Children and Hyperthermia

Children and Hyperthermia

What is Hyperthermia?

Hyperthermia is the condition of having a body temperature greatly above normal.

Florida is a warm state.  It is one of the characteristics that draw many people to Florida.  It can also be a characteristic that is deadly for children.  Heat stroke occurs when a person’s temperature exceeds 104o F.  The body’s thermoregulatory mechanism becomes overwhelmed and can no longer keep the body at the normal 98.6o F temperature.  A core body temperature of 107 o F is considered lethal.  Children's thermoregulatory systems are not as efficient as an adult's and their body temperatures warm at a rate 3 to 5 times faster than an adult’s. 

Five Florida Children Died of Hyperthermia in 2016

Each of the five children died due to being in a hot vehicle for an extended period of time.

When sunlight enters a car, the windows may warm very little however, the objects inside the car can warm up very quickly.  A dark seat or dashboard can reach 180 to 200 o F.  This heat not only warms the object but it warms the air inside the car.  In a vehicle heat study which was conducted, temperatures inside a car were found to rise 19 o F after just 10 minutes.  That means that with an outside temperature of 80 o F the car’s interior temperature climbs to 99 o F after just 10 minutes.  After 30 minutes the interior temperature rose to 114 o and after 60 minutes rose to 123 o degrees!  Cracking the windows of the car had very little effect on the interior temperature.  It would take a relatively short period of time for a child’s body temperature to climb to levels which can cause serious physical problems or even death.

So...what steps can be taken to protect our children from unnecessary harm?

·         Never leave a child unattended in a vehicle (not even for “I’ll only be a minute!”).

·         If a child is missing, always check the pool first, then the car, including the trunk

·         Glance inside cars as you walk past.  If you see a child left unattended in a car, call 911 immediately.

·         Teach children that a car is not a play area.

·         Lock your car and make sure children do not have access to keys or remote entry devices.

·         Use a trigger to remind yourself to check the back seat(s).  Put something you have to take with you when you leave the car in the back seat, put a sticky note that says “Check the Back” someplace conspicuous in the front seat, make checking the back seat(s) a routine every time you leave the car.

·         Notify the daycare or school if your child’s drop off or pick up routine changes.

·         If the child is not dropped off as expected and the daycare/school does not hear from the parent, within 15 minutes they call the parent to make sure the child is supposed to be absent.  This can be a critical trigger to check the back seats of the vehicle.

Awareness is the key to keeping our children safe!

Childhood Drowning Prevention


Florida's drowning death rate among children under age 5 is the highest in the nation.

 In Florida, drowning occurs year round but the highest number drownings occur in the spring and summer. Florida loses more children under age five to drowning than any other state. Over 60% of these drowning deaths occur in residential swimming pools every year.

Among preventable injuries, drowning is the leading cause of death for children 1 – 4 years old. Children less than a year old are more likely to drown at home in the bathroom or a bucket. Among children ages 1 to 4, most drownings occur in home swimming pools. Annually, in Florida, enough children to fill three to four preschool classrooms drown and do not live to see their fifth birthday.

Common household items are involved in many deaths of children under age 5.

  • Infants and toddlers can fall head first into 5 gallon buckets that have very little water in them, and drown. The same scenario applies to toilets.
  • Covered spas or hot tubs that have covers on them are also a threat. Toddlers can get under the cover and go un-noticed.
  • Other household items such as coolers, fish tanks, ponds, or anything else that holds 2 inches or more of water – are drowning hazards for infants and toddlers.

How can we prevent drowning?

  • Any time a child age 5 or under is in the bath tub – maintain constant supervision. Even one minute left alone, could result in drowning. Bath rings or seats have been involved in drowning and do not guarantee child safety. “Children can drown quickly and silently”. (CPSC)
  • Ensure the toilet seat is down. Keep the bathroom door shut and put a safety latch on it to ensure the toddler does not get inside the bathroom without supervision.
  • Never leave containers with water in them around the yard or house. Empty mop buckets, blow up pools and other water vessels immediately after use. Turn the items upside down once emptied to ensure water can not get back in them if it rains.
  • Always secure the safety cover on your spa or hot tub; and put security fencing or alarms around pools.

With the above prevention methods, most of these drowning accidents can be avoided. As a precaution it is also a good idea to learn CPR (cardiopulmonary resuscitation) - it can be a lifesaver.

Swimming Pool Safety:  Layers of Protection


Layer 1. Supervision: Supervision, the first and most crucial layer of protection, means someone is always actively watching when a child is in the pool.

Layer 2. Barriers: A child should never be able to enter the pool area unaccompanied by a guardian. Barriers physically block a child from the pool.

Layer 3. Emergency Preparedness: The moment a child stops breathing there is a small, precious window of time in which resuscitation may occur, but only if someone knows what to do. Even if you're not a parent, it’s important to learn CPR. The techniques are easy to learn and can mean the difference between life and death. In an emergency, it is critical to have a phone nearby and immediately call 911.

Home Visits with Children

What is the purpose of a Home Visit? The purpose of a home visit is to assess the safety and well- being of the child, as well as, address concerns and needs of the child and/or caregivers, determine appropriateness of the placement, and provide support to the caregivers and inform the progress of the case. 

When must a Home Visit be done?

·         Initial face-to face (FTF) contact with the child and caregiver is to occur within two working days after the case is accepted for services at the child’s current place of residence. 

·         When a child is in Shelter Status FTF contact shall occur every seven days.  (Shelter Status=legal status that begins when the child is taken into protective custody of the department and ceases when the court: grants custody to a parent and/or after disposition of the petition for dependency.)

·         Once the child has been Adjudicated Dependant (after Disposition) by the Court, FTF contact is required with each child a minimum of once every twenty five days in the child’s current residence. FTF contacts must occur more frequently when the child’s situation dictates more frequent contact as assessed by the case manager and the case manager supervisor.

·         At least once every three months the case manager will make an unannounced visit to the child’s current residence. 

·         Once a child in run away status returns, a FTF home visit should take place immediately in order to assess the child’s mental/physical state and gain insight into the reason he/she ran away. 

Expectations/Guidelines of a Home Visit:

·         Meet with the child and caregivers in their current residence.

·         Speak with each child individually, alone and away from others, to assess child’s                         adjustment, progress, needs and/or concerns and overall well-being.

·         Examine the child for cleanliness, health, and signs of injury, abuse and/or neglect.

·         Evaluate the home environment for appropriateness and safety.

·         Discuss concerns and/or needs with the caregiver and provide referrals for services.

·         Discuss stages of change and progress and/or concerns with services.

·         Inform the caregiver and child (if age appropriate) of upcoming court hearings, staffings,           etc.

·         Obtain updates and copies of the child’s medical, dental and mental health records,                   appointments, procedures, prescriptions and dosage.

·         Obtain updates and copies of the child’s educational records and progress (if age appropriate).

·         Observe interactions between the caregivers/family members and the child.

·         Obtain updated photographs of the child using the Mindshare mobile application.

·         Review the Child Resource Record at each home visit to ensure that information is                     current.

·         Follow up on previous concerns or referrals with caregiver and/or the child.

·         Discuss how visitation is going with parents/siblings.

·         Assess and discuss Safety Plan in effect with the current participants, their role in the                 plan and the safety management techniques being utilized to determine if the current               safety plan is still effective.

·         Document where the child sleeps and who (if applicable) sleeps in the bedroom with the           child.

·         Document home visit information in FSFN or the Mindshare mobile application (which               uploads to FSFN) within 48 hours of the FTF visit occurring.

Importance of Connecting With Teachers


The object of education is to prepare the young to educate themselves throughout their lives. ~Robert Maynard Hutchins

Education is a vital foundation for everyone and yet it can also be a great challenge for children involved in the child welfare system.  National data shows that children in state care have disabilities at a greater rate than the general population

Research indicates that the future success of children in foster care is correlated to education.  Children who have been removed from their home experience a great deal of transition and oftentimes school is the only stability they have.  Teachers and case managers are an integral part of this stability.

Contacting a child’s teacher as soon as possible will allow the case manager and teacher to begin developing a relationship and share information which can benefit the child.  Making the personal, face to face contact makes the process of developing this relationship much easier.

Case managers may have a depth of knowledge about children that can be extremely helpful in the classroom.  Have they been exposed to physical or emotional trauma?  Have they developed any new behaviors since child welfare became involved?  Are they receiving services in-home or are they placed in out of home care?  If they are in out of home care, how are they adjusting?  Are they currently able to visit with the parent(s) or are visits currently not able to be conducted.  All of these factors will have a tremendous impact on children’s ability to concentrate, participate, comprehend, and retain what is happening in school.

Teachers can provide valuable feedback to case managers related to the progress children are making in school.  Are they exhibiting any new behaviors?  Are they integrating with other classmates or isolating?  Are they progressing well related to assignments, homework, tests and projects?  Are they regularly attending school?  Are they able to concentrate, participate, comprehend, and retain what is happening in school?

The coordination between schools and child welfare agencies can reduce delays in school enrollment and disruption of daily attendance.  As studies suggest, a change or delay in school attendance can cause children to lose four to six months of progress so it is critical not only to get our children in school but to keep them attending.

The importance of connecting with teachers is to support what is best for children.  This collaboration between child welfare staff and educators will lead to a greater understanding of the role each plays in the life of the child and help move toward more support for those we serve.

Everyone is responsible for the education of a child in foster care:   School, case-worker, parent or foster parent or other caregiver, GAL and courts.

Child Placement Agreements

What are Child Placement Agreements?

•       Child Placement Agreement means that a Caregiver and a Child Welfare Professional have agreed upon specific care expectations for a child in out-of-home care whose behaviors or circumstances require additional supervision or safeguards.

Who needs a Child Placement Agreement?

•       A Child Placement Agreement needs to be created when there are concerns suspected or dependable information that a child has any of the following:

§  Severe self-harm

§  Problematic sexual behavior

§  Victim of sexual abuse

§  Victim of Commercial Sexual Exploitation of Children

§  Juvenile sexual abuse

§  Behavior(s) that are a significant threat to others

What is the difference between the 2 types of Child Placement Agreements?

•       Care Precautions are considered the least restrictive type of agreement. The requirements are intended to be in place for a short period of time until more information is known about the child. Once more information is known, the child’s placement requirements can be modified as necessary.

•       Behavior Management Plans are needed for children who have demonstrated any of the following behaviors within the past twelve months:

§  Juvenile sexual abuse

§  Behaviors that are a significant threat to others

Who creates Child Placement Agreements?

•       CBC Case Manager will create the Child Placement Agreement with the Caregiver and child and complete document in FSFN.

Who are our local qualified assessors?

•       CPT, CPC, Therapist, Psychiatrist, Psychologist

How are Child Placement Agreements monitored?

•       A Lead Agency POC consult is required within 24 hours of determining that a Child Placement Agreement is needed to help determine which type of plan is necessary.

•       Child Placement Agreements will be reviewed by the Lead Agency POC and the Case Manager Supervisor after development to ensure it keeps the child or other children in the home safe. 

•       The Child Placement Agreement will be reviewed in the 90 day staffing(s)with all participants in attendance along with information reported in the Progress Update

•       Discussions will occur during monthly consults/supervision between the Case Manager and the Case Manager Supervisor.

•       Case Manager will monitor during monthly home visits via discussions with the Caregiver and the child (if age appropriate).

•       Lead Agency POC will attend 6 month staffing(s) unless required to attend a staffing sooner.

What is the process for obtaining information from a qualified assessor?

When a Behavioral PLAN is developed

•       A referral will be made by the Case Manager for an assessment to be completed within the 45 days of initial placement or after determination Behavioral Plan is required.

•       If the child is being considered for a modified or terminated plan then a qualified assessor will be used to review the current plan and behaviors to determine if the plan can be terminated. This process will be completed by the Case Manager.

•       A qualified assessor is not needed for Precaution Plan.

What is the protocol for children being placed with respite care provider?

•       The respite care provider will be made aware during the time arrangements are made by placement that the child has a Child Placement Agreement. The plan will be developed/modified to meet the respite home environment by the Case Manager.

•       If there are no changes to the existing plan then the respite provider will be entered into the FSFN system and a new plan will be printed and brought with the Case Manager to be signed at the time of placement.

What is the protocol for terminating a Child Placement Agreement?

•       For previously created SAR’s a discussion will occur between the Case Manager, Case Manager Supervisor, Lead Agency POC and the Caregiver to determine if the plan is still needed.

•       Precautionary Plans require a consult with the Lead Agency POC, Caregiver, Case Manager, and Case Manager Supervisor to review whether the plan can be terminated.

•       Behavioral Plans require a qualified assessor to complete documentation that the Behavioral Plan is no longer required. Upon receipt of the document by the qualified assessor a consult should be held with the Lead Agency POC, Caregiver, Case Manager, and Case Management Supervisor and any other party needed to discuss terminating the Behavioral Plan or developing a Precautionary Plan.

No plan should be terminated without the appropriate documentation and discussions occurring.

LGBTQ Group Home Rules

In December, 2016, Florida Administrative Code (FAC) was amended to support and protect our LGBTQ+ youth in care, specifically those in group homes. We are only the 14th state to have anti-discrimination laws that protect youth based on sexual orientation AND gender identity. Some states have anti-discrimination laws for only sexual orientation; others have nothing in place for this population.


Sexual orientation: a person’s sexual, emotional or physical attraction to members of the same gender, different gender, or any gender. Heterosexual, homosexual, bisexual, and pansexual are examples.
Gender identity: a person’s perception of having a particular gender, or none at all. May or may not match the gender they were assigned at birth.
Transgender: a person whose gender identity is different than what is listed on their birth certificate.
Gender expression: the way people express their gender through mannerisms, behaviors, expressions, or physical appearance (clothing, hairstyle, etc.). Also may or may not match the gender they were assigned at birth

FAC changes pertinent to the LGBTQ population

65C-14.021 Discipline and Behavior Management

  • Group Home staff cannot engage in discriminatory treatment or harassment based on gender expression or sexual orientation.
  • Group Home staff cannot permit harassment or bullying of children by staff or other youth based on gender expression or sexual orientation.

65C-14.018 Individual Needs for Children in Care

  • Group Home staff cannot restrict access to hygiene, grooming and personal care items based on the child’s gender identity or expression.

65C-14.040 Admission, Placement, and Ongoing Services

  • For transgender youth, a decision will need to be made whether that child should be placed with their gender on the birth certificate, or their identified gender.
  • Factors to include while making the decision: physical safety, emotional well-being, youth preference, and opinions of case manager, GAL, parent (if rights aren’t terminated) and therapist.
  • Child placing agency must take into account the capacity of the placement to meet the child’s needs, and the needs of the other children already placed in that setting.

65C-14.023 Personnel and Staffing Requirements

  • Direct child care staff must obtain training within their first full year of employment in the area of sexual orientation, gender identity, and gender expression.

This information is ever-changing.

Safety Plans - Modifying

Once a case has been transferred from Investigations to Case Management, it is the Case Manager’s responsibility for developing and implementing modifications to the Safety Plan based on the Case Manager’s ongoing assessment of Safety Plan sufficiency within 5 days of case assignment. The Safety Plan should consist of the least intrusive actions necessary to protect the child consistent with diminished caregiver protective capacities and danger threats.  The Case Manager will exercise due diligence to modify Safety Plans in response to changing family dynamics, including when Conditions for Return are achieved.

A Safety Plan must be modified when any of the following changes occur:

  • A new danger threat has been identified
  • Danger threats have been eliminated

·         A child is released to the other parent, relocated in a family arrangement, or sheltered

·         Parent/legal guardian meets the Conditions for Return

·         There are changes in family dynamics or conditions which change the types and or level of safety services needed, including but not limited to:

Ø  A new child is born or comes into the home

Ø  A parent/legal guardian becomes involved with a new intimate partner relationship

Ø  There are significant changes to the household composition

Ø  There are changes in the availability of a physical location in which the Safety Plan can be implemented

Ø  The Safety Plan needs to become an out-of-home plan

Actions for modifying Safety Plans: 

The primary Case Manager will take the following actions to create a new Safety Plan.

  • Take protective actions immediately in order to keep the child from being harmed
  • To the extent possible, the Case Manager, the parent/legal guardian and any provider involved in the formulation of the original Safety Plan will collaborate to revise the Safety Plan.

Ø  Adhere to special considerations involving domestic violence

Ø  Review and discuss current family dynamics and conditions relative to criteria for an in-home Safety Plan or Conditions for Return

Ø  Review each specific component of the Safety Plan and whether any modifications are necessary

Ø  Identify options for plan modifications needed, eliciting family resources

Ø  Agree on modifications

Ø  Follow up with CLS when a Safety Plan is part of the court order

  • Identify whether there are ways to manage the identified danger threat with the child in the home; and if yes contact safety services providers who will participate in ongoing Safety Plan
  • Consult with your supervisor if assistance is needed in developing a sufficient ongoing Safety Plan.
  • The Case Manager should revise the ongoing Safety Plan and obtain signatures of the parents and any informal Safety Plan providers and file with the court.

FSFN/Documentation for Modifying Safety Plans:

  • Document any safety plan monitoring activity within 2 business days of any assessment information or action related to the assessment of the Safety Plan sufficiency.
  • Document modifications to any existing Safety Plan by terminating the current safety plan in FSFN and create a new version.  The date needs to be changed to capture the date of the modification.  This will allow for a complete history to the Safety Plans. Upload a signed version within 2 business days of creation.
  • The Case Manager will formally document an updated safety analysis when completing the FFA and any Progress Updates.
  • Supervisor or Case Manager will record supervisor case consultations about Safety Plans within 2 business days using supervisory case consultation functionality in FSFN.

Safety Planning Requirements

Florida Administrative Code defines “Safety Plan” as the specific course of action necessary to control threats of serious harm or supplement a family’s protective capacities implemented immediately when a family’s protective capacities are not sufficient to manage immediate or serious harm threats.” 

A safety plan addresses a specific parent behavior, emotion or condition that results in a child being unsafe.  A safety plan controls and manages danger threats to a child when a parent/legal guardian is unavailable, unable, or unwilling to protect their child.  A safety plan will be in effect as long as a case remains open and parents/legal guardians do not have the protective capacity necessary to protect the child from identified danger threats. 

Safety planning is an ongoing process, not an event and should be developed jointly between the case manager and the family.  The child welfare professional responsible for the case has primary responsibility for developing, monitoring and managing the safety plan. As individual and family circumstances change, safety plans require updates based on the changes.  

In order to have confidence in the sufficiency of the safety plan we must analyze danger threats, family functioning, and family and community resources. This depends on having collected sufficient, pertinent, relevant information. The intention is to arrive at a decision regarding the most appropriate and least restrictive means for controlling and managing identified danger threats and therefore assuring child safety.

The child welfare professional creating, monitoring or modifying the safety plan will determine that:

·         The safety plan controls the behavior emotion or condition that results in the child being unsafe

·         The effect of a safety plan is immediate, and/or continues to protect the child every day

·         The safety plan describes each specific action necessary to keep the child safe, including:

Ø  The person responsible for each specific action

Ø  Resources or people who will help with each action

Ø  The frequency of the action, including times and days of the week

Ø  The person responsible for monitoring each action is occurring as planned

·         The safety plan may be exclusively and in-home, an out-of-home, or a combination of both

·         The child welfare professional will develop separate safety plans with the perpetrator of domestic violence and the parent/legal guardian who is a survivor of domestic violence.

·         The safety plan will not include promissory commitments by the parent/legal guardian who is currently not able to protect the child. Example of INAPPROPRIATE safety plan actions include, but are not limited to:

Ø  Mom will not spank

Ø  Parents will remain sober

Ø  Mom will file an injunction and will not let the batterer back in the home

Ø  Dad will not use drugs

All safety plans must be documented in FSFN by the child welfare professional.




Critical Junctures


A Critical Juncture is any change to a family’s circumstances which has the potential to impact the safety of a child. Therefore, a Critical Juncture necessitates a re-assessment of the family.  A new Progress Update will be created in FSFN at a minimum every ninety days from the approval date of the Ongoing Family Functioning Assessment OR the approval date of the last Progress Update. A new Progress Update will be created sooner when fundamental decisions are being made for the children, or when Critical Junctures are occurring that necessitate a formal re-evaluation of protective capacities and child needs. Such times include but are not limited to the following Critical Junctures:

  • When safety management has resulted in a decision to remove a child from home.
  • At the birth or death of a sibling.
  • Upon the addition of a new family member, including intimate partners.
  • Before changing the case plan to include unsupervised visits.
  • Before recommending or implementing reunification as Conditions for Return are met.
  • Before a recommendation for case closure.
  • When case has been dismissed by the court.

The case manager shall seek a supervisory case consultation to review case dynamics when case circumstances include any of the following. The case consultation will determine if a Progress Update should be completed prior to the 90 day period based on the discretion of the supervisor.

  • When significant changes in family members’ and/or family circumstances warrant a

          review and possible revision to the safety plan and/or case plan, such as a change

          to unsupervised visitation.

  • When an emergency change in a child's out-of-home safety plan placement is


  • When the children and/or caregivers are making little or no progress toward the

established outcomes and/or an immediate change in the case plan is needed.

  • After any review (i.e., judicial, administrative, State, or County QA) recommends or

directs that changes be made.

  • At receipt of a new investigation or report of domestic violence in the home.

Supervisory case consultation will be required at Critical Junctures in the development and updating of Family Functioning Assessments; safety planning and safety monitoring; and case planning and progress assessments.

Getting Organized


Clutter and disorganization can be emotionally draining, cause delays, and be a source of frustration and stress. It is estimated that employees lose 2 hours each day due to disorganization. The good news is that organizing is a skill that can be learned by anyone. The following tips are geared toward Case Management but can be used by any person wanting to increase organization.

Desk Organization:

·         Clear clutter and start with a clean desk.  Place your computer in front of you and place frequently used items within reach (phone, supplies, etc).

·         Remove all items that don’t belong on your desk and find a location to store the item.

·         Keep supplies in one location such as a draw organizer or in a desk organizer.

·         Submit documents to the file room for scanning into ASK where you can easily access them later.

·         Box items not related to clients/cases that you need to keep but haven’t looked at in the last year (such as old daily planners). 

·         Use hanging file folders with specific labels to quickly identify forms when needed. Consider color-coding files for easier identification.

·         Straightening up your desk at the end of the work day or work week can make it more welcoming when you are ready to face the new day.

Paper Pile-Up:

·         Have an in-box or location to collect incoming papers.

·         Sort through papers and document/scan them in FSFN and ASK IMMEDIATELY (no later than 24 hours of the receipt). As papers pile up it can become increasingly harder to find time to sort through them and important documents can get lost in the clutter.

·         For items requiring attention, create action folders (i.e. To Read or Project A) and keep them nearby.

·         Try keeping a spiral notebook near the phone to jot down phone numbers and quick reminders. If typing and talking at the same time is difficult, then ensure to enter the FSFN note immediately after listening to a message or hanging up the phone. This will eliminate many scraps of paper and ensure important information is entered into the FSFN case timely.

·         Transfer information from flyers or to-do lists into your planner and discard the paper.

·         Only have documents related to your current case activity on your desk. This protects confidentiality and also helps maintain focus.

·         Beware of printing every document. Consider reviewing and saving documents electronically.

Email Inundation:

·         Most emails can be read once, documented/copied into FSFN and then deleted. After documenting the email in FSFN and replying, it can be deleted from the in box or moved to a folder. 

·         Schedule time each day to read and answer emails. Try to clean out your inbox daily. 

·         Create email folders to organize emails based on subject or particular project you are working on to move them out of your inbox. (Use detailed subject headers to find needed communication faster.)

·         Flag a “to-do-item” in your inbox or set a reminder for later.

·         Use your Outlook calendar to schedule and help you organize duties or dates in the future.

·         Schedule time on your calendar specifically to complete court documents, to document notes in FSFN, make calls, etc. and focus on those tasks during that time.

·         Save only the last message of an ongoing string of “conversation”.

·         Remind people not to forward you email jokes, stories and chain mail.

·         Sometimes talking in person or on the phone might be a better option to email. There is less to organize later.

Disorganization didn’t happen overnight and it will take more than a day to undo it.  Start slowly, one drawer or shelf at a time and celebrate your accomplishments.  When you get tired, stop.  Resume your organization another day. 

Quality Management Services sets the pace for consistency, clarity, and change.



Incarcerated Parent Contacts

Engaging families in services is critical to achieving permanency. Concerted efforts by the case manager are required to promote, support, and/or maintain positive relationships between the child, parents, and other significant family members. These efforts of engagement are provided on a continual basis and still apply when a parent is incarcerated.

On-going engagement of incarcerated parents or significant family members:

š  Develop positive relationships between the case manager and the parent.

š  Maintain family connections with the case manager facilitating correspondences.

š  Maintain connections with the parent as part of the team.

š  Enable the parent to participate in decision-making, case planning and coordinate case plan tasks.

When the case plan goal is Reunification or Maintain and Strengthen, face-to-face contact with the parent is required by the case manager at least every 30 days. Best practice is to have the required face-to-face contact with parents in their home to accurately assess risk and to empower the parent. When a parent is incarcerated, the facility is their home. If they are incarcerated locally the case manager must go to that facility to see that parent. If the parent is incarcerated out-of-county but within the state of Florida, an Out Of County (OCS) worker is to be requested for Case Plan Assistance. In that situation, the OCS worker is responsible for seeing the parent face-to-face in the facility every 30 days.  It is important to note that although there is an OCS worker assigned, the primary case manager should stay involved and maintain contact with the parent by telephone or letters at least monthly (send it certified for a return receipt), provide the incarcerated parent with self-addressed stamped envelopes so that they can write to the case manager and their child (through the CM), and maintain contact with the parent’s classification officer as to the services the parent is involved in at the facility.

The case manager ensures the parents are provided with reunification services including:

š  Maintain continued contact with the child through telephone calls, letters and any other reasonable and appropriate method when it is in the best interest of the child.

š  Work towards a realistic and timely goal.

š  Identify and remedy the problems that resulted in removal.

š  Advise the parent of their legal rights and how to contact any court appointed attorneys.

š  Assist the parent in making changes that will permit a safe reunification upon release.

š  Ensure the parent is involved in decision-making and case planning processes.

š  Ensure any time a critical incident occurs involving the child, the incarcerated parent(s) is notified.

š  Regularly and promptly inform the parent(s) of the child’s health, educational and developmental progress and needs.

š  Address the possibility of permanent separation.

š  Discuss child support requirements and obligations.

š  Contacts are purposeful and focus on the reasons for supervision, progress made and obstacles.

š  Any service providers working with the parent(s) including the social worker (often called the classification officer) at the facility are communicated with on an ongoing basis to determine the effectiveness of the service in reaching the case plan goal.

š  Discuss progress and determine action plans when problems arise.

š  Share pertinent information.

š  Request timely status and progress reports.

When the case plan goal is not Reunification or Maintain and Strengthen, monthly contacts with the parent are still required, however they do not have to be face-to-face.

The case manager documents all services offered, contacts, attempted contacts, letters sent and received, reports received and findings, and any other case activity in FSFN within 48 hours of the activity occurring.

 How to Change a Child’s Medicaid Plan and/or Primary Care Physician (PCP)

It is preferred that all children in Out-of-Home Care be enrolled in the Sunshine Child Welfare Specialty Plan (CWSP).  If the child is on the Sunshine CWSP, you can create a “Parent Profile” on the Sunshine website and add the children as dependents.  Changes to Primary Care Physician (PCP) can also be done online, as well as, view billed appointments, print a temporary ID card, etc. There are two options below that can be used to change a child’s Medicaid Plan or PCP or you can ask for assistance from a WATCH nurse or the Behavioral Health Specialist, Amber Salley if you find barriers in either of the options.

Option A – Website

Select a Plan

Click “Enroll Online” >click “login without using a PIN” > Enter the child’s information in the fields provided (3/5 fields must be filled in).

Click  “CBC/DCF ID number” > enter your FSFN login name under “government issued ID”  Click “Case Worker” > Safe Children Coalition  under “relationship”> Click login.

After you’re logged in, click “select medical plan” > select the child > answer the questions. Click the dropdown box “Primary Plan” > select the plan.

Select a PCP

Select a PCP by using the “PCP search” button.
IF you cannot find your PCP in the search, but know that the PCP accepts the plan you’ve selected, go ahead and enroll the child in the plan > click “no PCP selected” and finish.  Then call the plan directly to change the PCP.

***Note:  If you receive an error that says “login failed”, try changing the information you provided under “member information”.

Option B - Phone 1-877-711-3662

Call the Choice Helpline directly to switch the plan and select the PCP. They will ask for all of the child’s demographic information, so have that information ready.

The direct phone number to Sunshine CWSP is 1-855-463-4100 if you have trouble online. You can also use the CBCIH website to view the authorized caller list, authorizations, primary care doctors, etc. This information is under the “IMV” tab. This is also the website where you will complete the Health Risk Assessment (HRA) that is required by Sunshine.

Children Seen Not Seen Special Circumstance

Often times, special circumstances arise that make basic documentation of home visits difficult or confusing.  The following are special situations that may require different or additional efforts on the part of the Case Manager. 

Home Visit – Child’s Current Residence (Attempted)

When a Case Manager (CM) attempts a home visit with a child but is unable to complete it, the following occurs:

·          A note is entered into FSFN reflecting “child not seen” under the contact section of the note.  The CM must also document their efforts to complete visit in the narrative.

·          CM continues to make attempts to visit the child in the home until contact is made. 

·          CM should make attempts to see the child at school if visits to the home are not successful.

·          If the CM is denied access to a home under court-ordered supervision, the CM informs the family of the possible consequences of their actions.  The CM is to notify their supervisor and YMCA management to assess what action steps should be taken (i.e. contact legal service, call to Hotline).  The series of events surrounding the denial of access should be documented thoroughly in FSFN.

Child is on Runaway/Missing Status:

When a child is determined to be missing or has run away, the following occurs:

·          The CM updates the child’s placement information in FSFN through an Edit Request to reflect the child appropriate placement type.

·          CM documents all diligent efforts made to locate the child in FSFN, efforts must be made every 7 days until the child is located then completes a Face-to-Face (FTF) Home Visit immediately upon the child’s return.

Child/Family is on Vacation:

·          CM is responsible for seeing all children every 30 days.  If a family is on vacation for less than 30 days, the CM is responsible for ensuring that a FTF Home Visit occurs with the child.

·          If a family is away for longer than 30 days, the CM is to work with the caregiver to determine if having a video conference via Skype or other means is feasible. 

·          If using video conference is not a viable option, the CM works with the caregiver and the local Department of Children and Families (DCF) to arrange a ‘Well Child Contact’ at the DCF office.  The CM requests the DCF agency complete a ‘Face to Face Acknowledgement Form’ form that is provided to them, and email it back to the CM. If the DCF agency is not willing to do this, the CM arranges to have verbal conversations with the DCF worker and family when they are at the office.

·          As a last resort the local Law Enforcement Agency can be contacted to do a ‘Well Child Contact’ either where the family is staying or at the local LE station.  These visits/contacts should be documented in FSFN within 48 hours as a face-to-face visit indicating who and where the visit was conducted.

·          If none of the above efforts are able to be completed, the Case Manager is to enter a note into FSFN as a Home Visit “not attempted” and identifies in Reason Not Seen section of note, “Family Traveling/Away From Home”. Although the reason the child was not seen is clearly documented, this will still result in the child showing up on the children not seen list.

Out of County/ICPC Supervision Cases:

·          Safe Children Coalition primary CM is to contact the Out of County Services (OCS) worker on a regular basis for updates on the case and to ensure child is being seen.  The OCS worker documents the visit in FSFN.  (If there are issues with the OCS worker’s documenting visit, the primary CM should enter a note detailing the conversation with the OCS worker.)

·          If an OCS worker has not visited a child under SCC Legal Jurisdiction, and the CM has been unsuccessful in getting the OCS worker to do so, the CM is to contact their supervisor to assist from a higher management level and document the efforts in FSFN. However, the primary CM is ultimately responsible for ensuring the child is seen.

·          For out of state case: Home visits are requested through the receiving state’s ICPC worker in conjunction with the ICPC process.  CM documents all pertinent information into FSFN and follows up with the ICPC worker regularly.  Home visits are to be competed based on the ICPC agreement (we request a visit every 30 days) however the ICPC process allows other states to only complete quarterly at a minimum.  When encountering resistance with getting home visits completed, the CM can request a “Wellness/Safety Check” to be conducted by local law enforcement.  These visits/contacts should be documented in FSFN within 48 hours as a face-to-face visit indicating who and where the visit was conducted.

NOTE: A note must be entered into FSFN every 30 days, for the time period when the child was not seen by ICPC worker, enter a face to face contact noted by selecting the child under Contact Information then select Face to Face Contact as “Not Attempted”, Reason Not Seen -  “Out of Town/State”

·          SCC supervision of Out of County/State case: The CM completes home visits with child every 30 days, documents in FSFN within 48 hours.  Home visits are to be completed until written documentation of case closure is received from the other county/State.  

·          Whether a child is placed out of county or out of state, the case manager must maintain contact with the OCS/ICPC worker at minimum of every 30 days to obtain updates on assessment of risk, concerns, needs, etc.


All information regarding past, present and future clients of Community Based Care (CBC) and/or their relatives is confidential.  We must safeguard this information at all times and release information to others on a need-to-know basis only, in accordance with HIPAA laws and Florida Statute 39.205(3). Florida Statute states “any person who willfully or knowingly makes public or discloses any information contained in the child abuse registry or the records of any child abuse case except as provided in this section is guilty of a misdemeanor of the second degree.”  Client information is privileged and must not be disclosed to anyone other than authorized persons.  The media is not permitted to use the name, picture or any identifying information of a child in CBC care.  A child in CBC care may be photographed or interviewed for awards, sports or other ‘normalcy’ situations; as long as the CBC care components remain confidential.  All of us can do our part in ensuring our client’s rights are respected by adhering to the measures addressed in this tip.

General Measures:

·         Share and discuss client information only in secure staff areas on a need to know basis.  For example, when a client comes to the front desk, take the client to a private area to discuss case details.  The lobby is not a ‘confidential’ or ‘secure’ area.

·         Ensure case information is secure before leaving your desk so visitors to the building, vendors, etc. cannot view confidential information.  Ensure all documents that have case specifics and information are placed in the shredding bins, not in the trash.

·         Consult with CBC Management and/or Child Legal Services (CLS) prior to allowing clients and authorized persons outside of CBC supervised access to case records.

·         Obtain a signed Authorization for Release of Records and Receipt of Information form or Court Order prior to the release of any child identifying information outside of CBC/DCF. 

·         Remove child identifying information from documents that are released (names, social security number, address, etc).

·         Questions about confidentiality and release of records should be sent to CBC management and CLS.

·         Redirect any media calls and contacts to Media and External Affairs POC.

·         Report any breaches in security IMMEDIATELY to SCC/CBC management.

Case Files:

·         Safeguard case documents at all times. 

·         Make sure all documents, which are part of a case file, are sent to the records room in a timely manner for scanning.

·         Ensure case documents remain in the building except under strict procedure.

Computer/Email Access:

·         Log off secure databases and the network when you are not working in them.

·         Never share your passwords with anyone or post them where others can find them.

·         Do not connect remotely to the network on a public Internet venue (i.e. library, school, cafés).

·         Supervisors will IMMEDIATELY notify IT and Security Officer when a staff employment has terminated to ensure access to secure information is removed.

·         When sending email never include confidential information (i.e. children/case names, social security numbers, addresses etc) because it may not be secure.  Send the information in an attached word document that is password protected. 

To password protect a word document:

Go to Save As> Tools >Security Options>A Box will appear allowing you to enter a password for opening and/or modifying the document>Ok> type in a name for the document> Save.

Psychotropic Medications

What is Psychotropic Medication? Any drug prescribed with the primary intent to stabilize or improve mood, mental status, behavioral symptoms, or mental illness is considered a Psychotropic or Psychotherapeutic Medication.  Florida Department of Children and Families recognizes seizure medication as psychotropic even though the intended use is not psychotropic. The medications include, but are not limited to Antipsychotics; Antidepressants; Anxiolytics; Mood stabilizers; Psychomotor stimulants or Atomoxetine; and other medications commonly used that may include but are not limited to alpha 2 blockers, beta blockers, anticonvulsants, cognition enhancers, and opiate blockers.  These “other medications” must be considered a psychotropic medication when used to stabilize or improve mood, mental status, behavior, or mental illness. 

There is a formal process that must occur when a child comes into care already on, needs to start or needs a change in type or dosage of Psychotropic Medications.  The information below outlines this process for children in out-of-home care.

Express Informed Consent for Psychotropic Medication:Before providing psychotropic medications to a child in out of home care, the Case Manager (CM) must attempt to obtain ‘express and informed consent’ from the child's parent or legal guardian and document those efforts.  The Psychotropic Medication Report must be used to document ‘express and informed consent’ from the child’s parent or legal guardian after being informed about medication and treatment intent directly by the prescribing physician.

Court Ordered Consent for Psychotropic Medication:When ‘express and informed consent’ cannot be obtained from the child’s parents (parental rights of the parent have been terminated, the parent's location or identity is unknown or cannot reasonably be ascertained, or the parent declines to give express and informed consent) the CM must submit to Child Legal Services (CLS) a request for court authorization to provide psychotropic medications within 12 working hours of receipt of the prescription.  CLS will file a motion.  This motion must be accompanied by a Medication Report completed by the prescribing physician and a report by the CM detailing efforts to obtain ‘express and informed consent’ and other treatment recommended/considered for the child.  SCC/CLS must notify all parties of the proposed action within 48 hours of filing.

Emergency administration:                                                                                                              If the child's prescribing physician certifies that a delay in providing a prescribed psychotropic medication would more likely than not cause significant harm to the child, the medication may be provided in advance of the issuance of a Court Order.  In such event, the Medical Report must provide the specific reasons why the child may experience significant harm and the nature and the extent of the potential harm.  A motion seeking continuation of the medication and the physician's medical report must be filed with the Court within 3 working days.  CM must seek the order at the next regularly scheduled Court hearing, or within 30 days after the date of the prescription, whichever occurs sooner.  In emergency psychiatric placements Psychotropic medications may be administered in advance of a Court Order (hospitals, crisis stabilization units, and in statewide inpatient psychiatric programs).  Within 3 working days after the medication is started, CM must seek Court authorization.


Consent or Court Ordered Psychotropic Medications for children age 11 and under:                   If the child is age 11 or under and in an out-of-home placement, a Licensed Child Psychiatrist must provide a ‘Pre-Consent Review’ prior to the child beginning the medications.  A Pre-Consent Review and additional information may be obtained by clicking on the following link:  Additionally, PRIOR TO seeking parental consent or the Court Order for the psychotropic medications, the CM must submit the documentation to a DCF contracted consultant Child Psychiatrist who will review the Treatment Plan and document recommendations within 1 business day of receipt of the plan.  NOTE:  When a physician has clearly documented the psychotherapeutic medication is being prescribed for purposes other than to improve mood, mental status, behavior or mental illness; a Pre-Consent Review is not required.

Discontinuation of Psychotropic Medications:                                                                             The CM must obtain documentation that the Prescribing Physician recommends discontinuation of the psychotropic medication; and must notify the Court when it has been discontinued.

Documentation Requirements:                                                                                     Psychotropic medication MUST be documented in Florida Safe Families Network (FSFN) within 24 hours of the medication administration.  A standard date of 01/01/1900 must be used in FSFN for date of current court order or parental consent when the child begins the medication under emergency provisions and prior to consent or court order (FSFN will not allow this page to be saved without a date).  The CM must ensure copies of the parental consent or the Court Orders are obtained and placed in the case file. The CM is responsible to ensure a parental consent or Court Order is obtained any time there is a change in the dosage or type of psychotropic medications prescribed to the child.  The CM must also ensure these changes are documented in a FSFN note and entered into the Medications Tab in FSFN.  The CM ensures all Judicial Review Social Study Reports (JRSSR) include details of the effectiveness of all psychotropic medications and any changes not otherwise found in the medical records being filed as attachments.

CM home visit responsibilities for children on psychotropic medication:                                 The Home Visit Checklist is to be completed at each monthly home visit for a child prescribed psychotropic medication.  The checklist needs to be completed at the home with the caregiver and child, if developmentally appropriate.  The caregiver, CM, and child (if appropriate) must sign and date this checklist and it is to be uploaded into FSFN as an attachment to the home visit note and filed in ASK. The checklist includes (1)the names of all psychotropic medications prescribed (2)Children Resource Record (CRR) review and signature, (3)Medication Log viewed, discussed and filed monthly, (4)ensuring all medication information, Medication Report and Court Order are in CRR, (5)discussion of medication with child as appropriate and his assent, (6)discussion of updates and details with caregiver regarding treatment including upcoming appointments and lab tests or assessments and who will be responsible for reporting any test/assessment results to all parties, and (7)side effects and who will be notified and by whom.

***All Psychotropic Medication resources can be found on the J-drive in the Forms folder.


Medical - Mental Health Record - FSFN

FSFN Medical/Mental Health Record

The Florida Safe Families Network (FSFN) Medical/Mental Health Record details important medical information about a Child’s current health care providers, basic health problems and histories (such as allergies, medications, and dietary concerns) and medical/mental health/dental and vision appointments.

The child’s Medical/Mental Health Record is visible when looking at the Case Records on the FSFN Desktop. If one has been created and is not visible, uncheck the ‘Date Restricted’ box at the top of the desktop. Ensuring the information is entered timely, is accurate and complete is important.  It feeds directly into the FSFN Case Plan and FSFN Judicial Review Social Study Report.   

This Record consists of four tabs:

§  The Medical Profile tab provides information about medical, dental or mental health providers involved with the child. Case Managers must enter all providers the child has on this tab (doctor, dental, therapist, eye doctor, specialist, etc.). This page also captures whether there are health concerns, allergies and the child’s current immunization dates. Immunizations must be kept current per the CDC Immunization Schedule

§  The Medications tab provides information on medications, whether over the counter or prescribed. Psychotropic drug information, prescribing physician, and any issues relating to the prescriptions are detailed here. If the child takes a daily multi-vitamin or supplement it also should be entered in. Over the counter vitamins or supplements can cause allergic reactions. You may need to research a drug if it does not appear in the drop down list, as new brand-name drugs and generic drugs are continually manufactured.  If the name of the medication does not appear in the list, choose other and insert the name of the medication.

§  The Mental Health Profile tab provides important mental health information about a Child’s current mental health treatment and transition information.  Information about the Comprehensive Behavioral Health Assessment date and findings is captured on this tab. The mental health history is also detailed in this tab.

§  The Medical History tab must provide information on every medical, mental health, eye and dental appointment/event that have occurred.  All doctors, specialists, eye, and other medical appointments the child attends must be entered into this tab by the CM or with the assistance of WATCH. Regular therapy appointments are also detailed in this tab. All children in out of home care age 3 and older must have dental maintenance appointments documented at minimum every 6 months.

The Case Manager must ensure all supporting documents for the medical/mental health/eye/dental information entered, are obtained and scanned into the client file; as well as filing with the court and attaching to Court Reports such as the Judicial Review Social Study and the Case Plan.

The data in the Medical/Mental Health Record is to be entered in by the Case Manager no later than 48 hours after each medical/mental health/eye/dental event.  The Medical/Mental Health Record must be filled in completely and maintained up to date.

Runaways – Possible Reasons and Ways to Decrease Frequency

Running away from foster care settings not only places young people in harms way, but frequently jeopardizes their current placement.  This often leads to more restrictive placements, and an interruption in learning opportunities at school.  These interruptions can hinder the youth’s ability to build the life skills necessary for greater self sufficiency and to form the social support network essential for resilience and quality of life.  We must make greater efforts to stabilize our teens, keep them safe and allow for them to have normalcy in their everyday lives.

Reasons for Running:

Ø  Restrictions in placement

Ø  Feeling alone, isolated, alienated

Ø  Mistreatment by staff in current placement

Ø  Peer or gang pressure

Ø  Wanting autonomy

Ø  To see family or friends

Ø  To avoid consequences

Factors That Increase Risk of Running:

Ø  Age

Ø  Victim of abuse

Ø  History of runs

Ø  Use of substances

Ø  Presence of mental health diagnosis

Ø  Placement type

Ø  Placement changes

Some Ways to Decrease Run Episodes:

Ø  Case Manager establishing a good rapport with the teen.

Ø  Using a team approach.

Ø  Responding swiftly when windows of opportunity arise

Ø  Advocating for appropriate alternative placement.

Ø  Enhancing skills of the caregivers for the teen.

Ø  Modifying house rules to allow for normalcy.

Ø  Enabling family and peer visits.

Ø  Assisting the teen with occupational and Independent Living Skills

When youth run and return we must conduct a debriefing to determine:

§ Where did they go?

§ What was their motivation for running? 

§ Was the youth running from or to something?

§ Was it a specific incident that triggered the run?

§ What do they do when on the run?

§ Are they having fun or in danger?

§ What can we do to keep them safe?

How do we prevent them from running again?

§ Ask questions about preferences- “What type of home would you like to live in?”, “What would you like to see changed in your current living situation?”, “How is school going?”.

§ Determine what the child’s interests are?

§ Open lines of communication with caregivers, schools and other providers.

§ Analyze the results to determine a plan that would reduce the child’s wanting to run and ensure the child agrees to the plan (written agreements are great).

Less Likely to Run If:

Placed with relatives

Placed with siblings

Pharmacy Pitfalls

Pharmacy Pitfalls

Often our children receive prescriptions from a doctor, ER or hospital and they are denied at the pharmacy. It’s VERY important to contact your WATCH RN whenever you encounter a problem. However, here are a few tips to PREVENT issues:

·         Before leaving the doctor’s office or hospital, ask the nurse or doctor if the medication is generally covered by your insurance. If not, ask them if they can prescribe a similar drug that is covered

·         Ask the doctor or hospital if they can call the drug into the pharmacy before you leave

·         If it’s a medication that needs compounding (or it’s a specialty medication), make sure the pharmacy carries the medication

·         Make sure your pharmacy has the correct insurance information

·         Keep your insurance company’s Pharmacy Department information handy (i.e. Sunshine uses US Script: 800-460-8988 BIN# 008019)

If you follow the above steps &

the medication is still denied

·         Ask the pharmacy to call the Medicaid help desk and/or your insurance’s pharmacy department

·         If the medication is rejected due to wrong dosage orders, ask the pharmacist to call the doctor’s office while you wait

·         If the medication is rejected due to needing prior authorization from your doctor, ask when and if this can be accomplished

·         CALL YOUR WATCH NURSE, your assigned Sunshine RN Case Manager or your insurance company nurse help line (ex. Sunshine: 866-796-0530)

WATCH Nurse Contact Information:Melanie Simmons - Manatee (941)721-7670 X 102Liz Harris - Sarasota/DeSoto @Northgate (941)371-4799 X 145

Stress Management

What is Stress?

Stress is a normal reaction a person experiences due to a demand or threatening situation. Stress can be a motivator to meet life’s challenges, but too much stress can sometimes lead to mental or physical problems, negative relationships, and poor productivity. 

What are some symptoms or “warning” signs of stress?

Stress signals can vary from person to person. It is important to recognize individual reactions to stress in order to better manage it. Symptoms can be physical such as fatigue, headaches/migraines, muscle tension, restlessness, stomachaches, acne, breathlessness, back pain, allergies/a cold, high blood pressure, or chest pain. They can also be emotional or behavioral such as anxiety, anger, loneliness, worrying, arguing/snapping at people, neglecting one’s needs, difficulty concentrating, over/under eating, or withdrawing from family and friends. 

What are some causes of stress?

Stressors can be as varied as the symptoms they induce. Sometimes they are financial, environmental, health, family, or work related. They can also be imbedded in our daily routines such as chores, car trouble, forgetting/misplacing something, oversleeping, waiting in line, etc.

How do we manage stress?

Accepting what cannot be changed and proactively working to remove the stressors that can be changed is one way to decrease stress. Some methods of controlling stress are moderating physical and emotional reactions, developing coping skills, practicing stress-relieving techniques, and finding humor as a release. 

What are some techniques for reducing stress?

·         Exercising, eating a healthy diet, and getting regular check ups

·         Getting plenty of sleep

·         Writing in a journal

·         Talking it out – expressing feelings or venting

·         Reframing negative thoughts to positive ones and using humor              when possible

·         Using time management – getting up on time, planning ahead,               making a “to-do-list”, breaking larger jobs down into smaller tasks,         prioritizing, and delegating when possible

·         Getting organized and setting limits

·         Taking breaks to re-energize and avoid fatigue

·         Setting realistic and reasonable goals and expectations

·         Practicing relaxation techniques such as yoga, meditation, listening        to music, or getting a massage

·         Spending time with friends or family doing things that are fun

·        Taking time for you – schedule free time and treat yourself (you              deserve it!)

If stress is not able to be managed with the above techniques, seeking professional medical or mental health treatment can help. Contacting the Employee Assistance Program is one way to attain this assistance.  

Conditions for Return

The Conditions for Return describe what must exist or be different with respect to specific family circumstances, home environment, caregiver perception, behavior, capacity and/or safety service resources that would allow for reunification to occur with the use of an in-home safety plan.

Impending danger threats do not have to be reduced or eradicated in order for children to be reunified with their families if an in-home safety plan can sufficiently control the threat.

What is necessary for children to return to their families is the establishment of well-defined circumstances within a child’s home that mitigates threats to child safety.

The basis for Conditions for Return is the In-Home Safety Analysis and Planning section of the Family Functioning Assessment and Progress Update and the five questions located there.

 Conditions for Return are the explanations of how answering “No” to Safety Analysis questions can be changed to a “Yes”.

 Once all five questions are answered with a “Yes” the child must be returned to the home with an In-Home Safety Plan.

The 5 In-Home Safety Analysis Questions

1.    Are the parents willing and cooperative?

2.    Is the home environment calm and consistent enough?

3.    Are sufficient safety services available?

4.    Can danger be managed without professional evaluations? (i.e.- psychological)

5.    Do parents have a residence/stable home?


Case Info: Fred and Wilma’s home is near being condemned because of the physical structure, faulty wiring and unhealthy living conditions. There is no heat and the plumbing is inadequate. The couple is mildly developmentally disabled and makes poor choices about use of money and care of home.

Impending Danger: The child’s physical living conditions are hazardous and a child has already been seriously injured or will likely be seriously injured. The living conditions seriously endanger a child’s physical health. (This is one of the 11 standardized impending danger threats)

Conditions for Return:

  • Fred and Wilma accept and follow the instructions and guidance of a homemaker safety service provider related to money and home management (Safety Services).
  • The home is sufficiently clean and cared for so that no hygiene problems exist (Calm and Consistent).
  • A plan for proper maintenance and adequate repair to make sure the home is livable day by day (Safety Services).
  • Fred and Wilma set aside money for and make good decisions about the upkeep of their house (Willing and Able).

The conditions for return must be addressed and discussed at all staffings and hearings.