NC Sample Referral Form for Child Protective Services (CPS) and Foster Care (FC) Child Care Assistance 2014 free printable template
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SUBSIDIZED CHILD CARE SERVICES MANUAL CHAPTER 4 APPLICATION, ELIGIBILITY DETERMINATION AND DOCUMENTATION REVISED 05/01/14 SAMPLE REFERRAL FORM FOR CHILD PROTECTIVE SERVICES (CPS) and FOSTER CARE (FC)
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NC Sample Referral Form for Child Protective Services (CPS) and Foster Care (FC) Child Care Assistance Form Versions
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How to fill out NC Sample Referral Form for Child Protective
How to fill out NC Sample Referral Form for Child Protective Services
01
Start by downloading the NC Sample Referral Form from the Child Protective Services website.
02
Fill in the child's full name in the designated area.
03
Provide the child's date of birth, including month, day, and year.
04
Enter the child's current address along with the city, state, and ZIP code.
05
Include the names and contact information for the child's parents or guardians.
06
Describe the nature of the concern or incident that prompted the referral, including any specific details.
07
Indicate your relationship to the child and how you came to know the information.
08
Attach any additional documentation or evidence that supports the referral, if available.
09
Review the completed form for accuracy and completeness.
10
Submit the form to the appropriate Child Protective Services agency via mail, fax, or online submission.
Who needs NC Sample Referral Form for Child Protective Services?
01
Anyone who suspects abuse or neglect of a child, including teachers, healthcare professionals, and social workers.
02
Family members or friends of the child who have concerns about their welfare.
03
Community members who witness troubling behavior or circumstances affecting a child.
04
Law enforcement professionals who encounter cases involving child safety.
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People Also Ask about
Who is a mandated reporter in Michigan?
Law Enforcement Officers. County medical examiner and employees of the county medical examiner. Adult Day Care Providers. Michigan Bank and Credit Union Staff.
What are pastors required to report?
Clergy must report suspected child maltreatment except to the extent the clergy member: • Has acquired knowledge of suspected child maltreatment through communications required to be kept confidential pursuant to the religious discipline of the relevant denomination or faith • Received the knowledge of the suspected
When must a Ldss-2221A form be filed quizlet?
Who defines and articulates what child abuse is? FALSE a mandated reporter is required to make an oral report immediately and submit a written report (LDSS-2221A) within 48 hours.
How do I contact local CPS?
Click on the website above for information on reporting or call Childhelp (800-422-4453) for assistance. Mandated reporters may use the online child abuse reporting system in non-emergency situations. Click on the website above for information on reporting or call Childhelp (800-422-4453) for assistance.
What is a 8572 form?
BCIA 8572, Suspected Child Abuse Report.
When must a Ldss 2221A form be filled?
Mandated reporters are required to make an oral report of suspected child abuse or maltreatment/neglect immediately and the person in charge must submit written report (LDSS 2221-A) within seventy-two hours.
Who is mandated to report in California?
P.C. 11165.7 defines “mandated reporters” as any of the following: 1) A teacher. 2) An instructional aide. 3) A teacher's aide or a teacher's assistant employed by any public or private school.
What is a 3200 in Michigan?
Report of Actual or Suspected Child Abuse or Neglect - DHS-3200. Was Complaint Phoned to MDHHS? INSTRUCTIONS: REPORTING PERSON: Complete items 1-19 (20-28 should be completed by medical personnel, if applicable). Send to Centralized Intake at the address listed on page 2.
Can you file a CPS report online in Michigan?
A Guide to Online Reporting This Guide to Online Reporting is designed to help mandated reporters use the Michigan Online Reporting System (MORS) to submit complaints of suspected child abuse or neglect to Michigan Department of Health and Human Services (MDHHS).
How do I file a 3200 in Michigan?
Michigan Disproportionality Reporting online eliminates the requirement to fill out a DHS-3200 form. If you call the hotline to report, please fax or email the completed DHS-3200 form to Centralized Intake within 72 hours. Do not use the Michigan Online Reporting System if you already called the hotline.
How long do mandated reporters have to report in NY?
Oral reports to the SCR from a mandated reporter must be followed within 48 hours by a written report to the local department of social services' CPS unit on form LDSS-2221A.
How long does a mandated reporter have to report in Virginia?
Pursuant to § 63.2-1509 D of the Code of Virginia, a mandated reporter's failure to report as soon as possible, but no longer than 24 hours after having reason to suspect a reportable offense of child abuse or neglect, shall result in a fine.
What is a 8572 state form for California?
Suspected Dependent Child Abuse SS 8572 Form.
What is mandatory reporting in Ohio?
A mandated reporter is someone required by law to report if they suspect or know that child abuse if occurring. A list of mandated reporters for Ohio includes: Attorneys. Audiologists. Child Care Workers.
What is a scar report?
Font Size: Share & Bookmark. If you suspect that a child has been abused or neglected, call 1-800-442-4918. Mandated reporters must immediately report abuse to the Child Abuse Hotline at 1-800-442-4918.
How do I file a CPS report in Michigan?
Anyone, including a child, who suspects child abuse or neglect, can make a report by calling 855-444-3911. In addition, the Child Protection Law requires certain professionals to report suspected child abuse or neglect. Review the Mandated Reporters section of our website for more details.
What are the mandatory reporting requirements in NSW?
In some jurisdictions (e.g. NSW and NT) it is mandatory to report suspicions of all five recognised types of abuse and neglect (i.e. physical abuse, sexual abuse, emotional abuse, neglect, and exposure to family violence).
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What is NC Sample Referral Form for Child Protective Services?
The NC Sample Referral Form for Child Protective Services is a document used to report suspected child abuse or neglect to the appropriate authorities in North Carolina.
Who is required to file NC Sample Referral Form for Child Protective Services?
Mandated reporters, such as teachers, social workers, healthcare providers, and law enforcement personnel, are required to file the NC Sample Referral Form for Child Protective Services when they have suspicions of child maltreatment.
How to fill out NC Sample Referral Form for Child Protective Services?
To fill out the NC Sample Referral Form, provide clear and specific information about the child, the suspected maltreatment, the family, and any witnesses or other involved parties. It is important to include your contact information and details of the incident.
What is the purpose of NC Sample Referral Form for Child Protective Services?
The purpose of the NC Sample Referral Form is to facilitate the reporting of child abuse or neglect cases to Child Protective Services, allowing for timely intervention and protection of the child.
What information must be reported on NC Sample Referral Form for Child Protective Services?
The information that must be reported includes the child's name, age, and address; the suspected abusive caretaker's information; details of the suspected abuse or neglect; and your contact information as the reporter.
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