Novice Emerging Accomplished Distinguished Master In addition to Novice In addition to In addition to In addition to The family was Practice: Emerging Practice: Accomplished Distinguished given an Practice: Practice: explanation about The family was Included the need for provided with a behavioral the family A FCM was Agency clear detail in the about their held intervention understandable harm and understanding explanation of safety, danger Safety, harm, about the need harm, and statements danger and for Agency danger as it impact to the intervention related to Included child were their impact to the discussed Used the terms of investigation / child with the safety, harm, family family more and danger situation than once The child(ren) The family’s / youth and was family’s voice obtained was included more than in the safety, once harm, and danger statements Attempted to hold a FCM Please in the name/rating for each applicable family member: Mother: Father: Other: Other: Comments: If a Safety Plan was implemented did it effectively address the safety threat? Yes rate below No (The safety plan did not address the safety threat Explain in comments box below) – N/A: (circle all that apply) No Safety Plan was implemented; Safety Plan was not reviewed (not imported in CWS or was not in case file); other (specify the reason in the comments box below) Connection to key expectations SOP; Family Partnerships; Support Systems/Safety Networks – Novice Emerging Accomplished Distinguished Master In addition to Novice In addition to In addition to In addition to A Safety Practice: Emerging Practice: Accomplished Distinguished Plan was Practice: Practice: developed The Safety Plan A Safety Plan that was behaviorally was developed Attempts were At least one addressed specific which was: made to follow-up was
Novice Emerging Accomplished Distinguished Master The family was given an explanation about the need for Agency intervention In addition to Novice Practice: The family was provided with a clear understandable explanation about the need for Agency intervention Used the terms of safety, harm, and danger In addition to Emerging Practice: Included behavioral detail in the harm and danger statements Included impact to the child In addition to Accomplished Practice: the family about their understanding of safety, harm, and danger as it related to their investigation / family situation The child(ren) / youth and family’s voice was included in the safety, harm, and danger statements Attempted to hold a FCM In addition to Distinguished Practice: A FCM was held Safety, harm, danger and impact to the child were discussed with the family more than once The family’s was obtained more than once Please in the name/rating for each applicable family member: Mother: Father: Other: Other: Comments: If a Safety Plan was implemented did it effectively address the safety threat? Yes rate below No (The safety plan did not address the safety threat – Explain in comments box below) N/A: (circle all that apply) No Safety Plan was implemented; Safety Plan was not reviewed (not imported in CWS or was not in case file); other (specify the reason in the comments box below) Connection to key expectations – SOP; Family Partnerships; Support Systems/Safety Networks Novice Emerging Accomplished Distinguished Master A Safety Plan was developed that addressed In addition to Novice Practice: The Safety Plan was behaviorally specific In addition to Emerging Practice: A Safety Plan was developed which was: In addition to Accomplished Practice: Attempts were made to In addition to Distinguished Practice: At least one follow-up was
set_referral_review_tool_v24_1.docx