name Child’s Date of birth Address PRINT NAME Name of member of staff reporting the concern Signature Role Date DD/MM/YYYY Time Concern- Use the body- map below to show any marks or injuries. Additional form used? Yes / No Page of Children must not be undressed or photographs taken of any marks or injuries Concern Form Part B To be completed by the Designated Safeguarding Lead (D/DSL) school’s status with Early Help or Social Care. Child’s Children’s Tick and add name where known at time of initial report. Child Protection Previous social None CAF Child in Need Plan care involvement Name of allocated worker Name of D/DSL reviewing the concern Name of person taking Actions include whether concerns were shared with – Date actions parents/carers, MASH and if not outline reasons why
Child’s name Date of birth Address Name of member of staff reporting the concern PRINT NAME Signature Role Date DD/MM/YYYY Time Concern- Use the body- map below to show any marks or injuries. Additional form used? Yes / No Page of Children must not be undressed or photographs taken of any marks or injuries Concern Form Part B To be completed by the school’s Designated Safeguarding Lead (D/DSL) Child’s status with Early Help or Children’s Social Care. Tick and add name where known at time of initial report. None CAF Child in Need Child Protection Plan Previous social care involvement Name of allocated worker Name of D/DSL reviewing the concern Name of person taking actions Actions – include whether concerns were shared with parents/carers, MASH and if not outline reasons why Date
Wiltshire-Model-CP-policy-June-2018.docx