DISCLOSURE RISK ASSESSMENT FORM (Employment)

To be used to assess the suitability of the applicant where a Disclosure certificate has revealed offences.

NOTE: You MUST disregard any offences declared by the applicant that do not appear on the certificate.

Please note: the information and evidence referred to in this form will be relied upon to make an employment decision in relation to staff working with vulnerable groups. It is therefore important that it is fully completed and includes evidence rather than a series of statements. Forms that are not fully evidenced will be returned. Please refer to the guidance attached to this form and contact the Safe Staffing team if you require further assistance.

Name of Applicant
Position Applied For
Disclosure Type
Disclosure Ref No
Disclosure Issue Date
Tel No
School
Name of Hiring Manager/Head undertaking Risk Assessment

For help with completing this form please refer to the guidance notes via the Grid/Compass/Safe Staffing Team on 01992 555896

This form consists of three sections - please ensure that each section is completed in full, including a full account of offences disclosed.

SECTION A – To be completed during the discussion between hiring manager/Headteacher and applicant

Question / Applicable
(Please delete as appropriate) / Evidence relied upon to support this decision
Did the applicant declare the offence(s)/trace(s) on the Council declaration form and at the interview? / Yes / No
(if not why not)
Did the applicant agree that the information on the DBS Certificate was correct? / Yes / No
(if not why not)
Offences declared by applicant / Brief circumstances behind offence
Question / Applicable
(Please delete as appropriate) / Evidence relied upon to support this decision
How did the applicant regard the offence(s)/trace(s) with hindsight and what is their attitude towards the matters now? / Please explain
What would they have done/do differently now? / Please explain
Have the applicant’s circumstances changed since the offence? E.g. location, friends, partner, education? / Yes / No
Please explain
Is the applicant stating any mitigating circumstances? E.g. peer pressure, financial need or lack of judgement / Yes / No
Please explain

Declaration by individual and any additional comments in support of their employment

I understand that any offer of employment will be subject to the information I have supplied and that this is complete and correct. False information, or a failure to supply the details required, could result in disciplinary action being taken.

Signature: …………………………. Date: ……………………………….

Print Name:

SECTION B – Hiring Manager/Head Teacher Assessment

Question / Applicable
(Please delete as appropriate) / Evidence relied upon to support this decision
Did the offences/traces disclosed form any pattern? E.g. is there a cycle or history, reoccurrence, repeat offences / Yes/No
Please explain
Did the applicant demonstrate any efforts not to re-offend? E.g. rehabilitation course / Yes/No
Please explain
What is the nature of the contact the individual has with children/vulnerable adults? / Please describe
Can any safeguards be implemented to reduce/remove any risk? / Yes/No/Not applicable
Please explain
Will the nature of the post present any realistic opportunities for re-offending? / Yes/ No
Please explain
Does the post have any direct contact with the public and how vulnerable are they? / Yes/No
Please explain
What supervision is available and how will it be used to mitigate risk? / Please explain
Does the applicant have any gaps in employment history? / Yes / No
If Yes - Please explain
Have two satisfactory references been received for the applicants? (With matching dates to application form, correct role, etc.) / Yes/No
If No – Please explain

If the Risk Assessment has not been carried out by the Head Teacher, this section must be signed by the person who completed the Risk Assessment and then countersigned by the Head Teacher.

Summary of evidence taken into account and rationale for this decision. Any additional comments from the hiring manager/ Headteacher:
Do you wish to proceed with employment? Yes/No Date:
(if yes please explain here why)
Name: Head Teacher Name:
Signature:
Head Teacher Signature:

Once the form is completed please email it to Herts HR Safe Staffing Team or return it in a private and confidential envelope to Herts Safe Staffing Team, County Hall, Pegs Lane, Hertford SG13 8DF

SECTION C – Authorisation

Herts HR Safe Staffing Team
Outcome: Continue with offer/withdraw offer (please delete as appropriate)
Are there any conditions attached to this offer e.g. recommendations, restrictions, safeguards to be implemented by the employing service/school
Yes/No (if Yes, please detail)
Name of CRB Authorising Officer: Date:
Signature:
Education Lead
Outcome: Agreement to continue with offer/withdraw offer (if agreed please give details of the evidence relied upon to make this decision)
Name of Education Lead: Date risk assessment authorised:
Signature:

For high risk or complex cases: Statutory Director (or for Resources & Performance – Chief Financial Officer)

Outcome: Agreement to continue with offer/withdraw offer (if agreed please give details of the evidence relied upon to make this decision)

Name of Director: Date risk assessment authorised:

Signature:

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