Arkansas DCFS Child Protection Review Tool

Referral Information

(For inactive cases, only the questions in red will be answered by the reviewer.)

Reviewer Name: Review Date:

Referral ID: Referral Date:

Area: County:

Date of First Primary Assignment:

(Please note any significant delays in assignment, including the investigation being re-assigned multiple times in the Summary section at the end of the review.)

Priority I Priority II Closed Inactive

Family Report Facility Report

Hornby Zeller Associates, Inc.Page 1

Arkansas DCFS Child Protection Review Tool

Initiation

  1. Please list the children involved in the investigation and children in the home.
  • List all children except juvenile offenders.
  • If the children are listed in CHRIS as “Unknown,”are never located by the assessor, or the assessor is denied access to the childrenenter“Attempted” in the table below.
  • Assessors must observe and interview a child to be given credit in the table below, unless the child is too young to be interviewed.

Child’s Name / Child’s Age / Status / Has the child been observed and interviewed (if age appropriate)? / Was the child observed and interviewed (if age appropriate) outside the presence of the offender? / Was the victimchild interviewed/ observed in the required timeframe? (24 or 72 hours) / Date of interview/ observation
(Record the first date if multiple) / Did the assessor address all the reported allegations/ safety concerns during the interviews with the age appropriate victims? / If any of the child victims were not interviewed in the required timeframe, record the date that the caseworker first attempted to locate the child. / If any victim children were not interviewed/ observed within the required timeframe, please indicate why.[1]
Write in / Write in / Drop down: Victim or
Non-victim / Drop Down:
Yes,
interviewed and observed;
Yes, observed, but too young for interview;
No;
Attempted / Drop down:
Yes, interviewed and/or observed outside presence of offender;
No;
UTD / Drop down:
Yes;
No;
Attempted / Write in (date form)
__/__/__ / Drop down:
All;
Some;
None;
Attempted;
Too Young for interview / Write in
(date form)
__/__/__ / Drop Down:
Not Home;
Unable To Locate;
No attempts;
Other

Hornby Zeller Associates, Inc.Page 1

Arkansas DCFS Child Protection Review Tool

  1. If the family was never located, did the assessor employ reasonable diligence in attempting to locate members in accordance with Department Policy?[2]
  • See below for a list of required tasks

Yes - All Yes - Some No

2a. If the assessor did not exercise reasonable diligence or only exercised some reasonable diligence, please specify which sources the assessor failed to check.

The assessor did notvisit the child’s home three times.

The assessor did not contact the reporter of the maltreatment to obtain more information.

The assessor did not visit or contact the child’s school, day care and any other places where the child is thought to be located.

The assessor did not send a certified letter to the family home address provided by the reporter.

The assessor did not contactthe appropriate local Division of County Operations staff or request research of the AASIS and Answer systems and other files to obtain another address.

Interviews/Observations

  1. Was the reporter interviewed?

Yes No Attempted Anonymous

Date of interview:

1a. If Yes, was the interview thorough?

  • This refers to any potential safety concerns identified by the reporter, not just those accepted as allegations.

Yes No

  1. Please list all non-offending caregivers (PRFC), if any.
  • If there are no non-offending caregivers,check the box in the last column.
  • If the non-offending caregiver was never interviewed (i.e., no attempts were made to interview the PRFC) enter “No” for the interview.

Name / Was the non-offending caregiver interviewed? / Date of Interview / Did the assessor address the reported allegations/safety concerns with the caregiver? (Only include those listed as an allegation) / If only some allegations/safety concerns were addressed, please explain. / No non-offending caregivers
Write in / Drop down:
Yes
No
Attempted / Write in (date form)
__/__/__ / Drop down:
Yes – All
Yes - Some
None / Write in / Checked box
  1. Please list all alleged offenders.
  • If the offender is unknown, please write “Unknown” in the name field and select “Unknown Offender” in the PRFC and interviewed fields.
  • If the alleged offender was never located or if the assessor unsuccessfully attempted to interview the alleged offender, enter the name and PRFC status then select “attempted” in the interview field.
  • If the non-offending caregiver was never interviewed (i.e., no attempts were made to interview the PRFC), enter “No” for the interview.
  • If the alleged offender is a juvenile, complete the table and check the box in the last column. Even if the alleged juvenile offender was never interviewed, check the final box indicating a juvenile alleged offender.

Name / Is the alleged offender also a person responsible for the child (PRFC)? / Was the alleged offender interviewed? / Date of Interview / Did the assessor address the reported allegations / safety concerns with the offender? (Only include those listed as an allegation) / If only some allegations/safety concerns were addressed, please explain. / Juvenile Offender[3]
Write in / Drop down:
Yes
No
Unknown offender / Drop down:
Yes
No
Attempted
Unknown offender / Write in (date form)
__/__/__ / Drop down:
Yes – All
Yes – Some
None / Write in / Check box
  1. Please indicate which collateral contacts were interviewed and the date of the interview as well as all collateral contacts that the reviewer has identified as needing to be interviewed.
  • Do not include the reporter in this table.
  • If the reporter is interviewed more than once, the interview is still not included in this table. Instead, indicate subsequent interviews with the reporter in the Summary at the end of the tool.
  • If a collateral source is interviewed more than once, enter each interview separately.
  • In the final column do not check the box for collateral sources that the assessors attempted to reach; only include those who were neglected entirely.
  • Pay particular attention to unsubstantiated cases for missing collaterals.

Collateral / Interviewed / Date of Interview / Needs to be interviewed
Drop down with all possible collaterals from CHRIS / Drop down:
Yes
No
Attempted / Write in (date form)
__/__/__ / Checked box
  1. Did the assessor observe the family’s home environment?
  • If the assessor was denied access to the family home or the family was never home when the assessor attempted to visit, check “Attempted.”

Yes No Attempted

  1. Based on the allegations in the report, was a home visit necessary to make a determination on the allegations? (For example, if abuse occurred outside the home at daycare or school, a home visit would not be relevant to the investigation.)

Yes No

  1. Based on the allegations in the report, were the family interactions relevant to determining the findings of the allegations? (For example, if the offender is a peer at school, daycare provider or unknown, the interactions of the family are likely irrelevant.)

Yes No

  1. If yes, did the assessor document observations of the family’s interactions?
  • Only respondif the answer to 7 above is “yes.”
  • This should be documented under “Worker’s Observations” in the interview screens in CHRIS, but may also be found in the Findings screen under “Pertinent Information” or “Findings/Recommendation.”
  • Check “Attempted” if the assessorwas denied access into the family home or to the children, thus preventing the assessor’sability to observe the family together.

Yes No Attempted

Child Safety

  1. Please list out the Health and Safety Assessment (HSA) information for each child.

Name / Was the HSA completed? / Date of HSA / Did the HSA appropriately assess the safety and health of each child? / If no, please specify any areas of concern
Write in
(Pre-populate from Q1 in Initiation) / Drop down:
Yes
No / Write in (date form)
__/__/__ / Drop down:
Yes
No / Write in
  1. Did the assessor accurately determine the children to be safe during the first interview/observation?

Yes No Unable to determine

If Unable to Determine, please explain:

If no, did the assessor take steps to ensure the safety of the children?

Yes NoPlease specify:

  1. Please list out the Safety Plan information for each child.
  • If a Safety Plan was not needed select “Not Applicable.”
  • If it was not needed because the Health and Safety Assessment indicated it was not required but you believe the Assessment is inaccurate OR if the plan was needed according to the assessment and still not completed, select “No” and answer “Yes” for “If the Safety plan was not completed, are there safety concerns present that warrant the plan being completed?” and explain in the last column.

Name / Was the Safety Plan completed? / Date of Safety Plan / Did the Safety Plan appropriately address the safety and health of each child? / If the Safety Plan was not completed, are there safety concerns present that warrant the plan being completed? / If yes, please specify any areas of concern
Write in
(Pre-populate from Q1 in Initiation) / Drop down:
Yes
No
Not applicable / Write in (date form)
__/__/__ / Drop down:
Yes
No / Drop down:
Yes
No / Write in
  1. At any point in the investigation were the children removed from the home to ensure their safety?

Yes No(Skip to Conclusion)

If yes, indicate the date of removal:[4]

  1. If the children were removed, were they returned prior to the investigation closing?(Only respondif the answer to 4 above is “yes.”)

Yes No

If yes, indicate the date of return:[5]

Conclusions

  1. Does the information documented in CHRIS support the findings of the allegations?

Yes No

If no, please explain:

  1. Is there any concrete indication that any of the children are unsafe at the conclusion of the investigation?

Yes No

If yes, please explain:

  1. What was the overall disposition of the case?

True Unsubstantiated Inactive[6] Exempt

Record the date the investigation was closed:

If overdue, please explain: (Drop down of responses listed in CHRIS)

If “Other” was selected, please write in the explanation provided by the assessor:

  1. If the investigation was determined True or Exempt, please provide the Risk Assessment information for each child.
  • In the event that the assessor completed the Risk Assessment even though the investigation was Unsubstantiated, leave this table blank.

Name / Was the Risk Assessment completed? / Date of Risk Assessment / Did the Risk Assessment appropriately assess potential harm for each child? / If no, please specify any areas of concern
Write in
(Pre-populate from Q1 in Initiation) / Drop down:
Yes
No / Write in (date form)
__/__/__ / Drop down:
Yes
No / Write in
  1. Were any services offered to the family at the conclusion of the investigation?

Yes No

If no, are there any services that should have been offered based on the information documented in CHRIS? (Only respondif the answer to 5 above is “no.”)

Yes No

If yes, please explain:

  1. Was a case opened for services at the end of the investigation?

Yes No Case already open

If yes, which type? (Only respondif the answer to 6 above is “yes.”)

Supportive Services Protective Services Foster Care

Supervision

  1. How many times during the investigation did the supervisor meet with the assessor to review the referral?
  • Supervision may be recorded in multiple places including, but not limited to, the “Case Conn." tab, the “Findings” tab, or the “Inv. Close” tab.
  1. Record each date the supervisor met with the assessor to discuss the referral.
  • If the investigation indicates that the assessor met with the supervisor but a date is not provided, enter 5/5/5555.

Summary

Please describe issues and concerns identified within the case.

Hornby Zeller Associates, Inc.Page 1

[1] The web-based tool will preclude the reviewer from answering these questions if the child is a non-victim.

[2] This will ONLY be answered for inactive cases. The web-based system will now allow reviewers to answer this unless the Inactive box in the referral section is checked.

[3]Auto-populate names of juvenile offenders in the Health and Safety table.

[4] If children were removed at different points within the investigation, enter the first date in which a child was removed.

[5] If the children were removed at different points within the investigation, enter the last date the children were returned home prior to the investigation closing.

[6] Auto-populate from the checked box in the Referral section.