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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:

Volume:

X

Forms

Chapter:

A

Forms

09-29-2006

Subchapter:

1

Forms

Issuance:

22.41

CP&P Form 22-41, Participants Identified by Family

 

Click here to view or print the CP&P Form 22-41, Participants Identified by Family

 

Instructions                                                                         9-29-2006

 

PURPOSE AND USE

 

Use this form to:

 

·         Identify individuals whom the parent(s) would like to invite to a meeting to be held to engage the family.  See Family Engagement, CP&P-III-B-5-500.

 

·         Allow the family to give consent for information concerning their involvement with the Division to be discussed at the meeting with the individuals they identify to attend.

 

·         Contact individuals identified by the family, to invite them to attend the meeting.  The Worker coordinates the outreach in accordance with Local Office protocol.

 

·         Document participants who have been identified by the family, and invited by CP&P to attend the meeting.

 

INSTRUCTIONS FOR COMPLETING THE FORM

 

The Worker completes CP&P Form 22-41 during a meeting with the family.  CP&P Form 22-41 is a perforated, three-copy, no carbon required form.  After completing it in accordance with these instructions, the Worker pulls it apart, distributing copies according to "distribution" below.

 

SPECIAL INSTRUCTIONS -- USE BY ADOLESCENTS

 

This form is used when an adolescent requests a meeting.  The adolescent identifies who he or she would like invited to the meeting.

 

SPECIFIC INSTRUCTIONS

 

The Worker enters the family name, case identification number (the NJ SPIRIT system-generated case ID#) and date.

 

The parent reads the agreement and identifies persons whom he or she would like invited to the meeting by printing identifying information for each perspective participant, including his or her name, address, telephone number, and relationship to the family. 

The Worker helps the parent with entries if necessary.

 

The Worker enters potential date(s) for holding the meeting.

 

The Worker checks whether the meeting will be held at the family's home or at an other location.

The Worker enters the address of the location identified for the meeting.

 

Each parent signs and dates the form on the line provided.

 

The Worker signs and dates the form on the line provided.

 

The Worker enters "Yes" or "No" to indicate whether each identified participant intends to attend.

 

The Worker enters "Yes" or "No" to clarify whether each identified participant needs transportation.

 

Enter "Yes" or "No" for each participant to indicate whether CP&P Form 22-43, Invite Letter, was sent to him or her.

 

At "Comments," enter any relevant information about the individual, such as but not limited to: only speaks Spanish, is wheelchair bound, etc.

 

DISTRIBUTION

 

White/Original          -           Case Record

 

Canary                       -           RFSW

 

Pink                            -           Parent(s)