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NJ DCF Logo with reverse copy

 

New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection and Permanency

Effective Date:

5-21-2012

Volume:

X

Forms

Chapter:

A

Forms

Revised Date:

9-16-2019

Subchapter:

1

Forms

Issuance:

21.13

CP&P Form 21-13, Child Fatality/Near Fatality Concluding Summary

 

Click here to view, print, or complete CP&P Form 21-13, Child Fatality/Near Fatality Concluding Summary.

 

WHEN TO USE IT

 

Use this form to summarize all that has occurred since the completion of the Child Fatality/Near Fatality Update Summary, CP&P Form 21-12, regarding a given incident.  This form is prepared by the Area Director or Designee (with the assistance of the Local Office), completed immediately following the completion of the investigation.

 

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 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, resources, and anticipated time frames for goal achievement.  Describe progress made toward achieving case goals.

 

·         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, and that the investigation is sound and complete.

 

·         CCAPTA Memo

 

Click on the hyperlink to complete the CCAPTA Memo. This document is a required companion document to CP&P Form 21-13 which is a template for on-line use. This document, once completed, is forwarded with CP&P Form 21-13 to the Area Director, or Designee, for review.

 

DISTRIBUTION

 

Original

-

CP&P Director

 

Copy

-

CP&P Director              

 

Copy

-

Copies distributed at the discretion of the CP&P Director