Reporting Child Abuse and Neglect

Specific Concern

• What are your specific concerns about the child(ren)?

• Has something happened to the child? If so, what happened?
• When and where did it occur and who was involved?
• Was an object used and if so, what type of object?
• How serious is the harm to the child?
• Provide a detailed description of your specific concern.

Circumstances Surrounding Your Concern

• What was going on with the family before, during and after the specific circumstance/event/alleged child maltreatment you are concerned about?

• Where were the children at the time and where are they now?
• What did the child say happened?
• What is the caregiver’s explanation?
• How do you know about this circumstance/event/alleged maltreatment?
• Is your concern an ongoing concern with the children?
• Has this specific concern, or any other concerns about this child, come to your attention previously? If so, please provide an explanation of prior concerns you have.
• Who else knows about this?
• Were the police called? If so, what is the officer’s name?

Child Functioning

• Describe each child’s day-to-day functioning in relation to other children their age.

• What is the child’s overall appearance, health, and wellbeing?
• Does the child(ren) have any behavioral, mental, emotional, intellectual, or physical disabilities? If so, what, and how does it affect their functioning?
• Is the child(ren) receiving services from any agency? If so, who and what for?
• Are they on any medications?
• Do they get medicine regularly?
• If school age, what grade level? Describe attendance/discipline issues/general performance.
• How does the child(ren) interact with their peers?
• Has the child(ren) expressed concerns about going home? If so, what concerns and why?

Parenting Discipline

• How do the parents manage the child(ren)’s behavior?

• What do the parents do when the child(ren) gets in trouble?
• How do they view the purpose of discipline?
• Do they have house rules for the child(ren) and if so, what are they?
• What kind of things does the child(ren) get in trouble for?
• Is the caregiver ever out of control when disciplining the child(ren)? If so, explain when and the circumstances.

General Parenting

• What is the overall parenting style of the parents—structured, strict, laid-back?

• How do the parents/child(ren) interact?
• Do parents seem to understand the child(ren)’s needs?
• Are they able to meet these needs? Why or why not?
• Does the caregiver have realistic expectations of child(ren) given the their age/functioning? Explain.
• Describe how caregiver accesses and uses available resources to provide basic needs for the child(ren).
• Who usually cares for the child(ren)?
• Are the parents living in the same home? If not, is the non-residential parent involved with the child(ren)?
• Describe how caretakers react to bad behavior.
• Describe how they show love and nurturing.

Adult Functioning

• What is the overall functioning of each parent on a personal level-- rather than as a parent?

• How does the caretaker care for themselves?
• Are they employed? If so, what shift?
• Stable employment?
• Who cares for child(ren) when they are at work?
• Do caregivers have a steady source of income? Stable housing?
• Are there any concerns relating to mental health, substance abuse, domestic violence? If yes, what frequency?
• How do the parents respond when you approach them with concerns?

Additional Comments