background shadows

NJ DCF Logo with reverse copy

 

New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection and Permanency

Effective Date:

Volume:

X

Forms

Chapter:

A

Forms

5-21-2012

Subchapter:

1

Forms

Issuance:

21.12

CP&P Form 21-12, Child Fatality/Near Fatality Update Summary

 

 

Click here to view, print, or complete CP&P Form 21-12, Child Fatality/Near Fatality Update Summary.

 

WHEN TO USE IT

 

Use this form to summarize the case status since the completion of a Child Fatality/Near Fatality Report, CP&P Form 21-11, on a given report.  This form is prepared by the Area Director or Designee (with the assistance of the Local Office), completed within 14 calendar days after CP&P Form 21-11, Child Fatality/Near Fatality Report, is submitted.

 

TIPS FOR COMPLETING THE FORM

 

Complete the check boxes and text boxes for required fields.  Text boxes for fields requiring a narrative will expand as they are completed.

 

Complete text boxes in detail, as follows:

 

·        Status of CP&P Investigation/Findings

 

Provide a concise description of all actions taken to date as a result of the incident.  Indicate further action to be taken or recommended; additional information/reports to be forwarded; and anticipated changes in the case plan.

 

Note: The Area Director notifies the CP&P Director or Designee prior to entering the investigation finding determination.

 

·        Status of Prosecutor's Office Investigation

 

Provide a concise description of all actions taken by the County Prosecutor's Office.  Indicate any further action to be taken or recommended.

 

·        Current Assessment of Risk to Family Members and their Location

 

Provide a concise description of the whereabouts of all family members.  Explain the level of risk to each family member and their current involvement within the family.

 

·        Assessment of Service Needs/Provisions

 

Provide a concise description of all services identified and offered to family members.  Provide dates of referrals, names of providers, and approximate time for any waiting list.

 

·        NJ SPIRIT

 

Ensure that NJ SPIRIT is accurate.  Confirm that all family members are listed with current locations, names are spelled correctly, and dates of birth are completed.  Include address and legal status of all children. 

 

·        Case Plan

 

Provide a description of the best solutions in assisting the family in identifying their needs and strengths. Describe the action steps to be taken, resource provision, and anticipated time frames for goal achievement. 

 

·        Questions

 

After reviewing the information, the Area Director or Designee can ask various questions that require follow-up.  The Area Director or Designee documents information needed to ensure that the form is complete and accurate.

 

DISTRIBUTION

 

Original

-

CP&P Director

 

Copy

-

CP&P Director CP&P Director

 

Copy

-

Copies distributed at the discretion of the CP&P Director