Determining if matter is a limited intake response

INSTRUCTIONS:
Read through and answer the following questions: If any of the below questions are answered with a ‘yes’ response, the reported information is NOT to be recorded as a limited intake response and must be recorded on ICMS.
Is thereareanyallegations of harm or risk of harm received about a childreported, regardless of whether there is only limited information is available and regardless of whether family details are limited?
Does the information raise suspicion of a criminal offence against a child occurring? This includes a criminal offence committed by a child towards another child.*
Does the information require you to look up ICMS, follow up with the notifier or conduct any checks with other agencies?
If there is information regarding a child engaging in sexualised behaviour, is the children’s behaviour considered outside the normal parameters of age-appropriate sexualised behaviour?
Does the information contain any details regarding a domestic violence incident (verbal or physical) occurring, where the children were present, in the vicinity of or in hearing of OR if the children were not present, did the domestic violence incident result in a parent sustaining visible injuries?
If the information is regarding a breach of no-contact conditions for a domestic violence order (e.g. attending residence, sending text messages, emails or phone calls), is there any information to suggest this communication involved any direct or indirect threats towards the children OR if there were threats towards the parent, was the child in the vicinity (this includes in hearing or view)?
If the information relates to school attendance issues, has absenteeism being over a significant period of time, or/and is there information suggesting it may be impacting on the child’s development and/or coincides with any other indications of concerns in the home?
Does the information relate to concerns regarding a person driving with a child in the car and committing traffic offences which could place the child at risk (e.g. child being unrestrained, driving under the influence)?
If the information is related to custody arrangements, does the information identify any suggestion of a concern for the child’s safety or wellbeing based on the custody arrangements? There only needs to be a reference.
Is there any information regarding concerns for supervision of a child?
Does the information relate to a family’s engagement or lack of engagement in a universal or secondary service?
Is the matter an IJIS report?
Is the information from Family Law Court?
Does the information relate to high risk behaviours of a child?
Does the information identify the child having any mental health concerns, including engagement in suicide or self harm?
Is information about a child who is currently subject to departmental intervention?
Does the information relate concerns in regarding a child interstate?
Is the information in relation to information received from or relevant to statutory child protection agency in another jurisdiction?

*If you answered yes to the question, you are required to complete a police referral, as per our reporting obligations under section 14(2) of Child Protection Act 1999.

Checklist for determining a Limited Intake Response August 2014Page 1 of 1