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New Jersey Department of Children and Families Policy Manual

 

Manual:

CP&P

Child Protection and Permanency

Effective Date:

Volume:

X

Forms

Chapter:

A

Forms

1-14-2000

Subchapters:

1

Forms

Issuance:

26.82

CP&P Form 26-82, Relative Identification and Evaluation Chart

 

 

Click here to view, print or complete the CP&P Form 26-82.

 

PURPOSE AND USE

 

The Relative Identification and Evaluation Chart, CP&P Form 26-82, is used to identify relative resources for out-of-home placement cases and to document search and assessment results.

 

GENERAL INSTRUCTIONS FOR COMPLETING THE FORM

 

CP&P Form 26-82 is completed on-line within 30 days of placement. There are a total of eight pages to this form. A separate page is completed for each child in out-of-home placement. If there are more than eight children in a family in out-of-home placement a new form must be opened and completed for the additional children.

 

The form is reviewed, and updated as necessary, when the CP&P Form 26-81, Family Summary/Case Plan, is completed. The CP&P Form 26-82 must be updated when there is new information to be entered.

 

SPECIAL INSTRUCTIONS

 

For situations in which two or more siblings have the same maternal and/or paternal relatives, complete the entire maternal and/or paternal section(s) for the oldest child. For the next and any subsequent children who share the same maternal and/or paternal relatives, check the box before the phrase "The maternal relatives for this child are the same as the maternal relatives for member number ____" or "The paternal relatives for this child are the same as the paternal relatives for member ____" and complete the statement by entering the member number of the older sibling who shares the same relatives and for whom the entire section has been completed with the appropriate information.

 

SPECIFIC INSTRUCTIONS FOR COMPLETING THE FORM

 

HEADING

 

Report Date

Enter the date that the chart is prepared.

 

KC# Number

Enter the CP&P case ID number.

 

Docket #FN

When applicable, enter the FN docket number assigned to this case by the court. FN numbers are assigned when a child abuse or neglect case has been filed with the court.

 

Docket #FG

When applicable, enter the FG docket number assigned to this case by the court. FG numbers are assigned when a guardianship complaint has been filed with the court.

 

DO/ARC

Enter the name of the CP&P office supervising the case. If the case is being dual managed enter the name of the CP&P office has primary responsibility for the case.

 

District Office/ARC (Dual Management)

If a case is being dual managed, enter the name of the other CP&P office involved with the case. If a case is being dual managed, enter the name of the other CP&P office involved with the case.

 

Case/Family Name

Enter the case name for the family.

 

 

CHART

 

Member #

Enter the child's two-digit member number.

 

Child

Enter the child’s full name.

 

 

There are blocks down the left side with pre-printed information that indicate specific relationships. The pre-printed section from Maternal Aunt to Other Maternal Relative in the top half of the form and from Paternal Aunt to Other Paternal Relative in the bottom half of the form allow for the specific named relationship to be "typed over" if those relationships pre-printed on the form do not apply. This means that you may type over the words Maternal Aunt etc., with the relationship you wish to specify, for example:  Maternal Cousin. The blocks across the top indicate what is entered in the blank boxes next to each specific relationship.

 

The column headings and instructions for those spaces are given below.

 

Name

Enter the name of the maternal grandmother, grandfather etc. of that child. If a relative is deceased, indicate that immediately under their name. Enter the name of the maternal grandmother, grandfather etc. of that child. If a relative is deceased, indicate that immediately under their name.

 

Address Known

Select "yes" or "no" from the drop down menu to indicate whether or not the address of that person is known.

Search Dates:  Information is entered if a search needs to be or was conducted in order to locate that particular relative. When applicable enter the date that the search was initiated. If a search was initiated and completed, enter the date that the search is completed. Searches for relatives are not as extensive as a search for a parent. Rather, a relative search must be reasonable and practical. For example, one would write to a particular relative's last known address or employer if one is known.

 

Assessed

If applicable, enter the date that this relative was assessed as a placement resource for this child.

 

Interested

From the drop down menu, select "yes" if this relative is interested in being a placement resource for this child and "no" if he/she is not.

 

Appropriate

Select "yes" if the relative is interested in being a placement resource for the child and, after assessment, is found to be an appropriate placement for the child. Select "no" if the relative is not interested in being a placement resource or if, after assessment, was found to not be an appropriate placement for the child.

 

CP&P 5-52 Sent

Select "yes" if the CP&P 5-52 was sent and "no" if not.

 

Interstate Services

This column is used if the relative resides out of state and the Interstate Services Unit is involved in obtaining an assessment of the relative. From the drop down menu, select "yes" in the top half of the section if Interstate is involved and "no" if not. Enter the date the case referral was sent to Interstate Services in the bottom half.

 

 

Complete the relevant information for each relative who is known or is being searched for.

 

At the bottom of the page is a statement and a signature space which is to be completed (signed and dated) by the parent(s)/guardian(s).

 

DISTRIBUTION

 

This form is companion to the CP&P form 26-81 and is distributed with it. Specific distributions are:

 

Permanency Hearing Before Court on a Litigation Case

 

Original

-

Case Record

 

Copy

-

Court Conducting Permanency Hearing

 

Copy

-

DAG

 

Copy

-

Law Guardian

 

Copy

-

Parent(s)’ Attorney(s)

 

Copy

-

CPRB

 

 

Periodic (Child Abuse/Neglect FN) Court Review

 

Original

-

Case Record

 

Copy

-

Court

 

Copy

-

DAG

 

Copy

-

Law Guardian

 

Copy

-

Parent(s)’ Attorney(s)

 

Copy

-

CPRB

 

 

CPRB Reviews and/or CPRB Permanency Hearings

 

Original

-

Case Record

 

Copy

-

CPRB

 

 

CP&P Internal Placement Review

 

Original

-

Case Record

 

Copy

-

CPRB

 

Copy

-

Parent(s)

 

 

Exception Documentation

 

Original

-

Case Record

 

Copy

-

Local Office Manager

 

Copy

-

Area Office

 

 

If Completed Case Plan Only

 

Original

-

Case Record

 

Copy

-

CPRB

 

Copy

-

Parent(s)