Children and Young People’s Social Care
FOSTERING SERVICE
Referees Confidential Questionnaire
Name and Address of Applicant/s /

Name and Address of Referee

Part A – Please complete prior to the Fostering Officer visit on
1 / How long have you known the Applicant/s ?
In what capacity? E.g. neighbours, through work etc.
How often do you see them and where? Eg in their home, at work, socially.

2Can you describe the personality and strengths of the applicant/s?

3Do you consider the applicants’ relationship to be stable and supportive? If single, how do you feel they could cope as a single carer? From whom would they get support?
4How do you feel they cope with stress? Are you aware of any crisis that has confronted them? eg Bereavement, marital difficulties, redundancy.

5Do you know the applicant/s’ own children (if any) and have you any comments to make on their upbringing?

6What do you consider the effect of fostering would be on their children or other members of the family?

7 How do you feel fostering will fit in with the applicants’ lifestyle?

8Do you know of any relative or friend of the applicant/s who might adversely affect the wellbeing or happiness of a child placed with the applicants?

Yes / No
If yes, please comment
9What experience are you aware the applicant/s have, of caring for or working with children?
10If you have children, please comment on how the applicant/s relate to them and if the applicant/s have looked after your children any time.
11What particular characteristics do you feel will make the applicant/s suitable foster carers?

12Would you have any concerns about the safety and welfare of a child placed with this family?

13Please comment on the applicant/s sense of responsibility eg reliability, trustworthiness and the ability to keep information confidential.
14Are there any other matters that you consider relevant, which have not been included elsewhere in this questionnaire?
Signed:
Date:
Your reference will be absolutely confidential with the department and will not be shared with the applicants.
If you have any queries please ring
………………………......
Fostering Officer
On
……………………………..
Part B - To be completed by Fostering Officer at the visit

1Give brief details of the referee and their circumstances. Do they appear to understand the demands of Fostering?

2Summary of discussion
Signed
Referee
Date
Signed
Fostering Officer
Date

02/01/2019 1