| - RISK DECISION # 3 - |
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| Page 717 f2 =============== |
| === RISK ASSESSMENT MODEL === for Child Protection in Ontario |
| - THE THEORY - |
| - SAFETY ASSESSMENT FORMS - ( Form # 2 ) |
| Cont'd from Page 717 f1 |
| SAFETY ASSESSMENT FORM ( Form # 3 ) - > |
| PRESENT ? |
| INFORMATION SUPPORTING ASSESSMENT OF SAFETY FACTOR |
| SAFETY FACTOR |
| 1. |
| Caregiver's behaviour is violent or out of control |
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| Yes |
|
| No |
| Not Known |
|
| 2. |
| Caregiver describes or acts toward child/children in predominantly negative terms or has extremely unrealistic expectations. |
|
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| Yes |
| No |
|
| Not Known |
| 3. |
| Caregiver caused, or has made a plausible threat that has or would result in, serious physical harm to the child/children. |
|
| Yes |
|
| No |
|
| Not Known |
| 4. |
| Child/children's whaerabouts cannot be ascertained and/or there is reason to believe that the family is about to flee or refuse access to the child/children. |
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|
|
| Yes |
| No |
| Not Known |
| 5. |
| Caregiver has not, or will not, provide sufficient supervision to protect the child/children from potentially serious harm. |
|
|
|
| Yes |
| No |
| Not Known |
| 6. |
| Caregiver has not, or is unable, to meet the child/children's immediate needs for food, clothing, shelter, and/or medical care. |
|
|
| No |
|
| Not Known |
| 7. |
| Caregiver has previously harmed a child/children, and the severity of the harm, or the caregiver's prior response to the incident, suggest that child safety may be an immediate concern. |
| 8. |
| Child/children is fearful of people living in or frequenting the home. |
| 9. |
| The child/children's physical living conditions are hazardous and may cause serious harm to the child/children. |
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| Yes |
| No |
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|
|
| No |
| No |
| Not Known |
| Not Known |
| Not Known |
| Yes |
| Yes |
| Yes |