Safety Assessment is the process used to determine the level of immediate danger to a child. It considers the immediate threat of harm and the seriousness of the harm or danger given the current information and circumstances. Where imminent danger of harm to a child is present, the process then considers which interventions are needed to mitigate the threat to the child. After considering the immediate safety and interventions, the process leads to a safety decision.

Safety assessment differs from risk assessment in that the safety assessment assesses the present conditions, the danger resulting from those conditions and the interventions currently needed to protect the child. Risk assessment looks at the likelihood of future maltreatment due to family characteristics, behaviours and functioning.

The safety assessment process is conducted at the point of the first face-to-face contact with the child and family or at any subsequent point in the life of the case when child safety is of concern. Using the safety assessment tool as a guide, the information for each safety threat is collected from the child, caregivers and ollaterals using good social work practice and engagement. Each of the safety threats is addressed at some time during the initial contact to ensure that all safety areas are assessed; however, the Ontario Safety Assessment tool is not meant to be used as a questionnaire.

The minimum expectations for a safety assessment are that:

• the child who is the victim of alleged maltreatment is interviewed or observed
• the primary caregiver is interviewed
• other children cared for in the home are seen or interviewed if there are reported threats to their safety
• the home environment is seen if there are allegations that the child’s living conditions are hazardous.

Information from other relatives and collaterals (including the First Nation Band if the child is Aboriginal) may provide supporting information.

The Ontario Safety Assessment is completed for all family-based investigations at the point of the first face-to-face contact, within the response time, on new or ongoing cases that are assigned for investigation. In the Safety Assessment document, the child protection worker records:

• the assessment of safety
• the plan for securing the child’s safety
• the plan for monitoring the Safety Plan
• consultation/update with a supervisor.

The Ontario Safety Assessment must be conducted:

• before leaving a child in a home or returning a child to a home during an investigation
• when there is a change in the ability of safety interventions to mitigate safety threats.

The safety assessment process may be implemented within a family re-assessment in which changing circumstances known to induce stress have been identified (i.e. loss of income, moves, illness of caregiver or child, a change in family composition);

The Ontario Safety Assessment tool is not applied to:

• community caregiver investigations in non-family settings (e.g., school, daycare, residential setting)
• fatality investigations with no surviving siblings and no other children cared for in the home
• caregivers that have abandoned the child and whose whereabouts are unknown, and/or the caregivers are refusing contact with the CAS.

Most Vulnerable Child

The Ontario Safety Assessment form consists of three sections. In each section, the responses relate to the safety of the most vulnerable child in each domain.

Parent/Caregiver

For the purpose of the Safety Assessment, parents/caregivers are identified as being the adults, parents, or guardians in the family who provide care and supervision for the children. If any one of the caregivers poses a safety threat to the most vulnerable child, a “yes” response is indicated in relation to that safety threat and the safety intervention is targeted to address the issue and the individual.

1. Safety Threats

The safety items (Ontario Safety Assessment section 1) are a list of safety threats that are correlated to risk of immediate harm. If the critical threats are in existence, they render a child in danger of immediate harm. Use of an “other” category allows a child protection worker to identify a unique safety condition that has not been included but, in the child protection worker’s judgment, poses an immediate threat. Completion of this section of the Safety Assessment is dependent on the information available at the time of the assessment. Information gathered at the point of referral or subsequently may be factored into the assessment; however, child protection workers should make every effort to ensure that each safety threat is assessed prior to terminating the worker’s initial face to face contact with family members. Based on reasonable efforts to obtain information on each safety threat, the child protection worker reviews the threat and chooses the response that best suits the situation. “Yes” indicates the presence of the safety threat; “No” indicates the absence of the threat. In the event that no information is available to address a specific threat area, and there is no evidence to suggest that it is a concern, the child protection worker indicates “No”. If “Other” is used, the child protection worker provides a brief explanation in the allotted space.

2. Safety Interventions

Safety Interventions are actions deemed necessary whenever one or more safety threats have been identified in section 1. The presence of safety threats requires a worker to consider which interventions are necessary to resolve the identified threat or to mitigate it sufficiently in order to allow each child to remain safely in the home while the investigation continues. The severity of the threat, the availability of the needed safety intervention, the caregiver’s willingness and ability to work towards a constructive resolution, the vulnerability of the child, and the family’s history of cooperation must all be considered when assessing the potential for a successful safety-producing intervention.

In the Safety Assessment document, the Safety Intervention list is comprised of general categories of interventions. These interventions are meant to provide temporary risk reduction during the investigative phase of service. Each category of intervention should be considered in terms of its availability, its usefulness in the situation, and the caregiver’s willingness to implement and follow through with the strategy in order to reduce the imminence and severity of the threat of harm to the child. If a category represents an intervention that will be implemented, it is check-marked on the form.

Should the severity and imminence of the threat of harm to the child be high, and should no safety intervention be available to sufficiently mitigate the conditions, apprehension and placement in CAS is the final safety intervention available.

The Safety Plan is a discussion and description of the safety interventions implemented to resolve the identified safety threats. It is written at the end of the intervention section of the Safety Assessment document entitled Safety Plan. In it, the child protection worker details:

• the contact information for each individual involved in the safety activities
• the relationship between the child, family and support persons, organizations or First Nation community if the child is Aboriginal
• the specific actions that will be taken to secure the child’s safety
• specifically what each individual will do
• how often and how long they will do it
• how the plan will be monitored and by whom
• a backup plan if conditions of the safety plan cannot be met.

3. Safety Decision

In this section of the Ontario Safety Assessment document, the child protection worker records the decision that is the outcome of the safety assessment process. If, after consideration of the safety threats, no concerns have been identified, the child protection worker may decide that there is no likelihood of imminent harm or danger to a child in the home. The child protection worker decides that conditions are Safe.

If one or more safety threats have been identified, but protective interventions have been put in place to address those conditions and reduce the threat to the child, the child protection worker may decide that the child is Safe with Intervention.

Where the child protection worker has determined that one or more safety threats are present and there are no safety interventions available to sufficiently mitigate the threats to the child, the child protection worker must consider the child Unsafe.

The rationale for the Safety Decision, including how the intervention plan, if needed, is expected to mitigate safety concerns or is insufficient to address the concerns, is documented in the narrative area of this section.

Score 1 if the current complaint or an allegation made during the investigation is for any type of abuse. This includes:

• physical abuse
• emotional abuse
• sexual abuse or exploitation

Score the appropriate amount for each characteristic and record the sum as the item score (maximum score 3):

a) Score 0 if none of the characteristics below are applicable.
b) Score 1 if the primary parent/caregiver blames child for incident. Blaming refers to parent/caregiver’s statement that maltreatment occurred because of child’s action or inaction. For example, parent/caregiver claims that child seduced him/her or that child deserved beating because of misbehaviour.

Score 2 if the primary parent/caregiver justifies maltreatment of child. Justifying refers to parent/caregiver’s statement that his/her actions or inaction, which resulted in harm to the child was appropriate. An example would be to claim that the form of discipline was appropriate because it is how he/she was raised.

Score the appropriate amount for each characteristic present and record the sum as the item score (maximum score 3):

a) Score 0 if the primary parent/caregiver does not exhibit characteristics listed below.
b) Score 1 if the primary parent/caregiver provides insufficient emotional/ psychological support to the child, such as persistently berating/belittling/ demeaning child, or depriving child of affection or emotional support.
c) Score 1 if the parent/caregiver’s disciplinary practices caused or threatened harm to child because he/she was excessively harsh and/or inappropriate to the child given the child’s age and/or developmental stage. Examples include locking child in closed basement, holding child’s hand over heat, hitting child with dangerous objects or depriving young child of physical and/or social activity for extended periods.
d) Score 1 if the primary parent/caregiver’s behaviour is characterized by controlling, abusive, overly restrictive or unfair actions, or over-reactive rules.

The secondary parent/caregiver has a past or current alcohol/drug/substance problem that interferes with his/her or the family's functioning. Such interference is evidenced by:

• substance use that affects or affected:
  • employment
  • criminal involvement
  • marital or family relationships
  • ability to provide protection, supervision, and care for the child
• an arrest in the past two years for driving under the influence or refusing breathalyser testing
• self report of a problem
• received or receiving treatment
• multiple positive toxicology screens
• health/medical problems resulting from substance use
• child diagnosed with Fetal Alcohol Syndrome or effects, or child had a positive toxicology screen at birth and secondary caregiver was birthing parent.

Score the following:

a) Score 0 if no past or current substance abuse problem.
b) Score 1 if past or current substance abuse.

Legal, non-abusive prescription drug use should not be scored.

Score the appropriate amount for each characteristic present and record the sum as the item score (maximum score 3):

a) Score 0 if no child in the family exhibits characteristics listed below.
b) Score 1 if any child in the family has been referred to the Youth Criminal Justice System for an offence. Child behaviour that has not resulted in criminal involvement but has created stress within the family should also be scored. Examples include children engaging in behaviours such as truancy, breaking curfews and repeated running away.
c) Score 1 if any child is developmentally delayed, has a learning disability or any other developmental challenge.
d) Score 1 if any child in the family has mental health or behaviour problems not related to a physical disability or developmental delay. Examples include ADHD, ADD, a DSM diagnosis, receiving mental health treatment, special education placement due to behaviour, or use of psychotropic medication.

This factor refers to any form of alcohol; illegal drugs or abuse of prescription or over the counter medication; and the broad category of substances which include inhalants, solvents, or other concoctions used to alter emotions or functioning. Check mark the specific substance in the list provided for consideration in development of the service plan.

a) Promotes and demonstrates healthy understanding of alcohol, drugs and substance use
Parent/Caregiver may use alcohol or prescribed drugs, however use does not negatively affect parenting skills and functioning, and parent/caregiver promotes and demonstrates an understanding of the choices made (abuse, use or abstinence) and the effects of alcohol, drugs and substance use on behaviour and society.
b) Alcohol or prescribed drug use
Parent/Caregiver may have a history of substance abuse or may currently use alcohol or prescribed drugs, however, it does not negatively affect parenting skills and functioning.
c) Alcohol, drug or substance abuse
Parent/Caregiver continues to use despite negative consequences in some areas such as family, social relationships, health, legal, employment or finances. Parent/Caregiver needs help to achieve and/or maintain abstinence from alcohol, drugs or other substances.
d) Chronic alcohol/drug/substance abuse
Parent/Caregiver’s use of alcohol or drugs results in behaviours which impede ability to meet his/her own and/or the child’s basic needs. Parent/caregiver experiences some degree of impairment in most areas including family, social relationships, health, legal, employment and finances. Needs intensive structure and support to achieve abstinence from alcohol or drugs.

a) Promotes positive values
No criminal behaviour or child abuse and neglect history, and family members promote and demonstrate values that instil respect for self and others.
b) No criminal behaviour or child maltreatment history, or successful problem resolution
No history of prior criminal behaviour or child maltreatment; or there has been prior criminal behaviour or child maltreatment history, but family members have demonstrated ability to resolve crises appropriately through the use of community resources.
c) Active involvement
Parent/caregiver’s ability or availability to parent is negatively affected by criminal behaviour or child maltreatment such as outstanding warrants, arrests and/or history with child protection that has not been successfully resolved.
d) Chronic/severe involvement
No family member is able/available to safely assume caregiver role due to chronic criminal behaviour/child protection involvement with failed service plans.

If the response is b, c, or d, the parent/caregiver with the concern is identified in the chart and the nature of the past involvement is check marked.

1. Strong emotional adjustment
   Child displays strong coping skills in dealing with crises, trauma, disappointment and daily challenges. Child is able to develop and maintain trusting relationships. Child is also able to identify the need for guidance and to seek and accept it.
2. Adequate emotional adjustment
   Child displays developmentally appropriate emotional/ coping responses that do not interfere with school, family or community functioning. Child may demonstrate some depression, anxiety or withdrawal symptoms that are situationally related. Child maintains situationally appropriate emotional control.
3. Limited emotional adjustment
   Child has occasional difficulty dealing with situational stress, crises or problems; such difficulty impairs functioning. Child displays periodic mental health symptoms including, but not limited to depression, running away, somatic complaints, hostile behaviour or apathy.
4. Severely limited emotional adjustment
   Child’s ability to perform in one or more areas of functioning is severely impaired due to chronic/severe mental health symptoms such as fire-setting, suicidal behaviour or violent behaviour towards people and/or animals.

For children in voluntary or court-ordered placement, score child’s family, not placement family. For children in permanent placements, continue to score child’s family, basing assessment on visits and other contact such as telephone contact or letters. If child has no contact with his/her family, score “0”.

1. Nurturing/supportive relationships
   Child experiences positive interactions with family members. Child has a sense of belonging within the family. Family defines roles, has clear boundaries and supports child’s growth and development.
2. Adequate relationships
   Child experiences positive interactions with family members and feels safe and secure in family, despite some unresolved family conflicts.
3. Strained relationships
   Stress/discord within the family interferes with child’s sense of safety and security. Family has difficulty identifying and resolving conflict and/or obtaining support and assistance on their own.
4. Harmful relationships
   Chronic family stress, conflict or violence severely impedes child’s sense of safety and security. Family is unable to resolve stress, conflict or violence on its own and are not able or willing to obtain outside assistance.

1. Preventative health care is practiced
   Child has no known health care needs. Child receives routine preventative and medical, dental and/or vision care and immunizations.
2. Medical needs met
   Child has no unmet health care needs. Special conditions may exist but are adequately addressed.
3. Medical needs impair functioning
   Child has a medical condition that may impair daily functioning. Special conditions exist that are not adequately addressed and/or routine medical, dental and/or vision care is needed.
4. Medical needs severely impair functioning
   Child has a serious, chronic or acute medical condition that severely impairs functioning, and needs are unmet.

1. Advanced development
   Child’s physical and cognitive skills are above chronological age level.
2. Age-appropriate development
   Child’s physical and cognitive skills are consistent with chronological age level.
3. Limited development
   Child does not exhibit most physical and cognitive skills expected for chronological age level.
4. Severely limited development
   Most physical and cognitive skills are two or more age levels behind chronological age expectations.

1. Strong cultural/community identity
   Child identifies with culture/community, heritage and beliefs and is connected with people who share similar belief systems. Child knows cultural/ community resources, both formal and informal and accesses them as needed.
2. Adequate cultural/community identity
   Child identifies with culture/community, heritage and beliefs and practices, traditions within the family. Child recognizes how to access resources in the greater community. Child may experience some conflict and may struggle with cultural/community identity, but is able to cope.
3. Limited cultural/community identity
   Child experiences inter-generational and/or societal conflict surrounding values and norms related to culture/community differences. Child perceives services and supports as unavailable, or access as limited. Conflicts with culture/community identity create difficulties for child.
4. Disconnected from cultural/community identity
   Child is disconnected from culture/community heritage and beliefs resulting in isolation, lack of support and lack of access to resources. Connections are unavailable or perceived as unavailable due to lack of understanding of cultural and language differences of support networks. Conflicts with culture/community identity result in problematic behaviour.

1. No alcohol, drug or substance use
   Child does not use alcohol, drug or other substances and is aware of consequences of use. Child avoids peer relations/social activities involving alcohol, drugs or substance use and/or chooses not to use despite peer pressure/opportunities to use.
2. Experimentation/use
   Child does not use alcohol, drug or substances. Child may have experimented with alcohol, drugs or substances but there is no indication of sustained use. No demonstrated history or current problems related to substance use.
3. Alcohol, drug or substance use
   Child’s alcohol, drug or substance use results in disruptive behaviour and discord in relationships in school, community, family or work. Use may have broadened to include multiple substances.
4. Chronic alcohol, drug or substance use
   Child’s chronic alcohol, drug or substance use results in severe disruption of functioning, such as loss of relationships, job, school suspension/expulsion, problems with the law and/or physical harm to self or others. Child may require medical intervention to detoxify.

Does child have a special education placement or Individual Education Plan? Yes__ No__.

If Yes, describe in the space provided on the form.

1. Outstanding academic achievement
   Child is working above grade level and/or is exceeding the expectations of the child’s Individual Educational Plan.
2. Satisfactory academic achievement
   Child is working at grade level and/or is meeting the expectations of the child’s Individual Educational Plan.
3. Academic difficulty
   Child is working below grade level in at least one, but not more than half of academic subject areas and/or child is struggling to meet the goals of the existing Individual Educational Plan. Existing educational plan may need modification.
4. Severe academic difficulty
   Child is working below grade level in more than half of academic subject areas and/or child is not meeting the goals of the existing education plan. Existing Individual Educational Plan needs modification. Also score “d” for a child who is required by law to attend school and is not attending.

1. Strong social relationships
   Child enjoys and participates in a variety of constructive age-appropriate social activities. Child enjoys reciprocal, positive relationships with others.
2. Adequate social relationships
   Child demonstrates adequate social skills. Child maintains stable constructive relationships with others. Occasional conflicts are minor and easily resolved.
3. Limited social relationship
   Child demonstrates inconsistent social skills; child has limited positive interactions with others. Conflicts are more frequent and serious and child may be unable to resolve them.
4. Poor social relationships
   Child has poor social skills as demonstrated by frequent conflictual relationships or exclusive interactions with negative or exploitive peers; or child is isolated and lacks a positive social support system.

1. Preventative activities
   Child is involved in community service and/or crime prevention programs and takes a stance against crime. Child has no arrest history and there is no other indication of unlawful behaviour.
2. No unlawful behaviour
   Child has no arrest history and there is no other indication of illegal behaviour, or child has successfully completed probation and there has been no unlawful behaviour in the past two years.
3. Occasional unlawful behaviour
   Child is or has engaged in occasional, non-violent unlawful behaviour and may have been arrested or placed on probation within the past two years.
4. Significant unlawful behaviour
   Child is or has been involved in any violent or repeated non-violent unlawful behaviour which has or may have resulted in consequences such as arrests, incarcerations or probation.

Score the item based on the count of all investigations, verified or not, which were assigned for child protection investigation for any type of abuse or neglect prior to the investigation resulting in the current case opening. History from other jurisdictions is reviewed and included in this category.

Investigations of community caregivers (e.g. daycare, teacher etc) unless parent/caregiver failed to protect and brief service contacts are excluded.

Score the appropriate amount for each characteristic present and record the sum as the item score (maximum score 2):

a) Score 1 if one or more children in the family is developmentally delayed or physically disabled, or displays any of the following: learning disability, other developmental problem or significant physical handicap.
b) Score 1 if one or more children in the family is medically fragile (defined as having a long-term – six month or more – physical condition requiring medical intervention), or is diagnosed as showing failure to thrive.
c) Score 0 if no child in the family exhibits any of the above characteristics.

Indicate whether or not the primary and/or secondary parent/caregiver has a current alcohol/ substance/ drug abuse problem that interferes with the parent/caregiver’s or the family’s functioning, and the parent/caregiver is not addressing the problem.

If both parents/caregivers have an alcohol, drug or substance abuse problem, rate the more negative behaviour of the two caregivers.

Not addressing the problem may be evidenced by:

• alcohol, drug or substance use that affects caregiver’s employment; criminal involvement, marital or family relationships; or his/her ability to provide protection, supervision and care for the children
• an arrest since the last assessment/ reassessment for driving under the influence, or self report of a problem
• multiple positive urine screens
• health/medical problems resulting from substance abuse
• child diagnosed with Fetal Alcohol Syndrome or Effects (FAS or FAE) or child had positive toxicology screen at birth and primary or secondary caregiver was birthing parent.

Score the following:

a) Score 0 if there is no history of an alcohol, drug or substance abuse problem.
b) Score 0 if there is no current alcohol, drug or substance abuse problem that requires intervention.
c) Score 0 if there is an alcohol, drug or substance problem and the problem is being addressed.
d) Score 1 if there is an alcohol, drug or substance use problem and the problem is not being addressed.

Legal, non-abusive prescription drug use should not be scored.

Score this item based upon current status of adult relationships in the family.

a) Score 0 if there are no problems observed.
b) Score 1 if there are partner/adult relationships that are harmful to family functioning or the care the child receives.
c) Score 2 if partner/adult conflict is present. Family has had, since the most recent assessment, physical assault(s) or periods of intimidation/ threats/ harassment between parents/caregivers or between parent/caregiver and another adult.

Score 1 if physical care of child such as lack of ageappropriate feeding, clothing, shelter, hygiene and medical care threatens the child’s well being or results in harm to the child.

Examples include:

• repeated failure to obtain standard immunizations
• failure to obtain medical care for severe or chronic illness
• repeated failure to provide child with clothing appropriate to the weather
• persistent rodent or insect infestations
• inadequate or inoperative plumbing or heating, (in communities where these utilities are available) or excessive mould
• poisonous substance or dangerous objects lying within reach of small child
• child wearing unchanged clothes for extended periods of time
• child not bathed on a regular basis resulting in dirt caked on skin and hair and strong odour.

Score this item based on whether the primary parent/caregiver has demonstrated or is beginning to demonstrate skills learned from participation in services.

a) Score 0 if all desired services were unavailable during the last assessment period.
b) Score 0 if primary parent/caregiver successfully completed all services recommended, or is actively participating in services, or is pursuing objectives detailed in case plan. Observation demonstrates parent/caregiver’s application of learned skills in interaction between child and caregiver, caregiver to caregiver, caregiver to other significant adult, self-care, home maintenance, financial management, or demonstration of skills toward reaching the behavioural objectives agreed upon in the case plan.
c) Score 1 if there was minimal participation in pursuing objectives in the case plan. The parent/caregiver is minimally participating in services, has made progress but is not fully complying with the objectives in the case plan.
d) Score 2 if primary parent/caregiver has participated in services but is not meeting case plan objectives, refused involvement in services, or failed to comply/participate as required. The parent/caregiver refuses services, sporadically follows the case plan, or has not demonstrated the necessary skills due to a failure or inability to participate.

Rate this item based on whether the secondary caregiver has demonstrated or is demonstrating skills learned from participation in services:

a) Score 0 if not applicable. All desired services were unavailable during the last assessment period.
b) Score 0 if not applicable. Only one caregiver in the home. There is no secondary caregiver in the home.
c) Score 0 if caregiver successfully completed all services recommended, or is actively participating in services; or is pursuing objectives detailed in case plans. Observation demonstrates caregiver’s application of learned skills in interaction(s) between child/caregiver, caregiver to caregiver, caregiver to other significant adult, self-care, home maintenance, financial management, or demonstration of skills toward reaching the behavioural objectives agreed upon in the case plan.
d) Score 1 if there was minimal participation in pursuing objectives in case plan. The caregiver is minimally participating in services, has made progress but is not fully complying with the objectives in the case plan.
e) Score 2 if caregiver has participated in services but is not meeting case plan objectives, refused involvement in services, or failed to comply/participate as required. The caregiver refuses services, sporadically follows the case plan, or has not demonstrated the necessary skills due to a failure or inability to participate.

The baseline for all reunification reassessments is the risk level. This is the research-based component of the decision-making model. The appropriate risk level to be used in this factor is either:

• the final risk level from the initial referral, investigation and risk assessment or,
• the final risk level from the most recent subsequent referral, investigation and risk assessment (whether verified, not verified or inconclusive).

The most recent Ontario Family Risk Assessment result is recorded for this factor (Do not use a risk reassessment score).

Overriding Conditions represent conditions that, if in existence, are considered without exception to be indicative of increased risk to the child. In the Reunification Risk assessment, consider only the period of time between the original risk assessment (if this is the first reunification assessment), or the most recent reunification reassessment, and the current reassessment.

Indicate if an Overriding Condition exists. The presence of one or more overriding conditions increases risk to very high.

Discretionary considerations are used by the child protection worker whenever he/she believes that the risk score does not accurately reflect the family’s actual risk level.

The Reunification Risk Reassessment allows the worker to use discretion to increase or decrease the risk level by one step.

The rationale for allowing a change in either direction is that after 6 months of working with the family, the child protection worker has acquired significant knowledge of the family and is in a position to clinically assess the impact of the factors weighted in the Reunification Risk Reassessment. Reasons for a Discretionary Consideration are specified in #5 of the form.

Following review of Overriding Conditions and Discretionary Considerations, the Final Reunification Risk Level is indicated.

Determine access frequency by identifying the number of access visits that occurred and dividing that number by the number of access visits that were available to the family. Do not count visits that did not occur for reasons not attributable to the family (e.g. child’s illness, lack of transportation for the child).

Actual Visits/ Available Visits = Access Frequency

Determine access quality. Consider multiple sources of information including, but not limited to, access observation, parent/ caregiver/ guardian report, foster/ substitute caregiver report, and child report.

On the Access Evaluation matrix, locate the row corresponding with the family’s access frequency and the column corresponding with the family visitation quality. Mark the intersecting point. If the marked point falls within the shaded area, the family’s access evaluation is considered to be adequate. If the marked point falls outside of the shaded area, the family’s access evaluation is considered inadequate.

Overriding Conditions represent conditions that, if in existence, are considered without exception to be indicative of increased risk to the child.

Where access is fully supervised for safety reasons, reunification cannot be considered.

Reunification Safety Assessment

The Reunification Safety Assessment is only completed when:

• reunification risk level is low or moderate and
• access is assessed as acceptable.

The Reunification Safety Assessment is based on the principles of the initial safety assessment. It assesses the threat of immediate harm to a child in a particular environment. However, when reunification is considered, the tool guides the child protection worker to assess for the presence of eight protective factors. The Reunification Safety Assessment consists of three sections:

i) Protective Factor Identification
ii) Safety Interventions
iii) Safety Decision

C. Reunification Safety Assessment
(i) Protective Factor Identification.

Based on all information known (including a home visit at the time of the Reunification Assessment) about the family to whom the child is being returned, indicate whether each protective factor exists through “yes” or “no”. Item #9 allows the child protection worker to indicate that there is a unique condition in the home that would cause threat of immediate harm if the child was returned. In each section, all children in the family are considered and the responses documented relate to the safety of the most vulnerable child in each domain.

Reunification Tools Form Completion
C. Reunification Safety Assessment
(ii) Safety Interventions

If the response to questions 1 to 8 are all affirmative (“yes”), indicating that all protective factors are in place, and there is no unusual condition posing an immediate safety threat, there is no need for a Safety Intervention or a Safety Plan. The worker proceeds to the Reunification Safety Decision.

If one or more protective factors are absent, or there is an unusual condition that poses a threat of immediate danger, as indicated by a “no” response, it is necessary to consider whether there are safety interventions available and able to mitigate the threat of immediate harm if the child returned to the home.

As in the initial Ontario Safety Assessment, the Safety Intervention list consists of general categories of interventions rather than specific programs. The child protection worker considers each potential category of interventions and determines whether that intervention is available and sufficient to mitigate the danger of immediate harm and whether the caregiver will follow through with the planned intervention.

The child protection worker may determine that a combination of safety interventions is appropriate and that with an intervention or interventions, the child would be safe. The worker may determine that even with intervention, the child would be unsafe. The interventions provide a Safety Plan that is short-term and allows work to continue on the case plan.

If one or more protective factors are absent or an unusual condition exists and available safety interventions are insufficient to ensure the child’s safety, the final option is to indicate that the child will remain in care or in an alternate placement.

Reunification Tools Form Completion
C. Reunification Safety Assessment
(iii) Reunification Safety Decision

In this section of the Reunification Safety Assessment, the child protection worker records the result of the assessment. The rationale for the Reunification Safety Decision is documented in the narrative area of this section, including how the Safety Intervention Plan, if needed, is expected to mitigate safety concerns, how it will be monitored or if it is insufficient to address the concerns.

After the child protection worker has completed the Reunification Risk Assessment, Access Evaluation and/or Reunification Safety Assessment, the Placement/Permanency Planning Guide assists the worker to track case direction as it leads to one of three termination points:

• child’s return to caregivers
• continued reunification focus
• implementation of a permanent plan.

The primary considerations are the length of time that the child has been in care and the age of the child.

According to the Child and Family Services Act, a permanent plan must be developed for any child who is under the age of 6 years and who has been in substitute care for a cumulative period of 12 months within a 5-year period. Any child over the age of 6 years must have a permanent plan if in care for a period of 24 cumulative months. In following the Placement/Permanency Planning Guide, the worker considers the factors and assessments available and the worker follows the appropriate branch to the next decision point.

Substantial Probability of Reunification refers to the worker’s assessment of the caregiver’s potential success at meeting the goals of the service plan and to address the areas that contribute to risk. It also considers the potential success of access. When the child protection worker’s assessment indicates that the probability of reunification exists within the Child and Family Services Act timeframe appropriate for the child’s age, decision-making continues towards the appropriate end.

Intensify Concurrent Planning signals a need to identify and assess permanency planning options, while continuing to consider a goal of Family Reunification. This ensures that planning for either Return to Caregivers or Placement happens at the same time and that a permanent plan is attained for the child in a timely manner.

The Strength and Difficulties Questionnaire (SDQ) is a brief behavioural screening questionnaire designed to examine five areas of child/youth functioning: emotional symptoms, conduct problems, hyperactivity, peer relationship problems and prosocial behaviours. To explore these areas of a child’s emotional wellbeing, the SDQ poses questions that probe 25 child/youth attributes. It is not an effective screen for adolescent suicidal behaviour and should not be used for that purpose.

For Ontario child protection workers, the SDQ is used to assist in the identification of a child who may be experiencing emotional difficulties due to exposure to maltreatment, exposure to domestic violence or other life circumstances suspected to have a detrimental effect on child wellbeing. When using the SDQ, it is important that the family is engaged and consenting, and that the purpose of the tool is shared with the family members and others who are providing the information. The outcome of the instrument is also shared with the family and, where there is consent, it is shared with a recipient service provider to support the referral process and/or development of a service plan.

The SDQ is a supplement to the Family and Child Needs and Strengths Assessment for a child who remains in the care of his/her parents/caregivers. The SDQ may be used to further explore the child’s emotional wellbeing and need for further assessment when the child protection worker providing service to the child suspects a level of need in one or more of the following domains of the Child Strength and Needs evaluation:

• Emotional/behavioural
• Substance Use
• Peer/adult Social Relationships
• Unlawful Behaviour

When the child is self-harming or clearly demonstrating a need for further assessment of his/her emotional wellbeing, the child protection worker proceeds directly to pursuing the appropriate referrals for assessment and treatment services through the local hospital, children’s mental health or other appropriate community agency.

The SDQ may be conducted at any time during child protection involvement with a child and his/her family. It may be repeated in intervals of 6 months or more where concerns remain about a child’s emotional wellbeing, or to determine service effectiveness and improved functioning.

• Child protection worker involved with the child and family
• Other child protection agency staff with a working relationship with the child

The Ontario Supplementary Screening Tools includes four versions of the SDQ. Each one asks about the same 25 child attributes. The Informant versions of the SDQ are:

• Parent/caregiver or teacher of a child 3 to 4 years old
• Parent/caregiver or teacher of a child 4 to 10 years old
• Parent/caregiver or teacher of a child 11 to 16 years old

A self-report version is included for a Child/youth 11 to 16 years old.

The SDQ may be provided directly to the respondents for completion. Use within a focused interview in which the administering worker employs good social work practice and engagement is more likely to ensure the screening process is complete and that the purpose of the questionnaire is understood by the client. Having different informants (e.g. parent/teacher and adolescent) complete versions of the questionnaire also allows the worker and family to compare and contrast various perceptions of the child’s wellbeing and the impact of the child’s stress.

Friendships

Classroom Learning

Friendships

Classroom Learning

Friendships

Classroom Learning

Friendships

Classroom Learning

Excessive alcohol use can cause substantial risk to individual, family and child safety. The Adult Alcohol Use Disorder Identification Test-10 (AUDIT-10) was developed by the World Health Organization to identify adult individuals, whose alcohol consumption has become:

• hazardous, meaning that their pattern of drinking increases the risk of harmful consequences to themselves or others
• harmful, which means their drinking has jeopardized their physical or mental health
• alcohol dependence has resulted.¹

Screening for alcohol consumption assists the child protection worker to identify parents/caregivers whose drinking has the potential to contribute to negative child and family outcomes and to encourage the appropriate level of intervention to address the problem.

Use of the AUDIT-10 represents the first stage of an assessment process that correctly identifies whether or not a parent/caregiver is at risk of social, economic, family or personal problems associated with excessive drinking. The results from the test guide the child protection worker to support the parent/caregiver to pursue further assessment and/or intervention.

The AUDIT-10 screening test is a 10 item questionnaire that may be applied to any parent/caregiver, or adult residing in the child’s home who participates in caregiving, any time there are unconfirmed concerns about the extent of alcohol use. An explanation of the content of the questions, the purpose of the screening, and the need for accurate answers is discussed with the parent/caregiver. When determining the most appropriate time to involve the parent/caregiver in the screening process, the child protection worker considers:

• the cultural, religious and social context of the family
• whether the parent/caregiver may fear that disclosure will have a negative impact on the child protection worker’s assessment of his/her parenting
• the parent/caregiver’s willingness and ability to provide honest responses
• the possibility of minimization.

The child protection worker’s concerns about these or any other factors are discussed with the parent/caregiver before completing the screening process.

As the presenter/interviewer of the screening survey, it is important that:

• the child protection worker be friendly and non-threatening
• the parent/caregiver is not intoxicated or in need of emergency care at the time
• the purpose of the screening is clearly stated
• the information needed by the parent/caregiver to understand the questions and respond accurately is provided²
• confidentiality is discussed
• it is clear that responses are a part of a child protection file which cannot be shared without consent unless subject to a child protection hearing.

If excessive drinking has been confirmed by the parent/caregiver through selfreport, hospitalization, a request for treatment or any other clear criteria, the child protection worker proceeds directly to making the appropriate referral for service.

The AUDIT-10 may be re-administered yearly to conduct a subsequent screening if needed.

The AUDIT-10 can be administered as an interview or as a self-report questionnaire. The first three questions explore hazardous alcohol use, the second group of three questions explore alcohol dependency symptoms, and the final four questions explore harmful alcohol use. In determining which format to use, the child protection worker considers the parent/caregiver’s characteristics and chooses the method that is most likely to suit the respondent. Factors such as language, comfort, literacy, level of engagement, and level of cooperation are taken into account.

AUDIT-10 as an Interview

When the AUDIT-10 is administered as an interview, it is important that the questions are read with the wording and the order given. Use of the prescribed wording allows better comparability between one interviewer and another. When a response option has been chosen, it is useful to clarify during the initial questions to be sure that the parent/caregiver has selected the most accurate response.

When a response is ambiguous or evasive, the child protection worker may continue asking for clarification by repeating the question and the response options, asking the parent/caregiver to choose the best one. If answers are difficult to record because the parent/caregiver’s behaviour has undergone a recent change making it difficult to characterize “typical” drinking, it is best to record the amount and symptoms related to the heaviest drinking period. The child protection worker can note the fact that this may be atypical or transitory for the parent/caregiver and can be addressed at a later point³.

All responses gathered in the interview are recorded carefully. Observations and additional information may be documented for analysis when interpreting the AUDIT-10 total score.

AUDIT-10 as a Written Questionnaire

Using a written questionnaire eliminates many of the uncertainties of parent/caregiver response by allowing only specific choices. It also eliminates the possibility of gathering additional information and of strengthening the worker-parent/caregiver working relationship, making the process less personal. A questionnaire requires the respondent to be literate and have the ability to perform the required actions.

The time required to complete the AUDIT-10 is estimated to be between 2 and 4 minutes. The AUDIT-10 allows the screening process to be shortened for respondents who indicate that they drink infrequently, moderately, or abstain from alcohol entirely. The “skip out” option is recommended for use only in the interview format or in a computer- assisted format.

The “skip out” options are as follows:

• In Question 1, if a respondent answers that “no drinking has occurred during the last year”, the interviewer may skip to Questions 9 and 10 to probe for indications of past alcohol problems. A respondent who scores points on Questions 9 and 10 may be considered to be at risk if he/she begins to drink again.
• If a parent/caregiver scored 0 on Questions 2 and 3, the interviewer may skip to Questions 9 and 10 because the respondent’s drinking has not exceeded the low risk drinking limits.

The AUDIT-10 is easy to score. Each of the questions has a range of responses that are scored from 0 to 4. In the interview format, the interviewer enters the score shown next to the choice that corresponds with the parent/caregiver’s response. In the self-report questionnaire format, the number in the column of each response checked by the parent/caregiver is entered by the scorer in the column to the extreme right. In either the interview or the questionnaire format, the scores for each of the questions are totalled and recorded.

In the general population, total scores of 8 or more are recommended as indicators of hazardous and harmful alcohol use as well as possible dependence. For respondents over the age of 65, a cut-off score of 7 is recommended to increase the sensitivity for that group. Higher scores indicate greater likelihood of hazardous and harmful drinking, and may also reflect greater severity of alcohol problems and dependence.

The following guidelines are provided by the AUDIT: the Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Health Care, Second Edition

• Scores of 8 to 15 represent a medium level of alcohol problems and may be appropriate for referral to services focused on providing advice on the reduction of hazardous drinking.
• Scores between 16 and 19 represent a high level of alcohol problems and suggest need for brief counselling and continued monitoring.
• Scores of 20 or more warrant further evaluation for alcohol dependence.

In addition to considering the numerical scores and guidelines for intervention, interpretation of all scores should include consideration of clinical judgment, family history and perceived honesty in responding to the AUDIT-10 questions.

The Drug Abuse Screening Test (DAST-10), developed by Dr H. Skinner (1982) is designed to screen adults for drug use. It is a 10-item questionnaire that explores consumption, dependence and the impact of usage on an individual’s functioning

The DAST-10 may be administered to a parent/caregiver or adult residing in the child’s home who participates in caregiving when there are unconfirmed concerns about possible use of drugs or other substances. DAST does not apply to alcohol or tobacco use. The AUDIT-10 is the instrument designed to explore alcohol use. Before administering the test, an explanation of the content of the questions, the purpose of the screening test and the need for accurate answers is discussed with the parent/caregiver or adult. As with the alcohol screening test, when determining the most appropriate time to involve a parent/caregiver in the screening process, the child protection worker considers:

• the cultural, religious and social context of the family
• whether the parent/caregiver may fear that disclosure will have a negative impact on the child protection worker’s assessment of his/her parenting
• the parent/caregiver’s willingness and ability to provide honest responses
• the possibility of minimization.

Concerns about these or any other factors are discussed with the parent/caregiver before completing the screening process.

During screening, it is important that:

• the child protection worker engage the parent/caregiver in a supportive and non-threatening manner
• the parent/caregiver is not under the influence of a substance or in need of emergency care
• the purpose of screening is clearly stated
• the information needed by the parent/caregiver to understand the questions and respond accurately is provided
• the parent/caregiver understands that the responses are a part of a child protection file and cannot be shared without consent unless subject to a child protection hearing.

If substance abuse has been confirmed by the parent/caregiver through selfreport, hospitalization, a request for treatment, or any other clear criteria, the child protection worker proceeds directly to making an appropriate referral for substance abuse assessment and treatment.

The DAST-10 can be administered as an interview or as a self-report questionnaire. In determining which format to use, the child protection worker considers the parent/caregiver’s characteristics and chooses the method that is most likely to suit the respondent. Factors such as language, comfort, literacy, level of engagement and level of cooperation are taken into account.

DAST-10 as an Interview

The DAST-10 may be administered as an interview. When this process is used, the child protection worker must read the instructions and the questions to the parent/caregiver in the order presented. Use of the given wording and instructions allows for greater consistency between interviewers.

DAST-10 as a Written Questionnaire

The DAST-10 may be administered as a written questionnaire when the child protection worker is confident that the parent/caregiver has the required skills and ability to use this format. A written questionnaire eliminates the possibility of gathering additional information and of strengthening the workerparent/ caregiver relationship, making the process less personal.

Each “yes” answer on the DAST-10 is given a score of 1 point. A “no” response receives a score of 0. The number of points scored is added. Scores of 2 to 4 are considered indicative of a need for further substance abuse assessment. Higher scores suggest greater functional impact of drug/substance abuse.

In determining the most appropriate course of follow up within the child protection environment, the child protection worker considers the score within the context of the other information known about the parent/caregiver/adult, and the possibility of minimizing due to parent/caregiver’s concerns about the potential consequences of disclosure.

The primary intent of a mental health screening tool is to identify whether an individual may be experiencing a mental health concern that requires further assessment. The Mental Health Inventory (MHI-5) is a 5-item questionnaire that explores the presence of psychological distress that may be manifested in individuals with a variety of mental health disorders. The items in the screening test are taken from the mental health portion of the longer, widely used Short- Form Health Survey Medical Outcomes Study (SF-36) that was designed to evaluate general health.

Use of the MHI-5 is intended to assist the child protection worker to recognize parents/caregivers who may be experiencing symptoms of distress and need further assessment. The screening instrument is not meant to be diagnostic or provide an absolute finding. Rather, the results are combined with the child protection worker’s observation and clinical judgment to consider a need for further action.

The MHI-5 is a supplementary tool that may be administered to a parent/caregiver or other adult residing in the home who participates in caregiving, whenever there are unconfirmed concerns about that person’s emotional wellbeing. Stressed emotional functioning may be suspected based on the child protection worker’s observations, clinical judgment, or reflections in the following Family and Child Strength and Needs Assessment, Caregiver domains:

• Mental Health/Coping Skills
• Family Relationships
• Domestic Violence
• Social Support System
• Resource Management
• Physical Health

When a parent/caregiver or involved adult is clearly demonstrating a need for mental health assessment or treatment, or there is confirmed evidence such as a medical diagnosis, recent hospitalization for mental health issues, self-report, or request for service, the child protection worker proceeds directly to making the appropriate referral.

When a parent/caregiver or involved adult is considered a threat to self or others, or is demonstrating otherwise out-of-control behaviour, the child protection worker engages the appropriate emergency service.

When considering the most appropriate time to involve the parent/caregiver or other adult in the screening process, the child protection worker takes into account:

• the cultural, religious and social context of the family
• the potential impact of child protection involvement on the parent/caregiver
• whether the parent/caregiver may fear the outcome of a disclosure
• the parent/caregiver’s willingness and ability to provide honest responses
• the possibility of minimization.

The child protection worker discusses concerns about any of these or other factors with the parent/caregiver or other adult before commencing the screening process. The child protection worker also discusses the purpose and use of the screening instrument with the parent/caregiver or adult prior to use and shares the results with the respondent to engage in developing a plan to address any concerns. The child protection worker addresses confidentiality issues, helping the parent/caregiver to understand that the responses are a part of a child protection file and cannot be shared without consent unless subject to a child protection hearing.

The MHI-5 can be administered in either an interview format or as a self-report questionnaire. Each of the five questions provides a range of 6 possible responses to explore the respondent’s feelings during the past month

MHI-5 as an Interview

The MHI-5 may be administered in an interview format. This format allows interaction between the child protection worker and the parent/caregiver or other adult. Interaction provides opportunities to clarify concepts that may be difficult to understand and to gather additional information that may be explored after the screening has been completed. When using this format, the worker uses the wording provided and gives the parent/caregiver the range of responses available. The parent/caregiver’s response to each question is recorded.

MHI-5 as a Questionnaire

The MHI-5 may be administered as a written questionnaire in which the parent/caregiver is encouraged to choose an available response. This format requires that the participant has the necessary skills to complete the instrument.

For each of the 5 questions in the MHI-5, the respondent has a choice of 6 possible responses.

For questions 1 and 2 Scoring is as follows:
Response 1 - score as 6 points
Response 2 - score as 5 points
Response 3 - score as 4 points
Response 4 - score as 3 points
Response 5 - score as 2 points
Response 6 - score as 1 point.

For questions 3, 4 and 5 Scoring is as follows:
Response 1 - score as 1 point
Response 2 - score as 2 points
Response 3 - score as 3 points
Response 4 - score as 4 points
Response 5 - score as 5 points
Response 6 - score as 6 points

The MHI-5 has a maximum score of 30 points and a minimum score of 5 points. Higher scores are suggestive of psychological wellbeing and an absence of psychological distress within the past month. Lower scores are indicative of greater psychological distress, which in turn suggests need for further assessment.

A cut-off score of 21 has been established by Rumpf, Meyer, Hapke and John⁴ as being the score which identifies individuals who are experiencing psychological distress. As with all screening tools, the child protection worker considers the parent/caregiver’s score in the context of all of the other information known about the family and their circumstances, and responds appropriately to work with the parent/caregiver to develop a plan to address the level of distress.

Depending on the parent/caregiver’s distress level, interventions considered may range from monitoring and follow-up by the child protection worker, to consultation with the family physician, to referral to community or mental health services for further evaluation.

To support the philosophy that families are the experts at solving their problems and to focus on broadening a family’s circle of support, workers are encouraged to engage family members in identifying useful supports who may be potential participants in service planning to address child protection risks.

At the point of Receipt of a Referral, when considering family-based conferencing, or at any point of service, the Family Support Scale helps the family and the child protection worker systematically consider sources of support and the quality of support offered by a particular resource. Developed by Carl J. Dunst, Vicki Jenkins and Carol M. Trivette, the Family Support Scale is a clinical tool that is not scored, but is used to elicit or structure discussion or consideration of useful supports. The Family Support Scale encourages exploration of a number of supports but is not an exhaustive list. A family may have access to additional resources through their cultural, religious or social affiliations that warrant further consideration.

The Family Support Scale can be administered in an interview format or as a selfreport questionnaire. The parent/caregiver is asked to consider 18 general categories of family or social supports. For each available support, the parent/caregiver is asked to rate the degree of helpfulness experienced along a 5-point scale. In determining the best method of administration for a family, the child protection worker considers the family’s comfort level, ability to complete the task, and the opportunity for engagement.

Information derived from the Family Support Scale is used to identify participants to a Family Group Conference, or within the context of service development.