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New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection & Permanency

Effective Date:

 2.15.2018

Volume:

X

Forms

Chapter:

A

Forms

Revised Date:

11.18.2020

Subchapter:

1

Forms

Issuance:

22.22

CP&P Form 22-22, Safety Assessment

 

Click to view, complete, or print Form 22-22 SDM Safety Assessment.

 

Click to view, complete, or print Form 22-22(S) SDM Safety Assessment.

 

Note: This form is a part of the SDM policy.

 

WHEN TO USE IT

1.    The form documents the child’s safety at the time of assessment. Safety assessment is a process that is continual. The form is completed at every investigation and for permanency cases.

2.    Timeframes to complete Safety Assessment:

·      Initial Assessment: At the first face-to-face contact following referral.

·      Review: When circumstances within the home change. If new information changes what was previously scored as threats to safety, or changes the safety decision, a new safety assessment shall be created in NJ SPIRIT. It is not necessary to create a safety assessment review document in NJ SPIRIT if there are no changes, or changes only to vulnerabilities, protective actions and strengths, or which in-home interventions are being used in the safety protection plan.  

Once every three (3) months thereafter

·      Closing: Prior to terminating a family’s involvement with CP&P, create a closing safety assessment documented in NJ SPIRIT. If threat to safety remains present, the case remains open.

·      Investigation: Complete a closing Safety Assessment ONLY if a previous safety assessment was unsafe or safe with a safety protection plan and the case is not being transferred for intervention.

HOW TO USE IT

1.    The Worker prints out and completes the form using information gathered about the family. Use CP&P Form 22-22, Safety Assessment (In-Home Cases), to assess whether any child residing with his or her family (i.e., "in-home") is currently in immediate or impending danger of serious physical harm, which requires protective intervention.

2.    When placing a child out of home, CP&P Form 22-22 can be used to document holding a Pre-Placement Conference.

3.    Only complete this template outside of the NJ Spirit application as a part of a contingency plan when the application is unavailable. However, in doing so, you are still required to create the form in NJ Spirit when the application becomes available.

 

INSTRUCTIONS FOR COMPLETING THE FORM

1.    A paper form of CP&P 22-22 is available through the on-line CP&P Forms Manual. The Worker refers to the paper tool when gathering information to assess child safety.

2.    If a safety threat(s) is identified, if possible, develop a Safety Protection Plan with the family or remove the child. If there are no safety threats, the Worker conferences with the Supervisor within three business days. CP&P-III-B-6-600.

 

SPECIAL INSTRUCTIONS FOR SPRU

1.    A SPRU Worker completes CP&P Form 22-22 when conducting a child protective services investigation while service the After-Hours Response System.

2.    Indicate if a new child safety assessment needs to be conducted by the Worker on the next workday. Indicate this in the space, “Conference Notes,” in Section 3.

 

RELATED POLICY

·         CP&P-III-B-6-600

 

DISTRIBUTION

 

Original (with signatures)               -           Case Record

Safety Protection Plan ONLY        -           Parent or Caregiver

Copy               -           Casework Supervisor for approval

Copy               -           Litigation Specialist or Resource Development Specialist

Copy               -           Private Agency Staff (as necessary for service

provision and monitoring the Safety Protection Plan).