WPC  %VaR(>k5,~[mL{d:ɋ ͫ,jhbm"$ndƋ;N c=Ѷ4Gԣ\ITc^ЖMvk[}_0*\S=^L; }P6?gp>Bȉ'W.bS\[Zimm+!>U}J`}~xV$o \sR5 7bE$FKq1o-d/iBi(Ӝ zmMmjUDoG{˪5VL;݀n '\c 橺O29GH*/i47h7zHkVM$Ir\GI+(}{OA.[e+4UB %  0 0Z 0 D+{  0l 0= 06 AQ # nX 0rENw4; 0 ^  m 0N\  `*Times New RomanTT'  $Shirley Dwyer$0Shirley Dwyer .   h:Default ParaDefault Paragraph Font        `:footnote reffootnote reference        (e2y$ ҇!X1XX1XXX1   'dxd Level 1 Level 2 Level 3 Level 4 Level 5(e2y$ ҇!X1XX1XXX1   ($    (e2y$ ҇!X1XX1XXX1    C<< cSAVIN 2055DP PCL 603|x\  `*Times New RomanTTC\  P6QP\  `*Times New RomanTTXXP\  P6QXP(J҇$XJXXJXXXJ  _,bh, 1 'X1XX1XXX1   _  @5(#XX1CFS2030EInstructions X Rev.October2001  Page1of1#X1X#(f3$ ҇!X1XX1XXX1   ҝ, U>$"Small Circle"0  ҇!X1XX1XXX1   _XX1X @ COMPLETINGTHECINC/NANASSESSMENT,FORMCFS2030E   @ppCompleteONLYforNonA_buse_/Neglect  3  3"0    CASENAME: 󀀀Usethesamecasenameasonpage1,SectionII,#1offormCFS1000.3݌ ((#(# Ќ  3  3y"0    CASENUMBER: 󀀀Usethesamecasenumberasonpage1offormCFS1001.3y݌z(#(# Ќ  3  3S"0    EVENTNUMBER: 󀀀Usethesameeventnumberasonpage1offormCFS1001.3Sn݌ (#(# Ќ  3  3/"0    SOCIALWORKER: 󀀀EnterthenameoftheassignedworkerfromformCFS1002,3/J݌Z x (#(# Ќ    page2,SectionIII.   0   3  3I"0    DATEOFASSIGNMENT: 󀀀EnterthedateofcaseacceptancefromformCFS1002,3Id݌  (#(# Ќ    page1. :X   SectionI:PRESENTINGPROBLEM       Indicateanypresentingproblem(s)basedontheassessmentofthefamily. 8   SectionII:DANGERTOSELFOROTHERS       Indicateanypresentingproblem(s)basedontheassessmentofthefamily.   SectionIII:CONTRIBUTINGFACTORS j   Completeonlyforchildrenidentifiedinthereportnarrative(CFS1000,p.2).Completeonall_caregivers_Ԁin  the  home.#X1Xu#XX1ԀCheckanyfactorsidentifiedbasedontheassessmentofthefamily.    SectionIV:DESCRIPTIONANDANALYSISOFPRESENTINGPROBLEMANDCONTRIBUTING   FACTORS `      Describethepresentingproblem,dangertoselforothers,andthecontributingfactorsspecifyingcircumstances r   andconditionsrelatedtosituation.Assessthefamily'sabilitytouseitsstrengthsandresourcestomanage *H   identifiedproblemsandcontributingfactors.      OTHERSTRENGTHS: Describeanyothersignificantfamilyorchildstrengthsorresourcesnotnoted Rp" above.   (#   PERSONSCONTACTED/INTERVIEWED: 󀀀Listallofthepersonscontactedorinterviewed,theresults z% of  theinterview(includingdateandtime)andwheretheinterviewcanbefound.Ifattempttocontact\interview 2 P&   apersonrelevanttocasewasnotsuccessful,documentwhynot.  '  SectionV:ASSESSMENTCONCLUSION Z"x)     Assessmentconclusionconsidersproblemsidentifiedwithfamilystrengthsandresourcestoreducethe #+ problem. ` Chooseoneofthefollowing:  $,      NoProblemBehaviors: Therewerenosignificantbehaviorproblemsorcontributingfactorsidentifiedand %!.   thechildisnotadangertoselforothers. &!/     ProblemBehaviorsControlled: Significantproblembehaviorsandcontributingfactorswereidentifiedbut (8#1   familystrengthsandresourcesaresufficienttocontrolidentifiedproblemssuchthatthechildisnotof (#2   dangertoselforothers. )$3    `   ProblemBehaviorsPresent: (child/youthisadangertoselforothers).Significantproblembehaviorswere *&5   identifiedandthereareNOTsufficientfamilystrengthsandavailableresourcestocontrolidentifiedproblem.  +&6  #X1X#