Documentos de Académico
Documentos de Profesional
Documentos de Cultura
Case #
County
Case Manager
Neglect
Score
0
1
0
1
2
0
1
0
1
0
1
1
1
0
1
2
0
1
2
(Revised 09/06)
Date
CM ID#
Abuse
Score
0
1
0
1
2
3
0
1
0
1
0
1
0
1
0
2
0
1
0
1
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0
2
b. Yes
Developmental disability
including emotionally impaired
History of delinquency
A11. Secondary caretaker motivated to improve
parenting skills
a. yes, or no secondary caretaker in
home
b. No
0
2
1
2
0
1
0
2
2
3
Abuse Score
0 - 3
4 - 8
9 - 16
Supervisors Review
Date
Policy Override Required (Override to High reason 1-6. Check appropriate reason)
1. Sexual abuse case where the maltreater is likely to have access to a child victim
2. Non-accidental physical injury to an infant or physical injury or threat of physical injury to a child with a disability.
3. Non-accidental physical injury that requires hospitalization or medical treatment.
4. There is medical documentation of abuse
5. Non-accidental injury to a child age four and younger.
6. Death (previous or current) of a sibling as a result of abuse or neglect.
7. Other / Optional. Reason
Override Risk Level
Low
(Revised 09/06)
Moderate
High
Date
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