Post
Establishment
Job Ref.
PSU Contact
PROTECTION OF CHILDREN
DECLARATION OF SUITABILITY

THIS FORM MUST BE COMPLETED AND SIGNED BY ANY PERSON APPLYING FOR A POST (IN A PAID OR VOLUNTARY CAPACITY) WORKING WITH CHILDREN OR VULNERABLE ADULTS

East Sussex County Council has a responsibility to ensure that no person dealing with children has been involved in any activities which would make it undesirable that that person should be allowed contact with or care of children.

The County Council therefore, in addition to enquiries of the Police, makes enquiries into any information and records held by the Children’s Services Department, including Child Protection records, before making decisions about people who will have access to children. The information you give on this form will be used for this purpose.

Any information you give will be treated confidentially. Please complete, sign and return this declaration in the envelope provided; a second copy is supplied for you to keep.

Surname: / Forenames:
D.O.B.: / Former Names:
Address: / Postcode:
Address(es) in last 5 years if different (give dates):

Have you ever? (Answer YES or No. If YES give details)

1. / Admitted to the commission of any offence or attempt to commit any offence against children although not convicted in court?
2. / Had any court order made against you or any child in your care which resulted in a child being removed from your care or placed under supervision?
3. / Had your parental rights and powers with respect to a child vested in a Local Authority?
4. / Been employed as a Foster Carer with any Local Authority or Agency?
5. / Been prohibited from fostering or had a foster or adoptive child compulsorily removed from or prevented from being received into your care?
6. / Had your registration as a childminder or the registration of any of your premises for the purposes of providing care compulsorily refused or cancelled?
7. / Carried on, otherwise managed or had a financial interest in any voluntary or registered children’s home that was removed from the register?
8. / Have you (or your children) to the best of your knowledge been the subject of Child Protection Plans and had your name(s) placed on a Child Protection Register?
Please tick: Yes No

Now complete the declaration below:

I have read and understood the information given above, and I declare that the details I have entered on this form are correct.

I agree to East Sussex County Council making the necessary enquiries into any information and records held by the Children’s Services Department including Child Protection records. (These Agencies are asked not to visit you in connection with this matter).

I UNDERSTAND THAT INFORMATION DISCLOSED WILL BE USED IN CONNECTION WITH CONSIDERATION OF MY APPLICATION FOR EMPLOYMENT.

NB. If there is anything you do not understand, or upon which you would like further explanation, please contact the address on the application form before signing your name below.

Signed: / Date:

A person who makes, with respect to themselves or another, any statement which is false may be dismissed or have an offer of employment withdrawn.


Protection of Children – Child Protection Enquiry

Surname: / Forenames:
D.O.B.: / Former Names:
Address: / Postcode:
Address(es) in last 5 years if different (give dates):

The above named person will have substantial access to children under the provisions of Joint Circular No. 44/86. Please check the information about this person or their children on the Child Protection records and other relevant Local Authority Files. I am satisfied that the particulars given overleaf are accurate. Written permission for the check to be made has been given.

If the person admits to an entry on the register, tick box:

Signed: /
Head of HR Strategy, Personnel & Training
To be completed by the CP Unit, and whole form returned to the appropriate person as shown below.
1. No trace on the details supplied / 2. Entry on Children’s Services records, including
Child Protection Register
Signed: / Consult with key worker
Position: / Name:
Date: / Tel. No:
Forms ticked in Box 1 to be returned to: / Forms ticked in Box 2 to be returned as follows:
Named Contact
Personnel Support Unit
Personnel and Training
County Hall
Lewes
East Sussex
BN7 1SW / To be opened only by:
Deputy Director (Children’s Services)
County Hall
Personal and Confidential
Custodian of the CPR
Child Protection Unit
East Sussex County Council
Children’s Services Department
St. Mark’s House, 14 Upperton Road
Eastbourne, East Sussex BN21 1EW