Information gathering for the purpose of completing a s95 (QPS requests only) – complete Section A & C & D Section A Mandatory – Family Details Family name Given names: Date of birth: Home address: Gender Relationship to child: (include alias): SMITH John 12/12/1988 123 Fake Street Male Father Runaway Bay, QLD 4874 JANE Lisa 10/12/1987 Unknown Female Mother BROWN Ralph 10/01/2016 Unknown Male Subject Child Other Relevant Family Members Family name Given names: Date of birth: Home address: Gender: Relationship to child: (include alias): MAKE Jason 31/04/1987 5 Knock Knock Street Male Mother’s Partner Kingston, QLD 4207 Integrated Client Management System (ICMS) Date ICMS check ICMS check completed 21 October 2016. completed Has this prescribed entity No Yes previously provided If yes, please provide a brief date and a description of what information was information in relation to provided: this family? Case note located in ICMS. Information in relation to previous DV, (Please articulate if the previously provided criminal history and call outs to the address of 123 Fake Street, Runaway information is in relation to a prior Bay was provided by the QPS on the 2/09/2016. child protection matter or if it relates to the current child protection concerns). Section B Mandatory Contextual Information for S159 requests – Summary of Current Child Protection Concerns (notified concerns) The family is currently subject to a current investigation following concerns that Lisa JANE has removed Ralph BROWN from the care of his father. There are significant concerns for safety given previous child protection concerns raised in Ralph’s relation to Ms JANE and her capacity to parent Ralph. Additional concerns have been received in relation to Ms JANE recommencing her relationship with previous partner Jason MAKE 31/04/1987 and ongoing serious domestic violence between the two parties. It is reported that Ms JANE has been residing in with Ralph however has several women’s refuges been kicked out of these refuges as she has allowed unknown persons in. Ms current whereabouts are unknown. JANE’s The contact number of 0414656787 held by our department is no longer connected. Police have recently spoken to Jason MAKE who advised that there was a DV order between Ms JANE and himself however he was not aware of the conditions. He further advised that Ms JANE had made false allegations against him and this resulted in police raiding his at 5 Knock Knock Street Kingston. parents’ home
Information gathering for the purpose of completing a s95 (QPS requests only) – complete Section A & C & D Section A – Mandatory Family Details Family name (include alias): Given names: Date of birth: Home address: Gender Relationship to child: SMITH John 12/12/1988 123 Fake Street Runaway Bay, QLD 4874 Male Father JANE Lisa 10/12/1987 Unknown Female Mother BROWN Ralph 10/01/2016 Unknown Male Subject Child Other Relevant Family Members Family name (include alias): Given names: Date of birth: Home address: Gender: Relationship to child: MAKE Jason 31/04/1987 5 Knock Knock Street Kingston, QLD 4207 Male Mother’s Partner Integrated Client Management System (ICMS) Date ICMS check completed ICMS check completed 21 October 2016. Has this prescribed entity previously provided information in relation to this family? (Please articulate if the previously provided information is in relation to a prior child protection matter or if it relates to the current child protection concerns). No Yes If yes, please provide a brief date and a description of what information was provided: Case note located in ICMS. Information in relation to previous DV, criminal history and call outs to the address of 123 Fake Street, Runaway Bay was provided by the QPS on the 2/09/2016. Section B – Mandatory Contextual Information for S159 requests Summary of Current Child Protection Concerns (notified concerns) The family is currently subject to a current investigation following concerns that Lisa JANE has removed Ralph BROWN from the care of his father. There are significant concerns for Ralph’s safety given previous child protection concerns raised in relation to Ms JANE and her capacity to parent Ralph. Additional concerns have been received in relation to Ms JANE recommencing her relationship with previous partner Jason MAKE 31/04/1987 and ongoing serious domestic violence between the two parties. It is reported that Ms JANE has been residing in several women’s refuges with Ralph however has been kicked out of these refuges as she has allowed unknown persons in. Ms JANE’s current whereabouts are unknown. The contact number of 0414656787 held by our department is no longer connected. Police have recently spoken to Jason MAKE who advised that there was a DV order between Ms JANE and himself however he was not aware of the conditions. He further advised that Ms JANE had made false allegations against him and this resulted in police raiding his parents’ home at 5 Knock Knock Street Kingston.
guidelines-requesting-info-s159.docx