CPS INVESTIGATION CASE PROCESS REVIEW
Reviewer's Name (Last, First)
Review Date
(mm/dd/yyyy)
Team Leader's Name (Last, First)
Review Quarter
Region
Case Manager's Name (Last, First)
County
Child's Name (Last, First)
Client ID
Number
Investigation Number
Referral Date
(mm/dd/yyyy)
Status of File
INTAKE INFORMATION
1.
CPS Referral
2.
Response time assigned
INVESTIGATION
3.
Initial CPIT convened within 24 hours per DCS Policies 14.5, 14.6 and Work Aid 3
4.
CPIT staffed and documented per DCS Policy 14.6
5.
Case history reviewed and documented in TFACTS per DCS Policy 14.1 and Work Aid 3
6.
Documentation in TFACTS case recordings of assignment notification to referrent (or good faith attempt) per DCS Policy 14.1
7.
TFACTS dictation per DCS Policy 14.1
8.
Documentation that a good faith attempt was made for face-to-face contact with victim(s) if no contact was made
9.
Interview with referent per DCS Policy 14.1
10.
Interview with victim per Work Aid 3
11.
Interview with perpetrator(s) per Work Aid 3
12.
Interview with sibling(s) per Work Aid 3
13.
Interview with caretaker(s) per Work Aid 3
14.
Interview with non-related household member(s) per Work Aid 3
15.
Interview with collateral(s)/witness(es) per Work Aid 3
16.
Description of physical injuries/condition in the narrative per Work Aid 3
17.
Photographs supporting written description and appropriately labeled per Work Aid 3
18.
Medical Report
19.
Psychological Report
20.
Substance Abuse Reports/Drug Screen Results
21.
DA notification (initial) documented in TFACTS case recordings per DCS Policy 14.5
22.
Judge notification (initial) documented in TFACTS case recordings per DCS Policy 14.5
23.
Home visit and/or site visit per DCS Policies 14.7 and 14.26
24.
Background check obtained per DCS Policy 14.24
25.
Documentation of Supervisor conference with Case Manager per DCS Policies 14.5, 14.7, 14.8, 14.10, 14.12, 14.25 and 14.26
26.
All required FSTMs/CFTMs per DCS Policy 14.4
27.
CPS Classification and Summary (CS-0740) per DCS Policy 14.7
28.
Classification within 30 days, waiving some CPIT cases and some pending autopsy cases per DCS Policy 14.7
29.
Family Permanency Plan (FPP) current and in Permanency Plan/TFACTS
30.
Notification to DA (classification) documented in TFACTS case recordings per DCS Policy 14.7
31.
Notification to judge (classification) documented in TFACTS case recordings per DCS Policy 14.7
32.
Client's Rights Handbook given to client per Work Aid 3
33.
Authorization for Release of Information and HIPAA Protected Health Information to the Department of Children's Services (CS-0668) signed by client per Work Aid 3
34.
Native American Heritage Veto Verification (CS-0824) signed by client per Work Aid 3
35.
MRS pamphlet given to client per DCS Policy 14.26
ASSESSMENT TOOL
36.
A Family Functional Assessment initiated within thirty (30) calendar days of case assignment and updated on a quarterly basis per DCS Policy 14.4 and FFA Protocol.
37.
FAST per DCS Policy 14.26
38.
Immediate Protection Agreement per Policy 14.9
39.
SDM Safety Assessment per DCS Policy 14.5 and Work Aid 3
SERVICES
40.
Referral to Tennessee Early Intervention Services (TEIS) through the TN DOE if the case is classified allegation indicated on a child under the age of three (3) per DCS Policy 14.7
41.
Referral for services per DCS Policy 14.26
42.
Contact made with provider(s) per DCS Policy 14.26
43.
Progress reports from provider(s) per DCS Policy 14.26
CASE CLOSURE
44.
TFACTS record complete
45.
File organized and stamped "Confidential" per DCS Policy 31.5
46.
Status of Immediate Protection Agreement per DCS Policy 14.9
47.
For children placed in custody, initial petition/custody order/protective custody order per DCS Policy 31.5
48.
For children placed in custody, the Affidavit of Reasonable Efforts and/or removal order per DCS Policy 14.12
49.
Investigation cases closed within 60 days/Assessment cases closed within 120 days per DCS Policies 14.26 and 14.8
50.
Notification to indicated perpetrator(s) of due process or a Commissioner's Case File Review (Letter A) per DCS Policy 14.10
51.
Notification of Equal Access to Programs and Services and Grievance Procedures (CS-0158) acknowledgement per DCS Policy 14.10
52.
Relative Caregiver Disclosure Statement and Service Options (CS-0660) per DCS Policy 16.59
53.
Family Intervention Services Application (CS-0498) per DCS Policy 14.27
VISITATION
Worker Visits with the Child/Youth
Do the case recordings reflect...
54.
that all required face-to-face contacts were made with the child within the required timeframes per DCS Policies 14.07 and 14.3 for an investigations case open at least 30 days?
55.
that the worker assessed the child's environment for any risk or safety concerns, including adults or other children the child is exposed to?
56.
that the worker spoke to the child to identify any concerns the child may have?
57.
that the worker explored the child's well-being needs by asking the child to talk about how he/she is feeling, how school is going, whether services are helpful, etc.?
58.
that the worker has discussed the case planning process in an age-appropriate manner with the child, inviting the child to describe his or her hopes, fears, wishes, etc., for the outcome of the case?
Worker Visits with the Parent(s)/Caregiver.
Do the case recordings reflect...
59.
that the case has been open at least 30 days and the worker has had face-to-face visitation with the parent(s)/caregiver?
60.
that the worker has met with parent(s)/caretaker to discuss any current safety and risk concerns that may be preventing the child's continued stay in the home for an investigation case?
61.
that the worker has met with parent(s)/caretaker to discuss any current safety and risk concerns that may be preventing the child's continued stay in the home for an assessment case?
62.
that the worker discussed the child's well-being needs with the parent(s)/ caregiver - this could include sharing information about, or eliciting their perceptions of, the child's health, development, mental health, education, independent living, adjustment to the placement, etc.?
63.
that the worker has discussed the status of the case with the parent(s)/caregiver, such as CFTM decisions, preparing them for the next CFTM, goal/action steps and timeframes, etc.?
64.
that the worker has asked the parent's/caregiver's opinion about their current situation and what the parent(s) felt they needed to make progress?
65.
that the worker discussed the delivery of services to the parent(s)/caregiver and/or the child and asked them how effective they feel those services are?
ACTION STEPS
Action Step
Anticipated Completion Date
(mm/dd/yyyy)
Action Step
Anticipated Completion Date
(mm/dd/yyyy)
Anticipated Completion Date
(mm/dd/yyyy)
Action Step
Action Step
Anticipated Completion Date
(mm/dd/yyyy)
Action Step
Anticipated Completion Date
(mm/dd/yyyy)
Anticipated Completion Date
(mm/dd/yyyy)
Action Step
Action Step
Anticipated Completion Date
(mm/dd/yyyy)
Action Step
Anticipated Completion Date
(mm/dd/yyyy)