Patricia VanBuren
PO Box 1437, Slot 570 Human Social Services Facility Division
Little Rock, AR 72203-1437 825 North Capital Street NE
Phone: (501) 683-2045 Washington, DC 20002
E-mail: Debbie.Roark@arkansas.gov Phone: (202) 442-5929
Fax: (202) 442-9430
California Department of Social Services E-mail: patricia.vanburen@dc.gov
Community Care Licensing
744 P Street, MS 17-17 Florida Department of Children and Families
Sacramento, CA 95814 Chris Lolley
Phone: (916) 657-2346 Office of Family Safety
Fax: (916) 657-3783 1317 Winewood Boulevard -- Building 6
URL: http://ccld.ca.gov/default.htm Tallahassee, FL 32399-0700
Phone: (850) 921-1928
Colorado Department of Social Services E-mail: Chris_Lolley@dcf.state.fl.us
Marlene Romero
Division of Child Care Georgia Department of Human Resources
1575 Sherman Street Carol Winstead
Denver, CO 80203 Office of Regulatory Services
Phone: (303) 866-5958 Two Peachtree Street NW
Fax: (303) 866-4453 Atlanta, GA 30303-3142
Toll-Free: (800) 799-5876 Phone: (404) 657-9611
E-mail: marlene.romero@state.co.us Fax: (404) 657-5708
URL: http://www.cdhs.state.co.us/childcare/ E-mail: cswinstead@dhr.state.ga.us
URL: http://www.ors.dhr.state.ga.us/

© 2008 Dawn De Lorenzo

Hawaii Department of Human Services Kentucky Cabinet for Health and Family
Lynn Kazama Services
810 Richards Street Division of Regulated Child Care
Suite 400 275 East Main Street ? 6E-B
Honolulu, HI 96813 Frankfort, KY 00004-0601
Phone: (808) 586-5698 Phone: (502) 564-7962
Fax: (808) 586-4806 Fax: (502) 564-9350
E-mail: lkazama@dhs.hawaii.gov E-mail: rob.hester@ky.gov
URL: http://www.hawaii.gov/dhs/ URL: http://chfs.ky.gov/oig/drcc.htm

Idaho Department of Health and Welfare Louisiana Department of Social Services

Steve Green Bureau of Licensing
Division of Family and Community Services PO Box 3078
450 West State Street -- PO Box 83720 Baton Rouge, LA 70821-3078
Boise, ID 83720-0036 Phone: (225) 922-0015
Phone: (208) 334-5534 Fax: (225) 922-0014
Fax: (208) 334-6699 E-mail: ystewart@dss.state.la.us
E-mail: greens@idhw.state.id.us URL:
http://www.dss.state.la.us/departments/os/Li
censing_.html
Illinois Department of Children and Family
Services Maine Department of Health and Human
Denise Murray Services
Division of Foster Care and Permanency Linda Brissette
Services Office of Child and Family Services
406 East Monroe Street 221 State Street -- Station 11
Springfield, IL 62701-1498 Augusta, ME 04333-0011
Phone: (217) 785-2688 Phone: (207) 287-5060
URL: http://www.state.il.us/dcfs Phone: (207) 287-4139
Fax: (207) 287-5282
Indiana Department of Child Services E-mail: Linda.Brissette@maine.gov
Beverly Gatling URL: http://www.afamilyforme.org/foster.html
402 West Washington Street
Room W-364 Maryland Department of Human Resources
Indianapolis, IN 46204-2739 Social Services Administration
Phone: (317) 232-3476 311 West Saratoga Street
Fax: (317) 232-4436 Baltimore, MD 21201
E-mail: Beverly.Gatling@dcs.in.gov Phone: (410) 767-7359
URL: E-mail: emooney@dhr.state.md.us
http://www.state.in.us/dcs/protection/lcpa.html
Massachusetts Department of Early
Iowa Department of Human Services Education and Care
LaVerne Armstrong Central Office
Adult, Children, and Family Services 600 Washington Street, Suite 6100
Hoover State Office Building, 5th Floor Boston, MA 02211
Des Moines, IA 50319 Phone: (617) 988-6600
Phone: (515) 281-6802 E-mail: David.Mcgrath@state.ma.us
Fax: (515) 281-4597 URL: http://www.eec.state.ma.us
E-mail: larmstr@dhs.state.ia.us
URL:
http://www.dhs.state.ia.us/dhs2005/dhs_hom Michigan Department of Human Services
epage/children_family/adoption/index.html James B. Gale
Office of Child and Adult Licensing
7109 West Saginaw -- PO Box 30650
Kansas Department of Health and Lansing, MI 48909
Environment Phone: (517) 335-6124
Linda Sturgeon, MSW, LBSW Fax: (517) 335-6121
Child Care Licensing & Regulation, Child E-mail: jbgale@michigan.gov
Placing Agency and Residential Programs URL:
1000 SW Jackson, Suite 200 -- Curtis State http://www.cis.state.mi.us/brs_cwl/sr_cwl.asp
Office Building
Topeka, KS 66612-1274
Phone: (785) 296-8892
Fax: (785) 296-7025
E-mail: lsturgeo@kdhe.state.ks.us

© 2008 Dawn De Lorenzo

Minnesota Department of Human Services Nevada Department of Human Resources
Division of Licensing Wanda Scott
Human Services Building Division of Child and Family Services
444 Lafayette Road North 4220 South Maryland Parkway -- Building B,
St. Paul, MN 55155 Suite 300
Phone: (651) 296-3971 Las Vegas, NV 89119
Fax: (651) 297-1490 Phone: (702) 486-7633
Fax: (702) 486-7626
Mississippi Department of Human Services E-mail: wlscott@dcfs.state.nv.us
Gloria Shelton URL:
Division of Family and Children Services http://www.dcfs.state.nv.us/DCFS_Adoption.
750 North State Street Htm
Jackson, MS 39202
Phone: (601) 359-4599 New Hampshire Department of Health and
E-mail: gshelton@mdhs.state.ms.us Human Services
Gail DeGoosh
Mississippi Department of Human Services, Division of Children, Youth and Families
Division of Family and Children Services 129 Pleasant Street -- Brown Building
Linda Owens Concord, NH 03301-6522
750 North State Street Phone: (603) 271-4711
Jackson, MS 39202 Fax: (603) 271-4729
Phone: (601) 359-4656 E-mail: gdegoosh@dhhs.state.nh.us
E-mail: lowens@mdhs.state.ms.us URL:
http://www.dhhs.state.nh.us/DHHS/FCADOP
Missouri TION/default.htm
Dept. of Social Services
Residential Programs Unit New Jersey Department of Human Services
1500 Vandiver Drive, Suite 103 Anna Montes
Columbia, MO 65203 Office of Licensing - Youth and Family
573-884-4394 Licensing
PO Box 707
Montana Department of Public Health and Trenton, NJ 08625-0707
Human Services Phone: (609) 987-1985
Laura Taffs E-mail: anna.montes@dcf.state.nj.us
PO Box 8005 URL:
Helena, MT 59604-8005 http://www.state.nj.us/humanservices/adopti
Phone: (406) 444-5919 on/resourceframe.html
Fax: (406) 444-5956
E-mail: ltaffs@mt.gov New Mexico Department of Children, Youth
URL: and Families
http://www.dphhs.mt.gov/cfsd/adoption/adopt PERA Building
ioninmontana.shtml PO Drawer 5160
Santa Fe, NM 87502-5160
Phone: (505) 476-0343
Nebraska Department of Health and Human Fax: (505) 827-8480
Services E-mail: isabel.garcia@state.nm.us
Mary Dyer URL: http://www.cyfd.org/
PO Box 95044
301 Centennial Mall South -- Child and
Family Services Division New York State Office of Children and
Lincoln, NE 68509-5044 Family Services
Phone: (402) 471-9331 Carol McCarthy
Fax: (402) 471-9034 52 Washington Street
E-mail: mary.dyer@hhss.ne.gov Riverview Center, 6th Floor
URL: http://www.hhs.state.ne.us/adoption/ Rensselaer, NY 12144
Intercountry Program Phone: (518) 474-9406
- Agency Able to Place Children with United Fax: (518) 486-6326
States Citizens Living Abroad (Intercountry) Toll-Free: (800) 345-5437
E-mail: carol.mccarthy@dfa.state.ny.us
URL:
http://www.ocfs.state.ny.us/adopt/agcymenu.
Asp

© 2008 Dawn De Lorenzo

North Carolina Division of Social Services Pennsylvania Department of Public Welfare
Bob Hensley Office of Children, Youth and Families
Division of Social Services, Regulatory and PO Box 2675
Licensing Services Harrisburg, PA 17105
932 Old US 70 Highway, Building 17 -- Black Phone: (717) 214-9780
Mountain Center Fax: (717) 346-9663
Black Mountain, NC 28711 E-mail: ewhitesell@state.pa.us
Phone: (828) 669-3388 URL:
Fax: (828) 669-3365 http://www.dpw.state.pa.us/Child/AdoptionFo
E-mail: bob.hensley@ncmail.net sterCare/
URL:
http://www.dhhs.state.nc.us/dss/licensing/ind Puerto Rico Department of the Families
ex.htm Hon. Angie Varela Llavona
P.O. Box 11398
North Dakota Department of Human Santurce, PR 00910
Services Phone: (787) 722-7450
Julie Hoffman Fax: (787) 723-1223
Children and Family Services Division
State Capitol, Department 325 Rhode Island Department of Children, Youth,
Bismarck, ND 58505 and Families
Phone: (701) 328-4805 Lee Sperduti
Fax: (701) 328-3538 101 Friendship Street
Toll-Free: (800) 245-3736 4th Floor
E-mail: sohofj@nd.gov Providence, RI 02906
URL: Phone: (401) 528-3605
http://www.state.nd.us/humanservices/servic Fax: (401) 528-3650
es/childfamily/adoption/ E-mail: lee.sperduti@dcyf.ri.gov
URL: http://www.dcyf.ri.gov/licensing.htm
Ohio Department of Job and Family
Services, Office for Children and Families South Carolina Department of Social
Amy Eaton Services
50 West Town Street 1535 Confederate Avenue
PO Box 182709 PO Box 1520
Columbus, OH 43218-2709 Columbia, SC 29202
Phone: (614) 466-1213 Phone: (803) 898-7507
Fax: (614) 466-6185 E-mail: Lstaudt@Dss.state.sc.us
URL: http://jfs.ohio.gov/oapl/index.htm URL:
http://www.state.sc.us/dss/adoption/index.ht
Oklahoma Department of Human Services ml
Division of Child Care
PO Box 25352 South Dakota Department of Social Services
2400 North Lincoln Boulevard David Hanson
Oklahoma City, OK 73125 Child Protection Services
Phone: (405) 522-1511 700 Governor's Drive
Toll-Free: (800) 347-2276 Pierre, SD 57501-2291
E-mail: susan.case@okdhs.org Phone: (605) 773-3227
Fax: (605) 773-6834
E-mail: david.hanson@state.sd.us
Oregon Department of Human Services URL:
Treatment Services and Licensing http://www.state.sd.us/social/cps/services/lic
500 Summer Street NE, E83 ensing.htm
Salem, OR 97301-1066
Phone: (503) 947-5208 South Dakota Department of Social Services
Fax: (503) 947-5084 District Office
E-mail: kathy.spear@state.or.us Division of Child Protection Services
URL: 811 East 10th Street, Department 10
http://www.oregon.gov/DHS/children/adoptio Sioux Falls, SD 57103-1650
n/indadoptions/licensedag.shtml Phone: (605) 367-5600
Fax: (605) 782-3149
E-mail: Ronald.Riedel@state.sd.us
URL:
http://www.state.sd.us/social/cps/services/lic
ensing.htm

© 2008 Dawn De Lorenzo

Tennessee Department of Children's Services Washington Department of Social and Health
Mark Anderson Services
1272 Foster Avenue Randy Roberts
Nashville, TN 37210 Division of Licensed Resources
Phone: (865) 594-2836 PO Box 45700
E-mail: Mark.Anderson@state.tn.us Olympia, WA 98504
URL: Phone: (360) 902-7570
http://state.tn.us/youth/adoption/2005Adoptio E-mail: Rmra300@dshs.wa.gov
nFeeSchedule.pdf
West Virginia Department of Health and
Texas Department of Family and Protective Services Human Resources
Char Bateman Kathie King
PO Box 149030 Bureau for Children and Families
E-550 350 Capitol Street -- Room 691
Austin, TX 78714-9030 Charleston, WV 25301
Phone: (512) 438-3269 Phone: (304) 558-8839
Fax: (512) 438-3848 Fax: (304) 558-4563
E-mail: char.bateman@dfps.state.tx.us E-mail: kking@wvdhhr.org
URL: http://www.dfps.state.tx.us
Wisconsin Department of Health and Family
Utah Department of Human Services Services
Janice P. Knaphus Mary E. Morse
Office of Licensing Bureau of Regulation and Licensing
120 North 200 West, #303 1 West Wilson Street -- PO Box 8916
Salt Lake City, UT 84103 Madison, WI 53708-8916
Phone: (801) 538-4242 Phone: (608) 266-0415
Fax: (801) 538-4553 Fax: (608) 267-7252
E-mail: jknaphus@utah.gov E-mail: morseme@dhfs.state.wi.us
URL: http://www.hslic.utah.gov URL:
http://www.dhfs.state.wi.us/licensing.htm
Vermont Department for Children and
Families Wyoming Department of Family Services
Lucy Abair Rose Fry
103 South Main Street 851 Werner Court
Waterbury, VT 05671 Suite 200
Phone: (802) 241-2159 Casper, WY 82601
E-mail: labair@srs.state.vt.us Phone: (307) 473-3924
URL: Fax: (307) 473-3967
http://www.projectfamilyvt.org/adoption.html E-mail: Rfry@state.wy.us
URL: http://dfsweb.state.wy.us/certlist.htm

Virgin Islands Department of Human

Services, Children, Youth and Families
Janet Turnbull-Krigger
1303 Hospital Ground
Building A-Knud Hansen Complex
St. Thomas, VI 00802
Phone: (340) 774-4393
Phone: (340) 774-7865
Fax: (340) 774-0082

Virginia Department of Social Services

Leslie Knachel
7 North 8th Street
Richmond, VA 23219-3301
Phone: (804) 726-7137
E-mail: leslie.knachel@dss.virginia.gov
URL:
http://www.dss.virginia.gov/family/ap/index.html

© 2008 Dawn De Lorenzo