WPC0 ;Gfr) ؃i6P@/VtGq'ةBK1XG̰rM`j 㹀Bά(sP=11⨤MVTT6nX> )5GR Y;“ר f:]V:X^-`GA4GO24x [ ck2)ڃ)L+ky;Ø Yt] fromthedateofcustodyifthechildisinSRScustody)/InitialServicePlan.#9j#j9T (# (#  X   SectionI ALLEGATIONTYPE(asdeterminedbythesupervisorordesignee)   ̀.0  ABUSE/NEGLECTALLEGATIONS: 󀀀Inthissectiontheallegation(s)tobeinvestigatedisidentifiedfrom f informationprovidedbythereporterorfollowingapreliminaryinquiry,(#(# ̀.0  NONABUSE/NEGLECTALLEGATIONS: 󀀀 Inthissectiontheallegation(s)tobeassessedisidentified b  frominformationprovidedbythereporterorfollowingapreliminaryinquiry.z (!(#(# #9j ##9#q` j q` SectionIIFACTORSCONSIDEREDINCOMPLETINGTHEINITIALASSESSMENT "#  0  FormCFS1002lists13factorsrelatedtochildwellbeingwhichshouldbeconsideredinprioritizing "p$ departmentresponse.Factorsrequiredtobeconsideredarepredesignatedontheformbyacheckmark(3). #4% Eachofthesefivefactorsmustreceiveanappropriatewrittencommentontheformindicatingthatthefactor J$& wasconsideredandtheresultsoftheconsideration.Thepreprintedcheckmarkwillnotsufficetoindicate %' considerationwithoutawrittencomment.Otherfactorsmustreceivecommentor,ifdeterminedtobenot %( appropriatetothecase,indicate None.&D)(#(# #9j#!n/ 9#9 !n/:##9#q`  q`  q`   SectionIIIRESPONSETIME#   q`# # #9j9 0( + ̀.0  RESPONSETIME: 󀀀Indicatetheresponsetimechosenforthesuspectedabuse/neglectconcern.Only )d"- tworesponsetimesareallowedbydepartmentpolicyforabuse/neglect:Immediate/SameDayor72Hours.|**#.(#(# 0  20workingdaysisallowablefor_CINC:NAN_Ԁreports@+#/(#(# #9jp##9Q#q` j q`  #9jz#j9#q` j#j q` SectionIVBASISFORDECISIONREGARDING #q` j*# q`  q`#   q`# q`  ASSIGNMENTOFREPORT#q`   q`## q`#q` j q` ,v%1  0  Brieflydescribethereasonsforassigningthereportforassessment.The decisionmustbeunderstandableto -8&2 thepersontowhomthecasemaybereferredandtooutsidecasereviewers,(includingthecourtiftherecord R issubpoenaed).Thisfieldspellsout"why"andtheassessmentwillbeconducted. (#(# #9j[#j9 0  #q` jz#q`  q`Thebasisshouldidentifytheallegedvictimandallegedperpetratorassociatedwitheachallegationtype  L assigned.Ifthereisanallegationofabuse/neglectidentifiedinthewhichisnotbeingassignedforassessment, b  thebasisshallindicateanallowablereasonaccordingtopolicythattheallegationwillnotbeassessed.& (#(# # q`^###9j9 .0  CASEFINDING(Abuse/NeglectOnly)TOBECOMPLETEDBY: Ifthereportallegesabuse/neglect,  \ enterthedatethecasefindingistobecompleted.Thedatemustnotbemorethan25workingdaysafterdate t " acceptance. 8 (#(# .0  FAMILYBASEDASSESSMENTTOBECOMPLETEDBY: EnterdatetheFamilyBasedAssessment l  istobecompleted.Thedatemustnotexceed45workingdaysfromacceptancedateor,ifthechildisinSRS 2  custody,30calendardaysfromthedateofcustody(whichevercomesfirst).H (#(# #9j#j9#q` j#j q`#9j#j9#q` j#j q` . 0  72HOURRESPONSETIME: Ifa72hourresponsetimehasbeengiven,indicatethedayandhourof72 ~  hourexpirationfromthedateofacceptance.D (#(# #q` jt#j q`#9j2#j9 . #9j #j9#q` j #j q`0  ScreeningDecisionMadeby: Nameofthesocialworkscreenerorsocialworksupervisormakingthe   screeningdecision.#9j#!##9e!#(#(# !r !n/  !r SectionVASSIGNMENTTobecompletedbythelocaloffice 0  #9 !n/"#j9T(#(#  #9j9##j9#q` j"#j q`.0  JOINTINVESTIGATIONWITHLAWENFORCEMENTOFFICERREQUIRED?: Indicate Yesif  ajointinvestigationwithlawenforcementofficerisrequired.Ifajointinvestigationwithlawenforcementis b notrequired,indicate Noandprovideabriefexplanationastowhynot.x&(#(# #q` j##j q`.0  ASSIGNEDSOCIALWORKER: 󀀀EnterthenameandworkerFACTSnumberofthesocialworkerassigned  toprocessthecase.t(#(#  .0  SUPERVISOR\DESIGNEESIGNATURE: 󀀀Signatureofthesupervisorordesigneesupervisingtheassigned L case.#q` j%## q`##  (#(#