Case Name: Cllse #I: Date: --L.{...L' County Name: Worker Name: Worker IDN:

NEW MEXICO FAMILY RISK ASSESSMENT OF ABUSFJNEGLECT Case Name: Cllse #I: Date: --L.{...L' County Name: Worker Name: Worker IDN: Neglect ~ AbuK, NI. Current Complaint is for Neglect A I. Prior Complaint is for Sexual Abuse a. No.... o B. No... 0 b. Yes.... 2 b. Yes... I Number of Prior Investigations A2. Number of Prior Investigations a. None... -1 a. None.............................. -1 b. One... 0 b. One.......... 0 c. Two or more... +2 c. Two or more... +2 N3. Number ofchildren in the Home A3. Household has Previously Received CPS (voluntaryllegallprotective case) a. One... -1 a. No... "... 0 b. Two..., 0 b. Yes....... I c. Three or more...................... + 1 c. Yes, and a terminal ion petition was filed... 3 N4. Number of Adults in the Household A4. Number ofchildren in the Home a. Two or more............................ 0 a. One...,... -1 b. One... I b. Two... 0 c. Three or more... +I N5. Household has Previously Received CPS (voluntary/ legal/ protective case) a. No... 0 AS. Primary Caretaker has a History ofabuse or Neglect as a Child b. yes... I a No... 0 b. yes... 1 N6. Characteristics ofchildren in Household (check & add for score) c. Yes, and caretaker was in foster care as a child... 2 a Not applicable... 0 b. _ Medically fragile/failure to thrive... I A6. Primary or Secondary Caretaker has an Alcohol or Drug Abuse Problem c. _ Mental health problem.... I a. No... O d. Developmental disability................ 2 b. Alcohol and/or marijuana................. I c. Other drug (cocaine, heroin, amphetamines, etc.) _... 2 N7. Problematic Adult Relationships in the Household a. No... 0 A7. Age ofyoungest Child b. Problematic relationships/multiple live-in partners I a. 15 or older _... _... " 1 c. Household has a domestic violence history...... 2 b. 6 to 14..,... 0 c. 5 or younger.......................... I NS. Primary Caretaker has an Alcohol or Drug Abuse Problem a. No... 0 AS. Problematic Adult Relalionships in the Household b. Alcohol and/or marijuana.................... I a. No... 0 c. Other drug(s) (cocaine, heroin, amphetamines, etc) 2 b. Yes, problematic adult relationships/multiple live-in partners I c. Yes, household has a domestic violence history... 2 ~~9. Primary Caretaker has a Prior Arrest Record Disclosed During the Investigation A9. Primary Q! Secondary Caretaker Characteristics (check applicable items and a. No... 0 add for score) b. yes... I a None applicable....... 0 b. _ Provides inadequate emotional support... I NIO. Primary Caretaker has a History of Abuse or Neglect as a Child c. _Injured a child in current or previous incident... I a. No... 0 d. _ Domineering parent............... 2 b. Yes... I e. _ Mental health problem... 2 Nil. Caretaker(s) Response to Jnvestigation A 10. Child in Home has a Developmental Disability and/or History ofdelinquency a. Caretaker(s) cooperated with investigator 0 (Check applicable items and add for score) b. One or more caretaker(s) did l!q! cooperate a. None applicable....... 0 with investigalor.... b. _ Delinquency history....... I c. _ Developmental disability......................... I N12. Primary or Secondary Caretaker has an Impulse Control Problem a. No... 0 A II. Caretaker(s)' Response to Investigation b. Yes... 1 a. Caretaker(s) cooperaled with investigator... 0 b. One or more caretaker(s) did 1!Q! cooperate with investigalor 2 TOTAL NEGLECT RISK SCORE TOTAL ABUSE RISK SCORE RISK LEVEL Assign the family's risk level based on the highest score on either scale, using the following chart: Neglect Score Abuse SCQre Risk Level -2-0 -3-0 Very Low +1 -+4 +1-+5 Low +5 - +8 +9-.+19 +6 - +9 +10-+24 Moderate High OVERRIDES Policy: Override to High. Check appropriate reason. I. Sexual Abuse cases where the perpetrator is likely to have access to the child victim. 2. Cases with non-accidental physical injury to an infant. 3. Serious non-accidental physical injury requiring hospital or medical treatment. 4. Death (previous or current) of a sibling as a result ofabuse or neglect. 5. Discretionary: Reason _~_----:-:--_-;:- ':- -:-::--: -=-:- OVERRIDE RISK LEVEL (Circle one ifoverride used): Low Moderate High Supervisor's Review/Approval ofdiscretionary Override Date: I 8

The risk assessment fonn is composed of two scales: the neglect assessment scale and the abuse assessment scale. Onlv FAMILY RISK ASSESSMENT OF ABUSEINEGLECT DEFINITIONS one household can be assessed on a risk assessment form. If two households are involved in the alleged incident(s), ~ separate risk assessment forms should be completed for each household. On items involving "caretaker(s)," select one, but no more than two, parent(s)/substitute(s) based on physical/emotional proximity to child(ren). If an item relates to all caretakers and the household has more than one caretaker, rate the caretaker with the more severe behavior. The primary caretaker is the adult living in the household who assumes the most responsibility for child care. When two adult caretakers are present and the social worker is in doubt which one assumes the most child care responsibility, the adult with legal responsibility for the child(ren) involved in the incident should be selected as the primary caretaker. For example, when a mother and her boyfriend reside in the same household and appear to equally share caretaking responsibilities for the child, the mother is selected. If this does not resolve the question, the legally responsible adult who was a perpetrator or alleged perpetrator should be selected. For example, when a mother and a father reside in the same household and appear to equally share caretaking responsibilities for the child and the mother is the perpetrator (or the alleged perpetrator), the mother is selected. In circumstances where both parents are in the household, equally sharing caretaking responsibilities, and both have been identified as perpetrators or alleged perpetrator, the parent demonstrating the more severe behavior is selected. Only one primary caretaker can be identified. The secondary caretaker is defined as an adult living in the household who has routine responsibility for child care, but less responsibility than the primary caretaker. A partner may be a secondary caretaker even though he/she has minimal responsibility for care of the child. NEGLECT SCALE Nt. Current Complaint is for Neglect. "Yes" if the current referral is for neglect or both abuse and neglect. This includes any problem under investigation not identified in the referral. N2. Number of Prior Iuvestigations. Count all investigations, substantiated or not, which were assigned for CPS field investigation for any type of abuse or neglect prior to the complaint resulting in the current investigation. N3. Number of Children in the Home. Number of individuals under 18 years ofage residing in the home at the time of the current complaint. If a child is removed as a result of the investigation or is on runaway status, count the child as residing in the home. N4. Number of Adults in the Household. Number of individuals 18 years ofage or older residing in the home at the time ofthe current complaint. N5. Household has Previously Received Child Protective Services. "Yes" if household has previously received child protective services or is currently receiving services as a result of a prior investigation. Service history includes voluntary family services, legal services, FINS, Family Preservation Services, or protective supervision, but does not include delinquency services. 9

N6. Characteristics of Children in the Household. Score the appropriate amount for each characteristic present and record the sum as the item score: a) No child in the household exhibits characteristics listed below; b) score I if any child in the household is medically fragile, defined as having a long term (six months or more) physical condition requiring medical intervention, or shows failure to thrive; c) score I ifany child in the household exhibits a mental health or behavioral problem requiring regular visits to a therapist, enrollment in special education program or prescriptions for psychoactive medication; d) score 2 if any child is developmentally disabled, including any ofthe following - mental retardation, learning disability, or other developmental problem. N7. Problematic Adult Relationsbips in tbe Housebold. Score the appropriate amount for each: a) no; b) yes, problematic adult relationships which are harmful to domestic functioning or child care including criminal activities with others which cause problems between adults in the home (but not at the level ofdomestic violence), or multiple live-in partners; c) yes, household has a domestic violence history, a relationship characterized by domestic disturbances or conflicts that require intervention by police, family or others, involving verbal or physical abuse by one or both caretakers (includes berating, physical fighting, threats or intimidation). N8. Primary Caretaker bas an Alcobol or Drug Abuse Problem. The primary caretaker has a past or current alcohol/drug abuse problem that causes conflict in home, extreme behavior, financial difficulties, frequent illness, job absenteeism, job changes or unemployment, or driving under the influence, traffic violations, criminal arrests, disappearance of household items or life organized around substance use. Score the following: a) no problems; b) alcohol and/or marijuana abuse but no problem with other drugs, c) abuse of other drugs such as cocaine, heroin, amphetamines, etc. Legal, non-abusive prescription drug use should not be scored. N9. Primary Caretaker bas a Prior Arrest Record Disclosed During tbe Investigation. "Yes" if the primary caretaker has been arrested or convicted Dri.2r to the current complaint as either an adult or a juvenile (excluding traffic offenses). This does not require the social worker to conduct a criminal records check., except in cases indicating criminal behavior may be involved. NIO. Nll. Primary Caretaker bas a History of Abuse or Neglect as a Cbild. "Yes" if credible statements by the primary caretaker or others indicate that the primary caretaker was maltreated as a child. Maltreatment includes neglect or physical, sexual or other abuse. Caretaker(s)' Response to Investigation. Based on the caretaker who is least cooperative or is least in agreement with the investigator. a) Caretaker(s) cooperates with investigator - a single caretaker or both are cooperative as evidenced by involvement in service planning for self/child(ren), making safety plans for the child(ren), etc.; b) One or more caretakers(s) provides limited cooperation, or is uncooperative and refuses involvement in the investigation and/or refuses access to the child(ren) during the investigation or is hostile and/or threatening. N12. Primary or Secondary Caretaker bas an Impulse Control Problem. Caretaker(s) does not consistently manage or control behavior, demonstrated by an exp10sive personality, an inability to delay gratification, a tendency to make abrupt, unreasonable, or destructive decisions, or acting without consideration of consequences. 10

ABUSE SCALE Prior Complaint is for Sexual Abuse. "Yes" if CPS received a referral for sexual abuse prior to the current investigation. Al. Number of Prior Investigations. Count all investigations, substantiated or not, which were assigned for CPS field investigation for any type of abuse or neglect prior to the complaint resulting in the current investigation. A3. Household has Previously Received Child Protective Sen'ices. Score one of the following: a) No; b) "Yes" if household has previously received child protective services or is currently receiving services as a result of a prior investigation. Service history includes voluntary family services, legal services, FINS, Family Preservation Services, or protective supervision, but does not include delinquency services; c) same as b mld household has a prior petition for termination of parental rights filed against them or granted for a child in their custody. " A4. Number of Children in the Home. Number of individuals under 18 years of age residing in the home at the time of the current complaint. Ifa child is removed as a result of the investigation or is on runaway status, count the child as residing in the home. A5. Primary Caretaker has a History of Abuse or Neglect as a Child. Score the appropriate amount for e~ch: a) No; b) credible statements by the primary caretaker or others indicate that the primary caretaker was maltreated as a child (maltreatment includes neglect or physical, sexual or other abuse); c) same as b and primary caretaker was placed in substitute care as a child. Primary or Secondary Caretaker has an Alcohol or Drug Abuse Problem. Caretaker(s) has a past or current alcohol/drug abuse problem that causes conflict in home, extreme behavior, financial difficulties, frequent illness, job absenteeism, job changes or unemployment, or driving under the influence, traffic violations, criminal arrests, disappearance of household items or life organized around substance use. Take the highest score for either caretaker: a) no problems; b) alcohol and/or marijuana abuse but no problem with other drugs; c) abuse of other drugs such as cocaine, heroin, amphetamines, etc. Legal, non-abusive prescription drug use should not be scored. A7. Age of Youngest Child. Record the current age in years ofthe youngest child residing in the household. Ifa child is removed as a result of the investigation or is on runaway status, count the child as residing in the home. A8. Problematic Adult Relationships in the Household. Score the appropriate amount for each: a) no; b) yes, problematic adult relationships which are harmful to domestic functioning or child care including criminal activities with others which cause problems between adults in the home (but not at the level ofdomestic violence), or mu1tiple live-in partners; c) yes, household has a domestic violence history, a relationship characterized by domestic disturbances or conflicts that require intervention by police, famfly or others, involving verbal or physical abuse by one or both caretakers (includes berating, physical fighting, threats or intimidation). A9. Primary or Secondary Caretaker Characteristics. Score the appropriate amount for each characteristic present and record the sum as the item score: a) neither caretaker exhibits characteristics listed below; b) score 1 if either caretaker does not adequately provide emotional support to the child(ren), such as not providing praise or recognition of child(ren)'s achievements, not giving 11

physical affection, giving negative reinforcement, etc.; c) score I if either caretaker physically injured a child in the current or a previous incident; d) score 2 if either caretaker is domineering, indicated by controlling, abusive, overly restrictive, or over reactive rules or unfair behavior; e) score 2 if either caretaker has a documented history of depression, suicide attemp:s, and/or any current or prior mental health treatment. AIO. All. Child in the Home has a Developmental Disability and/or History ofdelinquency. Score one for each characteristic present and record the sum as the item score: a) No child in the household exhibits characteristics listed below; b) score 1 if any child in the household has been referred to juvenile court for delinquent or status offense behavior, status offenses not brought to court attention but which create stress within the household should also be scored, such as children who run away, are habitually truant or have drug or alcohol problems; c) score 1 if any child is developmentally disabled, including any ofthe following - mental retardation, learning disability, or other developmental problem. Caretaker(s)' Response to Investigation. Based on the caretaker who is least cooperative or is least in agreement with the investigator: a) caretaker(s) cooperates with investigator - a single caretaker or both are cooperative as evidenced by involvement in service planning for selfjchild(ren), making safety plans for the child(ren), etc.; b) One or more caretakers is uncooperative and refuses involvement in the investigation and/or refuses access to the child(ren) during the investigation or is hostile and/or threatening. 12

FAMILY RISK ASSESSMENT INSTRUCTIONS Ris!-:. assessment identifies families which have high, moderate, low, or very low probabilities ofcontinuing to abuse or neglect their children. By completing the risk assessment, the worker obtains an objective appraisal of the likelihood that a family will maltreat their children in the next 18 to 24 months. The difference between the risk levels is substantial. High risk families have significantly higher rates than low risk families of subsequent referral and substantiation and are more often involved in serious abuse or neglect incidents. When we clearly define and objectively quantify risk, the choice between serving one family and another family is simplified: agency resources are targeted to higher risk families because ofthe greater potential to reduce subsequent maltreatment. The family risk scales are based on research on cases with substantiated abuse or neglect that examined the relationships between family characteristics and the outcomes of subsequent substantiated abuse and neglect. The scales do not predict recurrence, but simply assess whether a family is more or less likely to have another incident without intervention by the agency. One important finding ofthe research is that a single instrument should not be used to assess the risk of both abuse and neglect. Different family dynamics are present in abuse and neglect situations. Hence, separate scales are used to assess the future probability of abuse or neglect. The risk level is determined by scoring each of the scales, totaling the score, and taking the highest level from either the abuse or neglect scale as shown below. RISK LEVEL Assign the family's risk level based on the highest score on either scale, using the following matrix:. Nejilect Score Abuse Score Risk Level -2-0 -3-0 Very Low 1-4 1-5 Low 5-8 6-9 Moderate 9-19 10-24 High Which Cases: Decisions: When: All CPS investigations. The family risk level is combined with the family needs and strengths level to determine whether to open the case for services and the service options. See the following sections on Needs and Strengths Assessment and on Service Options Matrices for further guidance. Prior to the decision on investigation disposition (e.g., close the case or provide ongoing services to the family). Appropriate Completion: The assessment is completed based on conditions that exist at the time of the reported incident. Only ODe household can be assessed on the risk assessment form. Both scales (abuse and neglect) are completed regardless ofthe type ofallegation(s) reported or investigated, or the substantiated type(s) of maltreatment. All items on the risk assessment scales are completed. The social worker makes every effort throughout the investigation to obtain the information needed to answer each assessment guestion. However, if information cannot be obtained to answer a specific item, score the item as "0." 13

Note that item A9 requires that the social worker check if each characteristic is present for either the primary or secondary caretaker and total the score. Items N6 and A 10 require tha the social worker check the type of problem present for.!!m: child in the home and total the score. After all scale items are scored, the social worker totals the score for each scale. Using the risk level matrix above, the social worker identifies the corresponding risk level for the score on each scale. The overall risk level is the higher of the two levels. When the assessment is incorporated into FACTS, the system will automatically total the scores. The social worker's supervisor reviews and approves the risk assessment.,. Policy Overrides After completing the risk scales, the social worker then determines if any of the policy override reasons exist. Policy overrides reflect incident seriousness and child vulnerability concerns, and have been determined by the agency to be case situations that warrant services from the agency regardless of the risk scale score. If any policy override reasons exist, the risk level is increased to high. Policy overrides are used only to increase risk level and must be approved by the supervisor. Discretionary Overrides The social worker also determines if there are any discretionary override reasons. A discretionary override is applied by the social worker to increase the risk level in any case where the social worker feels the risk level set by the scales is too low. At initial assessment a discretionao' override is only used to increase the risk level as determined by the scale scores. All discretionary overrides must be approved by the social worker's supervisor. Narrative A narrative is required for all items that require a social worker's assessment in order to score. For the Neglect scale, these are items N6 through NI2. For the Abuse scale, the items are AS through A 11. This narrative replaces any current narrative requirement on risk assessment. The narrative should include a concise description of the conditions that led the worker to score the item. For example, if a parent is determined to lack basic parenting skills, the worker should describe what observations led to this assessment. Who: The social worker assigned to the investigation. 14