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State of Kansas Department for Children and Families Prevention and Protection Services PPS 10110 REV 1/14-Page 1 of 4 ADULT PROTECTIVE SERVICES SCREENING REPORT Name of Involved Adult: Case Assignment:
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How to fill out adult protective services screening

How to fill out adult protective services screening:
01
Start by obtaining the necessary forms. You can usually find these forms on the website of your local adult protective services agency or by visiting their office in person.
02
Read the instructions carefully. Make sure you understand what information is being requested and how it should be provided.
03
Begin filling out the form by providing your personal information. This may include your full name, address, date of birth, and contact information.
04
Next, provide information about the person who is being referred for adult protective services. This may include their name, age, address, and any relevant identifying information.
05
Be detailed and specific when describing the concerns or reasons for the referral. Provide as much information as possible to help the agency understand the situation.
06
If applicable, provide any additional information or documentation that supports your concerns. This may include medical records, witness statements, or other evidence.
07
Review the completed form for accuracy and completeness. Make any necessary corrections or additions before submitting it.
08
Submit the completed form to the adult protective services agency. Follow their instructions regarding submission methods, such as mailing, faxing, or delivering the form in person.
Who needs adult protective services screening:
01
Individuals who are elderly and may be at risk of abuse, neglect, or exploitation.
02
Adults with disabilities who may be unable to protect themselves from harm.
03
Individuals who are experiencing situations that may be detrimental to their well-being, such as domestic violence, financial exploitation, or inadequate living conditions.
04
Concerned family members, friends, or caregivers who suspect that an adult may be in need of protective services.
Remember, each state may have specific criteria or guidelines regarding who is eligible for adult protective services screening, so it is always best to consult with your local agency to determine if a referral is appropriate.
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What is adult protective services screening?
Adult Protective Services screening is a process used to identify and assess potential abuse, neglect, or exploitation of vulnerable adults.
Who is required to file adult protective services screening?
Certain professionals, such as healthcare workers, social workers, and law enforcement personnel, are mandated reporters and required to file adult protective services screenings.
How to fill out adult protective services screening?
Adult protective services screening forms can typically be completed online or submitted in person at a designated agency. It is important to provide detailed and accurate information.
What is the purpose of adult protective services screening?
The purpose of adult protective services screening is to ensure the safety and well-being of vulnerable adults by identifying and addressing instances of abuse, neglect, or exploitation.
What information must be reported on adult protective services screening?
Information that should be reported on adult protective services screening includes details of the alleged abuse or neglect, the identity of the victim, and any relevant background information.
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