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CASE NAME:
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REVIEWERS—
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FEDERAL:
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STATE:
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CASE DEBRIEFED:
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Child
and Family
Services
Reviews
Onsite
Review
Instrument
and Instructions
July
2008
Children’s
Bureau
Child
and Family Services Reviews
Onsite
Review Instrument and Instructions
General
Instructions
The
Onsite Review Instrument is used to review both foster care and
in-home services cases during the onsite review component of the
Child and Family Services Reviews (CFSRs) of State child welfare
agencies. In completing the Onsite Review Instrument, reviewers will
conduct case file reviews and case-related interviews with children,
parents, foster parents, caseworkers, and other professionals
involved with the child.
The
instrument is organized into a Face Sheet and three sections. On the
Face Sheet, reviewers document general information about a case, such
as the type of case. Reviewers are to document the names of
individuals involved in the case on the Face Sheet. For the remainder
of the instrument, reviewers are not to use proper names, but should
use titles (for example, biological mother, target child, caseworker,
etc.) when referencing individuals. When it is necessary to identify
a child to clarify a response on the instrument, enter the child’s
first name only. No surnames are to appear anywhere in the
instrument, except on the first page.
The
three sections focus on the outcome domains that form the basis of
the CFSRs: safety, permanency, and child and family well-being. For
each outcome, reviewers collect information on a number of “items”
related to that outcome.
While
reviewers use the Onsite Review Instrument to review both foster care
and in-home services cases, they complete the permanency section only
if the case under review is a foster care case.
For
children in foster care, reviewers should consider the Safety items
(1 through 4) for all children in the family, but complete the
Permanency items (5 through 16) and the Child and Family Well-Being
items (17 through 23) only as they apply to the specific child whose
case is under review. For children receiving in-home services,
reviewers should apply the Safety and Child and Family Well-Being
items to all the children in the family who are residing with, and
included in services to, the family.
Reviewing
the Case
Reviewers
must answer all the questions for each applicable item. If the
question is not applicable to the case, then Not Applicable (NA)
should be marked for that question.
Reviewers
should document relevant and supporting information in the Reason for
Rating and Documentation section at the end of each item. It is
critical that reviewers document in this space the information
gathered from the case record and interviews that supports the
responses to the questions and indicate the source of the information
(for example, during the interview with the biological mother she
stated that she visits with the child weekly). While the instrument
provides directions on where to find information, reviewers should
use their professional judgment to determine how best to gather all
the relevant information. Further direction for answering the
questions relating to the individual items is provided below the
relevant question.
July 2008
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OMB
Control No: 0970-0214 Expiration date: 1/31/2010
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CHILD AND FAMILY SERVICES
REVIEWS
ONSITE
REVIEW INSTRUMENT
Face
Sheet
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A.
Name of State and county (or local area):
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B.
Case name:
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C.
Period under review:
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Instructions:
For
the local area, use the name that is used by the State for the
review. This may be a region rather than a county, or may be
multiple counties.
Enter
the case name that is the official name on the case file.
The
period under review is the timeframe used for making decisions
about the case.
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D.
Federal Reviewer:
State
Reviewer:
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E.
Date case reviewed:
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F.
Complete the chart below:
Instructions:
For
both foster care cases and in-home services cases, enter the
first and last names (first name first) of all children in the
family as identified in the case file. If the case is a foster
care case, mark the checkbox next to the name of the target
child. It is essential that the target child be clearly
identified for all foster care cases.
Enter
the race/ethnicity information as provided in the case file. If
the child is of two or more races/ethnicities, list all that
are provided in the case file (for example, White and Hispanic,
or White and Native American, etc.). If during the course of
the interviews, it is learned that a child is of a different
race/ethnicity than is noted in the file or is of two or more
races and only one is noted in the file (for example, Native
American instead of Hispanic, or both Hispanic and Native
American), please change the race identification information
presented below to reflect the accurate information.
Provide
the date of birth for all children in the family, even if this
is a foster care case.
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Target
Child
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Child(ren)’s
name(s):
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Race
and/or ethnicity:
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Date(s)
of birth (MM/DD/YY):
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Gender:
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Type
of case reviewed:
Foster
Care Case
In-home Services Case
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Instructions:
The
case is a foster care case if the target child was in foster
care at any time during the period under review. A child is
considered to be in foster care if the State child welfare
agency (hereafter “the agency”) has care and
placement responsibility for the child. This includes a child
who is placed by the agency with relatives or in other kin-type
placements, but the agency maintains care and placement
responsibility. It does not include a child who is living with
relatives (or caregivers other than parents) but who is not
under the care and placement responsibility of the agency.
The
case is an in-home services case if no child in the family was
in foster care at any time during the period under review, and
the case was open for at least 60 days. If the case was not
open for 60 days, please notify the Local Site Leader.
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H.
Was this case opened for reasons other than child abuse and
neglect?
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Yes
No
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Instructions:
Examples
of cases opened for reasons other than child abuse or neglect
include the following: (1) cases opened because of the child’s
behavior, including juvenile delinquency, substance abuse, or
“child in need of supervision,” and there were no
maltreatment concerns in the family; or (2) cases for which the
reasons for contact with the family were not related to child
abuse or neglect.
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I.
Date of most recent case opening for all cases (MM/DD/YY):
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Instructions:
Provide
the date that the case was actually opened within the agency. If
a child was on a trial home visit and returned to a foster care
placement, it is not considered a “case opening”
unless the trial home visit was longer than 6 months and there
was no court order extending the trial home visit beyond 6
months.
If
the family received in-home services before the removal of a
child and placement of the child in foster care and the case was
not closed prior to placement, reviewers should enter the date
that the case was opened for in-home services. The date of the
child’s removal from home will be captured in the next
item.
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J.
Date of the child’s most recent entry into foster care
(MM/DD/YY):
Not Applicable
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Definitions
and Instructions:
If
a child was on a trial home visit and returned to a foster care
placement, the return is not considered an “entry into
foster care” unless the trial home visit was longer than 6
months and there was no court order extending the trial home
visit beyond 6 months.
If
the case is an in-home services case, check Not Applicable.
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K.
Date of discharge from foster care for the most recent foster
care episode (MM/DD/YY):
Not
Applicable
Not Yet Discharged
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Definitions
and Instructions:
“Discharge
from foster care” is defined as the point when the child
is no longer in foster care under the care and placement
responsibility or supervision of the agency.
If
a child returns home on a trial home visit and the agency
retains responsibility or supervision of the child, the child
should be considered discharged from foster care only if the
trial home visit was longer than 6 months, and there was no
court order extending the trial home visit beyond 6 months.
If
the child is in foster care but has not yet been discharged,
check Not Yet Discharged.
If
the case is an in-home services case, check Not Applicable.
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Date
of case closure (for all cases) (MM/DD/YY):
Case
not closed by time of review
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Instructions:
Provide
the date that the agency officially closed the case. For foster
care cases, this may or may not be the same date as the
discharge date.
If
the case is still open at the time of review, check “Case
not closed by time of review.”
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M.
Reason for agency involvement:
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Instructions:
Indicate
the reason for the agency’s involvement with this child
or family for the most recent case opening. Check all reasons
that apply.
Place
an asterisk next to the square that indicates the primary
reason that the case was opened. It is essential that the
primary reason is identified with an asterisk.
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Physical
abuse
Sexual
abuse
Emotional
maltreatment
Neglect
(not including medical neglect)
Medical
neglect
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Abandonment
Mental/physical
health of parent
Mental/physical
health of child
Substance
abuse by parent(s)
Child’s
behavior
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Substance
abuse by child
Domestic
violence in child’s home
Child
in juvenile justice system
Other
(specify)
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N.
Persons interviewed by the reviewers (list below):
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Relationship
to Case
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Date
of Interview
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Type
of Interview
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In-Person
Phone
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In-Person
Phone
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In-Person
Phone
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In-Person
Phone
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THE
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104–13)
Public
reporting burden for this collection of information is estimated to
average 8 hours per response, including the time for reviewing
instructions, reading case files and conducting interviews, and
reviewing the collection of information.
An
agency may not conduct or sponsor, and a person is not required to
respond to, a collection of information unless it displays a
currently valid OMB control number.
SECTION
I: SAFETY
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SAFETY
OUTCOME 1: CHILDREN ARE, FIRST AND FOREMOST, PROTECTED FROM ABUSE
AND NEGLECT.
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Item
1: Timeliness of initiating investigations of reports of child
maltreatment (case file and interview with caseworker)
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Purpose
of Assessment: To
determine whether responses to all accepted child maltreatment
reports received during the period under review were initiated,
and face-to-face contact with the child made, within the
timeframes established by agency policies or State statute.
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Applicable
Cases:
Cases
are applicable for an assessment of this item if an accepted
child maltreatment report on any child in the family was
received during the period under review.
“Accepted”
means that the report was assigned to the agency to conduct an
assessment or investigation. This includes reports assigned for
an “alternative response” assessment. Reports that
are screened out are not considered “accepted.”
“Alternative
response” refers to an agency’s approach to
addressing child maltreatment reports that meet agency criteria
for acceptance but at the initial screening do not meet the
agency’s requirements for a mandated investigation. For
example, the agency’s policy may be that reports that
appear to present low to moderate risk to the child may be
referred for a family assessment, rather than an investigation.
Under such a response, no determination of child maltreatment is
made. The alternative response may include an assessment to
determine the safety of the child(ren), the risk of
maltreatment, and the family’s strengths and needs. The
assessment may lead the State agency to provide services to
eliminate or lessen the safety concerns and maltreatment risks.
Cases
are Not Applicable for an assessment of this item if, during the
period under review, there were no child maltreatment reports on
any child in the family, or if a report was received on a child
in the family but was “screened out, ” that is, not
referred for an assessment or investigation.
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Is
this case applicable? (Select
the appropriate response. If the response is “No,”
complete question A1, then rate the case as Not Applicable in the
ratings section, provide your reason for the rating in the
documentation section, and continue to item 2.)
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Yes
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No
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Number
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How
many reports of suspected abuse or neglect have been received on
any child(ren) in the family (including
those that were
screened out by the agency) during the life of the case?
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Instructions:
The
information collected in question A1 is intended to provide
background information on the family. It is not to be used to
determine the rating.
The
life of the case begins with the first recorded maltreatment
report received by the agency on any child in the family, even
if the report was screened out.
For
foster care cases, reviewers should record the total number of
reports of child maltreatment for all children in the family,
not just the child in foster care.
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Number
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How
many accepted reports alleging abuse or neglect were received on
any child(ren) in the family during the
period under
review
(i.e.,
they were not screened out)?
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Instructions
for completing the table below:
Complete
the following table for all accepted reports received during the
period under review.
The
date the investigation or assessment was initiated is the date
that the agency made the first attempt to contact the family.
The
date assigned for an investigation or assessment is the date the
report is assigned to a specific worker to conduct the
investigation or assessment (unless the State policy has a
different definition for “assigned”).
Under
date assigned for investigation or assessment, indicate what
action was taken (i.e., was the report investigated or referred
for assessment?).
In
the last column, report the disposition of the case (for
example, substantiated, indicated, not substantiated, unfounded,
etc.). If the case was not investigated and, therefore, did not
have a disposition, indicate whether it was opened for services.
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ReportDate
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First
Name of Child
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Allegation
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Priority
Level (if Applicable)
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Date
Assigned for an Investigation or Assessment
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Date
Investigation or Assessment Initiated
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Date
of Face-to- Face Contact With Child
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Relationship
of Alleged Perpetrator to Child
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Disposition
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Number
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In
how many of the reports listed above was the investigation NOT
initiated in accordance with the State’s
timeframes
and requirements for a report of that priority?
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In
how many of the reports listed above was face-to-face contact
with the child(ren) who is the subject of the report NOT made
in accordance with the State’s timeframes and
requirements for a report of that priority? (If the State does
not have a written policy regarding face-to-face contact, check
with your Local Site Leader to determine how this factor is to
be assessed.)
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For
all reports identified in B and C, were the reasons for the
delays due to circumstances beyond the control of the agency?
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Yes
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No
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NA
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Instructions:
If
the answers to both questions B and C are zero, the answer to
question D should be Not Applicable (NA).
Delays
in services provided by organizations or agencies under
contract with the agency would not be considered to be beyond
the control of the agency. However, where services are provided
by another public State or local agency, such as law
enforcement, the actions of these agencies may be beyond the
control of the child welfare agency.
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Rating
Criteria:
Item
1 should be rated as a Strength if either of the following
applies:
Item
1 should be rated as an Area Needing Improvement if the
following applies:
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Rating
for this indicator (select one):
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Strength
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Area
Needing Improvement
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Not
Applicable
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Reason
for Rating and Documentation
Please
provide below your main reason for rating this item as a
Strength, an Area Needing Improvement, or Not Applicable, and
provide documentation for the identified issues. If any issue is
Not Applicable to the case, enter NA in the appropriate space.
For each issue, indicate the source of your information (for
example, case file, interview with biological mother, interview
with caseworker, etc.).
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Main
Reason
Item
1 is rated as ________________________________________ because:
Documentation
Information
If
not explained in the “reason for rating” section,
identify reasons why a response was not initiated within
established timeframes (if applicable and reason is available):
If
not explained in the “reason for rating” section,
identify reasons why face-to-face contact was not made within
established timeframes (if applicable and reason is available):
Discuss
the special circumstances that the reviewers considered in
determining a rating of Strength for this item even if there was a
delay in initiating the response or making face-to-face contact,
if applicable:
Other
Issues:
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SAFETY
OUTCOME 1: CHILDREN ARE, FIRST AND FOREMOST, PROTECTED FROM ABUSE
AND NEGLECT.
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Repeat
maltreatment (case file and interview with caseworker)
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Purpose
of Assessment: To
determine if any child in
the family experienced repeat maltreatment within a 6-month
period.
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Applicable
Cases:
A
case is applicable if there was at least one maltreatment report
involving any child in the family that met all of the following
criteria: (1) it was received during the period under review,
(2) it referred to a maltreatment incident that occurred during
the period under review, and (3) it was investigated and
determined to be “substantiated” or “indicated”
(some States will have different terminology, such as “founded”
rather than “substantiated”); or
There
was at least one maltreatment report involving any child in the
family that met all of the following criteria: (1) it was
received during the period under review, (2) it referred to a
maltreatment incident that occurred during the period under
review, and (3) it was referred for an assessment and the
decision was made to open the case for services to address
concerns relevant to the safety of at least one of the children
in the family (this decision may have been made by the agency or
by a private provider under contract with the agency).
Cases
are not applicable for assessment of this item if either of the
following applies:
All
maltreatment reports received during the period under review
were “screened out,” that is, the reports were
neither investigated nor referred for an alternative response,
or
The
only maltreatment report that was received and investigated or
assessed during the period under review referred to an incident
that occurred before the period under review.
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Is
this case applicable? (Select
the appropriate response. If the response is No, rate the case as
Not Applicable in the ratings section, provide your reason for
this rating in the documentation section, and continue to rate
Safety Outcome 1.)
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Yes
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No
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During
the period under review, was there:
at
least one substantiated or indicated maltreatment report
involving any child in the family?
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Yes
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No
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at
least one maltreatment report involving any child in the family
that was referred for an assessment and the decision was made to
open the case for services to address concerns relevant to the
safety of at least one of the children in the family (this
decision may have been made by the agency or by a private
provider under contract with the agency)?
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Yes
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No
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Definitions:
“Substantiated”
refers to an investigation in which the report of maltreatment
or risk of maltreatment was supported or founded according to
State law or policy. Reviewers should be aware that a State may
have different terms for this and identify the correct terms.
“Indicated”
means that the investigation resulted in a reason to suspect
maltreatment, but there was insufficient evidence to
substantiate the report under State law or policy.
Instructions:
Use
the information provided in the table for item 1 to answer
questions A1 and A2. The key information is provided in the
columns pertaining to (1) the report date, (2) whether there was
an assessment or an investigation, and (3) the disposition or
whether the case was opened for services.
If
the answers to questions A1 and A2 are No, the case should be
rated Not Applicable in the ratings section. Provide your reason
in the documentation section, and move to the rating for Safety
Outcome 1.
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If
the answer to either question A1 or A2 is Yes, within a 6-month
period before or after any maltreatment report identified in
question A:
was
there at least one additional substantiated or indicated
maltreatment report involving any child in the family? Or
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Yes
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No
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was
there at least one additional maltreatment report involving any
child in the family that was handled by an alternative response
and resulted in a decision to open the case for services to
address concerns relevant to the safety of at least one of the
children in the family (the case may have been opened for
services by the agency or by a private provider under contract
with the agency)?
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Yes
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No
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Instructions:
Reviewers
should answer No to questions B1 and B2 if the only additional
maltreatment reports occurring within 6 months of one another
referred to the same maltreatment incident identified in
question A.
Reviewers
should be aware that sometimes when children come into contact
with a child welfare agency they disclose maltreatment incidents
that occurred prior to the maltreatment incident that brought
them into contact with the agency. The agency then may
investigate these earlier incidents. If the case under review
involves this type of maltreatment report and the report was
substantiated or indicated, please follow the instructions
below:
If
the maltreatment report refers to an incident that occurred
within 6 months before another maltreatment report received
during the period under review, and the report is substantiated
or indicated, then the answer to question B1 or B2 should be
Yes.
If
the maltreatment report refers to an incident that occurred more
than 6 months before another maltreatment report received during
the period under review, then the answers to questions B1 and B2
should be No, even if the report is substantiated or indicated.
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If
the response to either question B1 or B2 is Yes, did:
(1)
the report(s) identified in questions A and B above involve the
same or similar circumstances? Or
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Yes
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No
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NA
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(2)
any of the reports involve maltreatment of the child by the
foster parents, members of the foster parents’ family,
other children in the foster home or facility, or facility staff
members?
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Yes
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No
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NA
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Instructions:
If
the answers to questions B1 and B2 are No, then the reviewers
should answer Not Applicable (NA) to questions C1 and C2.
Reviewers
should answer No to question C1 if the answer to either question
B1 or B2 is Yes, but there is no relationship between the
circumstances involved in the two events. In determining the
similarity of the circumstances, reviewers should consider the
perpetrator of the maltreatment and other individuals involved
in the incident.
Reviewers
should answer No to question C2 if the answer to either question
B1 or B2 is Yes, but none of the substantiated or indicated
maltreatment reports involved maltreatment of the child by the
foster parents, members of the foster parents’ family,
other children in the foster home or facility, or facility staff
members.
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Rating
Criteria:
Item
2 should be rated as a Strength if either of the following
applies:
The
answer to either question A1 or A2 is Yes, and the answers to
both questions B1 and B2 are No.
The
answers to both questions C1 and C2 are No or Not Applicable.
Item
2 should be rated as an Area Needing Improvement if the answer to
at least one question in each of A, B, and C is Yes.
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Rating
for this indicator (select one):
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Strength
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Area
Needing
Improvement
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Not
Applicable
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Reason
for Rating and Documentation
Please
provide below your main reason for rating this item as a
Strength, an Area Needing Improvement, or Not Applicable, and
provide documentation for the identified issues. If any issue is
Not Applicable to the case, enter NA in the appropriate space.
For each issue, indicate the source of your information (for
example, case file, interview with biological mother, interview
with caseworker, etc.).
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Main
Reason
Item
2 was rated as
_______________________________________________because:
Documentation
Information
If
the item is rated as an Area Needing Improvement, indicate the
dates of the maltreatment reports (or incidents) that occurred
within the 6-month period:
For
each situation that was assigned to an alternative response track,
document the information demonstrating that the case was opened
for services to address children’s safety or for determining
that the case was opened for reasons not related to child safety:
If
not explained in the “reason for rating” section, if
there was maltreatment recurrence, document the circumstances
related to maltreatment incidents including information related to
the perpetrators, and indicate why the reviewers determined that
the two incidents did or did not involve the same circumstances:
Describe
the circumstances related to any substantiated or indicated
reports of maltreatment (if relevant) involving the foster
parents, members of the foster parents’ family, other
children in the foster home or facility, or facility staff
members:
Other
Issues:
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RATING SAFETY OUTCOME 1
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SAFETY
OUTCOME 1: CHILDREN ARE, FIRST AND FOREMOST, PROTECTED FROM ABUSE
AND NEGLECT.
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Select
the level of outcome achievement that best describes the extent
to which this outcome is being or has been achieved, based on the
ratings for items 1 and 2.
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Level
of Outcome Achievement
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Substantially
Achieved:
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Safety
Outcome 1 should be rated as Substantially Achieved if either of
the following applies:
Item
1 and item 2 are rated as Strengths.
One
of the two items is rated as a Strength, and the other is Not
Applicable.
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Partially
Achieved:
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Safety
Outcome 1 should be rated as Partially Achieved if the following
applies:
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Not
Achieved:
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Safety
Outcome 1 should be rated as Not Achieved if either of the
following applies:
Item
1 and item 2 are rated as an Area Needing Improvement.
One
of the two items is rated as an Area Needing Improvement, and
the other is
Not Applicable.
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Not
Applicable:
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Safety
Outcome 1 should be rated as Not Applicable if the following
applies:
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CHILDREN
ARE SAFELY MAINTAINED IN THEIR HOMES WHENEVER POSSIBLE AND
APPROPRIATE.
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Services
to family to protect child(ren) in the home and prevent removal
or re-entry into foster care (case file
and interviews with
caseworker, parent(s), service providers)
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Purpose
of Assessment: To
determine whether, during the period under review, the agency made
concerted efforts to provide services to the family to prevent
children’s entry into foster care or re-entry after a
reunification.
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Applicable
Cases: A case is
applicable for an assessment of this item if it meets at least one
of the following criteria:
It
is an in-home services case and the reviewer determines that
there are concerns regarding the safety of at least one child in
the family during the period under review.
It
is an in-home services case and services were provided for
children at risk of foster care placement to remain safely in
their homes.
It
is a foster care case and the child entered foster care during
the period under review due to safety concerns.
It
is a foster care case, the child was reunified during the period
under review or was returned home on a trial basis, and the
reviewer determines that there are concerns regarding the safety
of that child in the home.
It
is a foster care case, and although the target child entered
foster care before the period under review and remained in care
for the entire period under review, there are other children in
the home and the reviewer determines that there are concerns
regarding the safety of these children during the period under
review.
|
Is
this case applicable? (Select
the appropriate response. If the response is No, rate the case as
Not Applicable in the ratings section, provide your reason for the
rating in the documentation section, and continue to item 4.)
|
Yes
|
No
|
For
the period under review, did the agency make concerted efforts to
provide or arrange for appropriate services for the family to
protect children and prevent their entry into foster care or
re-entry into foster care after a reunification? (Be sure to
assess the entire period under review.)
|
Yes
|
No
|
Definitions:
“Appropriate
services” for purposes of item 3 are those that are
provided to, or arranged for, the family with the explicit goal
of ensuring the child’s safety, such as homemaking
services, family preservation services, anger management classes,
or substance abuse treatment services, etc., and that meet the
specific needs or circumstances of the family. For example, if a
parent’s substance abuse is associated with the neglect
that brought the case to the attention of the agency, then
substance abuse treatment would be an appropriate service. If, in
this situation, all that is offered is parenting education, then
that service by itself would not be appropriate to address the
safety issues. As another example, if there was domestic violence
in the family and there was no effort to offer or provide
domestic violence prevention services to the family, then the
services would not be considered appropriate to ensure the
child’s safety. If a child needs mental health services,
education-related services, or services to address behavioral
problems, in most cases these would not be considered relevant to
the child’s safety if the child remained in the home.
Efforts of the agency to meet these service needs are assessed in
other items.
“Appropriate
services” also would include services provided to, or
arranged for, a noncustodial parent, but only if the parent has
contact with the child and there are safety concerns associated
with that contact. It would not include services to assist the
noncustodial parent in becoming a permanent caregiver.
“Concerted
efforts” for purposes of item 3 refers to the following
activities: conducting a safety assessment to identify the
services that are necessary to ensure the child’s safety in
the home, working to engage families in services, and
facilitating a family’s access to those services.
Instructions:
In
answering question A, focus only on whether the agency made
concerted efforts to provide appropriate and relevant services to
the family to address the safety issues in the family so that the
child could remain in the home or would not re-enter foster care.
Concerns about monitoring service participation and safety
planning and assessment of progress made will be captured in item
4.
If
the agency removed the child from the home without making
concerted efforts to provide services, the answer to question A
should be No, even if the agency determined that it was necessary
to remove the child for safety reasons. This issue will be
addressed in question B.
|
If,
during the period under review, any child was removed from the
home without providing or arranging for services, was this action
necessary to ensure the child’s safety?
|
Yes
|
No
|
NA
|
Instructions:
If
the answer to question A is Yes, but, after making efforts to
provide services, the child(ren) were removed from the home
during the period under review due to safety concerns, the answer
to question B should be Not Applicable (NA).
If
the child was not removed from the home during the period under
review, the answer to question B should be Not Applicable (NA).
Reviewers
should focus on whether the circumstances of the case suggest
that services would not have been able to ensure the child’s
safety if the child remained in the home. If the information
indicates that it was necessary to remove the child to ensure the
child’s safety, the answer to question B should be Yes. If
the information indicates that services should have been provided
to prevent removal (for example, homemaking or family
preservation services) but the child was removed without
providing those services, this question should be answered No.
If
services should have been offered to protect the child, but were
not because those services were not available in the community,
the answer to question B should be No.
|
Rating
Criteria:
This
item should be rated as a Strength if either of the following
applies:
The
answer to question A is Yes, and the answer to question B is Not
Applicable.
The
answer to question A is No, but the answer to question B is Yes.
This
item should be rated as an Area Needing Improvement if either of
the following applies:
The
answer to question A is No, and the answer to question B is No.
The
answer to question A is No, and the answer to question B is Not
Applicable.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing
Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Please
provide below your main reason for rating this item as a Strength,
an Area Needing Improvement, or Not Applicable, and provide
documentation for the identified issues. If any issue is Not
Applicable to the case, enter NA in the appropriate space. For
each issue, indicate the source of your information (for example,
case file, interview with biological mother, interview with
caseworker, etc.).
Main
Reason
Item
3 is rated as ________________________________________because:
|
Documentation
Information
If
not explained in the “reason for rating” section,
describe the circumstances of the case that indicate a safety risk
to the child:
If
not explained in the “reason for rating” section,
identify the services that were needed by the family to address
safety issues and describe how those services were or were not
provided by the agency during the period under review:
If
not explained in the “reason for rating” section,
provide the reason for removing the child from the home during the
period under review without providing services (if relevant and
reason is available) and provide the reviewers’ reasons for
determining whether the reason was appropriate or inappropriate:
Other
Issues:
|
CHILDREN
ARE SAFELY MAINTAINED IN THEIR HOMES WHENEVER POSSIBLE AND
APPROPRIATE.
|
Risk
assessment and safety management (case file and interviews with
caseworker, parent(s), child, foster parent(s), service
providers, guardians ad litem)
|
Purpose
of Assessment: To
determine whether, during the period under review, the agency made
concerted efforts to assess and address the risk and safety
concerns relating to the child(ren) in their own homes or while in
foster care.
|
Applicable
Cases: All
cases are applicable for an assessment of this item.
|
If
the case was opened during the period under review, did the
agency conduct an initial assessment of the risk to the target
child in foster care and/or any child(ren) in the family
remaining in the home?
|
Yes
|
No
|
NA
|
During
the period under review, did the agency conduct ongoing
assessments of the risk to the target child in foster care and/or
any child(ren) in the family remaining in the home?
|
Yes
|
No
|
NA
|
Definitions:
Instructions:
Questions
A and B should be answered for the target child in foster care or
receiving in-home services and any other children in the family
remaining in the home.
Question
A should be answered Not Applicable (NA) if the case was opened
before the period under review.
Reviewers
should note that in some cases, the issue of ongoing risk
assessments may not be relevant because the case was opened near
the end of the period under review and was not closed during the
period under review (for example, if the case was opened shortly
before the end of the period under review and during the initial
assessment the agency determined that there were no risk
concerns, then it may be reasonable to conclude that the agency
would not have conducted a second risk assessment during the
period under review). In this case, reviewers should determine
whether the agency conducted ongoing risk assessments and, if
not, whether it should have given the timeframe of the case. If
reviewers believe that ongoing risk assessments were not
necessary, question B may be answered Not Applicable (NA).
In
responding to question B, reviewers should determine whether
ongoing risk assessments (formal or informal) were conducted
during the period under review. If the agency conducted a risk
assessment at the onset of the case, but did not assess for risk
on an ongoing basis (for example, when there were new allegations
of abuse or neglect, changing family conditions, changes to
visitation, upon reunification, or at case closure, etc.) then
the answer to question B should be No unless the reviewers have
sufficient information, based on their review of the case, to
determine that during the period under review there were no
apparent risk concerns for the child in foster care or any
child(ren) in the family who remained in the home.
If
a case was closed during the period under review, reviewers
should determine whether the agency conducted a risk assessment
before closing the case. If not, the answer to question B should
be No, unless the reviewers have sufficient information, based on
their review of the case, to determine that such an assessment
was not necessary because during the period under review there
were no apparent risk concerns for the child in foster care or
any child(ren) in the family remaining in the home.
|
If
the case was opened during the period under review for either
foster care or in-home services, did the agency: (1) conduct an
initial assessment of the safety of the target child in foster
care and/or any child(ren) remaining in the home, and (2) develop
a safety plan with the family for addressing identified safety
issues?
|
Yes
|
No
|
NA
|
During
the period under review, did the agency: (1) conduct ongoing
safety assessments of the target child in foster care and/or any
child(ren) remaining in the home, and (2) continually monitor and
update the safety plan, including encouraging family engagement
in services designed to promote achievement of the goals of the
safety plan?
|
Yes
|
No
|
NA
|
Definitions:
“Safety
assessment” refers to the determination of whether a child
is in a safe environment. A safe environment is one in which
there are no threats that pose a danger or, if there are
threats, there is a responsible adult in a caregiving role who
demonstrates sufficient capacity to protect the child.
“Safety
plan” refers to a plan that describes strategies developed
by the agency and family to ensure that the child(ren) is safe.
Safety plans should address safety threats and how those will be
managed/addressed by the caregiver, caregiver capacity to
implement the plan and report safety issues to the agency, and
family involvement in implementation of the plan. Safety plans
may be separate from or integrated into the case plan.
Instructions:
Questions
C and D should be answered for the target child in foster care
or receiving in-home services and any other child(ren) in the
family remaining in the home.
Question
C should be answered Not Applicable (NA) if the case was opened
before the period under review.
Question
D should be answered Not Applicable (NA) if the reviewers
determine that during the period under review there were no
apparent safety concerns for the target child in foster care
and/or any child(ren) in the family remaining in the home.
Reviewers
should note that in some cases, the issue of ongoing safety
assessments may not be relevant because the case was opened near
the end of the period under review and was not closed during the
period under review (for example, if the case was opened shortly
before the end of the period under review and during the initial
assessment the agency determined that there were no safety
concerns, then it may be reasonable to conclude that the agency
would not have conducted a second safety assessment during the
period under review). In this case, reviewers should determine
whether the agency conducted ongoing safety assessments and, if
not, whether the assessments should have been conducted given
the timeframe of the case. If reviewers believe that ongoing
safety assessments were not necessary, question D may be
answered Not Applicable (NA).
In
responding to questions C and D, reviewers should determine
whether the agency conducted initial and ongoing safety
assessments (formal or informal) during the period under review.
If
the agency did not assess the child(ren)’s safety on an
ongoing basis (for example, when there were new allegations of
abuse or neglect, changing family conditions, changes to
visitation, upon reunification, or at case closure, etc.) then
the answer to question D should be No unless the reviewer
determines that during the period under review there were no
apparent safety concerns for any child(ren) in the family
remaining in the home.
If
the case was closed during the period under review, reviewers
should determine whether a safety assessment was conducted
before closing the case. If not, the answer to question D should
be No, unless the reviewer has sufficient information, based on
review of the case, to determine that such an assessment was not
necessary because during the period under review there were no
apparent safety concerns for any child(ren) in the family
remaining in the home.
|
During
the period under review, were there safety concerns pertaining
to the target child in foster care or any child(ren) in the
family remaining in the home that were not adequately or
appropriately addressed by the agency?
|
Yes
|
No
|
NA
|
Instructions:
There
were maltreatment allegations on the family that were reported to
the agency but were inappropriately screened out
(based on reviewers’ judgments).
There
were maltreatment allegations on the family but they were never
formally reported or formally investigated.
There
were extensive delays in accepting an allegation for
investigation or assessment.
There
were maltreatment allegations that were not substantiated despite
evidence that would support a substantiation.
The
case was closed prematurely (based on reviewers’ judgments
and because of either an agency or court decision).
|
|
|
F.
During the period under review, was there a safety concern
related to the target child in foster care during visitation by
parents or other family members that could be attributed to not
providing sufficient monitoring of visitation, permitting
unsupervised visitation when it was not appropriate, or
court-ordered visitation against agency recommendations?
|
Yes
|
No
|
NA
|
Instructions:
The
answer to question F should be Not Applicable (NA) if this is not
a foster care case.
If
the child does not have visits with the parents or with other
family members (for example, parental rights have been terminated
and the parents are no longer involved in the child’s life,
or parents are incarcerated and there are no visits with family
members), the answer to question F should be Not Applicable (NA).
Reviewers
should determine whether the visitation arrangements with parents
or other family members with regard to supervised or unsupervised
visits or home visits were appropriate given the circumstances of
the case.
If
a reviewer determines that unsupervised visitation is permitted,
but that this type of visitation presents safety concerns for the
child, then the answer to question F should be Yes.
Reviewers
should assess whether any safety concerns existed during the
child’s visitation with parents. For example, were there
allegations of child maltreatment during visitation or was the
child in an unsafe situation during visitation (for example,
because the custodial parent’s significant other, who was
known to be a drug user, was present in the home or because
previously identified risk factors had not been mitigated through
effective treatment)?
|
G. During
the period under review, was there a concern for the target
child’s safety related to the foster parents, members of the
foster parents’ family, other children in the foster home or
facility, or facility staff members that was not adequately or
appropriately addressed by the agency? (Foster parents include
pre-adoptive parents and nonlicensed relatives providing care to a
child in State custody.)
|
Yes
|
No
|
NA
|
Instructions:
The
answer to question G should be Not Applicable (NA) if this is not
a foster care case.
The
answer to question G should be Yes if reviewers determine that,
during the period under review, the child was in at least one
foster care placement in which he or she was unsafe, and
appropriate action was not taken (such as providing closer
monitoring of the placement, placing fewer children in the home,
providing services to address potential problems or existing
problems, finding a more appropriate placement, etc.). The
following are examples:
There
was a substantiated allegation of maltreatment of the child by a
foster parent (including a relative foster parent) or facility
staff member that could have been prevented if the agency had
taken appropriate actions.
There
was a critical incident report or other major issue relevant to
noncompliance by foster parents or facility staff that could
potentially make the child unsafe, and the agency could have
prevented it or did not provide an adequate response after it
occurred.
The
child’s placement during the period under review presented
other risks to the child that are not being addressed, even
though no allegation was made and no critical incident reports
were filed.
The
reviewers discover that there are safety concerns related to the
child in the foster home that the agency is unaware of because
of inadequate monitoring.
|
H.
During the period under review, if the target child was
discharged from foster care to be reunited with parents or
relatives or returned home on a trial home visit, did the agency
conduct a thorough safety assessment?
|
Yes
|
No
|
NA
|
Instructions:
The
answer to question H should be Not Applicable (NA) if, during the
period under review, the child was not discharged from foster
care to reunification with parents or relatives or was not
returned home on a trial visit at any time.
The
answer to question H should be Yes if the child was reunified
with parents or relatives on a permanent or trial basis, and a
thorough safety assessment was conducted before reunification.
If
a thorough safety assessment was not conducted before
reunification or a trial home visit, the answer to question H
should be No.
|
Rating
Criteria
Item
4 should be rated as a Strength if both of the following apply:
The
answers to questions A, B, C, D, and H are either Yes or Not
Applicable, and
The
answers to questions E, F, and G are either No or Not Applicable.
Item
4 should be rated as an Area Needing Improvement if either of the
following applies:
The
answer to any one of questions A, B, C, D, or H is No, or
The
answer to any one of questions E, F, or G is Yes.
|
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Reason
for Rating and Documentation
Please
provide below your main reason for rating this item as a Strength
or an Area Needing Improvement and provide documentation for the
identified issues. If any issue is Not Applicable to the case,
enter NA in the appropriate space. For each issue, indicate the
source of your information (for example, case file, interview
with biological mother, interview with caseworker, etc.).
Main
Reason
Item
4 is rated as ____________________________________________
because:
Documentation
Information
If
not explained in the “reason for rating” section,
describe the circumstances of the case that indicate risk
concerns related to the child(ren):
Describe
the characteristics of the risk assessment(s) (for example, was
one conducted, how was it conducted, how comprehensive was it,
what did it include or not include?), including the timing of the
risk assessments (for example, at first contact, at the
conclusion of the investigation, at case transfer, on an ongoing
basis, when new allegations of abuse or neglect were received,
when determining changes to visitation, at reunification, or
before case closure):
If
not explained in the “reasons for rating” section,
describe the circumstances of the case that indicate safety
concerns related to the child(ren):
Describe
the characteristics of the safety assessment(s) (for example, was
one conducted, how was it conducted, how comprehensive was it,
what did it include or not include?), including the timing of the
safety assessments (for example, at first contact, at the
conclusion of the investigation, at case transfer, on an ongoing
basis, when new allegations of abuse or neglect were received,
when determining changes to visitation, at reunification, or
before case closure):
Identify
the activities undertaken to monitor participation in
safety-related services (or the absence of activities to monitor
service participation):
Describe
the nature of the safety concerns related to the child(ren)
during visitation (if relevant), including a description of the
visitation (for example, was it unsupervised, and if so, was this
appropriate?):
Describe
the nature of the safety concerns related to the child(ren) from
foster care providers (if relevant) and the agency activities
with regard to addressing safety. (For example, was there
sufficient monitoring of the placement? Was there an excessive
number of children in the foster home? Did the agency respond to
the foster parent’s request for services to address
problems? Is there sufficient monitoring of residential
facilities? Are there people living in the home of whom the
agency is unaware?):
Was
there a report substantiating that the foster care provider(s)
maltreated the child during the period under review? If Yes,
describe the circumstances of that report, whether the agency
might have prevented the maltreatment, and the agency’s
response:
Other
Issues:
|
RATING SAFETY OUTCOME 2
|
CHILDREN
ARE SAFELY MAINTAINED IN THEIR HOMES WHENEVER POSSIBLE AND
APPROPRIATE.
|
Select
the level of outcome achievement that best describes the extent
to which this outcome is being or has been achieved, based on the
ratings for items 3 and 4.
|
Level
of Outcome Achievement
|
|
Substantially
Achieved:
|
Safety
Outcome 2 should be rated as Substantially Achieved if either of
the following applies:
|
|
Partially
Achieved:
|
Safety
Outcome 2 should be rated as Partially Achieved if the following
applies:
|
|
Not
Achieved:
|
Safety
Outcome 2 should be rated as Not Achieved if either of the
following applies:
|
|
Not
Applicable:
|
Safety
Outcome 2 should be rated as Not Applicable if the following
applies:
|
SECTION
II: PERMANENCY
|
PERMANENCY
OUTCOME 1: CHILDREN HAVE PERMANENCY AND STABILITY IN THEIR LIVING
SITUATIONS.
|
Item
5: Foster care re-entries (case files, court orders, interview
with caseworker)
|
Purpose
of Assessment: To
assess whether children who entered foster care during the period
under review were re-entering within 12 months of a prior foster
care episode.
|
Applicable
Cases: A
case is applicable for an assessment of this item if the
child
entered foster care at least once during the period under review.
Special
Circumstances:
If a child was on a trial home visit and then returned to a
substitute care setting, that return is not considered an “entry
into foster care” and the case is not applicable, unless the
child was on a trial home visit for more than 6 months and there
is no court order extending the trial home visit beyond 6 months.
|
Is
this case applicable? (Select
the appropriate response. If the response is No, rate the item as
Not Applicable in the rating section, provide your reason for this
rating in the documentation section, and continue to item 6.)
|
Yes
|
No
|
Did
any of the child’s foster care entries during the period
under review occur within 12 months of the child’s
discharge from a prior foster care episode?
|
Yes
|
No
|
Definitions:
“Entry
into foster care” refers to a child’s removal from
his or her normal place of residence and placement in
a substitute care setting under the care and placement
responsibility of the State or local title IV-E/IV-B
agency. Children are considered to have entered foster care
if the child has been in substitute care for 24
hours or more.
“Episode
of foster care” refers to the timeframe between a child’s
entry into foster care (the date shown in Section J on the Face
Sheet) and the child’s discharge from foster care (the
date shown in Section K on the Face Sheet).
“Discharge”
refers to the point when the child is no longer in foster care
under the care and responsibility or supervision of the agency.
If the agency retains supervision of a child and the child
returns home on a trial basis for an unspecified period of time,
the child should be considered discharged from foster care after
a 6-month period of time, unless a longer period of time has
been specified in a court order.
Instructions:
|
If
the answer to question A is Yes, was there evidence that
concerted efforts were made to prevent re-entry?
|
Yes
|
No
|
NA
|
Instructions:
If
the answer to question A is No, the answer to question B should
be Not Applicable (NA).
Reviewers
should examine the reasons why a child had multiple entries into
foster care and what efforts were made to prevent the re-entry.
|
Rating
Criteria:
Item
5 should be rated as a Strength if either of the following
applies:
The
answer to question A is No.
The
answer to question A is Yes, and the answer to question B is Yes.
Item
5 should be rated as an Area Needing Improvement if both of the
following apply:
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Please
provide below your main reason for rating this item as a
Strength, an Area Needing Improvement, or Not Applicable, and
provide documentation for the identified issues. If any issue is
Not Applicable to the case, enter NA in the appropriate space.
For each issue, indicate the source of your information (for
example, case file, interview with biological mother, interview
with caseworker, etc.).
Main
Reason
Item
5 is rated as ___________________________________________________
because:
Documentation
Information
Date
of child’s first entry into foster care during the period
under review: _____________________
Was
this entry within 12 months of a previous discharge:
Yes
No
Date
of discharge, if any, within 12 months of this entry:
______________________
Document
the circumstances related to the re-entry within 12 months:
If
there are additional entries into foster care after a discharge
during the period under review, provide the above information for
each of those entries:
Other
Issues:
|
PERMANENCY
OUTCOME 1: CHILDREN HAVE PERMANENCY AND STABILITY IN THEIR LIVING
SITUATIONS.
|
Item
6: Stability of foster care placement (case files and interviews
with caseworker, foster parent(s), child)
|
Purpose
of Assessment: To
determine if the child in
foster care is in a stable placement at the time of the onsite
review and that any changes in placement that occurred during the
period under review were in the best interest of the child and
consistent with achieving the child’s permanency goal(s).
|
Applicable
Cases: All
foster care cases are applicable for an assessment of this item.
|
Is
this case applicable? (Select
the appropriate response. If the response is No, rate the item as
Not Applicable in the rating section, provide your reason for this
rating in the documentation section, and continue to item 7.)
|
Yes
|
No
|
|
Number
|
How
many placement settings did the child experience during the
period under review?
|
|
Definitions:
“Placement
setting” refers to a physical setting in which a child
resides while in foster care under the care and placement of the
agency. A new placement setting would result, for example, when a
child moves from one foster family home to another or to a group
home or institution. Placement settings may include shelter care,
treatment facilities, and juvenile justice placements. If,
however, a foster family with whom a child is placed moves and
the child moves with them, this does not constitute a change in
placement.
Instructions:
If
there were multiple episodes of foster care during the period
under review, add up the placement settings within each episode.
If there is a re-entry into foster care and the child is placed
in a different placement setting at the time of re-entry, then it
would count as a new placement setting. If the child returns to
the placement setting that he or she was in before the return
home, then it would not count as a new placement setting.
Reviewers
should not consider the following as placement settings: (1) a
trial home visit; (2) a runaway episode; (3) temporary absences
from the child’s ongoing foster care placement, including
visitation with a sibling, relative, or other caretaker (for
example, pre-placement visits with a subsequent foster care
provider or pre-adoptive parents); (4) hospitalization for
medical treatment, acute psychiatric episodes, or diagnosis; (5)
respite care; and (6) day or summer camps.
Complete
the table below. Begin with the child’s placement setting
at the onset of the period under review, or if the child entered
foster care during the period under review, begin with the first
placement setting at entry into foster care. If there was only
one placement setting, complete only the first two columns of the
first row.
|
Placement
Date
|
Placement
Type
|
Reason
for Change in Placement Setting
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
If
the response to question A is greater than one (1), were all
placement changes during the period under review planned by the
agency in an effort to achieve the child’s case goals or to
meet the needs of the child?
|
Yes
|
No
|
NA
|
Definitions:
Placement
changes that reflect agency efforts to achieve case goals
include moves from a foster home to an adoptive home, moves from
a more restrictive to a less restrictive placement, moves from
non-relative foster care to relative foster care, moves that
bring the child closer to family or community, etc.
Placement
changes that do not reflect agency efforts to achieve case goals
include moves due to unexpected and undesired
placement
disruptions; moves due to placing the child in an inappropriate
placement (that is, one that was based on availability rather
than on appropriateness); moves to more restrictive placements
when this is not essential to achieving a child’s
permanency goal; temporary placements while awaiting a more
appropriate placement; and practices of routinely placing
children in a particular placement type, such as shelter care,
upon initial entry into foster care regardless of individual
needs.
Instructions:
If
the response to question A is one (1), then the response to
question B should be Not Applicable (NA). If the single
placement is not stable, that information will be collected in
question C.
If
ALL placement changes during the period under review reflect
planned agency efforts to achieve the child’s case goals
or meet the needs of the child, then the answer to question B
should be Yes.
If
any single placement change that occurred during the period
under review was for a reason other than agency efforts to
achieve case goals or to meet the child’s needs, the
answer to question B should be No.
Placement
changes that occur as a result of unexpected circumstances that
are out of the control of the agency (such as the death of a
foster parent or foster parents moving to another State) can be
considered similar to those that reflect agency efforts to
achieve case goals for purposes of question B.
|
Is
the child’s current placement setting (or most recent
placement if the child is no longer in foster care) stable?
|
Yes
|
No
|
Instructions:
If
any of the following apply to the child’s current
placement, the answer to question C should be No (select all that
apply). If none of the following applies, then the answer to
question C should be Yes.
The
child’s current placement is in a temporary shelter or
other temporary setting.
There
is information indicating that the child’s current
substitute care provider may not be able to continue to care for
the child.
There
are problems in the current placement that threaten the
stability of the placement but that the agency is not
addressing.
The
child has run away from this placement more than once in the
past, or is in runaway status at the time of the review.
Other
(describe):
|
Rating
Criteria:
Item
6 should be rated as a Strength if either of the following
applies:
The
answer to question A is one (1), the answer to question B is Not
Applicable, and the answer to question C is Yes.
The
answer to question A is greater than one (1), but the answers to
questions B and C are Yes.
Item
6 should be rated as an Area Needing Improvement if either of the
following applies:
The
answer to question A is one (1), but the answer to question C is
No.
The
answer to question A is greater than one (1), and the answer to
either question B or C is No.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Please
provide below your main reason for rating this item as a Strength
or an Area Needing Improvement, and provide documentation for the
identified issues. If any issue is Not Applicable to the case,
enter NA in the appropriate space. For each issue, indicate the
source of your information (for example, case file, interview
with biological mother, interview with caseworker, etc.).
Main
Reason
Item
6 is rated as ____________________________________________
because:
Documentation
Information
If
not explained in the “reason for rating” section,
indicate why you determined that the placement changes were or
were not planned in an effort to achieve the child’s case
goals or to meet the needs of the child:
If
not explained in the “reasons for rating” section,
provide your reasons for determining that the child’s
current placement (or most recent placement if the child is no
longer in foster care) is or is not stable:
Other
Issues:
|
PERMANENCY
OUTCOME 1: CHILDREN HAVE PERMANENCY AND STABILITY IN THEIR LIVING
SITUATIONS.
|
Permanency
goal for child (case file and interviews with caseworker and
other relevant persons involved in the case, including the child,
when age appropriate, parent(s), foster parent(s), service
providers, CASA workers, guardian ad litem)
|
Purpose
of Assessment: To
determine whether appropriate permanency goals were established
for the child in a timely manner.
|
Applicable
Cases: All
foster care cases are applicable for assessment of this item,
unless the case has not been open long enough (less than 60 days)
for the agency to have developed a case plan and established a
permanency goal. If the case has been open for less than 60 days,
but a permanency goal has been established, the case is applicable
for assessment.
|
Is
this case applicable? (Select
the appropriate response. If the response is No, rate the item as
Not Applicable in the rating section, provide your reason for this
rating in the documentation section, and continue to item 8.)
|
Yes
|
No
|
|
Permanency
Goal 1
|
Permanency
Goal 2 (if applicable)
|
What
is (are) the child’s current permanency goal(s) (or if the
case was closed during the period under review, what was the
permanency goal before the case was closed)?
|
|
|
Instructions:
Permanency
goals are the following: adoption, guardianship, reunification
with parents, reunification with relatives, and other planned
permanent living arrangements. A goal of other planned permanent
living arrangement often will not be specified in the case file
using that term. This goal refers to a situation in which the
State maintains care and custody responsibilities for the child,
but places the child in a setting in which the child is expected
to remain until adulthood, such as with foster parents who have
made a commitment to care for the child permanently, with
relatives who have made the same commitment, or with a
residential care facility (for example, for children with
developmental disabilities who require residential care).
The
permanency goal or goals identified in question A1 determine the
additional items to be completed for this outcome (items 8, 9, or
10). If two concurrent permanency goals have been established and
are identified in the case plan, identify both goals and complete
the corresponding items (items 8, 9, or 10) for each of the
goals. If both goals fall under item 8, complete item 8 with both
goals in mind. Do not report concurrent goals in A1 unless both
are identified in the case file.
|
Is
(are) the child’s permanency goal(s) specified in the case
file?
|
Yes
|
No
|
Instructions:
Permanency
goals should be established in the case file. If the permanency
goal is not specified anywhere in the case file, such as in the
case plan or in a court order, then the answer to question A2
should be No, and item 7 should be rated as an Area Needing
Improvement.
If
no permanency goal is specified in the case file, reviewers
should ask the caseworker to identify the permanency goal toward
which the agency is working for the child. This goal should be
entered for question A1, and should be used to determine which
additional item is completed for the case. Reviewers should ask
the caseworker to explain why the child’s permanency goal
is not specified in the case file and include that information in
the documentation section.
|
B.
Were all permanency goals in effect during the period under review
established in a timely manner?
|
Yes
|
No
|
Instructions:
Reviewers
should answer this question based on their professional judgment
regarding the timeliness of establishing the goal, particularly
with regard to changing a goal, and provide the rationale for
their decision in the documentation section.
For
children who recently entered care, reviewers should expect the
first permanency goal to be established no later than 60 days
from the date of the child’s entry into foster care
consistent with the Federal requirement that a case plan be
established within 60 days from the date of the child’s
entry into foster care. For children whose goal was changed from
reunification to adoption, reviewers should consider the
guidelines established by the Federal Adoption and Safe Families
Act (ASFA) regarding seeking termination of parental rights,
which might impact the timeliness of changing a goal from
reunification to adoption.
|
Reviewers
should answer this question for all permanency goals in effect
during the period under review. If there are concurrent goals,
the answer should apply to both goals. For example, if there are
concurrent goals of reunification and adoption, and you believe
that the reunification goal was established in a timely manner,
but the adoption goal was not, the answer to question B should be
No.
Complete
the table below for each of the goals in place during the period
under review. Begin with the child’s first permanency goal
in place during the period under review, and end with the current
or latest permanency goal or goals identified in section A.
|
Permanency
Goal
|
Date
Established
|
Time
in Foster Care Before Goal Established
|
Date
Goal Changed
|
Reason
for Goal Change
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Were
all permanency goals in effect during the period under review
appropriate to the child’s needs for permanency and to the
circumstances of the case?
|
Yes
|
No
|
Instructions:
Reviewers
should answer this question based on their professional judgment
regarding the appropriateness of the permanency goal and provide
the rationale for their decision in the documentation section.
Reviewers
should consider the factors that the agency considered in
deciding on the permanency goal and whether all of the relevant
factors were evaluated.
If
one of the goals is other planned permanent living arrangement
and the reviewer determines that the goal was established without
a thorough consideration of other permanency goals, then the
answer to question C should be No.
|
Has
the child been in foster care for at least 15 of the most recent
22 months?
|
Yes
|
No
|
Instruction:
In
answering question D, reviewers should begin the “count”
with the date of the judicial finding of child abuse and neglect
(usually the adjudicatory hearing) or 60 days after the child’s
removal from the home and placement in a substitute care setting,
whichever is earlier.
|
If
the answer to question D is No, does the child meet other
Adoption and Safe Families Act (ASFA) criteria for termination
of parental rights (TPR)?
|
Yes
|
No
|
NA
|
Definitions:
The
child is an abandoned child, or
The
child’s parents have been convicted of one of the felonies
designated in Section 475(5)(E) of the Social Security Act,
including: (1) committed murder of another child of the parent;
(2) committed voluntary manslaughter of another child of the
parent; (3) aided or abetted, attempted, conspired, or solicited
to commit such a murder or such a voluntary manslaughter; or (4)
committed a felony assault that resulted in serious bodily injury
to the child or another child of the parent.
Instructions:
If
the answer to question D is Yes, the answer to question E should
be Not Applicable (NA).
Question
E must be answered if the answer to question D is No.
If
any of the conditions noted above apply to the case under review,
question E should be answered Yes.
|
If
the answer to either question D or E is Yes, did the agency file
or join a TPR petition before the period under review or in a
timely manner during the period under review?
|
Yes
|
No
|
NA
|
Instructions:
If
the answers to both questions D and E are No, the answer to
question F should be Not Applicable (NA).
Reviewers
should review the case file for evidence of petitioning for TPR.
If there is no evidence of this in the file, then reviewers
should ask the caseworker for documentation regarding petitioning
for TPR. If there is no evidence in the file or other
documentation, then question F should be answered No.
|
If
the answer to question F is No, is an “exception”
or compelling reason for not filing for TPR specified in the
case file?
|
Yes
|
No
|
NA
|
Definitions:
Exceptions
to the TPR requirement include the following: (1) at the option
of the State, the child is being cared for by a relative; (2)
the agency has documented in the case plan a compelling reason
for determining that a TPR would not be in the best interest of
the child; or (3) the State has not provided to the family the
services that the State deemed necessary for the safe return of
the child to the child’s home if reasonable efforts of the
type described in Section 471(a)(15)(B)(ii) of the Social
Security Act are required to be made with respect to the child.
Instructions:
If
the answer to question F is Yes or Not Applicable (NA), then
question G should be answered Not Applicable (NA).
Question
G can be answered Yes only if the “exception” or
compelling reason for not seeking TPR is noted somewhere in the
case file or if there is a court order that acknowledges the
exception. If, during an interview, the caseworker provides a
reason for not seeking TPR, but cannot provide any
documentation, then question G should be answered No. However,
the caseworker’s verbal description of the reason for not
seeking TPR should be noted in the documentation section.
|
Rating
Criteria:
Item
7 should be rated as a Strength if any one of the following
criteria apply:
The
answers to questions A2, B, and C are Yes, and the answers to
questions D and E are No.
The
answers to questions A2, B, C, D, and F are Yes.
The
answers to questions A2, B, and C are Yes, the answer to
question D is No, and the answers to questions E and F are Yes.
The
answers to questions A2, B, and C are Yes, the answer to
question D or E is Yes, the answer to question F is No, and the
answer to question G is Yes.
Item
7 should be rated as an Area Needing Improvement if any of the
following apply:
The
answer to question A2, B, or C is No.
The
answers to questions A2, B, and C are Yes, but the answer to
question D or E is Yes, and the answers to questions F and G are
No.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Please
provide below your main reason for rating this item as a Strength
or an Area Needing Improvement, and provide documentation for the
identified issues. If any issue is Not Applicable to the case,
enter NA in the appropriate space. For each issue, indicate the
source of your information (for example, case file, interview
with biological mother, interview with caseworker, etc.).
Main
Reason
Item
7 is rated as
__________________________________________________because:
Documentation
Information
If
not explained in the “reason for rating” section,
document the reasons the reviewers determined that the goals were
not timely and/or appropriate (if relevant):
|
If
the caseworker reported an “exception” or a compelling
reason for not filing for TPR, but it was not in the case file,
provide any information obtained about the exception/compelling
reason:
Other
Issues:
|
CHILDREN
HAVE PERMANENCY AND STABILITY IN THEIR LIVING SITUATIONS.
|
Reunification,
guardianship, or permanent placement with relatives (case files
and interviews with caseworker, child, parent(s), foster
parent(s), guardian ad litem, service providers)
|
Purpose
of Assessment: To
determine whether concerted efforts were made, or are being
made, during the period under review, to achieve reunification,
guardianship, or permanent placement with relatives in a timely
manner.
|
Applicable
Cases: All
foster care cases in which the child’s current (or most
recent) goal is reunification, permanent placement with
relatives, or guardianship, including cases in which any one of
these is the concurrent goal.
|
Is
this case applicable? (Select
the appropriate response. If the response is No, rate the item
as Not Applicable in the rating section, provide your reason for
this rating in the documentation section and continue to item
9.)
|
Yes
|
No
|
What
is/was the child’s most recent permanency goal? (Select
the appropriate response.)
|
Reunification
|
Guardianship
|
Permanent
Placement With Relatives
|
Definitions:
A
goal of reunification is defined as a plan for the child to be
discharged from foster care to his or her parents or primary
caretaker.
A
goal of guardianship is defined as a plan for the child to be
discharged from foster care to a legally established custody
arrangement with an individual that is intended to be
permanent.
A
goal of permanent placement with relatives is defined as a plan
for the child to be discharged from foster care to the
permanent care of a relative other than the one from whose home
he or she was removed.
If
there are concurrent goals and both are relevant for item 8,
identify both goals.
|
Are
the agency and court making (or did they make) concerted
efforts to achieve the goal (or these goals, if there are
concurrent goals) in a timely manner?
|
Yes
|
No
|
Definitions:
“Discharge
from foster care” is defined as the point when the child
is no longer in foster care under the care and placement
responsibility or supervision of the agency. If a child returns
home on a trial home visit and the agency retains
responsibility or supervision of the child, the child is not
considered discharged from foster care unless the trial home
visit is longer than 6 months, and there was no court order
extending the trial home visit beyond 6 months.
Instructions:
|
|
|
|
Date
of the child’s most recent entry into foster care (this
date should be the same as the date provided in Section J on the
Face Sheet):
|
|
Time
in care (in months) at the time of the onsite review (this is
the number of months that the child was in foster care from the
date of the most recent entry into foster care to the beginning
of the onsite review week or from the date of the most recent
entry into foster care to the time of discharge):
|
|
Date
of discharge from foster care (this date should be the same as
the date provided in Section K on the Face Sheet; if the child
was not discharged, enter Not Applicable (NA)):
|
|
In
determining a response to question B, reviewers should consider
the time the child has been in foster care as well as agency and
court efforts. As a general rule, if the child has been in
foster care for more than 12 months and the goal has not yet
been achieved, then the answer to question B should be No,
unless there are particular circumstances that justify the
delay. If the reviewer determines that there is a justification
for the child remaining in foster care for longer than 12 months
before achieving the permanency goal, the justification should
be included in the documentation section for this item. For
example:
The
permanency goal of reunification has been in place for longer
than 12 months, but there is a concurrent goal of adoption and
the agency and court also are working toward the goal of
adoption.
The
permanency goal of reunification has been in place for longer
than 12 months, but the child was physically returned to the
parents during or before the 12th
month and remained at home on a trial home visit beyond the 12th
month. If the reviewer determines that the length of time that
the child spent in out-of-home care and on the trial home visit
was reasonable given the child and family circumstances, then
the item may be rated as a strength even though the child was
not discharged from foster care until after the 12th
month.
If
the reviewer determines that the agency and court could have
achieved the permanency goal prior to 12 months, but there was a
delay due to lack of concerted efforts on the part of the agency
or court, then the answer to question B should be No even if the
child was reunified within 12 months. A justification should be
included in the documentation section for this item.
|
Rating
Criteria:
Item
8 should be rated as a Strength if the answer to question B is
Yes.
Item
8 should be rated as an Area Needing Improvement if the answer to
question B is No.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing
Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Please
provide your reason for rating this item as a Strength, an Area
Needing Improvement, or Not Applicable, and provide documentation
for the identified issues. If any issue is Not Applicable to the
case, enter NA in the appropriate space. For each issue, indicate
the source of your information (for example, case file, interview
with biological mother, interview with caseworker, etc.).
Main
Reason
Item
8 is rated as _______________________________________________
because:
Documentation
Information
If
not explained in the “reason for rating” section,
document efforts made to achieve goal, including the
appropriateness and effectiveness of the efforts, and, barriers
to achieving the goal (for example, agency, court, or other
factors that prevented or are preventing timely achievement of
the goal):
|
If
item 8 was rated as a Strength even though the goal of
reunification or permanent placement with relatives was not
achieved or is not likely to be achieved within 12 months,
document the special circumstances that justify this rating:
If
item 8 was rated as an Area Needing Improvement even though the
permanency goal was achieved in 12 months, document the special
circumstances that justify this rating:
Other
Issues:
|
PERMANENCY
OUTCOME 1: CHILDREN HAVE PERMANENCY AND STABILITY IN THEIR
LIVING SITUATIONS.
|
Item
9: Adoption (case file and interviews with caseworker, child,
foster parent(s), guardian ad litem, service providers)
|
Purpose
of Assessment: To
determine whether, during the period under review, concerted
efforts were made, or are being made, to achieve a finalized
adoption in a timely manner.
|
Applicable
Cases: All
foster care cases in which the child’s current (or most
recent) permanency goal is adoption, including cases in which
adoption is the concurrent goal.
|
Is
this case applicable?
(Select the appropriate response. If the response is No, rate
the item as Not Applicable in the ratings section, provide your
reason for the rating in the documentation section, and continue
to item 10.)
|
Yes
|
No
|
Are
the agency and court making (or did the agency and court make)
concerted efforts to achieve the goal of adoption in a timely
manner?
|
Yes
|
No
|
Definition:
“Entry
into foster care” refers to a child’s removal from
his or her normal place of residence and placement in
a substitute care setting under the care and placement
responsibility of the State or local title IV-E/IV-B
agency. Children are considered to have entered foster
care if the child has been in substitute care for 24
hours or more.
“Discharge
from foster care” is defined as the point when the child
is no longer in foster care under the care and placement
responsibility or supervision of the agency. If a child returns
home on a trial home visit and the agency retains
responsibility or supervision of the child, the child is not
considered discharged from foster care unless the trial home
visit is longer than 6 months, and has not been extended by a
court order.
Instructions:
|
|
|
|
Date
of the child’s most recent entry into foster care (this
should be the same date as in Section J on the Face Sheet):
|
|
Time
in care (in months) at the time of the onsite review (this is
the number of months that the child was in foster care from the
date of the most recent entry into foster care to the beginning
of the onsite review week or from the date of the most recent
entry into foster care to the time of adoption finalization or
discharge from foster care):
|
|
Date
of adoption finalization (if relevant) (this is the date that
the court legally established the adoption and transferred care
and placement responsibility or supervision from the State to
the adoptive parent(s); this should be the same date as in
Section K on the Face Sheet; if the adoption has not been
finalized, enter Not Applicable (NA)):
|
|
The
length of time that the child has been in foster care.
The
agency-related efforts to achieve adoption in a timely manner
(for example, establishing a goal of adoption concurrent with
the goal of reunification at the onset of the case, placing the
child in a foster/adoptive home as the first placement,
completing paperwork in a timely manner, conducting a concerted
search for an absent parent early in the case, etc.).
The
court-related efforts (for example, holding termination of
parental rights hearings in a timely manner, not permitting
continuances, etc.).
The
determination of timeliness should be based on the date of the
child’s most recent entry into foster care, not the date
that the goal of adoption was established.
If
the adoption was not achieved within 24 months of the date of
the most recent entry into foster care, or it does not appear
that the adoption will be achieved within that timeframe, then
the answer to question A should be No, unless the reviewer
finds that there are particular circumstances that warrant the
delay. These circumstances must be beyond the control of the
agency or the courts. For example, there is evidence that the
agency has made concerted efforts to find an adoptive home for
a child with special needs, but the appropriate family has not
yet been found, or a pre-adoptive placement disrupted despite
concerted efforts on the part of the agency to support it.
|
If
the adoption occurs within 24 months, but the reviewer
determines that it could have been achieved earlier if the
agency and court had made more concerted efforts, then the
answer to question A should be No, but the reviewer must
specifically document the agency-related delays in the
documentation section.
|
Rating
Criteria:
Item
9 should be rated as a Strength if the answer to question A is
Yes.
Item
9 should be rated as an Area Needing Improvement if the answer to
question A is No.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing
Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Please
provide below your main reasons for rating this item as a
Strength, an Area Needing Improvement, or Not Applicable, and
provide documentation for the identified issues. If any issue is
Not Applicable to the case, enter NA in the appropriate space.
For each issue, indicate the source of your information (for
example, case file, interview with biological mother, interview
with caseworker, etc.).
Main
Reason
Item
9 is rated as _______________________________________________
because:
Documentation
Information
If
not explained in the “reason for rating” section,
document efforts made to achieve the child’s goal of
adoption, including the appropriateness and effectiveness of the
efforts, and barriers to achieving the goal of adoption (for
example, agency- or court-related factors that prevented or are
preventing achievement of the goal in a timely manner):
If
this item was rated as a Strength even though the child’s
goal of adoption was not achieved or is not likely to be achieved
within 24 months of the child’s entry into foster care,
document the special circumstances that justify this rating:
If
this item was rated as an Area Needing Improvement even though
the child’s goal of adoption was achieved within 24 months
of entry into foster care, document the special circumstances
that justify this rating:
Other
Issues:
|
PERMANENCY
OUTCOME 1: CHILDREN HAVE PERMANENCY AND STABILITY IN THEIR LIVING
SITUATIONS.
|
Item
10: Other planned permanent living arrangement (case files and
interviews with child, caseworker, foster parent(s), relative
caregiver(s), independent living services providers, service
providers, guardian ad litem)
|
Purpose
of Assessment: To
determine whether, during the period under review, the agency
made concerted efforts to ensure:
That
the child is adequately prepared to make the transition from
foster care to independent living (if it is expected that the
child will remain in foster care until he or she reaches the age
of majority or is emancipated).
That
the child, even though remaining in foster care, is in a
“permanent” living arrangement with a foster parent
or relative caregiver and that there is a commitment on the part
of all parties involved that the child remain in that placement
until he or she reaches the age of majority or is emancipated.
That
the child is in a long-term care facility and will remain in
that facility until transition to an adult care facility.
Reviewers
are not to rate this item based on the appropriateness of the
goal. If the reviewer believes that the goal is not appropriate,
this should be indicated under item 7 and the rationale for this
decision provided in the documentation for item 7.
|
Applicable
Cases: All
foster care cases in which at least one (if there are concurrent
goals) of the child’s current (or most recent) goals is
emancipation/independent living or a planned permanent living
arrangement other than adoption, guardianship, reunification, or
permanent placement with relatives.
|
Is
this case applicable? (Select
the appropriate response. If the response is No, rate the item as
Not Applicable in the rating section, provide your reason for the
rating in the documentation section and continue to Rating
Permanency Outcome 1.)
|
Yes
|
No
|
What
is the child’s other planned permanent living arrangement
goal (check the goal that most closely reflects the one in the
case file)?
Emancipation/Independence:
Child is expected to remain in existing placement until she/he
reaches the age of majority. Usually when this type of goal is
specified, the child is age 16 or older, but that is not always
the case.
Long-term
foster care placement with a non-relative foster parent.
Long-term
foster care placement with a specified relative.
Placement
in a long-term care facility until transition to an adult care
facility.
Other
(specify):
|
Instructions:
A
goal of other planned permanent living arrangement often is not
specified in the case file using that term. This goal refers to
a situation in which the agency maintains care and custody
responsibilities for and supervision of the child, and places
the child in a setting in which the child is expected to remain
until adulthood, such as with foster parents who have made a
commitment to care for the child permanently, with relative
foster caregivers who have made the same commitment, or with a
long-term care facility (for example, for those children with
developmental disabilities who require long-term residential
care services.).
If
the case plan permanency goal is to establish legal guardianship
with a relative or non-relative caregiver and for the child to
be discharged from foster care to the care of that relative,
then this item is not appropriate and item 8 should be completed
instead.
|
For
children with an other planned permanent living arrangement
permanency goal who are expected to eventually exit foster care
to independence, were concerted efforts made to provide the
child with services to adequately prepare the child for
independent living when the child leaves foster care?
Independent living services should be provided to all youth age
16 and older and to children of any age with a goal of
emancipation/independence.
|
Yes
|
No
|
NA
|
Instructions:
Question
B should be answered Not Applicable (NA) if the child did not
reach his or her 16th
birthday at any time during the period under review, and the
child does not have a goal of emancipation/independence.
In
making this determination, reviewers should consider the
following:
Did
the agency assess for independent living skills?
Is
there an independent living plan in the file? (This is required
for all youth age 16 and older.)
Is
the child receiving an age-appropriate range of independent
living services (for example, post-high school planning, life
skills classes, employment training, financial planning skills
training, etc.)?
Is
the child receiving transitional living services?
Does
the child have an independent living caseworker?
|
Were
concerted efforts made to achieve the goal of other planned
permanent living arrangement in a timely manner by placing the
child in a living arrangement that is “permanent,”
that is, the child will remain in the living arrangement until
discharge from foster care?
|
Yes
|
No
|
Instructions:
Question
C is relevant for all cases that are applicable for an
assessment of item 10, including those in which the child’s
stated goal is emancipation/independence. Regardless of the
specifics of the goal, reviewers must establish that there were
agency efforts to ensure that a child who does not have a goal
of adoption, reunification, or guardianship has long-term
stability until he or she reaches adulthood.
Examples
of “permanent” living arrangements include
situations where foster parents have made a formal commitment to
care for the child until adulthood, the child is with relatives
who plan to care for the child until adulthood, the child is in
a long-term care facility to meet special needs and will be
transferred to an adult facility at the appropriate time, the
child is an older adolescent in a stable group home and both the
group home directors and the child have agreed that it will be
the child’s placement until adulthood, or the child is in
agency-supervised transitional living.
Provide
the following information for the child:
|
Date
of the child’s most recent entry into foster care (this is
the same date as in Section J on the Face Sheet):
|
|
Time
in care (in months) at the time of the onsite review (this is the
number of months that the child was in foster care from the date
of the most recent entry into foster care to the beginning of the
onsite review week or from the date of the most recent entry into
foster care to the time of discharge from foster care):
|
|
Date
of documentation regarding “permanency” of the
child’s living arrangements (this is the date that there
was a court order, signed agreement or other method to formalize
that the caretaker of a particular facility would provide care
for this child until the child reaches adulthood):
|
|
Date
of discharge from foster care (this is the same date as in
Section K on the Face Sheet; if the child was not discharged,
enter Not Applicable (NA)):
|
|
If
the child is not in a living arrangement that can be considered
permanent, were concerted efforts made during the period under
review to achieve this type of living arrangement for the child?
|
Yes
|
No
|
NA
|
Instructions:
In
answering question D, reviewers should consider the child’s
current living arrangement and whether formal steps were
completed to make this arrangement permanent. For example, if
the child is in a shelter or living with foster parents without
a formal permanent foster care agreement, then the answer to
question D would be No. A formal agreement would include a
signed agreement, a court order, or other method the State uses
to formalize the agreement.
Reviewers
should consider the efforts or actions taken during the period
under review to achieve a planned permanency arrangement other
than adoption, guardianship, or reunification with family. This
might include asking foster parents or relatives to agree to and
sign a long-term care commitment, etc.
If
the child is no longer in foster care, then the answer to
question D should be based on the child’s last placement
before leaving foster care.
|
Rating
Criteria:
Item
10 should be rated as a Strength if either of the following
applies:
The
answers to questions B, C, and D are Yes or Not Applicable.
The
answer to question B is Yes or Not Applicable, the answer to
question C is No, and the answer to question D is Yes.
Item
10 should be rated as an Area Needing Improvement if either of
the following applies:
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing
Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Please
provide below your main reason for rating this item as a
Strength, an Area Needing Improvement, or Not Applicable, and
provide documentation for the identified issues. If any issue is
Not Applicable to the case, enter NA in the appropriate space.
For each issue, indicate the source of your information (for
example, case file, interview with biological mother, interview
with caseworker, etc.).
Main
Reason
Item
10 is rated as _________________________________________ because:
Documentation
Information
If
not explained in the “reason for rating” section,
document the efforts made to achieve the child’s goal,
including the appropriateness and effectiveness of the efforts,
and barriers to achieving the goal:
If
the item is rated as a Strength even though the child is not in a
permanent placement (the answer to question D is Yes), document
the special circumstances that justify that rating:
Document
the services provided, or not provided, to adequately prepare the
child for independent living:
Other
Issues:
|
RATING PERMANENCY OUTCOME
1
|
PERMANENCY
OUTCOME 1: CHILDREN HAVE PERMANENCY AND STABILITY IN THEIR LIVING
SITUATIONS.
|
Select
the level of outcome achievement that best describes the extent
to which this outcome is being or has been achieved, based on the
ratings for items 5 through 10.
|
Level
of Outcome Achievement
|
|
Substantially
Achieved:
|
Permanency
Outcome 1 should be rated as Substantially Achieved if both of
the following apply:
Item
7 and the relevant permanency goal item (or items, if there are
concurrent goals) for this case are rated as Strengths. The
relevant permanency goal items are items 8, 9, and 10.
Either
item 5 or item 6 is rated as a Strength (the other may be rated
as an Area Needing Improvement or Not Applicable), or both are
rated Not Applicable.
|
|
Partially
Achieved:
|
Permanency
Outcome 1 should be rated as Partially Achieved if both of the
following apply:
The
criteria for Substantially Achieved do not apply.
At
least one of items 5, 6, 7, 8, 9, or 10 is rated as a Strength.
|
|
Not
Achieved:
|
Permanency
Outcome 1 should be rated as Not Achieved if the following
applies:
Items
5, 6, 7, 8, 9, and 10 are rated as either Areas Needing
Improvement or Not Applicable, but not all items are rated Not
Applicable.
|
|
Not
Applicable:
|
Permanency
Outcome 1 should be rated as Not Applicable if the following
applies:
Items
5, 6, 7, 8, 9, and 10 are rated as Not Applicable. (This would
only occur if the case is an in-home services case.)
|
THE
CONTINUITY OF FAMILY RELATIONSHIPS AND CONNECTIONS IS PRESERVED
FOR CHILDREN.
|
Item
11: Proximity of foster care placement (case file and interviews
with caseworker, parent(s), foster parent(s))
|
Purpose
of Assessment: To
determine whether, during the period under review, concerted
efforts were made to ensure that the child’s foster care
placement was close enough to the parent(s) to facilitate
face-to-face contact between the child and the parent(s) while
the child was in foster care.
|
Applicable
Cases: An
assessment of this item is applicable for all foster care cases
except those that meet the following criteria during the entire
period under review:
The
whereabouts of both parents is unknown despite documented
concerted agency efforts to locate them, and there are no other
family members who could potentially provide a permanent home
for the child. If there is no evidence that concerted efforts
were made to locate the parents, then the case is eligible for
assessment of item 11.
Parents
are deceased and there are no other close family members that
could potentially provide a permanent home for the child.
Parental
rights have been terminated and the parents are not involved in
case planning and there are no other close family members (for
example, grandmother, aunt, etc.) who could potentially provide
a permanent home for the child.
The
agency or the court has determined that continued contact
between the child and parents is not in the child’s best
interest and this is documented in the case file and there are
no other family members who could potentially provide a
permanent home for the child.
Parents
have a history of frequent moves that would make it difficult to
place the child in close proximity and there are no other family
members who could potentially provide a permanent home for the
child.
|
Is
this case applicable? (Select
the appropriate response. If the response is No, rate the item as
Not Applicable in the ratings section, provide your reason for
this rating in the documentation section, and continue to item
12.)
|
Yes
|
No
|
Is
the child’s current or most recent placement close enough
to his or her parents or other potential permanent caregiver to
facilitate frequent face-to-face contact between the child and
the parents while the child is (or was) in foster care?
|
Yes
|
No
|
Instructions:
Same
community
Different
community, but same county
Different
county, but same State
Different
State
If
placement is in the same community as the parents, the answer to
question A should be Yes.
If
placement is not in the same community, reviewers should
consider if the placement is sufficiently close to allow
frequent contact between the child and the parents. For example,
if placement is in another State, but is still very near where
the parents live, then the answer to question A should be Yes.
In contrast, if placement is in the same State or county, but is
actually quite a distance from the parents, then the answer to
question A would be No.
As
a general rule, reviewers should consider a travel distance of
less than 1 hour as close enough for face-to-face contact.
However, this is just a general guideline. Reviewers should
consider all relevant circumstances in determining whether the
location of the child’s placement allows parents to visit
the child on a frequent basis.
If
the child’s parents live separately, reviewers should
determine which parent is most involved in case planning and is
most likely to be reunified with the child. The answer to
question A then would be based on the location of that parent’s
residence.
|
If
the answer to question A is No, was the reason for the location
of the child’s current or most recent placement based on
the child’s needs and intended to ensure that the child’s
case plan goals are achieved?
|
Yes
|
No
|
NA
|
Instructions:
Reviewers
should check Not Applicable (NA) if the answer to question A is
Yes.
Reviewers
should determine if the placement decision was made in order to
achieve the child’s case goals or to meet the child’s
needs for specialized services (for example, to place with a
relative, to place in a potential adoptive home, to provide a
highly specialized treatment setting, etc.).
Question
B should be answered No if the only reason for not placing the
child in close proximity to the parents was a lack of existing
placement resources in the community, unless the resource is
such a highly specialized treatment facility that most
communities would not be expected to maintain one (for example,
a residential treatment program for sexual offenders).
|
Rating
Criteria
Item
11 should be rated as a Strength if either of the following
applies:
The
answer to question A is Yes, and the answer to question B is Not
Applicable.
The
answer to question A is No, and the answer to question B is Yes.
Item
11 should be rated as an Area Needing Improvement if the answers
to questions A and B are No.
|
Rating
for this Indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Please
provide below your main reason for rating this item as a
Strength, an Area Needing Improvement, or Not Applicable, and
provide documentation for each of the identified issues. If any
issue is Not Applicable to the case, enter NA in the appropriate
space. For each issue, indicate the source of your information
(for example, case file, interview with biological mother,
interview with caseworker, etc.).
Main
Reason
Item
11 is rated as ________________________________________ because:
Documentation
Information
Describe
the relationship between the child’s current or most recent
placement and the location of the parents or of a family member
with whom the child is likely to be reunified (for example, the
child will be reunified with a grandmother):
If
not explained in the “reason for rating” section, and
if the reviewers determine that the child’s placement is
not sufficiently close to the parent(s) to facilitate frequent
contact, document the reasons for this determination (and
identify any reasons provided by the agency):
Other
Issues:
|
PERMANENCY
OUTCOME 2: THE CONTINUITY OF FAMILY RELATIONSHIPS AND
CONNECTIONS IS PRESERVED FOR CHILDREN.
|
Item
12: Placement with siblings (case file and interviews with
caseworker, parent(s), foster parent(s), child)
|
Purpose
of Assessment: To
determine if, during the period under review, concerted efforts
were made to ensure that siblings in foster care are placed
together unless a separation was necessary to meet the needs of
one of the siblings.
|
Applicable
Cases: Cases
applicable for an assessment of this item include all foster care
cases in which the child has one or more siblings who are (or
were) also in foster care during the period under review. If the
child has no siblings in foster care during the period under
review, the case is not applicable for an assessment of this
item. For example, if the child in foster care has an older
sibling who was in foster care at one time, but not during the
period under review, this case would be Not Applicable.
|
Is
this case applicable? (Select
the appropriate response. If the response is No, rate the item as
Not Applicable in the ratings section, provide your reason for
the rating in the documentation section, and continue to item
13.)
|
Yes
|
No
|
A.
During the period under review, was the child placed with all
siblings who also were in foster care?
|
Yes
|
No
|
Definitions:
Siblings
are children who have one or more parents in common either
biologically, through adoption, or through the marriage of their
parents, and with whom the child lived before his or her foster
care placement, or with whom the child would be expected to live
if the child were not in foster care.
Instructions:
|
If
the answer to question A is No, was there a valid reason for the
child’s separation from the siblings (for example, the
separation was necessary to meet the needs of one of the
siblings, to address safety concerns for one or more of the
siblings, or to accommodate a large sibling group)?
|
Yes
|
No
|
NA
|
Instructions:
If
the answer to question A is Yes, the answer to question B should
be Not Applicable (NA).
Reviewers
should consider the circumstances of the placement of siblings,
focusing on whether separation was necessary to meet the child’s
needs. For example, were siblings separated temporarily because
one sibling needed a specialized treatment or to be in a
treatment foster home, or because one sibling was abusive to the
other, or because siblings with different fathers were placed
with paternal relatives?
If
the separation of siblings is attributed by the agency to a lack
of foster homes willing to take sibling groups, question B
should be answered No, unless the reviewer believes that the
size of the sibling group (i.e., five or more children) made
finding a single placement difficult and concerted efforts were
made to place the children in close proximity to each other.
If
siblings were separated for a valid reason, reviewers should
consider the entire period under review and determine if that
valid reason still exists and if the need for separation still
exists. For example, the siblings were separated because one
sibling needed temporary treatment services. However, during the
period under review, the sibling’s treatment services
ended. In this situation, reviewers should determine whether
concerted efforts were made to reunite the siblings after the
treatment service was completed. If the need for separation no
longer exists and no efforts have been made to reunite the
siblings, then the answer to question B should be No.
|
Rating
Criteria:
Item
12 should be rated as a Strength if either of the following
applies:
The
answer to question A is Yes.
The
answer to question A is No, but the answer to question B is Yes.
Item
12 should be rated as an Area Needing Improvement if the answers
to questions A and B are No.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Provide
below your main reason for rating this item as a Strength, an
Area Needing Improvement, or Not Applicable, and provide
documentation for the identified issues. If any issue is Not
Applicable to the case, enter NA in the appropriate space. For
each issue, indicate the source of your information (for
example, case file, interview with biological mother, interview
with caseworker, etc.).
|
Main
Reason
Item
12 is rated as ________________________________________
because:
Documentation
Information
Complete
the information in the chart below only if there are siblings
who were in foster care but were not placed with the target
child for some or all of the period under review.
Provide
the first name of siblings who are (or were) in foster care
during the period under review, identify their placements during
the period under review (for example, Smith foster home, Hope
Institution, Aunt Mary’s, etc.), and describe the reason
for separation of that sibling from the target child (if
applicable).
|
Sibling
First Name
|
Placement
Setting
|
Reason
for Separation
(if
applicable)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Other
Issues:
|
THE
CONTINUITY OF FAMILY RELATIONSHIPS AND CONNECTIONS IS PRESERVED
FOR CHILDREN.
|
Item
13: Visiting with parents and siblings in foster care (case file
and interviews with parent(s), child, caseworker, foster
parent(s), service providers)
|
Purpose
of Assessment: To
determine if, during the period under review, concerted efforts
were made to ensure that visitation between a child in foster
care and his or her mother, father, and siblings is of sufficient
frequency and quality to promote continuity in the child’s
relationship with these close family members.
|
Applicable
Cases: Foster
care cases are applicable for an assessment of this item if any
of the following apply:
The
child has at least one sibling in foster care who is in a
different placement setting.
The
whereabouts of the child’s parents is known and there is
no documented information in the case file indicating that
contact between the child and the parent is not in the child’s
best interest.
Cases
are not applicable for assessment if any of the following apply:
The
child has no siblings in foster care, and there is documentation
in the case file indicating that contact between the child and
both
of
his or her parents is not in the child’s best interest.
The
child has no siblings in foster care, and the whereabouts of
both parents is unknown despite documented concerted agency
efforts to locate the parents.
The
child has no siblings in foster care, both parents were deceased
during the entire period under review or the parental rights of
both parents have been terminated during the entire period under
review, and no parent is involved in the child’s life.
|
Is
this case applicable? (Select
the appropriate response. If the response is No, rate the case as
Not Applicable in the ratings section, provide your reason for
the rating in the documentation section, and continue to item
14.)
|
Yes
|
No
|
During
the period under review, were concerted efforts made to ensure
that visitation (or other forms of contact if visitation was not
possible) between the child and his or her mother was of
sufficient frequency to maintain or promote the continuity of
the relationship?
|
Yes
|
No
|
NA
|
Check
the box next to the statement that best describes the usual
frequency of visits between the mother and the child:
More
than once a week
Once
a week
Less
than once a week, but at least twice a month
Less
than twice a month, but at least once a month
Less
than once a month
Never
|
During
the period under review, were concerted efforts made to ensure
that visitation (or other forms of contact if visitation was not
possible) between the child and his or her father was of
sufficient frequency to maintain or promote the continuity of
the relationship?
|
Yes
|
No
|
NA
|
Check
the box next to the statement that best describes the usual
frequency of visits between the father and the child:
More
than once a week
Once
a week
Less
than once a week, but at least twice a month
Less
than twice a month, but at least once a month
Less
than once a month
Never
|
Instructions:
Reviewers
should answer Not Applicable (NA) if (1) contact between the
child and the mother/father was not in the child’s best
interest and this was documented in the case file or court
order, (2) the whereabouts of the mother/father was not known
during the entire period under review, despite documented
concerted efforts to locate her/him, (3) the mother’s/father’s
parental rights were terminated before the period under review
and she/he is not involved in the child’s life, or (4) the
mother/father was deceased during the entire period under
review.
Reviewers
should determine whether the frequency of visitation during the
period under review was sufficient to maintain the continuity of
the relationship between the child and the parent, depending on
the circumstances of the case. For example, frequency may need
to be greater for infants and young children than for some older
children. Frequency also may need to be greater if reunification
is imminent.
If,
during the period under review, frequent visitation with a
parent was not possible (for example, due to incarceration or
the parent being in another State), reviewers should determine
whether there are documented concerted efforts to promote other
forms of contact between the child and the parent, such as
telephone calls or letters in addition to facilitating visits
when possible and appropriate.
Reviewers
should address the question of appropriate frequency based on
the circumstances of the child and the family, rather than on
State policy.
|
During
the period under review, were concerted efforts made to ensure
that the quality of visitation between the child and the mother
was sufficient to maintain or promote the continuity of the
relationship?
|
Yes
|
No
|
NA
|
During
the period under review, were concerted efforts made to ensure
that the quality of visitation between the child and the father
was sufficient to maintain or promote the continuity of the
relationship?
|
Yes
|
No
|
NA
|
Instruction:
Same
as for questions A and B except that reviewers should determine
if concerted efforts were made to ensure that the quality of
parent-child visitation was sufficient to maintain the
continuity of the relationship. For example, did visits take
place in a comfortable atmosphere and were they of an
appropriate length? Did visitation allow for sufficient
interaction between parent and child? If siblings were involved,
did visits allow parents to interact with each child
individually? If appropriate, were unsupervised visits and
visits in the parent’s home in preparation for
reunification allowed?
|
During
the period under review, were concerted efforts made to ensure
that visitation (or other forms of contact if visitation was not
possible) between the child and his or her sibling(s) was of
sufficient frequency
to maintain or promote the continuity of the relationship?
|
Yes
|
No
|
NA
|
Check
the box next to the statement that best describes the usual
frequency of visits between the siblings and the child:
More
than once a week
Once
a week
Less
than once a week, but at least twice a month
Less
than twice a month, but at least once a month
Less
than once a month
Never
|
Instructions:
Reviewers
should answer Not Applicable (NA) if the child has no siblings
in foster care or if contact with all siblings who are in foster
care is not considered to be in the best interests of the child
(for example, one sibling is a physical threat to the other
sibling or has a history of physical or sexual abuse of the
other sibling).
Reviewers
should consider whether the frequency of visits during the
period under review was sufficient to maintain the continuity of
the sibling relationships.
|
During
the period under review, were concerted efforts made to ensure
that the quality
of visitation between the child and his or her sibling(s) was
sufficient to promote the continuity of their relationships?
|
Yes
|
No
|
NA
|
Instruction:
Same
as for question E, except reviewers should determine if
concerted efforts were made to ensure that the quality of
sibling visitation was sufficient to maintain the continuity of
the relationship. For example, were visits long enough to
permit quality interaction? Did sibling contacts only occur in
the context of parent visitations? Did visits occur in a
comfortable atmosphere?
|
Rating
Criteria:
Item
13 should be rated as a Strength if the answers to all of
questions A through F are either Yes or Not Applicable.
Item
13 should be rated as an Area Needing Improvement if the answer
to any one of questions A through F is No.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Provide
below your main reason for rating this item as a Strength, an
Area Needing Improvement, or Not Applicable, and provide
documentation for the identified issues. If any issue is Not
Applicable to the case, enter NA in the appropriate space. For
each issue, indicate the source of your information (for
example, case file, interview with biological mother, interview
with caseworker, etc.).
|
Main
Reason
Item
13 is rated as________________________________________ because:
Documentation
Information
For
each applicable relationship, document concerted efforts (for
example, establishing written visitation plans, providing or
arranging for transportation, encouraging visits, arranging for
flexible hours or meeting locations), or lack of efforts to
promote frequent visitation. If visitation was not possible or
limited by circumstance (for example, parents are out of State
or incarcerated), document efforts or lack of efforts to promote
contact through telephone or mail. If any relationship is
identified as Not Applicable, document the reason why it was
determined by the reviewers to be Not Applicable.
Mother:
Father:
Sibling(s):
Other
Issues:
|
THE
CONTINUITY OF FAMILY RELATIONSHIPS AND CONNECTIONS IS PRESERVED
FOR CHILDREN.
|
Item
14: Preserving connections (interviews with caseworker,
parent(s), foster parent(s), child)
|
Purpose
of Assessment: To
determine whether, during the period under review, concerted
efforts were made to maintain the child’s connections to
his or her neighborhood, community, faith, extended family,
tribe, school, and friends.
|
Applicable
Cases: Almost
all foster care cases are applicable for an assessment of this
item. A possible exception may be the situation of an abandoned
infant where the agency has no information about the child’s
extended family or connections.
|
Is
this case applicable? (Select
the appropriate response. If the response is No, rate the item as
Not Applicable in the ratings section, provide your reason for
the rating in the documentation section, and continue to item
15.)
|
Yes
|
No
|
During
the period under review, were concerted efforts made to maintain
the child’s important connections (for example,
neighborhood, community, faith, language, extended family
members including siblings who are not in foster care, school,
tribe, and/or friends)?
|
Yes
|
No
|
Instructions:
Reviewers
must determine what the important connections are for the child
(for example, a young child is more likely to have an important
connection with extended family than with school, and it is
important for Native American children to maintain tribal
connections) and then determine whether concerted efforts were
made to maintain those connections.
Reviewers
should not rate this item based on connections to parents or
siblings who are in foster care. Information about sustaining
those connections is captured in other items. However, the item
may be rated based on connections with siblings who are not in
foster care and other extended family members (who were not the
child’s primary caregivers before entry into foster care),
such as grandparents, uncles, aunts, cousins, etc.
|
Was
a sufficient inquiry conducted with the parent, child,
custodian, or other interested party to determine whether the
child may be a member of, or eligible for membership in, an
Indian tribe?
|
Yes
|
No
|
NA
|
Instructions:
If
there is no evidence found in the case file or through
interviews that the child is a member of, or eligible for
membership in, an Indian tribe, then the answer to question B is
Not Applicable (NA).
If
there is no information in the case file that indicates the
child is a member of, or eligible for membership in, an Indian
tribe, but the reviewers learn through interviews that the child
has Native American heritage and no apparent efforts were made
to determine this, then the answer to question B is No.
If
the child entered foster care during the period under review,
reviewers should determine whether timely and appropriate action
was taken to determine whether the child is a member of, or
eligible for membership in, an Indian tribe. This may include
exploring this with the parents and/or other persons with a
relationship to the child, contacting tribes, and contacting the
Bureau of Indian Affairs.
If
the child entered foster care before the period under review,
the answer to question B can be Yes if by the beginning of the
period under review an informed determination was made about the
child’s membership, or eligibility for membership, in an
Indian tribe and all appropriate steps were taken to determine
whether the child is Native American.
|
If
the child may be a member of, or eligible for membership in, an
Indian tribe, during the period under review, was the tribe
provided timely notification of its right to intervene in any
State court proceedings seeking an involuntary foster care
placement or termination of parental rights (TPR)?
|
Yes
|
No
|
NA
|
Instructions:
If
the child is not a member of, or eligible for membership in, an
Indian tribe, the answer to question C is Not Applicable.
If
the child entered care during the period under review or had a
TPR hearing during the period under review, reviewers should
determine if timely notice was provided to the tribe. Timely
notice is notice that was received no later than 10 days before
the proceeding. If timely notice was not provided, the answer to
question C is No.
If
the child entered care before the period under review and did
not have a TPR hearing during the period under review, the
answer to question C is Yes, if, by the beginning of the period
under review, all appropriate steps were taken to notify the
tribe.
|
If
the child is a member of, or eligible for membership in, an
Indian tribe, was the child placed in foster care in accordance
with the Indian Child Welfare Act (ICWA) placement preferences
or were concerted efforts made to place the child in accordance
with ICWA placement
preferences?
|
Yes
|
No
|
NA
|
Instructions:
If
the child is not Native American, then the answer to question D
is Not Applicable (NA).
Reviewers
should determine whether, during the period under review, the
child was placed (1) with a member of the child’s extended
family, (2) in a foster home licensed, approved, or specified by
the Native American child’s tribe, (3) in another Native
American foster home placement, or (4) in an institution
approved by a tribe or operated by a Native American
organization. Placement preference is in this order unless
another order is specified by tribal resolution.
If
the child’s placement was not made in accordance with ICWA
placement preferences, reviewers should determine if, during the
period under review, there were documented concerted efforts to
meet the ICWA placement preferences.
|
Rating
Criteria:
Item
14 should be rated as a Strength if the answer to question A is
Yes and the answers to questions C and D are either Yes or Not
Applicable.
Item
14 should be rated as an Area Needing Improvement if either of
the following applies:
The
answer to question A is Yes, but the answer to any one of
question C and/or D is No.
The
answer to question A is No, regardless of the answers to
questions B, C, and D.
The
answer to question B is not considered in rating this item.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Provide
below your main reason for rating this item as a Strength, an
Area Needing Improvement, or Not Applicable, and provide
documentation for the identified issues. If any issue is Not
Applicable to the case, enter NA in the appropriate space. For
each issue, indicate the source of your information (for example,
case file, interview with biological mother, interview with
caseworker, etc.).
Main
Reason
Item
14 is rated as________________________________________ because:
Documentation
Information
Document
the child’s important connections and how the child’s
placement does or does not promote maintaining these important
connections.
Document
agency efforts or lack of efforts to help children maintain
important connections when these are not being maintained through
the placement itself:
Other
issues:
|
PERMANENCY
OUTCOME 2: THE CONTINUITY OF FAMILY RELATIONSHIPS AND CONNECTIONS
IS PRESERVED FOR CHILDREN.
|
Item
15: Relative placement (case file and interviews with caseworker,
child’s caregiver, parent(s), child)
|
Purpose
of Assessment: To
determine whether, during the period under review, concerted
efforts were made to place the child with relatives when
appropriate.
|
Applicable
Cases: All
foster care cases except those in which (1) the agency determined
upon the child’s initial entry into care that his or her
needs required a specialized placement (such as residential
treatment services) and will continue to require such specialized
treatment the entire time the child is in care and a relative
placement would be inappropriate, or (2) situations such as
abandonment in which the identity of the parents and relatives
remains unknown despite documented concerted efforts to identify
them.
|
Is
this case applicable? (Select
the appropriate response. If the response is No, rate the case as
Not Applicable in the ratings section, provide your reason for
this rating in the documentation section, and continue to item
16.)
|
Yes
|
No
|
During
the period under review, was the child’s current or most
recent placement with a relative?
|
Yes
|
No
|
If
the answer to question A1 is Yes, is (or was) this placement
stable and appropriate to the child’s needs?
|
Yes
|
No
|
NA
|
Instructions:
If
the answer to question A1 is No, the answer to question A2
should be Not Applicable (NA).
If
the answer to question A2 is Yes, reviewers may rate the item as
a Strength, and answer Not Applicable (NA) to the remaining
questions for the item.
If
the answer to question A2 is No, reviewers should answer the
remaining questions for this item.
|
If
the answer to either question A1 or A2 is No, did the agency,
during the period under review, make concerted efforts to
identify, locate, and evaluate maternal relatives as potential
placements for the child, with the result that maternal
relatives were ruled out as, or were unwilling to be, placement
resources?
|
Yes
|
No
|
NA
|
If
the answer to either question A1 or A2 is No, did the agency,
during the period under review, make concerted efforts to
identify, locate, and evaluate paternal relatives as potential
placements for the child, with the result that paternal
relatives were ruled out as, or were unwilling to be, placement
resources?
|
Yes
|
No
|
NA
|
Instructions:
The
answers to question B and C should be Not Applicable (NA) if the
answers to both questions A1 and A2 are Yes.
If
a child entered foster care during the period under review,
reviewers must determine if the State followed the requirements
of the
title
IV-E provision that requires States to consider giving
preference to placing the child with relatives, and determine
whether the State considered such a placement and how (for
example, identifying, seeking out, and evaluating the child’s
relatives).
If
a child entered foster care before the period under review and
the answer to either question A1 or A2 is No, reviewers must
determine whether, during the period under review, the agency
made concerted efforts to search for and assess relatives as
placement resources, if appropriate. If reviewers determine
that, during the period under review, the agency did not
consider relatives as placement resources in cases in which
consideration was appropriate, the answer to question B should
be No.
|
Rating
Criteria:
Item
15 should be rated as a Strength if either of the following
applies:
The
answers to both questions A1 and A2 are Yes.
The
answer to either question A1 or A2 is No, but the answers to
questions B and C are Yes or Not Applicable.
Item
15 should be rated as an Area Needing Improvement if both of the
following apply:
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Provide
your main reason for rating this item as a Strength, an Area
Needing Improvement, or Not Applicable, and provide documentation
for the identified issues. If any issue is Not Applicable to the
case, enter NA in the appropriate space. For each issue, indicate
the source of your information (for example, case file, interview
with biological mother, interview with caseworker, etc.).
Main
Reason
Item
15 is rated as ________________________________________ because:
Documentation
Information
If
the child is placed with a relative, identify the relationship of
that relative to the child and provide details of the placement;
for example, appropriateness, how long the child has been in that
placement, etc.:
Document
agency efforts or lack of efforts to locate and evaluate maternal
relatives (including reasons why relatives were not considered as
placement resources, if relevant) if appropriate, during the
period under review:
Document
agency efforts or lack of efforts to locate and evaluate paternal
relatives (including reasons why relatives were not considered as
placement resources, if relevant) if appropriate, during the
period under review:
Other
Issues:
|
THE
CONTINUITY OF FAMILY RELATIONSHIPS AND CONNECTIONS IS PRESERVED
FOR CHILDREN.
|
Item
16: Relationship of child in care with parents (interviews with
child, parent(s), foster parent(s), service providers)
|
Purpose
of Assessment: To
determine whether, during the period under review, concerted
efforts were made to promote, support, and/or maintain positive
relationships between the child in foster care and his or her
mother and father or other primary caregiver(s) from whom the
child had been removed through activities other than just
arranging for visitation.
|
Applicable
Cases: All
foster care cases are applicable for assessment of this item
unless (1) the parental rights for both parents were terminated
before the period under review and neither parent made efforts to
be involved in the child’s life or in ongoing planning for
the child during the period under review; (2) the child was
abandoned and neither parent could be located; (3) the
whereabouts of both parents was not known during the entire
period under review despite documented concerted agency efforts
to locate both parents; (4) contact with both parents was
considered to be not in the best interests of the child (for
example, both parents are abusive and there is concern about
managing contact with the child); or (5) the child was initially
removed from a parent’s home, but, during the entire period
under review, both parents were deceased.
|
Is
this case applicable? (Select
the appropriate response. If the response is No, rate the item as
Not Applicable in the ratings section, provide the reason for
your rating in the documentation section, and continue to the
section on rating Permanency Outcome 2.)
|
Yes
|
No
|
A. During
the period under review, were concerted efforts made to promote,
support, and otherwise maintain a positive and nurturing
relationship between the child in foster care and his or her
mother?
|
Yes
|
No
|
NA
|
B. During
the period under review, were concerted efforts made to promote,
support, and otherwise maintain a positive and nurturing
relationship between the child in foster care and his or her
father?
|
Yes
|
No
|
NA
|
Instructions:
The
applicable question A or B should be answered Not Applicable
(NA) if (1) the parent’s parental rights were terminated
before the period under review and the parent was not involved
in planning for the child, (2) the parent’s whereabouts
was not known during the entire period under review despite
efforts to locate her/him, (3) contact between the child and the
parent was considered to be not in the child’s best
interest, or (4) the parent was deceased during the entire
period under review.
Foster
parents’ activities are considered for purposes of this
question. For example, if the foster parent provided
transportation to the parent so that the parent could attend the
child’s school event or medical appointment, that would be
considered as contributing towards concerted efforts.
Reviewers
should determine whether concerted efforts were made to support
or strengthen the parent-child relationship. For example, did
the agency (select all that apply):
Encourage
the parent’s participation in school activities and case
conferences, attendance at doctors’ appointments with the
child, or engagement in the child’s after school or sports
activities?
Provide
or arrange for transportation or provide funds for
transportation so that the parent could attend the child’s
special activities and doctors’ appointments?
Provide
opportunities for therapeutic situations to help the parent and
child strengthen their relationship?
Encourage
the foster parents to provide mentoring or serve as role models
to the parent to assist her/him in appropriate parenting?
Encourage
and facilitate contact with incarcerated parents (where
appropriate) or with parents not living in close proximity to
the child?
Reviewers
should
not
answer
this question based on efforts (or lack of efforts) to ensure
the frequency or quality of visitation between the parent and
the child. That information is captured under item 13. This
question pertains to additional activities to help support,
strengthen, or maintain the parent-child relationship.
|
Rating
Criteria:
Item
16 should be rated as a Strength if the answer(s) to question(s)
A and B are Yes or Not Applicable.
Item
16 should be rated as an Area Needing Improvement if the answer
to either question A or B is No.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Provide
below your main reason for rating this item as a Strength, an
Area Needing Improvement, or Not Applicable, and provide
documentation for the identified issues below. If any issue is
Not Applicable to the case, enter NA in the appropriate space.
For each issue, indicate the source of your information (for
example, case file, interview with biological mother, interview
with caseworker, etc.).
Main
Reason
Item
16 is rated as ________________________________________because:
Documentation
Information
If
not explained in the “reason for rating” section,
document efforts or lack of efforts to support or maintain a
positive mother-child relationship. (The focus should be on
activities such as the ones listed in the instructions, rather
than on visitation). Foster parent activities may be considered
equivalent to “agency” activities in responding to
this question:
If
not explained in the “reason for rating” section,
document efforts or lack of efforts to support or maintain a
positive father-child relationship. (The focus should be on
activities such as the ones listed in the instructions, rather
than on visitation.) Foster parent activities may be considered
equivalent to “agency” activities in responding to
this question:
Other
Issues:
|
RATING PERMANENCY OUTCOME
2
|
PERMANENCY
OUTCOME 2: THE CONTINUITY OF FAMILY RELATIONSHIPS AND CONNECTIONS
IS PRESERVED FOR CHILDREN.
|
Check
the level of outcome achievement that best describes the extent
to which this outcome is being or has been achieved, based on the
ratings for items 11 through 16.
|
Level
of Outcome Achievement
|
|
Substantially
Achieved:
|
Permanency
Outcome 2 should be rated as Substantially Achieved if both of
the following apply:
|
|
Partially
Achieved:
|
Permanency
Outcome 2 should be rated as Partially Achieved if both of the
following apply:
At
least two items, but fewer than all six items, are rated as an
Area Needing Improvement.
At
least one item is rated as a Strength.
|
|
Not
Achieved:
|
Permanency
Outcome 2 should be rated as Not Achieved if both of the
following apply:
|
|
Not
Applicable:
|
Permanency
Outcome 2 should be rated as Not Applicable if the following
applies:
|
SECTION
III: CHILD AND FAMILY WELL-BEING
|
FAMILIES
HAVE ENHANCED CAPACITY TO PROVIDE FOR THEIR CHILDREN’S
NEEDS.
|
Needs
and services of child, parents, and foster parents (case file
and interviews with caseworker, child, parent(s), foster
parent(s), service providers, guardian ad litem)
|
Purpose
of Assessment: To
determine whether, during the period under review, the agency
made concerted efforts to assess the needs of children, parents,
and foster parents (both at the child’s entry into foster
care [if the child entered during the period under review] or on
an ongoing basis) to identify the services necessary to achieve
case goals and adequately address the issues relevant to the
agency’s involvement with the family, and provided the
appropriate services.
|
Applicable
Cases: All
cases are applicable for an assessment of this item.
|
Special
Instructions:
Item
17 is divided into three sections: 17A: Needs assessment and
services to children, 17B: Needs assessment and services to
parents, and 17C: Needs assessment and services to foster
parents.
For
each section, answer the relevant questions and provide a rating
of Strength or Area Needing Improvement and a reason for the
rating. If a particular section is Not Applicable for the case,
rate that section as Not Applicable.
When
each section is completed, provide an overall rating for item
17, and the key reasons for the rating. Keep in mind that for
the overall item rating to be a Strength, all three sections
must be rated as a Strength or Not Applicable.
Special
Definitions:
For
in-home services cases, “parents” are defined as the
children’s primary caregivers with whom the children live
(for example, biological parents, relatives, guardians, adopted
parents, etc.) or a noncustodial parent who is involved, or has
indicated a desire to be involved, in the child’s life.
For
foster care cases, “parents” include the child’s
parents, or the child’s primary caregivers (if other than
the biological parents) from whom the child was removed.
“Parents” include adoptive parents if the adoption
has been finalized.
Foster
parents are defined as related or non-related caregivers who
have been given responsibility for care of the child by the
agency while the child is under the care and placement
responsibility and supervision of the agency. This includes
pre-adoptive parents if the adoption has not been finalized.
|
Section
17A: Needs Assessment and Services to Children
|
During
the period under review, did the agency conduct (1) a formal or
informal initial comprehensive assessment of the child(ren)’s
needs (if the case was opened during the period under review),
or (2) an ongoing assessment to provide updated information
regarding the child(ren)’s needs for case planning
purposes (if the case was opened before the period under
review)?
|
Yes
|
No
|
Instructions:
Assessment
of needs may take different forms. For example, needs may be
assessed through a formal evaluation conducted by another agency
or by a contracted provider or through a more informal case
planning process involving intensive interviews with the child,
family, service providers, etc.
Reviewers
are to answer question A1 based on a determination of whether
the agency made concerted efforts to achieve an in-depth
understanding of the needs of the child and family, regardless
of whether the needs were assessed in a formal or informal
manner. Consequently, the evaluation of the assessment should
focus on its adequacy in addition to whether one was conducted
or not.
Reviewers
are to consider whether there were safety concerns pertaining to
the child(ren), other than those identified in item 4 that could
be reasonably expected to escalate to an immediate safety issue
without intervention.
In
answering this question, reviewers should consider whether the
agency conducted an adequate assessment of the child’s
needs with regard to appropriate placement.
Reviewers
are to answer this question with regard to an assessment of
needs other than those related to the child’s education,
physical health, and mental/behavioral health (including
substance abuse). The assessment of the child’s needs
related to these issues is addressed in later items.
If
the case is a foster care case, reviewers are to determine only
whether the agency assessed the needs of the target child in the
case, even if there are other children in the family in foster
care or in the home.
|
Instructions
(continued):
If
the case is a foster care case, and the child is an adolescent,
reviewers should determine whether the child’s needs for
independent living services are being assessed on an ongoing
basis as part of the child’s independent living plan.
However, if the child is an adolescent and has a permanency plan
goal of other planned permanent living arrangement, the reviewer
is not to focus on independent living services assessments for
item 17 because this was reviewed under item 10.
|
During
the period under review, were appropriate services provided to
meet the child’s identified needs?
|
Yes
|
No
|
NA
|
Instructions:
If
the answer to question A1 is Yes, but the result of the
assessment was that no service needs were identified other than
those related to education, physical health, and
mental/behavioral health (including substance abuse), and
therefore no services were provided other than services to
address those needs, the answer to question A2 should be Not
Applicable (NA).
Reviewers
should focus on the agency’s provision of services during
the period under review. If services were provided before the
period under review, and an assessment conducted during the
period under review indicated no further service needs, then the
answer to question A2 should be Not Applicable (NA).
Reviewers
are to answer this question with regard to provision of services
other than those related to education, physical health, or
mental/behavioral health (including substance abuse). The
assessment of service provision related to these issues is
addressed in later items.
Reviewers
should determine whether the services provided matched
identified needs. For example, were the services provided simply
because those were the services available or were they provided
because the assessment revealed a particular need for a
particular type of service?
If
the case is an in-home services case, reviewers are to consider
whether the agency met the service needs of all children in the
family, even if only one child was the subject of the
maltreatment report.
If
the case is a foster care case, reviewers are to determine only
whether the agency met the service needs of the target child in
the case, even if there are other children in the family in
foster care or in the home.
If
the case is a foster care case, and the child is an adolescent
but does not have a permanency plan of other planned permanent
living arrangement, reviewers should determine whether the
agency met the service needs relevant to independent living.
Examples
of services that are assessed under this item include child care
services that are not required for the child’s safety
(those services would be covered under item 4), mentoring
programs that are not related to the child’s education,
recreational services, teen parenting education, preparation for
adoption and other permanency goals, services that address
family relationships that are not mental health in nature (for
example, services to assist children in reestablishing or
maintaining family ties), and services to assist the child that
are recommended by a therapist or other provider but are not
mental-health related (such as enrollment in an activity to
assist with social skills or to boost self-esteem), etc.
|
Rating
Criteria:
Section
17A should be rated as a Strength if either of the following
applies:
The
answers to both questions A1 and A2 are Yes.
The
answer to question A1 is Yes, and the answer to question A2 is
Not Applicable.
Section
17A should be rated as an Area Needing Improvement if the answer
to either question A1 or A2 is No.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
Reason
for Rating and Documentation
Provide
below your main reason for rating this item as a Strength or an
Area Needing Improvement, and provide documentation for the
identified issues that are relevant to this case. If any issue is
Not Applicable to the case, enter Not Applicable (NA) in the
appropriate space. For each issue, indicate the source of your
information (for example, case file, interview with biological
mother, interview with caseworker, etc.).
Main
Reason
Section
17A is rated as ____________________________________________
because:
|
Documentation
Information
Document
the method that the agency used to assess the child’s needs:
Document
the needs of the child(ren) identified by the agency:
Document
the needs that were present but were not identified by the agency:
Document
the services provided to the child(ren):
Document
the services that were needed but not provided:
Other
Issues:
|
Section
17B: Needs Assessment and Services to Parents
|
B1.
During the period under review, did the agency conduct (1) a
formal or informal initial
comprehensive assessment of the
mother’s needs (if the case was opened during the period
under
review) or (2) an ongoing assessment to provide
updated information regarding the mother’s needs
for
case planning purposes (if the case was opened before the period
under review)?
|
Yes
|
No
|
NA
|
B2.
During the period under review, did the agency conduct (1) a
formal or informal initial
comprehensive assessment of the
father’s needs (if the case was opened during the period
under
review) or (2) an ongoing assessment to provide
updated information regarding the father’s needs for
case planning purposes (if the case was opened before the period
under review)?
|
Yes
|
No
|
NA
|
Instructions:
The
applicable question B1 or B2 should be answered Not Applicable
(NA) if (1) the parent’s parental rights were terminated
before the period under review, (2) the parent’s
whereabouts was not known during the entire period under review
despite agency efforts to locate her or him, or (3) the parent
was deceased during the entire period under review.
Reviewers
are to determine whether the agency has made concerted efforts
to ensure that case planning is based on an in-depth
understanding of the needs of the child and parent, regardless
of whether the needs were assessed in a formal or informal
manner. (Assessment of needs may take different forms. For
example, needs may be assessed through a formal psychosocial
evaluation conducted by another agency or by a contracted
provider or through a more informal case planning process
involving intensive interviews with the child, family, service
providers, etc.)
Assessment
of parents’ needs refers to a determination of what
parents need to provide appropriate care and supervision to
ensure the safety and well-being of their children.
Assessment
of parents’ needs may include mental and physical health
needs, as later items do not address these concerns for the
parents.
If
the case was opened during the period under review, reviewers
should focus on whether the agency conducted an initial
comprehensive assessment as a basis for developing a case plan,
and whether ongoing assessment was conducted as appropriate.
If
the case was opened before the period under review, reviewers
should focus on whether the agency conducted periodic
comprehensive needs assessments (as appropriate) during the
period under review to update information relevant to ongoing
case planning.
If
the child is in an adoptive home (the adoption has been
finalized), reviewers should consider the adoptive parents as
the parents.
|
B3.
During the period under review, did the agency provide
appropriate services to the mother to meet
identified
needs (with respect to services the mother needs in order to
provide appropriate care and
supervision to ensure the
safety and well-being of her children)?
|
Yes
|
No
|
NA
|
B4.
During the period under review, did the agency provide
appropriate services to the father to address
identified
needs (with respect to services the father needs in order to
provide appropriate care and
supervision to ensure the
safety and well-being of his children)?
|
Yes
|
No
|
NA
|
Instructions:
Follow
the instructions for questions B1 and B2.
If
an assessment was conducted but no service needs were
identified, this question can be answered Not Applicable (NA).
Appropriate
services are those that enhance the parents’ ability to
provide care and supervision to their children and ensure the
child(ren)’s safety and well-being; for example, substance
abuse treatment, parenting skills classes, safety-related
services not included in item 4, etc.
|
Rating
Criteria:
Section
17B should be rated as a Strength if either of the following
applies:
The
answers to all four questions are Yes.
The
answer to at least one question is Yes, and the answers to the
others are Not Applicable.
Section
17B should be rated as an Area Needing Improvement if the answer
to any one of the four questions is No.
Section
17B should be rated as Not Applicable if the answers to all four
questions are Not Applicable.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Provide
below your main reason for rating this item as a Strength, an
Area Needing Improvement, or Not Applicable, and provide
documentation for the identified issues. If any issue is Not
Applicable to the case, enter Not Applicable (NA) in the
appropriate space. For each issue, indicate the source of your
information (for example, case file, interview with biological
mother, interview with caseworker, etc.).
Main
Reason
Section
17B is rated as ____________________________________________
because:
Documentation
Information
If
the assessment of the mother’s needs is determined to be
not applicable, indicate reason:
If
the assessment of the father’s needs is determined to be
not applicable, indicate reason:
Document
the mother’s needs identified by the agency:
Document
the mother’s needs that were not identified by the agency:
|
Document
the services that were provided to the mother:
|
Document
the services that the mother needed but that were not provided:
|
Document
the father’s needs identified by the agency:
|
Document
the father’s needs that were not identified by the agency:
|
Document
the services provided to the father:
|
Document
the services that the father needed, but that were not provided:
|
Other
Issues:
|
Section
17C: Needs Assessment and Services to Foster Parents
|
During
the period under review, did the agency conduct an assessment of
the needs of the foster or pre-adoptive parents on an ongoing
basis (with respect to services they need in order to provide
appropriate care and supervision to ensure the safety and
well-being of the children in their care)?
|
Yes
|
No
|
NA
|
During
the period under review, were the foster or pre-adoptive parents
provided with appropriate services to address identified needs
that pertained to their capacity to provide appropriate care and
supervision and ensure the safety and well-being of the children
in their care?
|
Yes
|
No
|
NA
|
Definitions:
Instructions:
Reviewers
should select Not Applicable (NA) for both questions C1 and C2
if the case is not a foster care case or if, during the entire
period under review, the child was in out-of-home care in a
residential facility or similar placement, but does not have
foster parents.
The
answer to question C2 should be Not Applicable (NA) if needs
were assessed but none were identified.
Reviewers
should determine whether an assessment was conducted to identify
what the foster parents needed to enhance their capacity to
provide appropriate care and supervision to the children in
their home, including needs for respite care, assistance with
transportation needs, counseling to address the child’s
behavior problems, etc.
Reviewers
should determine whether assessment of foster parent needs is
done on an ongoing basis. If there is no evidence in the case
file that the agency assessed the needs of the foster parents at
any time during the period under review, and the foster parents
(if available for interview) indicate that they have not been
assessed, then the answer to question C1 should be No.
|
Rating
Criteria for Section 17C:
Section
17C should be rated as a Strength if either of the following
applies:
The
answers to both questions C1 and C2 are Yes.
The
answer to question C1 is Yes, and the answer to question C2 is
Not Applicable.
Section
17C should be rated as an Area Needing Improvement if the answer
to either question C1 or C2 is No.
Section
17C should be rated as Not Applicable if the answers to questions
C1 and C2 are Not Applicable.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Provide
below your main reason for rating this item as a Strength, an
Area Needing Improvement or Not Applicable, and provide
documentation for the identified issues. If any issue is Not
Applicable to the case, enter NA in the appropriate space. For
each issue, indicate the source of your information (for example,
case file, interview with biological mother, interview with
caseworker, etc.).
Main
Reason
Section
17C is rated as _______________________________________________
because:
|
Documentation
Information
Document
the foster parent(s)’ needs identified by the agency:
Document
the foster parents’ needs that were not identified by the
agency:
Document
the services provided to the foster parent(s):
Document
the services that the foster parent(s) needed but that were not
provided:
Other
Issues:
|
Rating
Criteria for Item 17:
Item
17 should be rated as a Strength if sections A, B, and C are all
rated as a Strength or Not Applicable.
Item
17 should be rated as an Area Needing Improvement if any one of
sections A, B, or C is rated as an Area Needing Improvement.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
Reason
for Rating and Documentation
Provide
below your main reason for rating this item as a Strength, an
Area Needing Improvement, or Not Applicable and provide
documentation for the identified issues. If any issue is Not
Applicable to the case, enter NA in the appropriate space. For
each issue, indicate the source of your information (for example,
case file, interview with biological mother, interview with
caseworker, etc.).
Main
Reason
Item
17 is rated as ______________________________________________
because:
(Note:
The reviewers’ reason should address information pertaining
to the child, mother, father, and foster parents.)
|
FAMILIES
HAVE ENHANCED CAPACITY TO PROVIDE FOR THEIR CHILDREN’S
NEEDS.
|
Child
and family involvement in case planning (case file and
interviews with caseworker, parent(s), child, foster parent(s),
service providers)
|
Purpose
of Assessment: To
determine whether, during the period under review, concerted
efforts were made (or are being made) to involve parents and
children (if developmentally appropriate) in the case planning
process on an ongoing basis.
|
Applicable
Cases: All
cases are applicable for an assessment of this item except for
the following:
Foster
care cases involving a child for whom participating in planning
is not developmentally appropriate, and whose parents or
relatives cannot be located despite documented concerted efforts
on the part of the agency.
Foster
care cases involving a child for whom participation in planning
is not developmentally appropriate, and whose parents were
deceased during the entire period under review.
Foster
care cases involving a child for whom participation in planning
is not developmentally appropriate, and whose parents
voluntarily terminated their parental rights (i.e., consented to
adoption of the child) shortly after contact with the agency
and/or did not seek to be involved in any way in the child’s
life.
Foster
care cases involving a child for whom participation in planning
is not developmentally appropriate, and whose parents’
rights were terminated before the period under review.
Foster
care cases involving a child for whom participation in planning
is not developmentally appropriate, and, during the entire
period under review, it was documented in the case file that it
was not in the child’s best interest to involve the
parents and the child in case planning.
In-home
services cases are applicable even in States that do not require
a formal case plan to be developed for in-home services cases.
Therefore, the case is applicable even if there is no requirement
for a case plan and there is no case plan in the file.
|
Is
this case applicable? (Select
the appropriate response. If the response is No, rate the case as
Not Applicable in the ratings section, provide your reason for
the rating in the documentation section, and continue to item
19.)
|
Yes
|
No
|
During
the period under review, did the agency make concerted efforts
to actively involve the child in the case planning process?
|
Yes
|
No
|
NA
|
Definition:
“Actively
involved” means that the agency consulted with the child
(as developmentally appropriate) regarding the child’s
goals and services, explained the plan and terms used in the
plan in language that the child can understand, and included the
child in periodic case planning meetings, particularly if any
changes are being considered in the plan.
Instructions:
Reviewers
should select Not Applicable (NA) if the child is not old enough
to participate in case planning or is incapacitated. Although
the capacity to participate actively in case planning will need
to be decided on a case-by-case basis, as a guideline, most
children who are elementary school-aged or older may be expected
to participate to some extent.
If
the case is a foster care case, item 18 applies to the target
child only. If the case is an in-home services case, item 18
applies to all children in the family who are/were receiving
agency services or are/were residing within the family.
If
the case is a foster care case, reviewers should answer No to
this question if there is no case plan in the case file.
If
the case is an in-home services case, and there is no case plan
in the file (some States require that an identifiable written
case plan be included in the file for in-home services cases),
reviewers should identify the extent to which the child (if
developmentally appropriate) was involved in determining: (1)
his or her strengths and needs, (2) the type and level of
services needed, and (3) his or her goals and progress toward
meeting them. The reviewer should determine whether this
information was documented in the case file in any way.
Reviewers
should not assume that a child’s knowledge about his or
her case plan is an indicator of active involvement.
If
the initial case plan was developed before the period under
review, reviewers should focus on the child’s involvement
during the period under review in the ongoing case planning
process, particularly with regard to evaluating progress and
making changes in the type and level of services needed.
|
During
the period under review, did the agency make concerted efforts
to actively involve the mother in the case planning process?
|
Yes
|
No
|
NA
|
During
the period under review, did the agency make concerted efforts
to actively involve the father in the case planning process?
|
Yes
|
No
|
NA
|
Definition:
“Actively
involved” means that the agency involved the parent in (1)
identifying strengths and needs, (2) identifying services and
service providers, (3) establishing goals in case plans, (4)
evaluating progress toward goals, and (5) discussing the case
plan in case planning meetings.
For
in-home services cases, “parents” are defined as the
child’s primary caregivers with whom the child lives, or
as a noncustodial parent who is involved or wishes to be
involved in the child’s life.
For
foster care cases, “mother” and “father”
include the following:
The
child’s biological parents
The
child’s primary caregivers (if other than the biological
parents) from whom the child was removed (if relevant)
The
child’s adoptive parents if the adoption has been
finalized
Instructions:
Reviewers
should select Not Applicable (NA) if the parents’
involvement was determined to be contrary to the child’s
safety or best interests (for example, the parents are
considered abusive parents whose contacts with the child
continue to pose unmanageable risks). Documentation must be in
the case file.
Reviewers
should select Not Applicable (NA) if the parents’
whereabouts were not known, and there is documentation in the
case file regarding the agency’s concerted efforts to
locate her or him.
If
the initial case plan was developed before the period under
review, reviewers should focus on the parents’ involvement
during the period under review in the ongoing case planning
process, particularly with regard to evaluating progress and
making changes in the plan.
Reviewers
should select No if the agency did not make concerted efforts to
locate a parent whose whereabouts were unknown.
|
Rating
Criteria:
Item
18 should be rated as a Strength if the answers to questions A,
B, and C are either Yes or Not Applicable.
Item
18 should be rated as an Area Needing Improvement if the answer
to any one of questions A, B, or C is No.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing
Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Provide
below your main reason for rating this item as a Strength, an
Area Needing Improvement, or Not Applicable, and provide
documentation for the identified issues. If any issue is Not
Applicable to the case, enter NA in the appropriate space. For
each issue, indicate the source of your information (for example,
case file, interview with biological mother, interview with
caseworker, etc.).
Main
Reason
Item
18 is rated as
____________________________________________________ because:
|
Documentation
Information
Document
the ways in which each party listed below was or was not involved
in case planning (for example, identifying needs and services,
establishing goals, evaluating progress, etc.) If the involvement
of the child, mother, or father is determined by the reviewers to
be Not Applicable, document the reasons for this determination
(including any evidence of efforts to locate absent parents).
Child:
Mother:
|
Father:
Other
Issues:
|
WELL-BEING
OUTCOME 1: FAMILIES
HAVE ENHANCED CAPACITY TO PROVIDE FOR THEIR CHILDREN’S
NEEDS.
|
Caseworker
visits with child (case file and interviews with caseworker,
child, parent(s), foster parent(s), service providers, guardian
ad litem, CASA worker)
|
Purpose
of Assessment: To
determine whether the frequency and quality of visits between
caseworkers and the child(ren) in the case are sufficient to
ensure the safety, permanency, and well-being of the child and
promote achievement of case goals.
|
Applicable
Cases: All
cases are applicable for an assessment of this item.
|
During
the period under review, was the frequency of the visits between
the caseworker (or other responsible party) and the child(ren)
sufficient to address issues pertaining to the safety,
permanency, and well-being of the child and promote achievement
of case goals?
|
Yes
|
No
|
During
the period under review, what was the most typical pattern of
visitation between the caseworker or other responsible party and
the child(ren) in the case? (Select the box that describes the
usual pattern of visitation.)
More
than once a week
Once
a week
Less
than once a week, but at least twice a month
Less
than twice a month, but at least once a month
Less
than once a month
Never
Definitions:
“Other
responsible party” refers to contracted service providers
who have full responsibility for case planning and case
management (for example, fully or partially privatized child
welfare systems where full case management responsibilities are
delegated to contract agencies). It does not refer to contracted
service providers that provide services while the agency
maintains decisionmaking and case management responsibilities
regarding the case or the child.
A
“visit” is defined as a face-to-face contact between
the caseworker or other responsible party and the child.
Instructions:
If
the case is an in-home services case, question A should be
answered for all children in the family who are living in the
home and/or receiving services through the agency.
If
the case is a foster care case, question A should be answered
only for the target child in the case.
Reviewers
should consider only the pattern of visits during the period
under review and not over the life of the case.
Reviewers
should focus on the visitation frequency of the agency
caseworker responsible for the case.
Reviewers
should determine the most typical pattern of visiting during the
period under review because the actual frequency may vary in
specific time periods.
Reviewers
should base their determination on the frequency necessary to
ensure the child’s safety, permanency, and well-being and
not on State policy requirements regarding caseworker contacts
or visits with the child. For example, if State policy is that
the caseworker should visit the child at least once a month, and
the reviewer determines that given the circumstances of the case
(for example, there are safety concerns), the caseworker should
visit more frequently, then the answer to question A should be
No, and the reason for this answer should be provided in the
documentation section.
If
the typical pattern of visits is less than once a month, the
answer to question A should be No unless the reviewer determines
that there is a substantial justification for a Yes answer. In
this situation the justification should be included in the
documentation section.
If
the child is in a placement in another State, the reviewer
should determine whether a caseworker from the jurisdiction in
which the child is placed, or a caseworker from the jurisdiction
from which the child was placed, visits with the child in the
placement on a schedule that is consistent with the child’s
needs and no less frequently than once per year, as required by
Federal law.
|
During
the period under review, was the quality of the visits between
the caseworker and the child(ren) sufficient to address issues
pertaining to the safety, permanency, and well-being of the child
and promote achievement of case goals (for example, did the
visits between the caseworker or other responsible party and the
child(ren) focus on issues pertinent to case planning, service
delivery, and goal achievement)?
|
Yes
|
No
|
Instructions:
Reviewers
should consider both the length of the visit (for example, was it
of sufficient duration to address key issues with the child, or
was it just a brief visit) and the location of the visit (for
example, was it in a place conducive to open and honest
conversation, such as a private home, or was it in a more formal
or public environment, such as a restaurant or court house).
Reviewers
should consider whether the caseworker saw the child alone or
whether the parent or foster parent was usually present during
the caseworker’s visits with the child. If the child was
older than an infant, and the caseworker did not see the child
alone for at least part of each visit, then the answer to
question B should be No.
Reviewers
also should consider the topics that were discussed during the
visits, if that information is available in the case file or
through interviews. For the answer to question B to be Yes, there
must be some evidence that the caseworker and the child addressed
issues pertaining to the child’s needs, services, and case
goals during the visits.
|
Rating
Criteria:
Item
19 should be rated as a Strength if the answers to both questions
A and B are Yes.
Item
19 should be rated as an Area Needing Improvement if the answer to
either question A or B is No.
There
are no circumstances under which item 19 could be rated as Not
Applicable.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing
Improvement
|
Reason
for Rating and Documentation
Provide
below your main reason for rating this item as a Strength or an
Area Needing Improvement, and provide documentation for the
identified issues. If any issue is Not Applicable to the case,
enter NA in the appropriate space. For each issue, indicate the
source of your information (for example, case file, interview with
biological mother, interview with caseworker, etc.).
Main
Reason
Item
19 is rated as _____________________________________________
because:
Documentation
Information
If
not explained in the “reason for rating” section,
document barriers to more frequent visiting (if relevant):
|
If
not explained in the “reason for rating” section, and
visits were less frequent than monthly but reviewers determined
this was sufficient (question A was answered Yes), provide
documentation to support that decision and identify other contacts
the agency had with the child, if appropriate (for example, the
child is in a residential care facility that is 6 hours away, but
the caseworker calls and has private conversations with the child
weekly and visits the child regularly):
If
not explained in the “reason for rating” section, and
visits were at least monthly but reviewers determined this was not
sufficient, document the case circumstances requiring more
frequent visits to meet the child’s needs:
Document
the aspects of the caseworker visits with the child that
contributed to high quality visits (if relevant) or why caseworker
visits were not of high quality (if relevant):
Other
Issues:
|
WELL-BEING
OUTCOME 1: FAMILIES HAVE ENHANCED CAPACITY TO PROVIDE FOR THEIR
CHILDREN’S NEEDS.
|
Item
20: Caseworker visits with parents (case file and interviews with
caseworker, parent(s), service providers)
|
Purpose
of Assessment: To
determine whether, during the period under review, the frequency
and quality of visits between caseworkers and the mothers and
fathers of the children are sufficient to ensure the safety,
permanency, and well-being of the children and promote achievement
of case goals.
|
Applicable
Cases: This
item is applicable for assessment for all cases in which visits
between the caseworker and at least one parent were determined to
be appropriate and not contrary to a child’s safety or best
interests. The case is Not Applicable for an assessment of this
item if any of the following apply:
Both
parents are deceased (during the entire period under review) and
the child is not in a permanent home.
There
is no plan for further involvement between the parents and the
agency or the parents and the child, and the child is not in a
permanent home.
The
whereabouts of both parents is unknown and (during the entire
period under review) there is documentation of the agency’s
concerted efforts to locate them.
During
the period under review, neither parent indicated interest in
being involved in the child’s life after contact or
concerted efforts to contact were made by the agency, and/or
contact between the agency and the parent would not be in the
child’s best interest (for example, parental rights have
been terminated with no plan for further parental involvement,
the parents are considered abusive parents whose contacts with
the child continue to pose unmanageable risks).
Documentation
for this also must be in the case file.
Reviewers
may not rate the case as Not Applicable if the parents have not
been involved in the child’s life unless there is
documentation that the agency made concerted efforts to locate
both parents and could not locate them, or the agency located them
but the parents refused to have any contact with the worker.
|
Is
this case applicable? (Select
appropriate response. If the response is No, check Not Applicable
in the ratings section, provide your reason for the rating in the
documentation section, and continue to the Well-Being Outcome 1
rating section.)
|
Yes
|
No
|
During
the period under review, was the frequency of the visits between
the caseworker (or other responsible party) and the mother
sufficient to address issues pertaining to the safety,
permanency, and well-being of the child and promote achievement
of case goals?
|
Yes
|
No
|
NA
|
During
the period under review, what was the most typical pattern of
visitation between the caseworker or other responsible party and
the mother of the child(ren)?
More
than once a week
Once
a week
Less
than once a week, but at least twice a month
Less
than twice a month, but at least once a month
Less
than once a month
Never
Not
applicable
|
During
the period under review, was the frequency of the visits between
the caseworker (or other responsible party) and the father
sufficient to address issues pertaining to the safety,
permanency, and well-being of the child and promote achievement
of case goals?
|
Yes
|
No
|
NA
|
During
the period under review, what was the most typical pattern of
visitation between the caseworker or other responsible party and
the father of the child(ren):
More
than once a week
Once
a week
Less
than once a week, but at least twice a month
Less
than twice a month, but at least once a month
Less
than once a month
Never
Not
applicable
|
Definitions:
“Other
responsible party” refers to contracted service providers
who have full responsibility for case planning and case
management (for example, fully or partially privatized child
welfare systems where full case management responsibilities are
delegated to contract agencies). It does not refer to contracted
service providers who provide services while the agency maintains
decisionmaking and case management responsibilities regarding the
case or the child.
A
“visit” is defined as a face-to-face contact between
the caseworker or other responsible party and the parent.
For
in-home services cases, “parents” are defined as the
children’s primary caregivers with whom the children live,
or as a noncustodial parent who is involved or wishes to be
involved in the child’s life.
For
foster care cases, “parents” include:
The
child’s biological parents
The
child’s primary caregivers (if other than the biological
parents) from whom the child was removed (if relevant)
The
child’s adoptive parents if the adoption has been
finalized
Instructions:
Reviewers
should select Not Applicable (NA) if: (1) agency contact with the
mother or father was determined to be contrary to a child’s
safety or best interests (and this is documented in the case
file), (2) the location of the parent was unknown during the
entire period under review, despite documented concerted agency
efforts to locate her or him, (3) the parents’ parental
rights were terminated before the period under review and she or
he is not involved in the child’s life, or (4) during the
entire period under review, the parent was not involved in the
child’s life or in case planning in any way despite agency
efforts to involve her or him.
If
the answer to question A1 or B1 is Not Applicable (NA), the
answer to question A2 or B2 for that parent also should be Not
Applicable (NA).
Reviewers
should consider only the pattern of visits during the period
under review and not over the life of the case.
Reviewers
should determine the most typical pattern of visiting during the
period under review because the actual frequency may vary in
specific time periods.
Reviewers
should select Never for questions A2 and B2 if the agency
reported that the whereabouts of the mother or father was
unknown, but there was no evidence that the agency made concerted
efforts to locate either the mother or the father.
Reviewers
should consider the frequency of visits that is necessary to
effectively address: (1) the child’s safety, permanency,
and well-being, and (2) achievement of case goals. Reviewers
should not answer the question based on the caseworker visit
requirements that may be established by State policy.
The
answers to questions A1 and B1 should be No if the typical
pattern of contact is less than once a month, unless the reviewer
has a substantial justification for answering either question as
Yes. (Please provide this justification in the documentation
section.)
|
During
the period under review, was the quality of the visits between
the caseworker and the mother sufficient to address issues
pertaining to the safety, permanency, and well-being of the child
and promote achievement of case goals?
|
Yes
|
No
|
NA
|
During
the period under review, was the quality of the visits between
the caseworker and the father sufficient to address issues
pertaining to the safety, permanency, and well-being of the child
and promote achievement of case goals?
|
Yes
|
No
|
NA
|
Instructions:
Reviewers
should consider both the length of the visit (for example, was it
of sufficient duration to address key issues with the
mother/father, or was it just a brief visit?) and the location of
the visit (for example, was it in a place conducive to open and
honest conversation, such as a private home, or was it in a
formal or public environment that might be uncomfortable for the
parent, such as a court house or restaurant?).
Reviewers
should consider whether the visits between the caseworker or
other responsible party and the father/mother focused on issues
pertinent to case planning, service delivery, and goal
achievement.
|
Rating
Criteria:
Item
20 should be rated as a Strength if the answers to questions A1,
B1, C, and D are Yes or Not Applicable.
Item
20 should be rated as an Area Needing Improvement if the answer to
any one of questions A1, B1, C, or D is No.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Provide
below your main reason for rating this item as a Strength, an Area
Needing Improvement, or Not Applicable (NA) and provide
documentation for the identified issues. If any issue is Not
Applicable to the case, enter NA in the appropriate space. For
each issue, indicate the source of your information (for example,
case file, interview with biological mother, interview with
caseworker, etc.).
Main
Reason
Item
20 is rated as
______________________________________________________ because:
Documentation
Information
If
not explained in the “reason for rating” section,
describe barriers to more frequent visiting with the mother (if
relevant) and provide documentation to support a determination
that caseworker visits with the mother is Not Applicable (if
relevant):
If
visits with the mother were less frequent than monthly, and the
reviewers determined this was sufficient (answer to question A1 is
Yes), provide the rationale and documentation to support that
decision:
|
Describe
the general quality of the caseworker visits with the mother and
the issues that were or were not addressed during caseworker
visits (if relevant):
If
not explained in the “reason for rating” section,
describe barriers to more frequent visiting with the father (if
relevant) and provide documentation to support a determination
that caseworker visits with the father is Not Applicable:
If
visits with the father were less frequent than monthly, and
reviewers determined this was sufficient (the answer to question
B1 is Yes), provide the rationale and documentation to support
that decision:
Describe
the general quality of the caseworker visits with the father and
the issues that were or were not addressed during caseworker
visits (if relevant):
Other
Issues:
|
RATING CHILD AND FAMILY
WELL‑BEING OUTCOME 1
|
WELL-BEING
OUTCOME 1: FAMILIES HAVE ENHANCED CAPACITY TO PROVIDE FOR THEIR
CHILDREN’S NEEDS.
|
Check
the level of outcome achievement that best describes the extent
to which this outcome is being or has been achieved, based on the
ratings for items 17 through 20.
|
Level
of Outcome Achievement
|
|
Substantially
Achieved:
|
Well-Being
Outcome 1 should be rated as Substantially Achieved if both of
the following apply:
Item
17 is rated as a Strength, and
Only
one of items 18, 19, and 20 is rated as an Area Needing
Improvement.
|
|
Partially
Achieved:
|
Well-Being
Outcome 1 should be rated as Partially Achieved if either of the
following applies:
Item
17 is rated as an Area Needing Improvement, but at least one
other item is rated as a Strength.
Item
17 is rated as a Strength, but at least two of items 18, 19, and
20 are rated as Areas Needing Improvement.
|
|
|
Not
Achieved:
|
Well-Being
Outcome 1 should be rated as Not Achieved if the following
applies:
|
|
Not
Applicable:
|
Well-Being
Outcome 1 should be rated as Not Applicable if all items are
rated as Not Applicable.
|
CHILDREN
RECEIVE APPROPRIATE SERVICES TO MEET THEIR EDUCATIONAL NEEDS.
|
Educational
needs of the child (case file and interviews with caseworker,
child, foster parent(s), parent(s), service providers)
|
Purpose
of Assessment: To
assess whether, during the period under review, the agency made
concerted efforts to assess children’s educational needs at
the initial contact with the child (if the case was opened during
the period under review) or on an ongoing basis (if the case was
opened before the period under review), and whether identified
needs were appropriately addressed in case planning and case
management activities.
|
Applicable
Cases:
All
foster care cases involving a school-aged child, including those
in pre-school, are applicable for an assessment of this item. If
a child is 2 years old or younger and has been identified as
having developmental delays, the case may be applicable if the
developmental delays need to be addressed through an educational
approach rather than through physical therapy or some form of
physical health approach. In these latter cases, the issue of
developmental delays would be addressed under item 22.
Foster
care cases are Not Applicable if the child is age 2 or younger
and there are no apparent developmental delays.
In-home
services cases are applicable for an assessment of this item if
(1) educational issues are relevant to the reason for the
agency’s involvement with the family, and/or (2) it is
reasonable to expect that the agency would address educational
issues given the circumstances of the case. For example, it is
reasonable to expect that the agency would address educational
issues in a case in which the child is the subject of a
substantiated maltreatment report and, during the period under
review, the maltreatment appeared to be affecting the child’s
school performance.
In-home
services cases are Not Applicable for an assessment of this item
if the reviewer determines that, during the period under review,
there is no reason to expect that the agency would address
educational issues for any children in the family, given the
reason for agency involvement or the circumstances of the case.
Such a case would be Not Applicable, even if there is information
in the case file that the mother or other caregiver has obtained
educational services for the child.
|
Is
this case applicable? (Select
the appropriate response. If the answer is No, rate the item as
Not Applicable in the ratings section, provide a reason for the
rating in the documentation section, and continue to the
Well-Being Outcome 2 rating section.)
|
Yes
|
No
|
During
the period under review, did the agency make concerted efforts to
assess the child(ren)’s educational needs?
|
Yes
|
No
|
Instructions:
If
the case is a foster care case, question A should be answered
only for the child in foster care, even if the child was
reunified during the period under review and there are other
children in the home.
If
the case is an in-home services case, question A should be
answered for all children in the home who meet the case
applicability requirements.
Question
A should be answered Yes if there was evidence of an educational
assessment in the case file, such as the following:
An
educational assessment was included in the comprehensive needs
assessment.
A
separate educational assessment was conducted by the school (and
made available to the agency) or by the agency.
The
agency conducted an informal (and documented) educational
assessment.
|
During
the period under review, did the agency engage in concerted
efforts to address the child(ren)’s educational needs
through appropriate services?
|
Yes
|
No
|
NA
|
Instructions:
Question
B should be answered Not Applicable (NA) if an educational
assessment was conducted (i.e., question A is answered Yes) but
no needs were identified.
Reviewers
should identify the child(ren)’s educational needs and
determine if services were provided to address those needs. For
example, did the child need special education services, extra
help with school work (for example, tutoring), advocacy with
the school system, early intervention preschool classes, etc.?
Were the appropriate services provided to meet the needs?
Reviewers
should focus on agency efforts, even if these efforts were not
fully successful due to factors beyond the agency’s
control. For example, if the agency made concerted efforts to
advocate for special education classes, but the local school
continued to resist, reviewers may answer Yes to question B,
although the child did not receive the needed services.
|
Rating
Criteria:
Item
21 should be rated as a Strength if either of the following
applies:
The
answers to questions A and B are Yes.
The
answer to question A is Yes, and the answer to question B is
Not Applicable.
Item
21 should be rated as an Area Needing Improvement if the answer
to either question A or B is No.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Provide
below your main reason for rating this item as a Strength, an
Area Needing Improvement, or Not Applicable, and provide
documentation for the identified issues. If any issue is Not
Applicable to the case, enter NA in the appropriate space. For
each issue, indicate the source of your information (for
example, case file, interview with biological mother, interview
with caseworker, etc.).
Main
Reason
Item
21 is rated as
_____________________________________________________ because:
The
following information is being collected for analysis purposes:
For
foster care cases only, during the period under review, did the
agency conduct case management activities appropriate to
addressing the child’s educational needs? Reviewers should
determine if, during the period under review, the following
case-management requirements of Federal statute were met for an
applicable foster care case (select each one that was met):
To
the extent available and accessible, the child’s
educational records are in the case file and are up to date
[Social Security Act §475(1)(C)].
The
case plan addresses identified educational needs [Social
Security Act §475(1)(C)].
To
the extent available and accessible, foster parents or
caregivers of a child placed in a facility are provided with
the child’s educational records [Social Security Act
§475(5)(D)].
Educational
records include the names and addresses of the child’s
educational providers, the child’s grade level
performance, and any other relevant education information
[Social Security Act §475(1)(C)].
|
Documentation
Information
If
not explained in the “reason for rating” section,
document the process used for educational assessment, if
relevant:
|
Document
in the chart below the services provided or not provided to
address the child’s educational needs. Services would
include advocacy on the part of foster parents as well as the
caseworker; ensuring that the child received special education
classes; making provisions for the child to receive tutoring or
educational mentoring; or arranging for the child to be enrolled
in early intervention preschool classes, such as Head Start:
|
Educational
Needs
|
Services
Provided
|
Services
Needed but Not Provided
|
|
|
|
|
|
|
|
|
|
If
there are services that were not or are not being provided,
document agency efforts, or lack of agency efforts, to provide
those services:
Other
Issues:
|
RATING CHILD AND FAMILY
WELL‑BEING OUTCOME 2
|
CHILDREN
RECEIVE APPROPRIATE SERVICES TO MEET THEIR EDUCATIONAL NEEDS.
|
Check
the level of outcome achievement that best describes the extent
to which this outcome is being or has been achieved, based on the
rating for item 21.
|
Level
of Outcome Achievement
|
|
Substantially
Achieved:
|
Well-Being
Outcome 2 should be rated as Substantially Achieved if the
following applies:
|
|
Partially
Achieved:
|
Well-Being
Outcome 2 should be rated as Partially Achieved if the following
applies:
|
|
Not
Achieved:
|
Well-Being
Outcome 2 should be rated as Not Achieved if the following
applies:
|
|
Not
Applicable:
|
Well-Being
Outcome 2 should be rated as Not Applicable if the following
applies:
|
WELL-BEING
OUTCOME 3: CHILDREN RECEIVE ADEQUATE SERVICES TO MEET THEIR
PHYSICAL AND MENTAL
HEALTH
NEEDS.
|
Physical
health of the child (case file and interviews with caseworker,
foster parent(s), parent(s), medical service providers,
guardian ad litem, service providers)
|
Purpose
of Assessment:
To determine whether, during the period under review, the agency
addressed the physical health needs of the child, including
dental health needs.
|
Applicable
Cases:
All
foster care cases are applicable for an assessment of this item.
In-home
services cases are applicable for an assessment of this item if
(1) physical health issues were relevant to the reason for the
agency’s involvement with the family, and/or (2) it is
reasonable to expect that the agency would address physical
health issues given the circumstances of the case. For example,
it is reasonable to expect that the agency would address
physical health issues in a case in which the child is the
subject of a substantiated maltreatment report and there is
reason to suspect that, during the period under review, the
maltreatment may have affected the child’s physical
health.
In-home
services cases are not applicable for an assessment of this item
if the reviewer determines that there is no reason to expect
that the agency would address physical health issues for any
children in the family, given the reason for agency involvement
or the circumstances of the case. This “non-applicability”
applies even if there is evidence in the case file that the
agency has learned that the parent is effective in taking care
of the child’s physical health needs.
|
Is
this case applicable? (Select
the appropriate response. If the answer is No, rate the case as
Not Applicable in the ratings section, provide your justification
for the rating in the documentation section, and continue to item
23.)
|
Yes
|
No
|
During
the period under review, did the agency assess the child’s
physical health care needs?
|
Yes
|
No
|
NA
|
During
the period under review, did the agency assess the child’s
dental health care needs?
|
Yes
|
No
|
NA
|
Instructions:
If
the child is too young for a dental examination, then question
A2 should be answered Not Applicable (NA).
Reviewers
should determine if there is evidence that, during the period
under review, the agency arranged for assessment of the
child(ren)’s health care needs, including dental care
needs, both initially (if the child entered foster care during
the period under review), or on an ongoing basis through
periodic health and dental screening services conducted during
the period under review.
The
evidence to take under consideration would include, but is not
limited to:
Conducting
an initial health care screening, such as EPSDT (Early Periodic
Screening, Diagnosis, and Treatment) or other comprehensive
medical examination upon entry into foster care (if the child
entered foster care during the period under review).
Ensuring
that, during the period under review, the child received
ongoing periodic preventive physical and dental health
screenings to identify and avoid potential problems.
(Preventive health care refers to initial and periodic
age-appropriate dental or physical health examinations.)
Including
an assessment of physical and dental health needs in the
initial comprehensive needs assessment (if the child entered
foster care during the period under review), or in ongoing
needs assessments conducted to guide case planning.
|
During
the period under review, did the agency ensure that appropriate
services were provided to the child to address all identified
physical health needs?
|
Yes
|
No
|
NA
|
During
the period under review, did the agency ensure that appropriate
services were provided to the child to address all identified
dental health needs?
|
Yes
|
No
|
NA
|
Instructions:
If
the answers to question(s) A1 and/or A2 are Yes and no needs for
services or treatment were identified, then the corresponding
question(s) B1 and/or B2 should be answered Not Applicable (NA).
If question A2 is Not Applicable (NA) because of the child’s
age, then question B2 also should be Not Applicable (NA).
Reviewers
should answer these questions based on a determination of the
child(ren)’s physical health needs and the services
provided or not provided to address those needs during the
period under review. This would include immunizations, treatment
services, and dental services, including orthodontics.
For
foster care cases only, reviewers should determine if, during
the period under review, there was evidence that the following
case-management criteria required by Federal statute were met
(select each one that was met):
To
the extent available and accessible, the child’s health
records are up to date and included in the case file [Social
Security Act §475(1)(C)].
The
case plan addresses the issue of health and dental care needs
[Social Security Act §475(1)(C)].
To
the extent available and accessible, foster parents or
caregivers of a child placed in a facility are provided with the
child’s
health records [Social Security Act §475(5)(D)].
Health
records include the names and addresses of the child’s
health care providers, a record of the child’s
immunizations, the child’s known medical problems, the
child’s medications, and any other relevant health
information.
Reviewers
should answer No to question B1 or B2 if they determine that the
fact that the case management activities were not met had or has
a negative impact on the agency’s ability to meet the
child’s health and dental care needs. For example, foster
parents were unable to effectively address health care needs
because they had never seen the child’s health records, or
the child’s health care needs were not being met because
there were no health records in the case file and the worker was
unaware of the child’s health care needs.
|
Rating
Criteria:
Item
22 should be rated as a Strength if either of the following
applies:
The
answers to questions A1, A2, B1, and B2 are Yes.
The
answer to at least one of questions A1, A2, B1, and B2 is Yes,
and the rest are Not Applicable.
Item
22 should be rated as an Area Needing Improvement if the answer
to at least one question is No.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Provide
below your main reason for rating this item as a Strength, an
Area Needing Improvement, or Not Applicable, and provide
documentation for each of the identified issues. If any issue is
Not Applicable to the case, enter NA in the appropriate space.
For each issue, indicate the source of your information (for
example, case file, interview with biological mother, interview
with caseworker, etc.).
Main
Reason
Item
22 is rated as ________________________________________________
because:
Documentation
Information
If
not explained in the “reason for rating” section,
identify the evidence of physical or dental health assessment
(for example, what type of needs assessment was conducted, and
what kind of information was in the case file or missing from the
case file that is relevant to an assessment of physical or dental
health needs?):
|
Did
the child receive periodic, age-appropriate physical and dental
health examinations to ensure ongoing assessment of needs? If
not, document the reasons why the agency did not conduct this
ongoing assessment:
Document
in the chart below the services that were or were not provided to
address physical or dental health needs and link those services
to identified needs:
|
Identified
Physical or
Dental
Health Needs
|
Services
Provided
|
Services
Needed but Not Provided
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
If
there are services that were not provided, document why the
services were not provided (for example, lack of agency efforts
to secure services, lack of service availability in the
community, lack of transportation for foster parents to take
child to appointments, etc.):
Other
Issues:
|
WELL-BEING
OUTCOME 3: CHILDREN RECEIVE ADEQUATE SERVICES TO MEET THEIR
PHYSICAL AND MENTAL HEALTH NEEDS.
|
Mental/behavioral
health of the child (case file and interviews with caseworker,
foster parent(s), parent(s), child, service providers, guardian
ad litem)
|
Purpose
of Assessment: To
determine whether, during the period under review, the agency
addressed the mental/behavioral health needs of the child(ren).
|
Applicable
Cases:
Foster
care cases are applicable for an assessment of this item if the
reviewer determines that, during the period under review, the
child had existing mental/behavioral health needs, including
substance abuse issues. If the child had mental/behavioral
health issues before the period under review that were
adequately addressed and there are no remaining needs during the
period under review, the case should be rated as Not Applicable
(NA) and the reason(s) should be noted in the documentation
section.
In-home
services cases are applicable for an assessment of this item if
(1) mental/behavioral health issues were relevant to the reason
for the agency’s involvement with the family, and/or (2)
it is reasonable to expect that the agency would address
mental/behavioral health issues given the circumstances of the
case. For example, it is reasonable to expect that the agency
would address mental health issues in a case in which the child
is the subject of a substantiated maltreatment report and there
is reason to suspect that, during the period under review, the
maltreatment may have affected the child’s mental health.
In-home
services cases are Not Applicable for an assessment of this item
if the reviewer determines that there is no reason to expect
that, during the period under review, the agency would address
mental/behavioral health issues for any children in the family,
given the reason for agency involvement or the circumstances of
the case.
|
Is
this case applicable? (Select
the appropriate response. If the answer is No, rate the case as
Not Applicable in the rating section and provide your
justification for this rating in the documentation section.)
|
Yes
|
No
|
During
the period under review, did the agency conduct an assessment of
the child(ren)’s mental/behavioral health needs either
initially (if the child entered foster care during the period
under review) or on an ongoing basis to inform case planning
decisions?
|
Yes
|
No
|
Definition:
Instructions:
This
question should be answered for all cases determined to be
applicable for an assessment of this item, based on the above
criteria.
Reviewers
should determine whether, during the period under review, the
agency conducted a formal or informal mental/behavioral health
assessment on the child either at entry into foster care (if the
child entered foster care during the period under review), or on
an ongoing basis to provide updated information for case
planning decisions with regard to mental/behavioral health
issues.
If
the case is an in-home services case, question A should be
answered for all children in the home who meet the case
applicability requirements.
|
B.
During the period under review, did the agency provide
appropriate services to address the child(ren)’s
mental/behavioral health needs?
|
Yes
|
No
|
NA
|
Instructions:
If
question A is answered Yes, but no mental/behavioral health
service needs were identified, then the answer to question B
should be Not Applicable (NA).
Reviewers
should consider the mental/behavioral health needs that existed
during the period under review and the services that the agency
provided to address those needs, including outpatient treatment,
inpatient mental health treatment, treatment for substance abuse
disorders, individual therapy, group therapy, family therapy,
etc.
|
Rating
Criteria:
Item
23 should be rated as a Strength if the answer to question A is
Yes, and the answer to question B is Yes or Not Applicable.
Item
23 should be rated as an Area Needing Improvement if the answer to
either question A or B is No.
|
Rating
for this indicator (select one):
|
|
Strength
|
|
Area
Needing Improvement
|
|
Not
Applicable
|
Reason
for Rating and Documentation
Provide
below your main reason for rating this item as a Strength, an Area
Needing Improvement, or Not Applicable, and provide documentation
for each of the identified issues. If any issue is Not Applicable
to the case, enter NA in the appropriate space. For each issue,
indicate the source of your information (for example, case file,
interview with mother, interview with caseworker, etc.).
Main
Reason
Item
23 is rated as __________________________________________________
because:
Documentation
Information
Note
whether or not there is evidence of a mental/behavioral health
(including substance abuse) assessment. For example, (1) what type
of needs assessment was conducted, and (2) what kind of
information was in the case file or missing from the case file
that is relevant to an assessment of mental/behavioral health
needs? Indicate if a formal assessment was conducted, and, if so,
note the diagnosis:
If
the agency did not conduct initial and/or ongoing
mental/behavioral health (including substance abuse) assessments,
document the reasons why the assessments should have been provided
during the period under review and were not. Also, determine
whether any initial mental/behavioral health assessment arranged
for by the agency was done so in accordance with State policy
timeframes:
Identify
in the chart below the services that were or were not provided to
address mental/behavioral health needs and link those services to
identified needs:
|
Identified
Mental/Behavioral
Health Needs
|
Services
Provided
|
Services
Needed
but
Not Provided
|
|
|
|
|
|
|
|
|
|
|
|
|
If
there are services that were not or are not being provided,
describe why the services were not provided (for example, lack of
agency efforts to secure services, lack of service availability in
the community, no transportation for foster parents to take child
to appointments, parent’s unwillingness to engage child in
services, etc.):
Other
Issues:
|
RATING CHILD AND FAMILY
WELL‑BEING OUTCOME 3
|
WELL-BEING
OUTCOME 3: CHILDREN RECEIVE ADEQUATE SERVICES TO MEET THEIR
PHYSICAL AND MENTAL
HEALTH
NEEDS.
|
Check
the level of outcome achievement that best describes the extent
to which this outcome is being or has been achieved, based on the
ratings for items 22 and 23.
|
Level
of Outcome Achievement
|
|
Substantially
Achieved:
|
Well-Being
Outcome 3 should be rated as Substantially Achieved if either of
the following applies:
|
|
Partially
Achieved:
|
Well-Being
Outcome 3 should be rated as Partially Achieved if the following
applies:
|
|
Not
Achieved:
|
Well-Being
Outcome 3 should be rated as Not Achieved if either of the
following applies:
|
|
Not
Applicable:
|
Well-Being
Outcome 3 should be rated as Not Applicable if both items are
rated as Not Applicable.
|
/home/ec2-user/sec/disk/omb/icr/201202-0970-002/doc/30249501
| File Type | application/msword |
| File Title | Item 3 |
| Author | dastill |
| Last Modified By | DHHS |
| File Modified | 2009-08-24 |
| File Created | 2009-08-24 |