WPC  J n  փwhIm[#:؝r(~׈ݙ ] 0;ڊ)ݷDVZ.yh' 6k1,E{E<_aTLz#q7s'z/?]ғp"6 \t_MV0N$F+X@䨛/5e+φI24o'.P%0T {a\̛c-?BP`"c>dyAZF긡@"7 L_fsZY_-Fd2\wrrYMuM )ps'IS.Hʸ'NܰO[w/V<4J=T÷>qQ0 &g7n&$TԉG)% }Y,Vd{6wj#O[(*Y|.\SR$C~}MJ8H/qS1#L U. %C 0(IqUNyw4U"HU">6U Htttt 0DUN!^  mNbz 1@ 72 0c 0w\ 0 0] 0 0 0x 0S 0DB 1u 72 B-JU@DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD A 0D/// D-s 0Kfaf                            a HP LaserJet 8150 PCL 60<6X9`+CourierX($`6Times New Roman Regular\.3|x.X0 AZ0Univers (W1) Regular(\  p`&Times New Roman.\' AZ0Univers (W1) Regular '  _  @II7 $XuXXX9XXuCFS2011Instructions  July,2003(3$ !  (9 Z 6Times New Roman RegularLevel 1Level 2Level 3Level 4Level 5Level 1Level 2Level 3Level 4Level 5. UPage of &Level 1Level 2Level 3Level 4Level 5Level 1Level 2Level 3Level 4Level 5Level 1Level 2Level 3Level 4Level 5 !"#$%&hCEIMQUY]aAutoList1........i)1)a)'.(;3$2#  0  .3  0  (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(# 3#37=CIQYag1.a.i.(1)(a)(i)1)a)(i) d '  _XX  @II7 $,9CFS2011Instructions  Rev.July2003#,9v#(k9 Z(Times New Roman Z^]&OLE 2.0 Box <=8C HKKKK(3$ !  )!dxdx( $ Figure  1  TABLE BBTABLE AP !  _*X, XX*  X1XXX |X X1  TRX3'X3' Letter3'Letter3'LetterT  89dd8+@  &?% |COMPLETINGTHECASEFINDINGS,FORMCFS2011# |% &?#Ԉ   h   SectionI n   Y  | &v %  Y.# &?% % &vl## |% &?#0  A.0$$ AllegedVictimsName: 0L$$Enteronlythename(s)oftheallegedvictim(s)fromtheCFS1000.L$L$  NOTE: Anychildnotidentifiedasallegedvictimatthetimeofthereportbutwaslaterdiscoveredtobean   allegedvictimmustbeaddedtotheCFS1000.  T   Y  | &v %  Y.# &?% % &v## |% &?#0  B.0$$ AllegedVictimFinding: 󀀀Enterthefindingcodeassociatedwithoneallegationtypeforavictim.A    findingcodemustbecompletedforeachassignedreporttypeassociatedwithachildallegedtohave    beenavictiminthereport.Ifthereismorethanoneallegationassociatedwithachild,additionallines j   shouldbeusedtorecordthosevictimfindings.(T $$  Y  | &v %  Y.# &?% % &v## |% &?#C.0  FindingType: 󀀀Enterthecodeforthefindingtype.Afindingtypeshouldbeenteredforeachallegation   associatedwithachild.Ifthereismorethanoneallegationassociatedwithachild,additionallines |  shouldbeusedtorecordthosevictimfindings.:f $$ 0   $$  Y  | &v %  Y.# &?% % &v ## |% &?# #D. 0  InjuryType: Enterthecodewhichmostcloselydescribestheallegedvictim(s)injury.ASARESULT   ofabuse/neglect.Ifmorethanoneinjuryapplies,choosethemostserious.$$  Y  | &v %  Y.# &?% % &v ## |% &? #E.0  DegreeofInjury[SeverityCode]: EnterthedegreeofinjuryenteredincolumnD.dIfthedegreeofinjury  6 isnot_known_Ԁleavethefieldblank.$$ d     D  p      L  x      Y  | &v %  Y.# &?% % &v ## |% &? #F. 0  AllegedPerpetratorsRelationshiptoallegedvictim: Entertherelationshipoftheallegedor ^ substantiatedperpetratortotheallegedvictimbyenteringthenumberoftheallegedperpetratorfrom 6b SectionII,Ainthefirstbox,andthecodethatdescribestherelationshipoftheallegedperpetratorto   theallegedvictiminthesecondbox.$$  h   SectionII  .Z  Y  | &v %  Y.# &?% % &v1## |% &?P#A.0  AllegedPerpetratorsName: EntereachpersonlistedontheCFS1000asanallegedperpetrator.$$  NOTE:Anypersonnotidentifiedasanallegedperpetratoratthetimeofthereportbutwhowasdiscovered Ht! tobeanallegedperpetratorduringthecourseoftheassessment,istobeaddedtotheCFS1000.  6"   Y  | &v %  Y.# &?% % &vU## |% &?t#B.0  AllegedPerpetratorsFinding: Enterthefindingcodefortheallegedperpetrator. $$$  Y  | &v %  Y.# &?% % &vi## |% &?#C.0  FindingType: 󀀀Enterthecodeforthefindingtype.Ifmorethanoneapplieschoosethemostserious. ("T& Ѐ $$  NOTE:DandEarecompletedonlyiftheallegedincidentoccurredinafacility.  b | |$) # | b# Y  | &v %  Y.# &?% % &vT## |% &?s#D.0  FacilityType: Iftheabuseorneglectisallegedtohaveoccurredinafacilitysubjecttolicensing,enter %(!+ thecodeforfacilitytype.&",$$  Y  | &v %  Y.# &?% % &v## |% &?#E.0  RelationshiptoFacility: IfanentryismadeinD.,enterthecodefortheperpetratorsrelationshiptothe P(|#. facility.()T$/$$  h   SectionIII  *%1  Y  | &v %  Y.0  # &?% % &v8## |% &?W# ReporttoCountyorDistrictAttorneyrelatedto_CINC_ԀProceeding: 󀀀Check"Yes"or"No".IfYes,indicate (,T'3 whichrecommendationwasmaderegarding_CINC_ԀproceedingandenterthedatesenttotheCountyor -,(4 DistrictAttorney.Ifnorecommendationwasmaderegarding_CINC_Ԁproceeding,butareportwassenttothe -(5 CA\DAforpossiblecriminalaction,select"norecommendation".|.)6$$   :/f*7 _ +< h   SectionIV    Y  | &v %  Y.# &?% % &v{## |% &?# 0  BasisforFinding: X$$  Y  | &v %  Y0  # &?% % &vI# &?%% &?# |% &?h# Y  | &v %  Y.# &?% % &v## |% &?#0$$Entertherationaleonwhichthecasefindingdecisionisbased,the"why"ofthefindingdecisionas 4 relatedtothespecificfactsconsideredfromtheinvestigation. $$ 0  .0$$Ifthecasefindingdiffersfromtheoriginalreportallegation,explainhere(forexample,reportislackof \  supervision(runaway),findingissubstantiatedsexualabuse.) F$$ 0  .0$$Iftheinvestigationwasdelayedandcasefindingexceeds25workingdaysfromdateofacceptance,    explainhere.T  $$   !"#$%&'(x3("3"    3 2.3  0    Ifbasisforfindingisdraftedbyspecialinvestigator,socialworkerandsupervisorneedtoreview,   approveandsignit.3 ݌ $$ Ќ  *n*ddd Xdd Xdd X$$,dd +   6  6  PPracticeNote: n  Thisisacriticalfield.Discussionofdecisionreasoningrecordedheremustbeunderstandabletoan ,X  outsidereviewer(e.g.Administrativehearingofficer).The"BasisforFinding"mustincludetherationale  usedtoreachthefinding.ThisincludesaddressingALLallegationsfromtheCFS1002,Response  Determinationandfactsresultingfromtheinvestigation. f *e*dddd n*$$e,dd +  >>   +Exampleof"basisforfinding":"Childtoldconsistentstorytoteacherandtoscoutleader.Childhad v detaileddescriptionofmaleejaculationandnoplausiblealternativeexplanationwasofferedbyalleged 4` perpetrator.Allegedperpetratorhadopportunity.Sexualabuseissubstantiated."" " h   SectionV  \  Y  | &v %  Y.# &?% % &v,'## |% &?K'# 0  SignatureofSupervisororDesignee: Entersignature.Thecasefindingisnotcompleteuntilthe   supervisor/designeesignsanddatesthisdocument. | |Adesigneecannotbethesameworkerwhoconducted  theinvestigation.# | |p(#v$$ 0  Note:Ifthesupervisorordesigneedoesnotsignanddate,afindinghasnotbeenmade. !$$  Y  | &v %  Y.# &?% % &v)## |% &?)#0  DateofFinding: Enterthedatethefindingwasmade.r #$$  h