Attachment B - CFSR OSRI R4 April 2021 UPDATED 090121
Title IV-E Foster Care Eligibility Reviews, Child and Family Services Reviews
Attachment B - CFSR OSRI R4 April 2021 UPDATED 090121
OMB: 0970-0214
Child
and Family
Services Reviews
Onsite Review Instrument and Instructions
April 2021
PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 10413) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to review state child welfare systems’ performance related to child protective services, foster care, adoption, family preservation and independent living as well as their conformity to required child and family outcomes. Public reporting burden for this collection of information is estimated to average 1,186 hours per grantee, including the time for reviewing instructions, gathering and maintaining the data needed, and preparation for and conducting the case reviews and interviews as well as conducting the review itself, and reviewing the collection of information. This is a mandatory collection of information (45 CFR 1355.33(c)). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 09700214 and the expiration date is XX/XX/XXXX. If you have any comments on this collection of information, please contact the Children's Bureau's at Danielle.McConaga@acf.hhs.gov
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Table of Contents
SAFETY OUTCOME 1:
CHILDREN ARE, FIRST AND FOREMOST, PROTECTED FROM ABUSE
AND
NEGLECT 10
Item 1: Timeliness of Initiating Investigations of Reports of Child Maltreatment 10
SAFETY OUTCOME 2:
CHILDREN ARE SAFELY MAINTAINED IN THEIR HOMES WHENEVER
POSSIBLE
AND APPROPRIATE 15
Item 3: Risk and Safety Assessment and Management 19
PERMANENCY
OUTCOME 1: CHILDREN HAVE PERMANENCY AND STABILITY IN THEIR
LIVING
SITUATIONS 26
Item 4: Stability of Foster Care Placement 26
Item 5: Permanency Goal for Child 30
Item 7: Placement With Siblings 43
Item 8: Visiting With Parents and Siblings in Foster Care 45
Item 9: Preserving Connections 50
Item 10: Relative Placement 52
Item 11: Relationship of Child in Care With Parents 55
WELL-BEING OUTCOME 1: FAMILIES HAVE ENHANCED CAPACITY TO PROVIDE FOR THEIR CHILDREN’S NEEDS 60
Item 12: Needs and Services of Child, Parents, and Foster Parents 60
Item 13: Child and Family Involvement in Case Planning 70
Item 14: Caseworker Visits With Child 74
Item 15: Caseworker Visits With Parents 77
WELL-BEING OUTCOME 2: CHILDREN RECEIVE APPROPRIATE SERVICES TO MEET THEIR EDUCATIONAL NEEDS 82
Item 16: Educational Needs of the Child 82
Item 17: Physical Health of the Child 86
Item 18: Mental/Behavioral Health of the Child 91
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OMB Control Number: 0970-0214
Expiration Date: X/XX/2021
Children's Bureau
Child and Family Services Reviews
Onsite Review Instrument and Instructions
GENERAL INSTRUCTIONS
The Onsite Review Instrument and Instructions (OSRI) is used to review both foster care and in-home services cases during the onsite review component of the Child and Family Services Reviews (CFSRs). In completing the instrument, reviewers conduct case file reviews and case-related interviews with children, parents, foster parents, caseworkers, and other professionals involved with the child.
The instrument is organized into a Face Sheet and three sections. On the Face Sheet, reviewers document general information about a case, such as the type of case. The three sections focus on the outcome domains that form the basis of the CFSRs: safety, permanency, and child and family well-being. For each outcome, reviewers collect information on “items” related to that outcome.
Although reviewers use the instrument to review both foster care and in-home services cases, they should complete the permanency section only if the case under review is a foster care case. If reviewing an in-home services case, reviewers should select Not Applicable as the rating for the permanency items.
For children in foster care, reviewers should consider the safety items (1 through 3) for all children in the family, but complete the permanency items (4 through 11) and the child and family well-being items (12 through 18) only as they apply to the specific child whose case is under review (referred to as the target child). For children receiving in-home services, reviewers should consider the safety items (1 through 3) for all children in the family home and complete the well-being items (12 through 18) for all children in the family unless reviewers determine that only specific children should be receiving services and, based on case circumstances, the other children in the family home do not need to be considered in these items.
Reviewing the Case
Reviewers must respond to all the questions for each applicable item. Reviewers should use their professional judgment to determine how best to gather all the relevant information needed to respond to questions. The instrument provides some instructions on where to find information, such as the case record or court orders. Information gathered through case-related interviews should be considered when responding to questions.
Reviewers must consider all agency services and actions on all accepted maltreatment reports and cases from the start of the period under review (PUR) until the case review is complete. The PUR begins with the sampling period start date and ends with the date the case review is completed or the case is closed, whichever comes first.
Reviewers must indicate the case participants included in the assessment of certain items to identify which children in an in-home services case are included in the assessment of various items and to determine who is being considered as “mother” and “father” in various items. Participants should be selected from the case participants listed in the child and case participant tables in the Face Sheet.
Further instructions for answering the questions relating to the individual items, along with definitions for key terms, are provided below the relevant question. Reviewers should read all instructions and definitions carefully before responding to questions.
CHILD AND FAMILY SERVICES REVIEWS ONSITE REVIEW INSTRUMENT
Case
Information
Definition and Instructions for Questions A Through E Below:
A. Name of state and site: _____________________________
B. Case name: _____________________________
C. Period under review begins on: _____________________________
D. Reviewer name(s): _____________________________
Initial QA completed by (name): _____________________________
Second Level QA completed by (name): _____________________________
Secondary Oversight completed by (name): _____________________________
E. Date case review was completed: ------/-------/----------------
F. What is the type of case reviewed? Select one type only:
Foster
Care In-Home
Services In-Home
Services—Differential/Alternative Response
Question F Instructions:
The case is a foster care case if the target child was in foster care at any time during the PUR. Foster care means 24-hour substitute care for children placed away from their parents or guardians and for whom the title IV-E agency has placement and care responsibility. This includes a child who is placed by the agency with relatives or in other kin-type placements, and for whom the agency maintains placement and care responsibility. It does not include a child who is living with relatives (or caregivers other than parents) and who is not under the placement and care responsibility of the agency.
The case is an in-home services case if no child in the family was in foster care at any time during the PUR, and the case was open for at least 45 days.
The case is an in-home services differential/alternative response case if the state has some form of differential/alternative response program during the PUR and the in-home services case was served through that program.
G1. Child Table
Target Child |
Child’s Name |
Race(s) |
Ethnicity |
Date of Birth (MM/DD/YYYY) |
Gender |
Interviewed (Yes/No) |
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Table G1 Instructions:
For both foster care cases and in-home services cases, enter the first and last names (first name first) of all children in the family as identified in the case file. If the case is a foster care case, indicate “Yes” in the first column of the table next to the name of the target child. It is essential that the target child be clearly identified for all foster care cases.
Enter the race and ethnicity information as provided in the case file. If the child is of two or more races, list all that are provided in the case file (for example, White and Asian, or White and American Indian). If you learn during the interviews that a child is of a different race or ethnicity than is noted in the file or is of two or more races and only one is noted in the file (for example, Non-Hispanic instead of Hispanic, or both White and American Indian), please change the race or ethnicity identification information presented to reflect the accurate information.
Select from the following options for ethnicity: “Hispanic,” “Non-Hispanic,” “Unknown,” and “Unable to Determine.”
Select from the following options for race:
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Unknown or Unable to Determine
Provide the date of birth for every child in the family, even if this is a foster care case.
If the child is abandoned or the date of birth is otherwise unknown, enter an approximate date of birth. Use the 15th as the day of birth.
G2. Case Participant Table
Name |
Role |
Relationship to Child |
Interviewed (Yes/No) |
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Table G2 Instructions:
Participants include biological parents even if their identity is unknown, they are deceased, or their parental rights have been terminated; caregivers; adults in the home if they are involved with the child; foster parents; and interview subjects including caseworkers, supervisors, and key service providers.
In the Name column, for both foster care and in-home services cases, enter the first and last names (first name first) of the key case participants whose participation in this case will be assessed in the instrument and other persons who were interviewed to provide relevant information. If the identify of a parent is unknown, indicate “unknown” in the Name column.
In the Role column, list one of the following options for each participant listed: Mother, Father, Caregiver, Foster Parent, Caseworker, Caseworker’s Supervisor, Other. The same role may be indicated for more than one person (for example, a biological father may have the role of Father, and a stepfather may have the role of Father).
In the Relationship to Child column, indicate how the person is involved in the case and/or related to the child. Indicate whether the person is/was living with the child and/or in a caregiving role. If there is more than one child, identify the child or children with whom the person is connected by assigning each child a number that corresponds to their line on the table. For example: significant other of (child number 1)’s mother, lives in the home; biological mother of (child(ren) numbers 1 and 2) not living in the home, not a caregiver; legal father of (child number 3), not living in the home; biological mother termination of parental rights (TPR) (date); biological father deceased (date).
In the Interviewed column, note whether the person has been interviewed regarding the case.
H. Was this case opened for reasons other than child abuse and neglect?
Yes No
Question H Instruction:
Examples of cases opened for reasons other than child abuse or neglect include: (1) cases opened because of the child’s behavior, including juvenile delinquency, substance abuse, or “child in need of supervision,” and there were no maltreatment concerns in the family; or (2) cases opened because parents requested mental/behavioral health services for their child(ren).
I. Why was/were the case(s) opened for services?
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Question I Instructions:
Indicate the reason(s) for case opening(s) by selecting all that apply. Consider all cases open during the PUR. The reason for case opening should be based on whatever information is available in the case record and from interviews that identifies why the agency opened the case. This would include the maltreatment type that was substantiated or resulted in case opening, and it could also include other information that informed the agency’s decision to open the case. If “other” was checked as a reason the case was opened for services, the circumstances and reason must be very clearly documented in the narrative.
J. What is the date of the first case opening, of the cases open for services during the PUR?
------/-------/----------------
Question J Definition:
Typically, a case is considered “open for services” when the case was opened for case management and/or service provision.
Question J Instructions:
Using the MM/DD/YYYY format, enter the date on which the case was actually opened within the agency. Consider all cases that were open for services during the PUR, if there were multiple case openings. If the first case that was open during the PUR was opened before the PUR began, include it as the first case opening date for the period.
If a child was on a trial home visit and returned to a foster care placement, the return to foster care is not considered a “case opening” unless the trial home visit was longer than 6 months and there was no court order extending the trial home visit beyond 6 months.
If the family received in-home services before the removal of a child and placement of the child in foster care, and the case was not closed before placement, enter the date on which the case was opened for in-home services. The date of the child’s removal from home will be captured in the next question.
K. What is the date of the child’s latest removal?
------/-------/---------------- Not Applicable
Question K Definition:
The date of latest removal refers to a child’s removal from his or her normal place of residence and placement in a substitute care setting under the placement and care responsibility of the state or local title IV-B/IV-E agency. Children are considered to have been removed if the child has been in substitute care for 24 hours or more.
Question K Instructions:
Using the MM/DD/YYYY format, enter the date of the child’s latest removal from his or her normal place of residence.
If a child was on a trial home visit and returned to a foster care placement, the return is not considered the latest removal unless the trial home visit was longer than 6 months and there was no court order extending the trial home visit beyond 6 months.
If the case is an in-home services case, K is Not Applicable.
L. What is the date of the child’s most recent entry into foster care?
------/-------/---------------- Not Applicable
Question L Definition:
“Entry into foster care” refers to either the date of a judicial finding that the child had been subjected to child abuse or neglect (often the adjudicatory hearing), or 60 days after the date on which the child was removed from the home, whichever is earlier.
Question L Instructions:
Using the MM/DD/YYYY format, enter the date of the child’s most recent entry into foster care.
If a child was on a trial home visit and returned to a foster care placement, the return is not considered an entry into foster care unless the trial home visit was longer than 6 months and there was no court order extending the trial home visit beyond 6 months.
If the case is an in-home services case, L is Not Applicable.
M. What is the date the target child was physically returned from a foster care placement to live with his or her parent(s) or legal guardian?
------/-------/---------------- Not Applicable
Question M
Instructions
Using the
MM/DD/YYYY format, enter the date the child was physically
returned home.
The date the
target child was physically returned home may be different from
the date that legal custody of the child is returned to the parent
or legal guardian and the child is considered fully discharged
from foster care.
The state or local
child welfare agency may retain legal custody of the child, with
the plan that legal custody will be returned to the parent or
guardian after a period of time in the home (designated by the
court or child welfare agency), if that trial period is
successful.
If the child is
physically returned home multiple times during the PUR, reviewers
should use the date of the most recent physical return home.
If the target
child did not physically return home during the PUR or this is an
in-home services case, M is Not Applicable.
N. What is the date of discharge from foster care for the most recent foster care episode?
------/-------/---------------- Not Applicable Not Yet Discharged
Question N Definition:
“Discharge from foster care” is defined as the point when the child is no longer in foster care under the placement and care responsibility or supervision of the agency.
Question N Instructions:
Using the MM/DD/YYYY format, enter the date of discharge from foster care for the most recent foster care episode.
If a child returns home on a trial home visit and the agency retains responsibility or supervision of the child, the child should be considered discharged from foster care only if the trial home visit was longer than 6 months, and there was no court order extending the trial home visit beyond 6 months.
If the child is in foster care but has not yet been discharged, select Not Yet Discharged.
If the case is an in-home services case, N is Not Applicable.
O. What is the date of the most recent case closure during the PUR? ------/-------/----------------
Case not closed by time of review
Question O Instructions:
Using the MM/DD/YYYY format, enter the date on which the agency officially closed the case. For foster care cases, this may or may not be the same as the discharge date.
If there were multiple case openings and closures during the period under review, indicate the date of the last case closure that occurred during the period.
The date entered is the date on which the agency completed all case closure activities required by the state’s policy.
If the case is still open at the time of review, select “Case not closed by time of review."
Case Summary (optional) (Do not use proper names):
SECTION I: SAFETY
SAFETY OUTCOME 1: CHILDREN ARE, FIRST AND FOREMOST, PROTECTED FROM ABUSE AND NEGLECT.
Item 1: Timeliness of Initiating Investigations of Reports of Child Maltreatment
Purpose of Assessment: To determine whether responses to all accepted child maltreatment reports received during the period under review were initiated, and face-to-face contact with the child(ren) made, within the timeframes established by agency policies or state statutes.
Item 1 Applicable Cases:
Cases are applicable for an assessment of this item if an accepted child maltreatment report on any child in the family was received during the PUR. “Accepted” means that the report was assigned to the agency to conduct an assessment or investigation. This includes reports assigned for an “alternative response” assessment. Reports that are screened out are not considered “accepted.” “Alternative response” refers to an agency’s approach to addressing child maltreatment reports that meet agency criteria for acceptance but at the initial screening do not meet the agency’s requirements for a mandated investigation. For example, the agency’s policy may be that reports that appear to present low to moderate risk to the child may be referred for a family assessment, rather than an investigation. Under such a response, no determination of child maltreatment is made. The alternative response may include an assessment to determine the safety of the child(ren), the risk of maltreatment, and the family’s strengths and needs. The assessment may lead the state agency to provide services to eliminate or lessen the safety concerns and maltreatment risks.
Cases are not applicable for an assessment of this item if, during the PUR, there were no child maltreatment reports on any child in the family, or if a report was received on a child in the family but it was “screened out”; that is, not referred for an assessment or investigation.
Is this case applicable?
Select the appropriate response below. If the response is No, rate the case as Not Applicable in the ratings section and continue to Item 2.
Yes No
Optional: Provide comments in the narrative field below
Report Date |
Name of Child |
Allegation |
Priority Level, If Applicable |
Assessment or Investigation |
Date Assigned for an Investigation or Assessment |
Date Investigation or Assessment Initiated |
Date of Face-to-Face Contact With Child |
Relationship of Alleged Perpetrator to Child |
Disposition |
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Table 1A1 Instructions:
Complete the table for all accepted reports received during the PUR.
List reports by date, per child, and per allegation (for each perpetrator). If the same child had multiple allegations that resulted in separate dispositions, each allegation should be indicated in a separate row in the table so the disposition can be noted for each allegation. If multiple allegations received the same disposition, all allegations may be indicated in the same row.
If the state has policies outlining different priority levels for reports, indicate the priority level that was assigned.
Indicate whether the report was assigned for an investigation or referred for an assessment.
The date assigned for an investigation or assessment is the date the report is assigned to a specific worker to conduct the investigation or assessment. If the report was not assigned, document the date assigned as “Did not occur.”
The date the investigation or assessment was initiated is the date on which the agency made the first attempt to contact the family. Include the date on which the investigation/assessment was initiated per state policy, or if no state policy exists, include the date when contact with the family was first attempted. If the investigation or assessment was not initiated or face-to-face contact with the child did not occur, document these dates as “Did not occur.”
In the last column, report the disposition of the case. If the case was investigated, indicate whether the report was “Substantiated” or “Not Substantiated” (this may be documented in the record as “founded” or “unfounded,” or “indicated” or “not indicated”). If the investigation has not been completed as of the time of review, indicate “Investigation Pending.” If the case was referred for an assessment, indicate whether it was “opened for services” or “not opened for services.” If the assessment has not yet been completed, indicate “Assessment Still Pending.”
Question 1A and B Instructions:
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A. In how many of the reports listed in the table was the investigation or assessment NOT initiated in accordance with the state’s timeframes and requirements for a report of that priority?
B. In how many of the reports in the table was face-to-face contact with the child(ren) who is (are) the subject of the report NOT made in accordance with the state’s timeframes and requirements for a report of that priority?
C. For all reports identified in A and B, were the reasons for the delays due to circumstances beyond the control of the agency?
Yes No Not Applicable
Explain the reason for any delays related to reports identified in A and B in the narrative field below:
Question 1C Instructions:
If the answers to both questions A and B are zero, the answer to question C should be Not Applicable.
Delays in services provided by organizations or agencies under contract with the agency would not be considered as beyond the control of the agency. However, where services are provided by another public state or local agency, such as law enforcement, the actions of these agencies may be beyond the control of the child welfare agency.
Item 1 Rating Criteria:
Item 1 should be rated as a Strength if either of the following applies:
The answers to A and B are zero.
The answers to A or B are greater than zero, but the answer to C is Yes.
Item 1 should be rated as an Area Needing Improvement if the following applies:
The answer to A or B is greater than zero, and the answer to C is No.
Item 1 should be rated as Not Applicable if the response to the question of applicability is No.
Item 1 Rating (select one):
Strength Area Needing Improvement Not Applicable
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
RATING
SAFETY OUTCOME 1
SAFETY OUTCOME 1: CHILDREN ARE, FIRST AND FOREMOST, PROTECTED FROM ABUSE AND NEGLECT.
What is the level of outcome achievement that best describes the extent to which this outcome is being or has been achieved, based on the rating for Item 1?
Instructions:
Safety Outcome 1 should be rated as Substantially Achieved if the following applies:
Item 1 is rated as a Strength.
Safety Outcome 1 should be rated as Not Achieved if the following applies:
Item 1 is rated as an Area Needing Improvement.
Safety Outcome 1 should be rated as Not Applicable if the following applies:
Item 1 is rated as Not Applicable.
Select the appropriate response:
Substantially Achieved Not Achieved Not Applicable
SAFETY OUTCOME 2: CHILDREN ARE SAFELY MAINTAINED IN THEIR HOMES WHENEVER POSSIBLE AND APPROPRIATE.
Item 2: Services to Family to Protect Child(ren) in the Home and Prevent Removal or Re-Entry Into Foster Care
Purpose of Assessment: To determine whether, during the period under review, the agency made concerted efforts to provide services to the family to prevent children’s entry into foster care or re-entry after a reunification.
In the list of criteria below, check Yes for any that apply and No for any that do not apply. A case is applicable for an assessment of this item if it meets at least one of the following criteria:
It is an in-home services case and during the PUR:
Services were needed to address concerns for safety and/or risk of abuse/neglect of any child to prevent foster care placement and ensure that the child(ren) would be able to remain safely in the home or with an alternative caregiver or to return home safely from a temporary alternative caregiver arrangement. Yes No
It is a foster care case and during the PUR:
The target child entered foster care due to reasons associated with child safety and/or risk of child abuse/neglect. Yes No
The target child was reunified (or was returned home on a trial basis), and services were needed to support reunification and prevent foster care re-entry. Yes No
The target child was in foster care during the PUR and there are concerns regarding the safety and/or risk of child abuse or neglect for any child(ren) remaining in the home.
Yes No
Is this case applicable?
Select the appropriate response below. If the response is No, rate the case as Not Applicable in the ratings section and continue to Item 3.
Yes No
Optional: Provide comments in the narrative field below:
A. During the PUR, did the agency make concerted efforts to provide or arrange for services for the family (including any services for alternative caregivers) to protect the children and prevent their entry into foster care or re-entry into foster care after a reunification? (Be sure to assess the entire PUR.)
Yes No
If No, explain circumstances in the narrative field below:
Question 2A Instructions:
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B. If, during the PUR, any child was removed from the home without providing or arranging for appropriate services, was this action necessary?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
Question 2B Instructions:
If the answer to question A is Yes, but, after making efforts to provide appropriate services, the child was removed from the home during the PUR due to unmanageable safety concerns or risk of abuse/neglect, the answer to question B should be Not Applicable.
If the child was not removed from the home during the PUR, the answer to question B should be Not Applicable.
Focus on whether the circumstances of the case and of the removal suggest that appropriate services would not have been sufficient to ensure the child’s safety and protection if the child remained in the home. If the information indicates that it was necessary to remove the child immediately to ensure the child’s safety and protection, the answer to question B should be Yes. If the information indicates that services could have been provided to prevent removal but the child was removed without providing appropriate services, this question should be answered No.
If services should have been offered to protect the child but were not offered because those services were not available in the community, the answer to question B should be No.
Item 2 Rating Criteria:
This item should be rated as a Strength if either of the following applies:
The answer to question A is Yes, and the answer to question B is Not Applicable.
The answer to question A is No, and the answer to question B is Yes.
This item should be rated as an Area Needing Improvement if either of the following applies:
The answer to question A is No, and the answer to question B is No.
The answer to question A is No, and the answer to question B is Not Applicable.
Item 2 should be rated as Not Applicable if the response to the question of applicability is No.
Item 2 Rating (select one):
Strength Area Needing Improvement Not Applicable
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
SAFETY OUTCOME 2: CHILDREN ARE SAFELY MAINTAINED IN THEIR HOMES WHENEVER POSSIBLE AND APPROPRIATE.
Item 3: Risk and Safety Assessment and Management
Purpose of Assessment: To determine whether, during the period under review, the agency made concerted efforts to assess and address the risk and safety concerns relating to the child(ren) in their own homes or while in foster care.
Item 3 Applicable Cases: All cases are applicable for an assessment of this item.
A1. Did any of the following concerns exist during the PUR?
There were maltreatment allegations about the family, but they were never formally reported or formally investigated/assessed. Yes No
There were maltreatment allegations that were not substantiated despite evidence that would support substantiation. Yes No
A. If the case was opened during the PUR, did the agency conduct an initial assessment that accurately assessed all risk and safety concerns for the target child in foster care and/or any child(ren) in the family remaining in the home?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
Questions 3A and 3B Instructions:
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B. During the PUR, did the agency conduct ongoing assessments that accurately assessed all of the risk and safety concerns for the target child in foster care and/or any child(ren) in the family remaining in the home?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
Question 3B Instructions:
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C. During the PUR, if safety concerns were present, did the agency: (1) develop an appropriate safety plan with the family and (2) continually monitor and update the safety plan as needed?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
Question 3C Definition:
“Safety plan” refers to a plan that describes strategies developed by the agency and family to ensure that the child(ren) is (are) safe. Safety plans may address (1) safety threats and how those will be managed and addressed by the caregiver, (2) caregiver capacity to implement the plan and report safety issues to the agency, and (3) family or other support system involvement in implementation of the plan. Safety plans may be separate from or integrated into the case plan and may be evidenced by the articulation of the elements of the plan in case-related interviews.
Question C is applicable to all in-home services cases and to foster care cases in which there are other children remaining in the family home and/or the target child in foster care returned home during the PUR. For in-home cases in which children are placed temporarily with alternative caregivers to ensure safety, consider that as a safety plan to be assessed in question C.
Appropriate services needed to support a safety plan should be addressed in Item 2.
Question C should be answered Not Applicable if you determine that during the PUR there were no apparent safety concerns for any child in the family home.
D1. Indicate whether any safety-related incidents occurred during the PUR. Select all that apply:
Recurring maltreatment: There was at least one substantiated or indicated maltreatment report on any child in the family during the PUR AND there was another substantiated report within a 6-month period before or after that report that involved the same or similar circumstances. In determining the similarity of the circumstances, consider the perpetrator of the maltreatment and other individuals involved in the incident.
Recurring safety concerns: There was at least one maltreatment report involving any child in the family during the PUR that was handled by an alternative response and resulted in opening the case for services to address safety concerns (this decision may have been made by the agency or by a private provider under contract with the agency) AND there was at least one additional maltreatment report within a 6-month period before or after that report that was handled by an alternative response and resulted in a decision to open the case for services to address the same or similar safety concerns (the case may have been opened for services by the agency or by a private provider under contract with the agency). In determining the similarity of the concerns, consider the perpetrator of the maltreatment, other individuals involved in the incident, and the type of safety issues that existed.
The case was closed while significant safety concerns that were not adequately addressed still existed in the home.
Other (describe any other safety-related incidents that were not adequately addressed by the agency): _______________________________________________
Not Applicable (no safety issues were present during the PUR).
No safety-related incidents occurred that were not adequately addressed by the agency.
D. During the PUR, were there safety concerns pertaining to the target child in foster care and/or any child(ren) in the family remaining in the home that were not adequately or appropriately addressed by the agency?
Yes No Not Applicable
Question 3D Instructions:
Question D is applicable to all cases.
Answer Yes if any safety-related incidents in D1 are selected.
Answer No if no safety-related incidents occurred that were not adequately addressed by the agency.
Answer Not Applicable if no safety issues were present during the PUR.
E1. For foster care cases only, indicate whether any safety concerns related to visitation were present during the PUR. Select all that apply:
Not Applicable (this is an in-home services case, or the target child did not have any visitation).
No safety concerns existed for the target child related to visitation that were not adequately addressed.
Sufficient monitoring of visitation by parents/caregivers or other family members was not ensured.
Unsupervised visitation was allowed when it was not appropriate.
Visitation was court-ordered despite safety concerns that could not be controlled with supervision.
Other (describe the safety concerns that existed with visitation):
_____________________________________________
E. During the PUR, were there any safety concerns related to the target child in foster care during visitation with parents/caregivers or other family members that were not adequately or appropriately addressed by the agency?
Yes No Not Applicable
F1. For foster care cases only, indicate whether any concerns existed for the child in at least one foster care placement during the PUR. Select all that apply:
Not Applicable (this is an in-home services case).
No safety concerns existed for the target child while in foster care placement that were not adequately addressed.
There was a substantiated allegation of maltreatment of the child by a foster parent (including a relative foster parent) or facility staff member that could have been prevented if the agency had taken appropriate actions.
There was a critical incident report or other major issue relevant to noncompliance by foster parents or facility staff that could potentially make the child unsafe, and the agency could have prevented it or did not provide an adequate response after it occurred.
The child’s placement during the PUR presented other risks to the child that are not being addressed, even though no allegation was made and no critical incident reports were filed.
The reviewer discovers that there are safety concerns related to the child in the foster home of which the agency is unaware because of inadequate monitoring.
Other (describe any other safety concerns that existed with the child’s foster placement):
__________________________________________
Questions 3F1 and 3F Definition: Foster parents are defined as related or non-related caregivers who have been given responsibility for care of the child by the agency while the child is under the placement and care responsibility and supervision of the agency. This includes pre-adoptive parents if the adoption has not been finalized. |
F. For foster care cases only, during the PUR, were there any concerns for the target child’s safety related to the foster parents, members of the foster parents’ family, other children in the foster home or facility, or facility staff members, that were not adequately or appropriately addressed by the agency?
Yes No Not Applicable
Question 3F Instructions:
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Item 3 Rating Criteria
Item 3 should be rated as a Strength if the following applies:
Questions A and B are both answered Yes, or
The answer to either A or B is Yes and the other is Not Applicable, and
The answer to question C is either Yes or Not Applicable, and
The answers to questions D, E, and F are either No or Not Applicable.
Item 3 should be rated as an Area Needing Improvement if the following applies:
The answer to any one of questions A, B, or C is No, and/or
The answer to any one of questions D, E, or F is Yes.
There are no circumstances under which Item 3 could be rated as Not Applicable.
Item 3 Rating (select one):
Strength Area Needing Improvement
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement
Override reason:
RATING SAFETY OUTCOME 2
SAFETY OUTCOME 2: CHILDREN ARE SAFELY MAINTAINED IN THEIR HOMES WHENEVER POSSIBLE AND APPROPRIATE.
What is the level of outcome achievement that best describes the extent to which this outcome is being or has been achieved, based on the ratings for Items 2 and 3?
Instructions:
Safety Outcome 2 should be rated as Substantially Achieved if either of the following applies:
Items 2 and 3 are rated as Strengths.
Item 2 is rated as Not Applicable and Item 3 is rated as a Strength.
Safety Outcome 2 should be rated as Partially Achieved if the following applies:
One of the two items is rated as a Strength and the other as an Area Needing Improvement.
Safety Outcome 2 should be rated as Not Achieved if either of the following applies:
Items 2 and 3 are rated as Areas Needing Improvement.
Item 2 is rated as Not Applicable and Item 3 is rated as an Area Needing Improvement.
Select the appropriate response:
Substantially Achieved Partially Achieved Not Achieved
SECTION II: PERMANENCY
PERMANENCY OUTCOME 1: CHILDREN HAVE PERMANENCY AND STABILITY IN THEIR LIVING SITUATIONS.
Item 4: Stability of Foster Care Placement
Purpose of Assessment: To determine whether the child in foster care is in a stable placement at the time of the onsite review and that any changes in placement that occurred during the period under review were in the best interests of the child and consistent with achieving the child’s permanency goal(s).
Item 4 Applicable Cases: All foster care cases are applicable for an assessment of this item.
A1. Placement Table
Placement Date |
Placement Type |
Reason for Change in Placement Setting |
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Table 4A1 Definitions and Instructions: Complete the placement table. Begin with the child’s placement setting at the onset of the PUR, or if the child was removed during the PUR, begin with the first placement setting upon removal. If there was only one placement setting, complete only the first two columns of the first row. Select from the following options for placement type. Definitions for each placement type are provided:
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Select from the following options for reason for change in placement setting:
Not Applicable. This is the current placement.
Move to an adoptive or permanent guardian’s home.
Move from a more restrictive to a less restrictive placement.
Move from a less restrictive to a more restrictive placement.
Move to a relative placement.
Move that brings the child closer to family or other important connections.
Move to a temporary placement while awaiting a more appropriate placement.
Move due to foster parent’s request.
Other (describe): _______________________________________________________________
A. How many placement settings did the child experience during the PUR? _____________________
Question 4A Definitions:
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Question 4A Instructions:
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B. Were all placement changes during the PUR planned by the agency in an effort to achieve the child’s case goals or to meet the needs of the child?
Yes No Not Applicable
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Question 4B Instructions:
If the response to question A is one (1), the response to question B should be Not Applicable. If the single placement is not stable, that information will be collected in question C.
Placement changes that reflect agency efforts to achieve case goals include moves from a foster home to an adoptive home, moves from a more restrictive to a less restrictive placement, moves from non- relative foster care to relative foster care, and moves that bring the child closer to family or community.
Placement changes that do not reflect agency efforts to achieve case goals include moves due to unexpected and undesired placement disruptions; moves due to placing the child in an inappropriate placement (that is, moves based on mere availability rather than on appropriateness); moves to more restrictive placements when this is not essential to achieving a child’s permanency goal or meeting a child’s needs; temporary placements while awaiting a more appropriate placement; and practices of routinely placing children in a particular placement type, such as shelter care, upon removal regardless of individual needs.
If ALL placement changes during the PUR reflect planned agency efforts to achieve the child’s case goals or to meet the needs of the child, the answer to question B should be Yes.
If any single placement change that occurred during the PUR was for a reason other than agency efforts to achieve case goals or to meet the child’s needs, the answer to question B should be No.
Placement changes that result from unexpected circumstances that are out of the control of the agency (such as the death of a foster parent, or foster parents moving to another state) can be considered similar to those that reflect agency efforts to achieve case goals for purposes of question B.
C1. Indicate whether any of the circumstances below apply to the child’s current placement. Select all that apply:
None apply, placement is stable.
The child’s current placement is in a temporary shelter or other temporary setting.
There is information indicating that the child’s current substitute care provider may not be able to continue to care for the child.
There are problems in the current placement threatening its stability that the agency is not addressing.
The child has run away from this placement more than once in the past or is in runaway status at the time of the review.
Other (describe reasons why the current placement is not stable):
C. Is the child’s current placement setting (or most recent placement if the child is no longer in foster care) stable?
Yes No
Item 4 Rating Criteria:
Item 4 should be rated as a Strength if either of the following applies:
The answer to question A is one (1), the answer to question B is Not Applicable, and the answer to question C is Yes.
The answer to question A is greater than one (1), but the answers to questions B and C are Yes.
Item 4 should be rated as an Area Needing Improvement if either of the following applies:
The answer to question A is one (1), but the answer to question C is No.
The answer to question A is greater than one (1), and the answer to question B and/or C is No.
Item 4 Rating (select one):
Strength Area Needing Improvement
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement
Override reason:
PERMANENCY
OUTCOME 1: CHILDREN HAVE PERMANENCY AND STABILITY IN THEIR LIVING
SITUATIONS.
Item 5: Permanency Goal for Child
Purpose of Assessment: To determine whether appropriate permanency goals were established for the child in a timely manner.
Item 5 Applicable Cases: All foster care cases are applicable for assessment of this item, unless the child has been in foster care for less than 60 days, and a permanency goal has not been established.
Is this case applicable?
Select the appropriate response. If the response is No, rate the item as Not Applicable in the rating section and continue to Item 6.
Yes No
Optional: Provide comments in the narrative field below:
A1. Permanency Goal Table
Permanency Goal |
Date
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Time in Foster Care Before Goal Established |
Date Goal Changed |
Reason for Goal Change |
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Table 5A1 Definitions: Permanency goals are defined as follows:
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A2. What is (are) the child’s current permanency goal(s)? (If concurrent permanency goals have been established in the case plan, identify both goals.) Or, if the case was closed during the PUR, what was the permanency goal(s) before the case was closed?
Permanency Goal 1:
Permanency Goal 2 (if applicable):
A3. Is (are) the child’s permanency goal(s) specified in the case file?
Yes No Not Applicable
Question 5A3 Instructions:
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B. Were all the permanency goals that were in effect during the PUR established in a timely manner?
Yes No Not Applicable
If No, explain any concerns in the narrative field below.
Question 5B Instructions:
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C. Were all permanency goals in effect during the PUR appropriate to the child’s needs for permanency and to the circumstances of the case?
Yes No
If No, explain any concerns in the narrative field below:
Question 5C Instructions:
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D. Has the child been in foster care for at least 15 of the most recent 22 months?
Yes No
Question 5D Instructions:
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E. Does the child meet other Adoption and Safe Families Act criteria for TPR?
Yes No Not Applicable
Question 5E Instructions:
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F. Did the agency file or join a TPR petition before the PUR or in a timely manner during the PUR?
Yes No Not Applicable
Question 5F Instructions:
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G1. Indicate whether any of the following exceptions to the TPR requirement applies.
Not Applicable
(1) At the option of the state, the child is being cared for by a relative at the 15/22-month timeframe.
Yes No
(2) The agency documented in the case plan a compelling reason for determining that TPR would not be in the best interests of the child.
Yes No
(3) The state has not provided to the family the services that the state deemed necessary for the safe return of the child to the child’s home.
Yes No
Question 5G1 Instruction:
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G. Did an exception to the requirement to file or join a TPR petition exist?
Yes No Not Applicable
Question 5G Instruction:
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Item 5 Rating Criteria:
Item 5 should be rated as a Strength if any one of the following criteria applies:
The answers to questions A3, B, and C are Yes or Not Applicable, and the answers to questions D and E are No.
The answers to questions A3, B, and C are Yes or Not Applicable, and D and F are Yes.
The answers to questions A3, B, and C are Yes or Not Applicable, the answer to question D is No, and the answers to questions E and F are Yes.
The answers to questions A3, B, and C are Yes or Not Applicable, the answer to question D or E is Yes, the answer to question F is No, and the answer to question G is Yes.
Item 5 should be rated as an Area Needing Improvement if any of the following apply:
The answer to question A3, B, or C is No.
The answers to questions A3, B, and C are Yes or Not Applicable, but the answer to question D or E is Yes, and the answers to questions F and G are No.
Item 5 should be rated as Not Applicable if the response to the question of applicability is No. Item 5 Rating (select one):
Strength Area Needing Improvement Not Applicable
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
PERMANENCY
OUTCOME 1: CHILDREN HAVE PERMANENCY AND STABILITY IN THEIR LIVING
SITUATIONS.
Item 6: Achieving Reunification, Guardianship, Adoption, or Another Planned Permanent Living Arrangement
Purpose of Assessment: To determine whether concerted efforts were made, or are being made, during the period under review to achieve reunification, guardianship, adoption, or another planned permanent living arrangement.
Item 6 Applicable Cases: All foster care cases are applicable for this item.
A1. What is the date of the child’s latest removal?
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Question 6A1 Instruction:
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A2. What is the time in care (in months) at the time of the onsite review?
Question 6A2 Instruction:
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A3.
What is the date the child
discharged from foster care?
Not Applicable ------/-------/----------------
Question 6A3 Instruction:
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A4. What is (are) the child’s current permanency goal(s)? (If concurrent permanency goals have been established in the case plan, identify both goals.) Or, if the case was closed during the PUR, what was the permanency goal before the case was closed?
Reunification
Guardianship
Adoption
Another
planned permanent living arrangement
Question 6A4 Instruction:
If Item 5 was completed, select the same goal or goals identified in question 5A2. If Item 5 was not applicable, refer to the definitions and instructions provided for Table 5A1 in order to determine the child’s permanency goal(s). For cases in which the child has been in foster care less than 60 days and no goal is documented, ask the caseworker what the goal is (in most cases it should be reunification).
B. During the PUR, did the agency and court make concerted efforts to achieve permanency in a timely manner?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
Question 6B Instructions:
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Questions 6B and 6C Instructions:
If concurrent goals are in place and one of the goals has been, or will likely be, achieved in a timely manner, answer question B OR C based on the goal that has been or will be achieved.
If concurrent goals are in place (neither of which is another planned permanent living arrangement) but permanency will not be achieved in a timely manner, answer question B No and indicate in the documentation specific barriers to implementing concurrent planning.
If concurrent goals are in place and one of the goals is another planned permanent living arrangement and the child is or will be placed in a living arrangement that can be considered permanent until discharge from foster care, answer question B Not Applicable and question C accordingly.
If concurrent goals are in place and one of the goals is another planned permanent living arrangement but neither goal will be achieved in a timely manner, answer questions B and C No and indicate in the documentation specific barriers to implementing concurrent planning.
C1. If the child’s current (or most recent) permanency goal is (was) another planned permanent living arrangement, what is (was) the child’s permanent living arrangement?
Not Applicable
Placement with a non-relative foster parent until age of majority or extended age
Placement with a specified relative in foster care until age of majority or extended age
Placement in a longer-term facility until transition to an adult care facility
Placement in an independent living program/supervised independent living until the age of majority or extended age
Other:
Question
6C1 Instructions:
If the child’s current (or most recent) permanency goal was not another planned permanent living arrangement, select Not Applicable.
If the child’s current (or most recent) permanency plan is another planned permanent living arrangement, select the response that describes the permanent living arrangement for the child.
If the child does not have a permanent living arrangement specified, indicate that in “Other.”
If
the child has an arrangement that does not fit any of the options
noted in C1, describe it in “Other.”
If the goal for the child is noted as “emancipation/independent living” without a permanent placement specified, indicate that in “Other.”
C2. For a child with a goal of another planned permanent living arrangement during the PUR, what is the date of documentation regarding “permanency” of the child’s living arrangements? ------/-------/----------------
Not Applicable No Date
Question 6C2 Definition:
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Question 6C2 Instructions:
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C. For a child with a goal of another planned permanent living arrangement during the PUR, did the agency and court make concerted efforts to place the child in a living arrangement that can be considered permanent until discharge from foster care?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
Question 6C Instructions:
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Item 6 Rating Criteria:
Item 6 should be rated as a Strength if the answer to either question B or C is Yes.
Item 6 should be rated as an Area Needing Improvement if the answer to question B and/or C is No.
Item 6 Rating (select one):
Strength Area Needing Improvement
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement
Override reason:
RATING PERMANENCY OUTCOME 1
PERMANENCY OUTCOME 1: CHILDREN HAVE PERMANENCY AND STABILITY IN THEIR LIVING SITUATIONS.
What is the level of outcome achievement that best describes the extent to which this outcome is being or has been achieved, based on the ratings for Items 4, 5, and 6?
Instructions:
Permanency Outcome 1 should be rated as Substantially Achieved if either of the following applies:
Items 4, 5, and 6 are rated as Strengths.
Items 4 and 6 are rated as Strengths and Item 5 is rated as Not Applicable.
Permanency Outcome 1 should be rated as Partially Achieved if the following applies:
At least one of Items 4, 5, or 6 is rated as a Strength.
Permanency Outcome 1 should be rated as Not Achieved if either of the following applies:
All of Items 4, 5, and 6 are rated as Areas Needing Improvement.
Items 4 and 6 are rated as Areas Needing Improvement and Item 5 is rated as Not Applicable.
Select the appropriate response:
Substantially Achieved Partially Achieved Not Achieved
PERMANENCY OUTCOME 2: THE CONTINUITY OF FAMILY RELATIONSHIPS AND CONNECTIONS IS PRESERVED FOR CHILDREN.
Item 7: Placement With Siblings
Purpose of Assessment: To determine whether, during the period under review, concerted efforts were made to ensure that siblings in foster care are placed together unless a separation was necessary to meet the needs of one of the siblings.
Item 7 Applicable Cases: Cases applicable for an assessment of this item include all foster care cases in which the child has one or more siblings who are (or were) also in foster care during the PUR. If the child has no siblings in foster care during the PUR, the case is Not Applicable for an assessment of this item. For example, if the child in foster care has an older sibling who was in foster care at one time, but not during the PUR, this case would be Not Applicable.
Is this case applicable?
Select the appropriate response. If the response is No, rate the item as Not Applicable in the ratings section and continue to Item 8.
Yes No
Optional: Provide comments in the narrative field below:
A. During the entire PUR, was the child placed with all siblings who also were in foster care?
Yes No
Question 7A Definition:
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Question 7A Instructions:
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B. If the answer to question A is No, was there a valid reason for the child’s separation from the siblings?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
Question 7B Instructions:
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Item 7 Rating Criteria:
Item 7 should be rated as a Strength if either of the following applies:
The answer to question A is Yes.
The answer to question A is No, but the answer to question B is Yes.
Item 7 should be rated as an Area Needing Improvement if the answers to questions A and B are No.
Item 7 should be rated as Not Applicable if the response to the question of applicability is No.
Item 7 Rating (select one):
Strength Area Needing Improvement Not Applicable
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
PERMANENCY OUTCOME 2: THE CONTINUITY OF FAMILY RELATIONSHIPS AND CONNECTIONS IS PRESERVED FOR CHILDREN.
Item 8: Visiting With Parents and Siblings in Foster Care
Purpose of Assessment: To determine whether, during the period under review, concerted efforts were made to ensure that visitation between a child in foster care and his or her mother, father, and siblings is of sufficient frequency and quality to promote continuity in the child’s relationship with these close family members.
Definitions:
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Item 8 Applicable Cases:
Cases are applicable for an assessment of this item if the following applies:
The child has at least one sibling in foster care who is in a different placement setting. Yes No
Cases are Not Applicable for assessment if the child has no siblings placed separately in foster care, AND if one or more conditions applies to each of the parents, as defined for this item. (check Yes for any that apply and No for any that do not apply):
During the entire PUR, it was documented in the case file that contact between the child and the parent is not in the child’s best interests. Yes No
Child was abandoned and both parents’ identities were unknown during the entire PUR despite documented concerted agency efforts to identify the parents. Yes No
Parent’s whereabouts were unknown during the entire PUR despite documented concerted agency efforts to locate the parent. Yes No
Parent was deceased during the entire PUR. Yes No
Parental rights remained terminated during the entire PUR. Yes No
Parent(s) being assessed in this item do(es) not meet the definition of Mother/Father for this item.
Yes No
Is this case applicable?
Select the appropriate response. If the response is No, rate the case as Not Applicable in the ratings section, indicate the reason(s) in the second text box below, and continue to Item 9.
Yes No
In the text box below, indicate the case participants who are included in this item as Mother and Father:
If the case participants who are included in this item as Mother and/or Father are not applicable, identify which condition applies to the parent:
A1. What was the usual frequency of visits between the mother and the child during the PUR? Select the box next to the statement that best describes the typical frequency of visits during the PUR.
Not Applicable
More than once a week
Once a week
Less than once a week, but at least twice a month
Less than twice a month, but at least once a month
Less than once a month
Never
A. During the PUR, were concerted efforts made to ensure that visitation (or other forms of contact if visitation was not possible) between the child and his or her mother was of sufficient frequency to maintain or promote the continuity of the relationship?
Yes No Not Applicable
Questions 8A1 and 8B1 Instructions:
Answer Not Applicable if (1) contact between the child and the mother or father was not in the child’s best interests and this was documented in the case file or court order, (2) the whereabouts of the mother or father was not known during the entire PUR, despite documented concerted efforts to locate her or him, (3) the mother’s or father’s parental rights remained terminated during the entire PUR, or (4) the mother or father was deceased during the entire PUR.
B1. What was the usual frequency of visits between the father and the child during the PUR? Select the box next to the statement that best describes the typical frequency of visits during the PUR.
Not Applicable
More than once a week
Once a week
Less than once a week, but at least twice a month
Less than twice a month, but at least once a month
Less than once a month
Never
B. During the PUR, were concerted efforts made to ensure that visitation (or other forms of contact if visitation was not possible) between the child and his or her father was of sufficient frequency to maintain or promote the continuity of the relationship?
Yes No Not Applicable
Questions 8A and 8B Instructions:
If A1 is Not Applicable, question A is answered Not Applicable.
If B1 is Not Applicable, question B is answered Not Applicable.
Determine whether the frequency of visitation during the PUR was sufficient to maintain the continuity of the relationship between the child and the mother or father, depending on the circumstances of the case. For example, frequency may need to be greater for infants and young children who are still forming attachments. Frequency also may need to be greater if reunification is imminent. Visitation should be as frequent as possible unless safety concerns cannot be appropriately managed with supervision. The opportunity for visitation should not be used as a consequence or reward for parents or for children.
Frequency should be assessed based on the child’s needs and the circumstances of the case and not solely on state policy or resource availability.
If, during the PUR, frequent visitation with the mother or father was not possible (for example, due to incarceration in a facility where visitation is not feasible, or if the parent lives in another state), determine whether there are documented concerted efforts to promote other forms of contact between the child and the mother or father, such as telephone calls or letters, in addition to facilitating visits when possible and appropriate.
Address the question of appropriate frequency based on the circumstances of the child and the family, rather than on state policy.
C. During the PUR, were concerted efforts made to ensure that the quality of visitation (or other forms of contact if visitation was not possible) between the child and the mother was sufficient to maintain or promote the continuity of the relationship?
Yes
No
Not
Applicable
Questions 8C and 8D Instructions:
If A1 is Not Applicable or Never, question C is answered Not Applicable.
If B1 is Not Applicable or Never, question D is answered Not Applicable.
Determine whether concerted efforts were made to ensure that the quality of parent-child visitation, and/or other forms of contact, was sufficient to maintain the continuity of the relationship. For example, did visits take place in a comfortable atmosphere and were they of an appropriate length? Did visitation allow for sufficient interaction between the mother or father and child? If siblings were involved, did visits allow the mother or father to interact with each child individually? If appropriate, were unsupervised visits and visits in the mother’s or father’s home in preparation for reunification allowed?
D. During the PUR, were concerted efforts made to ensure that the quality of visitation (or other forms of contact if visitation was not possible) between the child and the father was sufficient to maintain or promote the continuity of the relationship?
Yes No Not Applicable
E1. What was the usual frequency of visits between the child and his or her siblings during the PUR? Select the box next to the statement that best describes the usual frequency of visits between the siblings and the child during the PUR.
Not Applicable
More than once a week
Once a week
Less than once a week, but at least twice a month
Less than twice a month, but at least once a month
Less than once a month
Never
Question 8E1 Instruction: Answer E1 Not Applicable if the child has no siblings in foster care or if contact with all siblings who are in foster care was not considered to be in the best interests of the child for the entire PUR (for example, one sibling is a physical threat to the other sibling or has a history of physical or sexual abuse of the other sibling and this concern remained throughout the PUR). |
E. During the PUR, were concerted efforts made to ensure that visitation (or other forms of contact if visitation was not possible) between the child and his or her sibling(s) was of sufficient frequency to maintain or promote the continuity of the relationship?
Yes No Not Applicable
Question 8E Instructions:
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F. During the PUR, were concerted efforts made to ensure that the quality of visitation (or other forms of contact if visitation was not possible) between the child and his or her sibling(s) was sufficient to promote the continuity of their relationships?
Yes No Not Applicable
Question 8F Instructions If E1 is Not Applicable or Never, question F should be answered Not Applicable. Determine whether concerted efforts were made to ensure that the quality of sibling visitation, and/or other forms of contact, was sufficient to maintain the continuity of the relationship. For example, were visits long enough to permit quality interaction? Did sibling visits occur only in the context of parent visitations? Did visits occur in a comfortable atmosphere? |
Item 8 Rating Criteria:
Item 8 should be rated as a Strength if at least one of the questions A through F is answered Yes and the other questions are answered Not Applicable.
Item 8 should be rated as an Area Needing Improvement if any one of the questions A through F is answered No.
Item 8 should be rated as Not Applicable if the response to the question of applicability is No. Item 8 Rating (select one):
Strength Area Needing Improvement Not Applicable
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
PERMANENCY OUTCOME 2: THE CONTINUITY OF FAMILY RELATIONSHIPS AND CONNECTIONS IS PRESERVED FOR CHILDREN.
Item 9: Preserving Connections
Purpose of Assessment: To determine whether, during the period under review, concerted efforts were made to maintain the child’s connections to his or her neighborhood, community, faith, extended family, kin, Tribe, school, and friends.
Item 9 Applicable Cases: Almost all foster care cases are applicable for an assessment of this item. A possible exception may be the situation of an abandoned infant where the agency has no information about the child’s extended family or connections.
Is this case applicable?
Select the appropriate response. If the response is No, rate the item as Not Applicable in the ratings section and continue to Item 10.
Yes No
Optional: Provide comments in the narrative field below:
A. During the PUR, were concerted efforts made to maintain the child’s important connections (for example, neighborhood, community, faith, language, extended family members including siblings who are not in foster care, kin, Tribe, school, and/or friends)?
Yes No
Question 9A Instructions:
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Item 9 Rating Criteria:
Item 9 should be rated as a Strength if the answer to question A is Yes.
Item 9 should be rated as an Area Needing Improvement if question A is No.
Item 9 should be rated as Not Applicable if the response to the question of applicability is No.
Item 9 Rating (select one):
Strength Area Needing Improvement Not Applicable
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
PERMANENCY OUTCOME 2: THE CONTINUITY OF FAMILY RELATIONSHIPS AND CONNECTIONS IS PRESERVED FOR CHILDREN.
Item 10: Relative Placement
Purpose of Assessment: To determine whether, during the period under review, concerted efforts were made to place the child with relatives when appropriate.
Item 10 Applicable Cases: All foster care cases are applicable for assessment of this item except those in which (1) the agency determined upon the child’s initial entry into care that his or her needs required a specialized placement (such as residential treatment services) and that they will continue to require such specialized treatment the entire time the child is in care and a relative placement would be inappropriate, or (2) situations such as abandonment in which the identity of both parents and all relatives remains unknown despite documented concerted efforts to identify them.
Is this case applicable?
Select the appropriate response. If the response is No, rate the case as Not Applicable in the ratings section and continue to Item 11.
Yes No
Optional: Provide comments in the narrative field below:
A1. During the PUR, was the child’s current or most recent placement with a relative?
Yes No
A2. If the child’s current or most recent placement is with a relative, is (or was) this placement appropriate to the child’s needs?
Yes No Not Applicable
Questions 10A1 and 10A2 Definition: “Relative” is defined as a person related to the child by blood, marriage, or adoption. |
Questions 10A1 and 10A2 Instructions:
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B. Did the agency, during the PUR, make concerted efforts to identify, locate, inform, and evaluate maternal relatives as potential placements for the child, with the result that maternal relatives were ruled out as placement resources (due to fit, relative’s unwillingness, or child's best interests) during the PUR?
Yes No Not Applicable
If No, specify the area in which concerns existed:
Identify Locate Inform Evaluate
Questions 10B and 10C Instructions:
The answers to questions B and C are Not Applicable if the answers to both questions A1 and A2 are Yes.
If a child entered foster care during the PUR, determine whether the state followed the requirements of the title IV-E provision that requires states to consider giving preference to placing the child with relatives, and determine whether the state considered such a placement and how (for example, identifying, seeking out, and informing and evaluating the child’s relatives).
If the parent’s whereabouts were not known during the entire PUR despite agency efforts to locate the parent, and relatives could not be identified as a result, the answer to question B and/or C should be Not Applicable.
If a child entered foster care before the PUR and the answer to either question A1 or A2 is No, determine whether, during the PUR, the agency made concerted efforts to search for and assess relatives as placement resources, if appropriate. If all maternal and/or paternal relatives had already been appropriately considered and permanently ruled out before the PUR, the answer to question B and/or C can be Not Applicable. If you determine that during the PUR, the agency should have reconsidered relatives who had previously been ruled out and they did not, however, the answer to question B and/or C should be No.
C. Did the agency, during the PUR, make concerted efforts to identify, locate, inform, and evaluate paternal relatives as potential placements for the child, with the result that paternal relatives were ruled out as placement resources (due to fit, relative’s unwillingness, or child's best interests) during the PUR?
Yes No Not Applicable
If No, specify the area in which concerns existed:
Identify Locate Inform Evaluate
Item 10 Rating Criteria:
Item 10 should be rated as a Strength if either of the following applies:
The answers to both questions A1 and A2 are Yes.
The answer to either question A1 or A2 is No, but the answers to questions B and/or C are Yes or Not Applicable.
Item 10 should be rated as an Area Needing Improvement if both of the following apply:
The answer to either question A1 or A2 is No.
The answer to question B and/or C is No.
Item 10 should be rated as Not Applicable if the response to the question of applicability is No.
Item 10 Rating (select one):
Strength Area Needing Improvement Not Applicable
Provide comments that highlight strengths
or challenges related to specific practices, systemic issues, or
resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
PERMANENCY OUTCOME 2: THE CONTINUITY OF FAMILY RELATIONSHIPS AND CONNECTIONS IS PRESERVED FOR CHILDREN.
Item 11: Relationship of Child in Care With Parents
Purpose of Assessment: To determine whether, during the period under review, concerted efforts were made to promote, support, and/or maintain positive relationships between the child in foster care and his or her mother and father or other primary caregiver(s) from whom the child had been removed through activities other than just arranging for visitation.
Item 11 Definitions:
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Item 11 Applicable Cases: All foster care cases are applicable for assessment of this item unless one (or more) of the following conditions applies to each person who is defined as a parent for this item (check Yes for any that apply and No for any that do not apply):
During the entire PUR, it was documented in the case file that contact between the child and the parent is not in the child’s best interests. Yes No
The child was abandoned and both parents’ identities were unknown during the entire PUR despite documented concerted agency efforts to identify the parents. Yes No
Parent’s whereabouts were not known during the entire PUR despite documented concerted agency efforts to locate the parent. Yes No
Parent was deceased during the entire PUR. Yes No
Parental rights remained terminated during the entire PUR. Yes No
Parent(s) being assessed in this item do(es) not meet the definition for Mother/Father for this item.
Yes No
Is this case applicable?
Select the appropriate response. If the response is No, rate the item as Not Applicable in the ratings section for this item, and indicate the reason(s) in the second text box below.
Yes No
Indicate the case participants who are included in this item as Mother and Father:
If the case participants who are included
in this item as Mother and/or Father are not applicable, identify
which condition applies to the parent:
A. During the PUR, were concerted efforts made to promote, support, and otherwise maintain a positive and nurturing relationship between the child in foster care and his or her mother?
Yes No Not Applicable
Questions 11A and 11B Instructions:
Question A or B should be answered Not Applicable if (1) contact between the child and the mother or father was not in the child’s best interests and this was documented in the case file or court order, (2) the whereabouts of the mother or father was not known during the entire PUR, despite documented concerted efforts to locate her or him, (3) the mother’s or father’s parental rights remained terminated during the entire PUR, or (4) the mother or father was deceased during the entire PUR.
Foster parents’ activities are considered for purposes of this question. For example, if the foster parent provided transportation so the mother or father could attend the child’s school event or medical appointment, that would be considered as contributing toward concerted efforts.
Do not answer this question based on efforts (or lack of efforts) to ensure the frequency or quality of visitation between the mother or father and the child. That information is captured under Item 8. This question pertains to additional activities to help support, strengthen, or maintain the parent-child relationship.
A1. What concerted efforts were made to support or strengthen the mother-child relationship? Select all that apply if question A is Yes.
Not Applicable
Encouraged the mother’s participation in school activities and case conferences, attendance at doctors’ appointments with the child, or engagement in the child’s after-school or sports activities, or hobbies?
Provided or arranged for transportation or provided funds for transportation so the mother could attend the child’s special activities and doctors’ appointments?
Provided opportunities for therapeutic situations to help the mother and child strengthen their relationship?
Encouraged the foster parents to provide mentoring or serve as role models to the mother to assist her in appropriate parenting (e.g., helping with homework, sharing meals, participating in bedtime routine)?
Encouraged and facilitated contact with a mother not living in close proximity to the child?
Other (describe other concerted efforts made):
Question 11A1 Instructions
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B. During the PUR, were concerted efforts made to promote, support, and otherwise maintain a positive and nurturing relationship between the child in foster care and his or her father?
Yes No Not Applicable
B1. What concerted efforts were made to support or strengthen the father-child relationship?
Select all that apply if question B is Yes.
Not Applicable
Encouraged the father’s participation in school activities and case conferences, attendance at doctors’ appointments with the child, or engagement in the child’s after-school or sports activities, or hobbies?
Provided or arranged for transportation or provided funds for transportation so that the father could attend the child’s special activities and doctors’ appointments?
Provided opportunities for therapeutic situations to help the father and child strengthen their relationship?
Encouraged the foster parents to provide mentoring or serve as role models to the father to assist him in appropriate parenting (e.g., helping with homework, sharing meals, participating in bedtime routine)?
Encouraged and facilitated contact with a father not living in close proximity to the child?
Other (describe other concerted efforts made): ____________________
Question 11B1 Instructions:
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Item 11 Rating Criteria:
Item 11 should be rated as a Strength if either of the following applies:
The answers to both questions A and B are Yes.
The answer to either question A or B is Yes and the answer to the other question is Not Applicable.
Item 11 should be rated as an Area Needing Improvement if the answer to question A and/or B is No.
Item 11 should be rated as Not Applicable if the response to the question of applicability is No.
Item 11 Rating (select one):
Strength Area Needing Improvement Not Applicable
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
RATING PERMANENCY OUTCOME 2
PERMANENCY OUTCOME 2: THE CONTINUITY OF FAMILY RELATIONSHIPS AND CONNECTIONS IS PRESERVED FOR CHILDREN.
What is the level of outcome achievement that best describes the extent to which this outcome is being or has been achieved, based on the ratings for Items 7 through 11?
Instructions:
Permanency Outcome 2 should be rated as Substantially Achieved if both of the following apply:
Not more than one of Items 7 through 11 is rated as an Area Needing Improvement.
At least one item is rated as a Strength.
Permanency Outcome 2 should be rated as Partially Achieved if both of the following apply:
At least two items, but fewer than all five items, are rated as an Area Needing Improvement.
At least one item is rated as a Strength.
Permanency Outcome 2 should be rated as Not Achieved if both of the following apply:
No item is rated as a Strength.
At least one item is rated as an Area Needing Improvement.
Permanency Outcome 2 should be rated as Not Applicable if the following applies:
All of Items 7 through 11 are rated as Not Applicable.
Select the appropriate response:
Substantially Achieved Partially Achieved Not Achieved Not Applicable
SECTION III: CHILD AND FAMILY WELL-BEING
WELL-BEING OUTCOME 1: FAMILIES HAVE ENHANCED CAPACITY TO PROVIDE FOR THEIR CHILDREN’S NEEDS.
Item 12: Needs and Services of Child, Parents, and Foster Parents
Item 12 is divided into three Sub-Items: 12A: Needs assessment and services to children, 12B: Needs assessment and services to parents, and 12C: Needs assessment and services to foster parents.
Purpose of Assessment: To determine whether, during the period under review, the agency made concerted efforts to (1) assess the needs of children, parents, and foster parents (both initially, if the child entered foster care or the case was opened during the period under review, and on an ongoing basis) to identify the services necessary to achieve case goals and adequately address the issues relevant to the agency’s involvement with the family, and (2) provide the appropriate services.
Item 12 Applicable Cases: Most cases are applicable for an assessment of this item because Sub-Item 12A is typically applicable to all cases. Sub-Items 12B and 12C may not be applicable to all cases, and instructions for applicability are provided before each sub-item.
Sub-Item 12A: Needs Assessment and Services to Children
For in-home services cases, indicate the names of the children who were included in the assessment of Sub-Item 12A:
A1. During the PUR, did the agency conduct a formal or informal initial and/or ongoing comprehensive assessment that accurately assessed the children’s needs?
Yes No
If No, explain any concerns in the narrative field below:
Question 12A1 Instructions:
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A2. During the PUR, were appropriate services provided to meet the children’s identified needs?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
Question 12A2 Instructions:
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Sub-Item 12A Rating Criteria:
Sub-Item 12A should be rated as a Strength if either of the following applies:
The answers to both questions A1 and A2 are Yes.
The answer to question A1 is Yes, and the answer to question A2 is Not Applicable.
Sub-Item 12A should be rated as an Area Needing Improvement if the answer to question A1 and/or A2 is No.
There are no circumstances under which Sub-Item 12A could be rated as Not Applicable.
Sub-Item 12A Rating (select one):
Strength Area Needing Improvement
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
Sub-Item 12B: Needs Assessment and Services to Parents
Sub-Item 12B Definitions: In-home services cases:
Foster care cases:
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Optional: Provide comments in the narrative field below:
Sub-Item 12B Applicable Cases:
Because multiple case participants can be assessed in these questions, consider applicability for all appropriate case participants before determining that the rating should be Not Applicable.
Questions in Sub-Item 12B should be answered Not Applicable for a specific parent if any of the following applies to that parent (check Yes for any that apply and No for any that do not apply):
Parental rights remained terminated during the entire PUR. Yes No
Parent’s identity or whereabouts were not known during the entire PUR despite agency efforts to identify or locate the parent. Yes No
Parent was deceased during the entire PUR. Yes No
During the entire PUR, it was documented in the case file that it was not in the child’s best interests to involve the parent in case planning. Yes No
During the entire PUR, the parent indicated that he or she did not want to be involved in the child’s life and this was documented in the case file. Yes No
Is Sub-Item 12B applicable for Mother?
Yes No
If No, answer questions B1 and B3 Not Applicable.
Is Sub-Item 12B applicable for Father?
Yes No
If No, answer questions B2 and B4 Not Applicable.
Indicate the case participants who are included in this item as Mother and Father:
If both parents are not applicable for this item, go to Sub-Item 12B rating criteria, select Not Applicable and continue to Sub-Item 12C.
B1. During the PUR, did the agency conduct a formal or informal initial and/or ongoing comprehensive assessment that accurately assessed the mother’s needs?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
Questions 12B1 and 12B2 Instructions:
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B2. During the PUR, did the agency conduct a formal or informal initial and/or ongoing comprehensive assessment that accurately assessed the father’s needs?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
B3. During the PUR, did the agency provide appropriate services to the mother to meet identified needs?
Yes No Not Applicable
If No is selected, explain any concerns in the narrative field below:
Question 12B3 and 12B4 Instructions:
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B4. During the PUR, did the agency provide appropriate services to the father to address identified needs?
Yes No Not Applicable
If No is selected, explain any concerns in the narrative field below:
Sub-Item 12B Rating Criteria:
Sub-Item 12B should be rated as a Strength if either of the following applies:
The answers to B1, B2, B3, and B4 are Yes.
The answer to at least one question is Yes, and the answer to the other questions is Not Applicable.
Sub-Item 12B should be rated as an Area Needing Improvement if the answer to any one of the questions is No.
Sub-Item 12B should be rated as Not Applicable if the answer to the questions of applicability for both Mother and Father is No.
Sub-Item 12B Rating (select one):
Strength Area Needing Improvement Not Applicable
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
Sub-Item 12C: Needs Assessment and Services to Foster Parents
Applicable Cases:
In-home services cases are not applicable for an assessment of this sub-item.
All foster care cases are applicable for assessment of this sub-item unless, during the entire PUR, the child was in out-of-home care in a residential facility or similar placement but does not have foster parents.
Is Sub-Item 12C applicable?
Yes No
Optional: Provide comments in the narrative field below:
If No, go to Sub-Item 12C rating criteria and select Not Applicable.
Item 12C Definition:
Foster parents are defined as related or non-related caregivers who have been given responsibility for care of the child by the agency while the child is under the placement and care responsibility and supervision of the agency. This includes pre-adoptive parents if the adoption has not been finalized.
C1. During the PUR, did the agency adequately assess the needs of the foster or pre-adoptive parents on an ongoing basis (with respect to services they need in order to provide appropriate care and supervision to ensure the safety and well-being of the children in their care)?
Yes No
If No is selected, explain any concerns in the narrative field below:
Question 12C1 Instructions:
All foster parents who cared for the child during the PUR are included in this assessment.
Determine whether an assessment was conducted to identify what the foster parents needed to enhance their capacity to provide appropriate care and supervision to the child in their home, such as respite care, assistance with transportation, or counseling to address the child’s behavior problems.
Determine whether assessment of foster parent needs is done on an ongoing basis. If there is no evidence in the case file that the agency assessed the needs of the foster parents at any time during the PUR, and the foster parents (if available for interview) indicate that they have not been assessed, the answer to question C1 should be No.
C2. During the PUR, were the foster or pre-adoptive parents provided with appropriate services to address identified needs that pertained to their capacity to provide appropriate care and supervision of the children in their care?
Yes No Not Applicable
If No is selected, explain any concerns in the narrative field below:
Question 12C2 Instructions:
The answer to question C2 should be Not Applicable if needs were assessed but no service needs were identified.
All foster parents who cared for the child during the PUR are included in this assessment.
Sub-Item 12C Rating Criteria:
Sub-Item 12C should be rated as a Strength if either of the following applies:
The answers to both questions C1 and C2 are Yes.
The answer to question C1 is Yes, and the answer to question C2 is Not Applicable.
Sub-Item 12C should be rated as an Area Needing Improvement if the answer to question C1 and/or C2 is No.
Sub-Item 12C should be rated as Not Applicable if the response to the question of applicability is No.
Item 12C Rating (select one):
Strength Area Needing Improvement Not Applicable
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
Item 12 Rating Criteria:
Item 12 should be rated as a Strength if sections A, B, and C are all rated Strength OR at least one of the sections is rated as a Strength and the others are Not Applicable.
Item 12 should be rated as an Area Needing Improvement if any one of sections A, B, or C is rated as an Area Needing Improvement.
Item 12 Rating (select one):
Strength Area Needing Improvement
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
WELL-BEING OUTCOME 1: FAMILIES HAVE ENHANCED CAPACITY TO PROVIDE FOR THEIR CHILDREN’S NEEDS.
Item 13: Child and Family Involvement in Case Planning
Purpose of Assessment: To determine whether, during the period under review, concerted efforts were made (or are being made) to involve parents and children (if developmentally appropriate) in the case planning process on an ongoing basis.
Item 13 Definitions:
In-home services cases:
“Mother” and “Father” in Items 12, 13, and 15 are typically defined as the parents/caregivers with whom the children were living when the agency became involved with the family and with whom the children will remain (for example, biological parents, relatives, guardians, adoptive parents).
If a biological parent does not fall into any of the categories above, determine whether that parent should be included in this item based on the circumstances of the case. Some things to consider in this determination are the reason for the agency’s involvement and the identified perpetrators in the case, the status of the children’s relationship with the parent, the nature of the case (court supervised or voluntary) and the length of case opening. If a biological parent indicates a desire during the PUR to be involved with the child and it is in the child’s best interests to do so, they should be assessed in this item.
Foster care cases:
“Mother” and “Father” in Items 12, 13, and 15 are typically defined as the parents/caregivers from whom the child was removed and with whom the agency is working toward reunification.
“Mother” and “Father” in Items 12, 13, and 15 include biological parents who were not the parents from whom the child was removed.
“Mother” and “Father” include adoptive parents if the adoption has been finalized during the PUR.
Item 13 Applicable Cases:
Because multiple case participants can be assessed in these questions, consider applicability for all appropriate case participants before determining that the rating should be Not Applicable. All cases are applicable for an assessment of this item except as determined below (check Yes for criteria that apply and No for those that do not).
Cases involving children for whom participating in planning is not developmentally appropriate.
Yes No AND:Cases in which a specific parent being assessed as Mother or Father meet any of these criteria:
Parental rights remained terminated during the entire PUR. Yes No
Parent’s identity or whereabouts were not known during the entire PUR despite agency efforts to identify or locate the parent. Yes No
The reviewer has determined that Item 12B is rated as an Area Needing Improvement due to lack of concerted efforts to find applicable parents. Yes No
Parent was deceased during the entire PUR. Yes No
During the entire PUR, it was documented in the case file that it was not in the child’s best interests to involve the parent in case planning. Yes No
During the entire PUR, the parent has indicated he or she does not want to be involved in the child’s life and this was documented in the case file. Yes No
In-home services cases are applicable even in states that do not require a formal case plan to be developed for in-home services cases. Therefore, the case is applicable even if there is no state requirement for a case plan and there is no case plan in the file.
Is this case applicable?
Select the appropriate response. If the response is No, rate the case as Not Applicable in the ratings section and continue to Item 14.
Yes No
Indicate the case participants who are included in this item as Mother and Father:
Optional: Provide comments in the narrative field below:
A. During the PUR, did the agency make concerted efforts to actively involve the child in the case planning process?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
For in-home services cases, indicate the names of the children who are included in the assessment of Item 13:
Question 13A Definition:
“Actively involved” means that the agency consulted with the child (as developmentally appropriate) regarding the child’s goals and services, explained the plan and terms used in the plan in language that the child can understand, and included the child in periodic case planning meetings, particularly if any changes are being considered in the plan.
Question 13A Instructions:
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B. During the PUR, did the agency make concerted efforts to actively involve the mother in the case planning process?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
Questions 13B and 13C Definition: “Actively involved” means that the agency involved the mother or father in (1) identifying strengths and needs, (2) identifying services and service providers, (3) establishing goals in case plans, (4) evaluating progress toward goals, and (5) discussing the case plan. |
Questions 13B and 13C Instructions:
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C. During the PUR, did the agency make concerted efforts to actively involve the father in the case planning process?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
Item 13 Rating Criteria:
Item 13 should be rated as a Strength if either of the following applies:
The answers to A, B, and C are Yes.
The answer to at least one question is Yes, and the answer to the other questions is Not Applicable.
Item 13 should be rated as an Area Needing Improvement if the answer to any one of questions A, B, or C is No.
Item 13 should be rated as Not Applicable if the response to the question of applicability is No.
Item 13 Rating (select one):
Strength Area Needing Improvement Not Applicable
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
WELL-BEING OUTCOME 1: FAMILIES HAVE ENHANCED CAPACITY TO PROVIDE FOR THEIR CHILDREN’S NEEDS.
Item 14: Caseworker Visits With Child
Purpose of Assessment: To determine whether the frequency and quality of visits between caseworkers and the child(ren) in the case are sufficient to ensure the safety, permanency, and well-being of the child(ren) and promote achievement of case goals.
Item 14 Applicable Cases: All cases are applicable for an assessment of this item.
A1. During the PUR, what was the most typical pattern of visitation between the caseworker or other responsible party and the child(ren) in the case? Select the box that describes the usual pattern of visitation.
More than once a week
Once a week
Less than once a week, but at least twice a month
Less than twice a month, but at least once a month
Less than once a month
Never
Question 14A1 Instructions:
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A. During the PUR, was the frequency of the visits between the caseworker (or other responsible party) and the child(ren) sufficient to address issues pertaining to the safety, permanency, and well-being of the child and promote achievement of case goals?
Yes No
B. During the PUR, was the quality of the visits between the caseworker and the child(ren) sufficient to address issues pertaining to the safety, permanency, and well-being of the child and promote achievement of case goals (for example, did the visits between the caseworker or other responsible party and the child(ren) focus on issues pertinent to case planning, service delivery, and goal achievement)?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
Item 14 Rating Criteria:
Item 14 should be rated as a Strength if the answers to both questions A and B are Yes.
Item 14 should be rated as an Area Needing Improvement if the answer to question A and/or B is No. There are no circumstances under which Item 14 could be rated as Not Applicable.
Item 14 Rating (select one):
Strength Area Needing Improvement
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Override rating:
Strength Area Needing Improvement
Override reason:
WELL-BEING OUTCOME 1: FAMILIES HAVE ENHANCED CAPACITY TO PROVIDE FOR THEIR CHILDREN’S NEEDS.
Item 15: Caseworker Visits With Parents
Purpose of Assessment: To determine whether, during the period under review, the frequency and quality of visits between caseworkers and the mothers and fathers of the child(ren) are sufficient to ensure the safety, permanency, and well-being of the child(ren) and promote achievement of case goals.
Item 15 Definitions:
In-home services cases:
“Mother” and “Father” in Items 12, 13, and 15 are typically defined as the parents/caregivers with whom the children were living when the agency became involved with the family and with whom the children will remain (for example, biological parents, relatives, guardians, adoptive parents).
If a biological parent does not fall into any of the categories above, determine whether that parent should be included in this item based on the circumstances of the case. Some things to consider in this determination are the reason for the agency’s involvement and the identified perpetrators in the case, the status of the children’s relationship with the parent, the nature of the case (court supervised or voluntary), and the length of case opening. If a biological parent indicates a desire during the PUR to be involved with the child and it is in the child’s best interests to do so, they should be assessed in this item.
Foster care cases:
“Mother” and “Father” in Items 12, 13, and 15 are typically defined as the parents/caregivers from whom the child was removed and with whom the agency is working toward reunification.
“Mother” and “Father” in Items 12, 13, and 15 include biological parents who were not the parents from whom the child was removed.
“Mother” and “Father” include adoptive parents if the adoption has been finalized during the PUR.
Item 15 Applicable Cases:
Because multiple case participants can be assessed in these questions, consider applicability for all appropriate case participants before determining that the rating should be Not Applicable. All cases are applicable for an assessment of this item except cases in which all parents being assessed as Mother and Father meet any of the following criteria (check Yes for any that apply and No for those that do not):
Parental rights remained terminated during the entire PUR. Yes No
Parent’s identity or whereabouts were not known during the entire PUR despite agency efforts to identify or locate the parent. Yes No
The reviewer has determined that Item 12B is rated as an Area Needing Improvement due to lack of concerted efforts to find applicable parents. Yes No
Parent was deceased during the entire PUR. Yes No
During the entire PUR, it was documented in the case file that it was not in the child’s best interests to involve the parent in case planning. Yes No
During the entire PUR, the parent has indicated he or she does not want to be involved in the child’s life and this was documented in the case file. Yes No
Is this case applicable?
Select the appropriate response. If the response is No, select Not Applicable in the ratings section and continue to Item 16. Yes No
Indicate the case participants who are included in this item as Mother and Father:
Optional: Provide comments in the narrative field below:
A1. During the PUR, what was the most typical pattern of visitation between the caseworker (or other responsible party) and the mother of the child(ren)? Select the appropriate response:
More than once a week
Once a week
Less than once a week, but at least twice a month
Less than twice a month, but at least once a month
Less than once a month
Never
Not Applicable
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Questions 15A1, 15A2, 15B1, and 15B2 Definitions:
“Other responsible party” refers to contracted service providers who have full responsibility for case planning and case management (for example, fully or partially privatized child welfare systems where full case management responsibilities are delegated to contract agencies). It does not refer to contracted service providers who provide services while the agency maintains decision-making and case management responsibilities regarding the case or the child.
A “visit” is defined as a face-to-face contact between the caseworker or other responsible party and the parent.
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Questions 15A1 and 15B1 Instructions:
Select Not Applicable if all case participants being assessed as Mother in 15A1 or as Father in 15B1 meet the criteria for Not Applicable in the Item 15 rating criteria above. Consider only the pattern of visits during the PUR and not over the life of the case.
Determine the most typical pattern of visitation during the PUR because the actual frequency may vary in specific time periods.
Select Not Applicable for questions A1 and B1 if the agency did not make concerted efforts to identify or locate a mother or father whose identity or whereabouts were unknown. In Well-Being Outcome 1, concerns about efforts to identify or locate a parent should only be reflected in Item 12.
A2. During the PUR, was the frequency of the visits between the caseworker (or other responsible party) and the mother sufficient to (1) address issues pertaining to the safety, permanency, and well-being of the child and (2) promote achievement of case goals?
Yes No Not Applicable
Questions 15A2 and 15B2 Instructions:
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B1. During the PUR, what was the most typical pattern of visitation between the caseworker (or other responsible party) and the father of the child(ren)? Select the appropriate response:
More than once a week
Once a week
Less than once a week, but at least twice a month
Less than twice a month, but at least once a month
Less than once a month
Never
Not Applicable
B2. During the PUR, was the frequency of the visits between the caseworker (or other responsible party) and the father sufficient to address issues pertaining to the safety, permanency, and well- being of the child and promote achievement of case goals?
Yes No Not Applicable
C. During the PUR, was the quality of the visits between the caseworker (or other responsible party) and the mother sufficient to address issues pertaining to the safety, permanency, and well- being of the child and promote achievement of case goals?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
Questions 15C and 15D Instructions:
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D. During the PUR, was the quality of the visits between the caseworker (or other responsible party) and the father sufficient to address issues pertaining to the safety, permanency, and well- being of the child and promote achievement of case goals?
Yes No Not Applicable
If No, explain any concerns in the narrative field below:
Item 15 Rating Criteria:
Item 15 should be rated as a Strength if any of the following apply:
The answers to A2, B2, C, and D are Yes.
The answer to A2 and C is Yes and the answer to B2 and D is Not Applicable.
The answer to A2 and C is Not Applicable and the answer to B2 and D is Yes.
Item 15 should be rated as an Area Needing Improvement if the answer to any one of questions A2, B2, C, or D is No.
Item 15 should be rated as Not Applicable if the response to the question of applicability is No.
Item 15 Rating (select one):
Strength Area Needing Improvement Not Applicable
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
RATING CHILD AND FAMILY WELL-BEING OUTCOME 1
WELL-BEING OUTCOME 1: FAMILIES HAVE ENHANCED CAPACITY TO PROVIDE FOR THEIR CHILDREN’S NEEDS.
What is the level of outcome achievement that best describes the extent to which this outcome is being or has been achieved, based on the ratings for Items 12 through 15?
Instructions:
Well-Being Outcome 1 should be rated as Substantially Achieved if both of the following apply:
Item 12 is rated as a Strength or Not Applicable; and
Only one of Items 13, 14, and 15 is rated as an Area Needing Improvement.
Well-Being Outcome 1 should be rated as Partially Achieved if either of the following applies:
Item 12 is rated as an Area Needing Improvement, but at least one other item is rated as a Strength.
Item 12 is rated as a Strength or Not Applicable, but at least two of Items 13, 14, and 15 are rated as Areas Needing Improvement.
Well-Being Outcome 1 should be rated as Not Achieved if the following applies:
All applicable items are rated as Areas Needing Improvement.
Select the appropriate rating:
Substantially Achieved Partially Achieved Not Achieved
WELL-BEING OUTCOME 2: CHILDREN RECEIVE APPROPRIATE SERVICES TO MEET THEIR EDUCATIONAL NEEDS.
Item 16: Educational Needs of the Child
Purpose of Assessment: To assess whether, during the period under review, the agency made concerted efforts to assess children’s educational needs at the initial contact with the child (if the case was opened during the period under review) or on an ongoing basis (if the case was opened before the period under review), and whether identified needs were appropriately addressed in case planning and case management activities.
Item 16 Applicable Cases:
All foster care cases involving a school-aged child, including those in pre-school, are applicable for an assessment of this item. If a child is 2 years old or younger and has been identified as having developmental delays, the case may be applicable if the developmental delays need to be addressed through an educational approach rather than through physical therapy or some form of physical health approach. In these latter cases, the issue of developmental delays would be addressed under Item 17.
Foster care cases are Not Applicable if the child is age 2 or younger and there are no apparent developmental delays.
In-home services cases are applicable for an assessment of this item if (1) educational issues are relevant to the reason for the agency’s involvement with the family, and/or (2) it is reasonable to expect that the agency would address educational issues given the circumstances of the case. For example, it is reasonable to expect that the agency would address educational issues in a case in which the child is the subject of a substantiated maltreatment report and, during the PUR, the maltreatment appeared to be affecting the child’s school performance.
In-home services cases are Not Applicable for an assessment of this item if you determine that, during the PUR, there is no reason to expect that the agency would address educational issues for any children in the family, given the reason for agency involvement or the circumstances of the case. This “non-applicability” applies even if there is evidence in the case file that the agency has learned that the parent/caregiver has obtained educational services for the children.
Is this case applicable?
Select the appropriate response. If the answer is No, rate the item as Not Applicable in the ratings section and continue to Item 17.
Yes No Not Applicable
Optional: Provide comments in the narrative field below:
A. During the PUR, did the agency make concerted efforts to accurately assess the children’s educational needs?
Yes No
For in-home services cases, indicate the
names of the children who are included in the assessment of Item 16:
Question 16A Instructions:
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A1. Education Table
Educational Needs |
Services Provided |
Services Needed But Not Provided |
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Table 16A1 Instructions:
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B. During the PUR, did the agency engage in concerted efforts to address the children’s educational needs through appropriate services?
Yes No Not Applicable
Question 16B Instructions:
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Item 16 Rating Criteria:
Item 16 should be rated as a Strength if either of the following applies:
The answers to questions A and B are Yes.
The answer to question A is Yes, and the answer to question B is Not Applicable.
Item 16 should be rated as an Area Needing Improvement if the answer to question A and/or B is No.
Item 16 should be rated as Not Applicable if the response to the question of applicability is No.
Item 16 Rating (select one):
Strength Area Needing Improvement Not Applicable
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
RATING CHILD AND FAMILY WELL-BEING OUTCOME 2
WELL-BEING OUTCOME 2: CHILDREN RECEIVE APPROPRIATE SERVICES TO MEET THEIR EDUCATIONAL NEEDS.
What is the level of outcome achievement that best describes the extent to which this outcome is being or has been achieved, based on the rating for Item 16?
Instructions:
Well-Being Outcome 2 should be rated as Substantially Achieved if the following applies:
Item 16 is rated as a Strength.
Well-Being Outcome 2 should be rated as Partially Achieved if the following applies:
Item 16 is rated as an Area Needing Improvement, but question A or B is answered Yes.
Well-Being Outcome 2 should be rated as Not Achieved if the following applies:
Item 16 is rated as an Area Needing Improvement and both questions A and B were answered No.
Well-Being Outcome 2 should be rated as Not Applicable if the following applies:
Item 16 is rated as Not Applicable.
Select the appropriate rating:
Substantially Achieved Partially Achieved Not Achieved Not Applicable
Overridden outcome rating:
Substantially Achieved Partially Achieved Not Achieved Not Applicable
Override reason:
WELL-BEING OUTCOME 3: CHILDREN RECEIVE ADEQUATE SERVICES TO MEET THEIR PHYSICAL AND MENTAL HEALTH NEEDS.
Item 17: Physical Health of the Child
Purpose of Assessment: To determine whether, during the period under review, the agency addressed the physical health needs of the children, including dental health needs.
Item 17 Applicable Cases:
All foster care cases are applicable for an assessment of this item.
If a child has been identified as having developmental delays, the case may be applicable if the developmental delays need to be addressed through physical therapy or some form of physical health approach. If the developmental delays need to be addressed through an educational approach, the issue of developmental delays would be addressed under Item 16.
In-home services cases are applicable for an assessment of this item if (1) physical/dental health issues were relevant to the reason for the agency’s involvement with the family, and/or (2) it is reasonable to expect that the agency would address physical/dental health issues given the circumstances of the case. For example, it is reasonable to expect that the agency would address physical health issues in a case in which a child is the subject of a substantiated maltreatment report of physical neglect and there is reason to suspect that, during the PUR, the neglect may have affected the child’s physical health.
In-home services cases are Not Applicable for an assessment of this item if you determine that there is no reason to expect that the agency would address physical and dental health issues for any children in the family, given the reason for agency involvement or the circumstances of the case. This “non-applicability” applies even if there is evidence in the case file that the agency has learned that the parent is effective in taking care of the children’s physical and dental health needs.
Is this case applicable?
Select the appropriate response. If the answer is No, rate the case as Not Applicable in the ratings section and continue to Item 18.
Yes No
Optional: Provide comments in the narrative field below:
A1. During the PUR, did the agency accurately assess the children’s physical health care needs?
Yes No Not Applicable
For in-home services cases, indicate the names of the children who are included in the assessment of Item 17:
Questions 17A1 and 17A2 Instructions:
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A2. During the PUR, did the agency accurately assess the children’s dental health care needs?
Yes No Not Applicable
Question 17A2 Instruction:
If the children are too young for a dental examination, question A2 should be answered Not Applicable.
A3. Physical and Dental Health Table
Identified Physical or Dental Health Needs |
Services Provided |
Services Needed But Not Provided |
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Table
17A3 Instructions:
Document in the table each identified physical or dental health need, the services provided to meet those needs, and the services needed but not provided related to each identified need. If all needed services were provided, enter “None” in the column labeled “Services Needed But Not Provided.”
Needed services could include immunizations, treatment services, and dental services, including orthodontics.
A4. For foster care cases only, determine whether, during the PUR, there was evidence that the following case-management criteria required by federal statute were met (select each one that was met).
Not Applicable (this is an in-home services case).
No evidence found.
To the extent available and accessible, the child’s health records are up to date and included in the case file [Social Security Act § 475(1)(C)].
The case plan addresses the issue of health and dental care needs [Social Security Act § 475(1)(C)].
To the extent available and accessible, foster parents or foster care providers are provided with the child’s health records [Social Security Act § 475(5)(D)].
Question 17A4 Definition: Health records include the names and addresses of the child’s health care providers, a record of the child’s immunizations, the child’s known medical problems, the child’s medications, and any other relevant health information |
B1. For foster care cases only, during the PUR, did the agency provide appropriate oversight of prescription medications for physical health issues?
Yes No Not Applicable
Question 17B1 Definition: “Appropriate oversight” includes but is not limited to:
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Question 17B1 Instructions:
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B2. During the PUR, did the agency ensure that appropriate services were provided to the children to address all identified physical health needs?
Yes No Not Applicable
Questions 17B2 and 17B3 Instructions:
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B3. During the PUR, did the agency ensure that appropriate services were provided to the children to address all identified dental health needs?
Yes No Not Applicable
Item 17 Rating Criteria:
Item 17 should be rated as a Strength if either of the following applies:
The answers to questions A1, A2, B1, B2, and B3 are Yes.
The answer to at least one of questions A1, A2, B1, B2, or B3 is Yes, and the rest are Not Applicable.
Item 17 should be rated as an Area Needing Improvement if the answer to any question is No.
Item 17 should be rated as Not Applicable if the response to the question of applicability is No.
Item 17 Rating (select one):
Strength Area Needing Improvement Not Applicable
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement
Override reason:
WELL-BEING OUTCOME 3: CHILDREN RECEIVE ADEQUATE SERVICES TO MEET THEIR PHYSICAL AND MENTAL HEALTH NEEDS.
Item 18: Mental/Behavioral Health of the Child
Purpose of Assessment: To determine whether, during the period under review, the agency addressed the mental/behavioral health needs of the children.
Item 18 Applicable Cases:
Foster care cases are applicable for an assessment of this item if the reviewer determines that, during the period under review, the child had existing mental/behavioral health needs, including substance abuse issues. If the child had mental/behavioral health issues before the period under review that were adequately addressed and there are no remaining needs during the period under review, the case should be rated as Not Applicable.
In-home services cases are applicable for an assessment of this item if (1) mental/behavioral health issues related to any of the children in the family were relevant to the reason for the agency’s involvement with the family, and/or (2) it is reasonable to expect that the agency would address mental/behavioral health issues given the circumstances of the case. For example, it is reasonable to expect that the agency would address mental health issues in a case in which a child is the subject of a substantiated maltreatment report and there is reason to suspect that, during the PUR, the maltreatment may have affected the child’s mental health.
In-home services cases are Not Applicable for an assessment of this item if the reviewer determines that there is no reason to expect that, during the PUR, the agency would address mental/behavioral health issues for any children in the family, given the reason for agency involvement or the circumstances of the case. This “non-applicability” applies even if there is evidence in the case file that the agency has learned that the parent is effective in taking care of the children’s mental/behavioral health needs.
Is this case applicable?
Select the appropriate response. If the answer is No, rate the case as Not Applicable in the rating section.
Yes No
Optional: Provide comments in the narrative field below:
A. During the PUR, did the agency conduct an accurate assessment of the children’s mental/behavioral health needs either initially (if the child entered foster care during the PUR or if the in-home services case was opened during the PUR) and on an ongoing basis to inform case planning decisions?
Yes No
For in-home services cases, indicate the names of the children who are included in the assessment of Item 18:
Question 18A Definition: “Behavioral health needs” includes needs related to behavioral problems that are not always specified as mental health needs, including substance abuse. |
Question 18A Instructions:
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A1. Mental/Behavioral Health Table
Identified Mental/ Behavioral Health Needs |
Services Provided |
Services Needed But Not Provided |
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Table 18A1 Instructions:
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B. For foster care cases only, during the PUR, did the agency provide appropriate oversight of prescription medications for mental/behavioral health issues?
Yes No Not Applicable
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Question 18B Definition:
“Appropriate oversight” includes but is not limited to the following:
Ensuring that the target child is seen regularly by a physician to monitor the effectiveness of the medication, assess any side effects and/or health implications, consider any changes needed to dosage or medication type, and determine whether medication is still necessary and/or whether other treatment options would be more appropriate
Regularly following up with foster parents/caregivers about administering medications appropriately and about the target child’s experience with the medication(s), including any side effects
Following any additional state protocols that may be in place related to the appropriate use and monitoring of medications
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Question 18B Instructions:
Select Not Applicable if this is not a foster care case.
If the child was not prescribed any medications for mental/behavioral health issues during the period under review, select Not Applicable.
C. During the PUR, did the agency provide appropriate services to address the children’s mental/behavioral health needs?
Yes No Not Applicable
Question 18C Instructions:
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Item 18 Rating Criteria:
Item 18 should be rated as a Strength if the answer to question A is Yes, the answer to question B is Yes or Not Applicable, and the answer to question C is Yes or Not Applicable.
Item 18 should be rated as an Area Needing Improvement if the answer to any question is No.
Item 18 should be rated as Not Applicable if the response to the question of applicability is No.
Item 18 Rating (select one):
Strength Area Needing Improvement Not Applicable
Provide comments that highlight strengths or challenges related to specific practices, systemic issues, or resources that affected this item in the narrative field below:
Override this rating?
Overridden rating:
Strength Area Needing Improvement Not Applicable
Override reason:
RATING CHILD AND FAMILY WELL-BEING OUTCOME 3
WELL-BEING OUTCOME 3: CHILDREN RECEIVE ADEQUATE SERVICES TO MEET THEIR PHYSICAL AND MENTAL HEALTH NEEDS.
What is the level of outcome achievement that best describes the extent to which this outcome is being or has been achieved, based on the ratings for Items 17 and 18?
Instructions: Well-Being Outcome 3 should be rated as Substantially Achieved if either of the following applies:
Well-Being Outcome 3 should be rated as Partially Achieved if the following applies:
Well-Being Outcome 3 should be rated as Not Achieved if either of the following applies:
Well-Being Outcome 3 should be rated as Not Applicable if the following applies: |
Select the appropriate rating:
Substantially Achieved Partially Achieved Not Achieved Not Applicable
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | CFSR Onsite Review Instrument and Instructions |
| Subject | CFSR Onsite Review Instrument and Instructions January 2016 |
| Author | Children's Bureau |
| File Modified | 0000-00-00 |
| File Created | 2022-03-30 |
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