WPCa 1>߭0"h&Q B&N% ԾW`si;椡9 Q*1uھ&sbZCMl)ʠGܿ<o_A _ -V_4Ğ7 ƛ`"ށ[RUhVK0m@KwTz"-Bzw-5 \qF HB,mfpa_NY5ذu\ ^*[#5| u\ܠQ -)#߾MU^xfo}Ki6tsjGzG~+0кq"U ӢT&T|,xbv*U&u/J e 扫t7o6A<ʋOtvsx0A3m#-mI@<įc KAbUoxvLj{PQr(6;OA{2#s.m#U N % 0: fM 0VO ^ w 4   m a f a f a f1 f3 0 c5 1u 72 0w? 0 0@ 0 0 0[ 06 0D% 1i 72 1$ 72fa 1 72zNfafaaafafa B              B'''''' B+DHP LaserJet 8100 Series PS0(hH  Z6Times New Roman RegularX($USUS.,(.3$ !USUS.,  ݇y3 3:i+003|xUTABLE AcTABLE BTABLE C`P(;3$2#  0  .3  0  3#37=CIQYag1.a.i.(1)(a)(i)1)a)i)(O;$0  2#  a  .3  0` (#(#(b$0  0` (#(#2#   .3  0 ` (#` (#(xir$0  0` (#(#0 ` (#` (#2#(  0  )3  0 (# (#($0  0` (#(#0 ` (#` (#0 (# (#2#(  a  )3  0h(#(#(F$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#2#(   )3  0h(#h(#($0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#2#  0  )3  0(#(#({$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#2#  a  )3  0p(#(#(F$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#0p(#(#2#     )3  0p(#p(# xGaeimquy}Bullet ListBullets List(5hCEKQW]cioAutoList11.1.1.1.1.1.1.1.!1.TABLE Dh3 CEIMQUY]aAutoList2i)1)a)%|TABLE ETABLE F  'USUS.,  _XX^\XX*3Z4ddd Xdd Xdd XX%X%, dd , dd , dd +  $ $  StateofKansas 4d DepartmentofSocialandRehabilitationServices  ChildrenandFamilyServices 'Hx  ' '4d '  CFS2030C 4d November1999"0 "TABLE GTABLE ITABLE HHTABLE J d  d d !USUS.,  _XXX,*(+d dd Xdd Xdd XX%X%,(#dd +  $ $ @RISKASSESSMENT(shortform) ^\XXԀ##D%Page1of1#X/X\^#Ԉ zd STATUS: fP ̈XX/ IdentifyingInformation: #X/Ẍ:#"R< " ̈XX/*lZdd(#dd (#(+X%X%l,dd , dd ,dd ,dd ,Fdd ,dd +  'D .D . 'CaseName: 7Z&!   7 0& Z 0FACTSCase# 7Z&!   7 0& Z 0FACTSEvent#: 7Z&!   7(   Z (*Zdddd  dd dd dd Fdd Fdd ZX%X%,dd ,dd ,dd ,dd +  '    'SocialWorker: 7Z&!    7 0&  Z 0DateofAssignment: 7Z&!    7 ;f*  Z ;,4*(X B  f 4,**-d ddd dd dd dd ZX%X%,(#dd +  +f   + NOTE: 0  Theshortformoftheriskassessmentmaybeusedif: %%  (y3"3"    3 23  0 l   thechild(_ren_)isassessedas Safeand3 I ݌ l%l% Ќ  "3"    3 23  0 l   thereportofabuseorneglectisunsubstantiated3 Y ݌l%l% Ќ  "3"    3 23  0 l   OR thereportofabuseorneglectissubstantiatedandtheperpetratoraccesstothechildis highlyimprobable. 3 L ݌fP l%l% Ќ  0  Itistheexpectationthatallriskfactorsareconsidered(asstatedinthefullRiskAssessmentForm),however,completion   ofthefullRiskAssessmentisnotrequired.;1/ %% f ;*l01d d(#dd (#*-X%X%l,(#dd +  $   $ &0G%̈SectionI:RiskFactors(abuseneglectcasesonly).#̈%&0G#     Considereachofthefollowingpossibleriskfactorsandindicatethepresenceofanyofthefollowing:"  " *lZ dd(#dd (#01X%X%l,wdd ,rdd ,#dd , dd ,dd +  +!  +   PossibleRisk <2$<&    <W   Yes 9/!<&"  9   No YO!<&"  ?1.? Y 1. \R@|  ?1. ?   \Isthereaprevioussubstantiatedreportor_CINC_Ԁadjudicationonanyfamilymember? 5ll&$|  5 -lll|ll - PF|lll  @2.@ P2. \R@  @2. @   \Doesanychildhaveaphysicalimpairment(examples:adevelopmentaldelay,achronicphysical   illness,aphysicaldisability) 5ll&$!  5 -lll"ll - PF#lll  @3.@ P3. \R@$  @3. @   \Doesanychildhavedisturbedorunusualbehavior?0 C ?ll0.%C!C!  ? -lll&ll - PF'lll  @4.@ P4. \R@^H(  @4. @   \Doesanyparent/_caregiver_Ԁhaveahistoryofdrug/alcoholabuse? 5ll&$^H)  5 -lll^H*ll - PF^H+lll  @5.@ P5. XN@,  @5. @  XOTHER(Specify) 0&!-  0 +lll.  + -llll/lll - PF0llll  @6.@ P6. XN@1  @6. @  XOTHER(Specify) 0&!2  0 .ll3  . 0lll4ll 0 4*5lll  4 Narrative (Questions16) 7-$fP6   7 >f-fP7  >,4*( 8  f 4,*#Z$d dwdd wrdd r#dd # dd dd Z X%X%,(#dd +  '!8! ' SectionII:Discusseachriskfactorwitha yesansweraboveandanyothersignificantriskfactorsasfollows: !j9 Describeeachriskfactoridentifiedandhowitaffectsthesafetyofthechild.Describetheuseoffamilystrengthsand B",: resourcestoreducetherisk. 0&!#; 0 .fZ$D<  .(%=  f ( *l.d d(#dd (##Z$X%X%l,(#dd +  $& =&  $SectionIII:RiskAssessmentConclusion :Recordrisk" ' > "*lZ)dd(#dd (#.X%X%l,wdd ,!dd +  $lll(!>(! $ 0&d(N"?lll 0-33F,; XX-1.0 F NoSignificantRisk 󀀀Therewerenosignificantriskfactorsidentified. *CompleteFBASummary. @lll-+d(N"@F%F% @ 0&)#Alll 02.0 F RiskControlled 󀀀Significantriskfactorswereidentified,butfamilystrengthsoravailableresourcesaresufficientto )#B provideforthechild(_ren_)ssafety. *CompleteFBASummary. @llll-+*n$CF%F%  @ 0&+%Dllll 03.0 F RiskPresent 󀀀Riskfactorswereidentified,andthereareNOTsufficientfamilystrengthsandavailableresourcesto +%E provideforthechild(_ren_)ssafety.Ifriskispresent,servicesmaybeindicated. *CompletetheFullRiskAssessment. ;1/,&FF%F%    ;