Section 2, Chapter 5 (Child Abuse and Neglect Reports), Subsection 2 – General Procedures for Completing a CA/N Report

Reported allegations or other concerns contained in the report;
Age and number of children involved in the report;
The household composition;
Location of household;
Prior reports/referrals to CD;
Indication of community involvement and possible collateral contacts (mental health providers, school involvement, medical providers, extended family, etc.); and
Indication of history or current conditions that might pose a danger to staff (i.e. report or history of weapons, dangerous dogs, drugs or meth production at the residence).

Staff should begin planning their first contact with the child(ren) and family while reviewing the categories above.

5.2.2 Reviewing Prior History

Reviewing prior history is an important first step. The CA/N-1/Ref-1 transmitted by CANHU will contain information regarding any prior CA/N Reports or Non-CA/N Referrals, as well as information from other systems, (i.e., Income Maintenance, Food Stamps, Child Support Enforcement, etc.). Local Office staff should complete a search for relevant information from prior reports, including a review of FACES and paper records prior to contacting the family. It may also be beneficial to contact law enforcement and/or to complete a check of case.net to determine if the family has had any relevant contact with law enforcement agencies and to identify any potential safety concerns.

Examining prior history provides staff with a base of information for their contact with the family. Additionally, the history may help inform staff what has worked well for the family in the past and what the Children’s Division may have worries about.

In reviewing prior history, staff should consider the following questions:

Have there been prior reports or referrals to the agency? (Investigations; Family Assessments; Juvenile Assessments, Newborn Crisis Assessments, etc.)
What was the nature and context of those reports?
Is there a reoccurring or chronic pattern of abuse/neglect indicated in the history?
Who was involved in prior reports?
What were the outcomes or findings?
What was the Division’s response? (Children were removed; the report substantiated; Family-Centered Services or Intensive In-Home Services were provided, etc.)
What was the outcome of services provided? (Linked to community resources; family; short term services; rights were terminated, etc.)

If it becomes known during an Investigation/Family Assessment/Juvenile Assessment that there is a history or alleged incident of domestic violence, staff should contact Law Enforcement and/or any other professionals known to be familiar with the domestic violence to obtain complete information on the family.

Calls to the Child Abuse and Neglect Hotline Unit (CANHU) that do not meet either criteria for a CA/N Report or a Non-CA/N Referral are classified as documented calls. Documented calls shall not be considered as a part of an individual or family’s prior history but may provide useful information.

Supervisors must ensure their staff have made every effort to search for prior CD involvement and given the information appropriate consideration.

5.2.2.1 Documenting Prior History

Staff should summarize the family’s relevant prior history in a contact within the narrative of the report, including all Preponderance of Evidence findings. Prior history may be relevant to provide information about the following:

- Whether the alleged perpetrator should have known their continued behavior would possibly result in abuse or neglect;
- Reasonable efforts; or
- Insight into facts or circumstances about the family, child, and/or alleged perpetrator.

Staff should exercise caution in simply providing a listing of report type and conclusion as some reports may be expunged in the future. Particular attention should be paid to any prior history that invite worries for the family’s current situation.

5.2.3 Reporter Contact

Pursuant to Section 210.145, RSMo., staff shall contact the person who made such report within forty-eight (48) hours of the receipt of the report in order to ensure that full information has been received and to obtain any additional information or medical records, or both, that may be pertinent.

The reporter is a valuable source of information. Staff should gather as much information as possible from the reporter, and not simply ask the reporter to confirm the allegations in the report. Child safety and other considerations can be assessed by exploring them with the reporter.

Questions to ask the reporter include, but are not limited to, the following:

What information can be provided in addition to what was shared with CANHU?
How did the reporter find out about the incident?
Has it ever happened before?
If it has happened before, what prompted the reporter to report this time?
What has the reporter done to address the problem?
What is the reporter’s worst fear for the child?
What is the reporter’s best hope for the child?
Is there other violence, such as domestic violence, sibling abuse, or elder abuse in the home?
Who else may have information regarding the report?
Does the child need medical attention? Has the child received medical attention?
Has the reporter discussed their concerns with anyone who knows the family? Would others agree with the reporter’s perspective? What would they say?
Are there times when the parent(s)/caretaker(s) call on other people for help? When? Who do they call on?
What are the best attributes of this mother’s/father’s parenting?
Which of the family’s strengths will be the most useful in terms of the problem(s)?
What does the reporter think needs to happen for the child(ren) to be safe?
What does the reporter think the parent(s)/caretaker(s) need to do to resolve the problem?
Is the reporter willing to be a part of the family’s safety network?

Staff should make every attempt to reach the reporter. When staff struggle to reach the reporter by telephone, staff should consider:

Sending a letter and/or email to the reporter explaining the importance of being able to speak to them to facilitate a thorough Investigation;
Asking the Children’s Service Supervisor for help contacting with the reporter;
Re-attempting to contact the reporter throughout the duration of the Children’s Division involvement in the report at different times of the day;
For Investigations, requesting law enforcement assistance with contacting the reporter;
Contact the reporter in-person.

5.2.3.1 Documenting Reporter Contact

Staff should fully document contact with the reporter in the report narrative, including attempts to contact the reporter. Concerns regarding reporter confidentiality are handled through redaction as opposed to limiting documentation. Failure to fully document reporter contact does not provide an accurate account of the Children’s Division’s involvement with the family. When records requests are made by individuals not entitled to the reporter’s identity, staff may utilize the CPS-1 Public Review Copy which does not generate the reporter contact. Staff may choose to add the reporter as a significant other or service provider, whichever is most appropriate, in order to document information from the reporter outside of the allegations when the reporter has an ongoing relationship or is providing treatment services to the family.

5.2.3.2 Notifying the Reporter of their Right to the Disposition of the CA/N Report

Pursuant to Section 210.145, RSMo., any person making a report of child abuse or neglect made to the Children’s Division which is not made anonymously shall be informed by the Children’s Division of his or her right to obtain information concerning the disposition of his or her report.

At the time of the reporter contact, staff should inform the mandated reporter that he/she will receive information regarding the date and disposition of the findings of the Investigation, Family Assessment, or Juvenile Assessment. Staff should inform the permissive reporter of their right to receive the results of the Investigation, Family Assessment, or Juvenile Assessment, if they request it in writing.

Staff should inform all reporters, who are not anonymous, that if the finding of an Investigation is “Unsubstantiated”, they may request, in writing, that the local county office make a referral to the Office of the Child Advocate.

5.2.3.3 Sharing Information with Reporters

Pursuant to Section 210.145, RSMo., mandated reporters may receive, if requested, findings and information concerning the case. Staff will notify the mandated reporter, or permissive reporter if requested in writing, of the disposition using the Reporter Disposition Notification Letter (CS-21B).

When the mandated reporter will continue to have on-going, professional contact with the family, he/she should be considered as a multidisciplinary team member. The Division should share information that would be helpful for the reporter’s efforts to offer support to the family and may share the following information:

1. The date the Investigation/Family Assessment/Juvenile Assessment was completed;
2. Conclusion of the Investigation/Family Assessment/Juvenile Assessment;
3. Facts utilized to reach the conclusion of the Investigation/Family Assessment/Juvenile Assessment;
4. Whether a referral for Family-Centered Services (FCS) or to other community services was made;
5. Treatment plan; and
6. Progress of the child/family.

Mandated reporters who will not have on-going, professional contact with the child/family may receive the following information verbally or in writing:

1. Date the Investigation/Family Assessment/Juvenile Assessment was completed;
2. Conclusion of the Investigation/Family Assessment/Juvenile Assessment; and
3. Facts utilized to reach the conclusion of the Investigation/Family Assessment/Juvenile Assessment.

Staff should exercise discretion as to how much information is shared depending on the mandated reporter’s role with the family. Provide the information to the reporter as soon as possible after the Investigation is completed.

5.2.3.4 Other Reporters (Permissive)

If a permissive reporter requests information in writing regarding the disposition of the report, this shall be made available within five (5) days of the conclusion.

The reporter may also receive, if requested, findings and information concerning the case. The release of information shall be at the discretion of the local office, based on the reporter’s ability to assist in protecting the child or the potential harm to the child or other children in the family. The local office shall respond to the request within forty-five (45) days from the conclusion of the report or from the request date, whichever is later.

5.2.3.5 Reporter Confidentiality

For information regarding reporter confidentiality, please refer to Section 5, Chapter 3.1, CA/N Investigations/Family Assessments.

5.2.4 Parental and Alleged Perpetrator Notification

5.2.4.1 Meeting with the Child(ren)

Pursuant to Section 210.145, RSMo., if the parents of the child are not the alleged perpetrators, a parent of the child must be notified prior to the child being interviewed by the Children’s Division. If a child is in immediate danger, law enforcement must be immediately contacted.

The duty to notify a parent holds true regardless of whether the report is an Investigation, Family Assessment, or Juvenile Assessment and regardless of whether the allegations are for abuse or neglect. The term “parent” with regard to the statute includes a mother, father, and/or legal guardian. The term “parent” with regard to the statute does not include a step-mother, step-father, paramour, grandparent, or other relative with physical custody, or a person with power of attorney.

Staff should attempt to notify the custodial parent to fulfill these statutory requirements. However, if the custodial parent cannot be notified, it may be necessary to notify the non-custodial parent in order to assure safety within timeframes. Staff must document all attempts to notify a parent, such as telephone calls, mail correspondence, home visits, etc.

Although not mandatory, it is best practice for staff to notify the custodial parent prior to interviewing the child when the non-custodial parent is the alleged perpetrator. Notice to a parent or legal guardian should include:

- Providing the Description of the Investigation (CS-24), the Description of the Family Assessment (CS-24a) , or the Description of the Juvenile Assessment (CS-24c) as written notice to the parent or legal guardian; or
- Providing initial notice through oral communication with a parent or legal guardian if it is deemed necessary to ensure children’s safety within required timeframes; and
- Informing the parent or legal guardian that the Division must directly observe and/or interview their child(ren) in conjunction with a reported concern.

There may be times when notifying a non-perpetrating parent would jeopardize the child’s safety or significantly hinder the Investigation, Family Assessment, or Juvenile Assessment process. Examples include:

- Alleged abuse occurring at the time of the call;
- Alleged injuries or symptoms of injuries or illness that require immediate medical care;
- Allegations of a child in need of immediate psychiatric care in conjunction with a child abuse or neglect report; and,
- Allegations of child sexual abuse in which the alleged perpetrator has access to the child within the next twenty-four (24) hours.

Staff should always seek supervisory approval to interview the child without notifying a parent when the alleged perpetrator is not a parent. If the decision is made to interview the child without notification due to an existing or imminent serious safety concern, staff must utilize law enforcement to facilitate contact with the child, pursuant to Section 210.145, RSMo. These are situations in which, if true, emergency protective custody may be necessary to ensure the safety of the child. Staff should clearly document the reason notification did not occur and document the reasons why an interview took place without notice. If staff have failed to contact a non-perpetrating custodial parent prior to interviewing the child, staff are expected to do so as soon as possible after the child is interviewed.

Although the statute does not make it mandatory to obtain the consent of the custodial parent prior to interviewing the child, it is best practice for staff to obtain their permission prior to interviewing the child when they are not the alleged perpetrator. Parents have the right to refuse access to their child. Staff must refrain from the use of coercion to gain access. However, notification to the non-offending, non-custodial parent may be useful when the custodial non-offending parent refuses access to the child. If all attempts to engage parents are unsuccessful and safety cannot be assured by any other means, it may be necessary to make a referral to the juvenile office.

5.2.4.2 Initial Notification of the Alleged Perpetrator

The alleged perpetrator should not be given notice of the report until safety of the child can be assured. The term ‘report’ includes Investigations, Family Assessments, or Juvenile Assessments. Pursuant to Section 210.145, RSMo., when conducting an Investigation, Family Assessment, or Juvenile Assessment staff shall not call prior to a home visit or leave any documentation of any attempted visit, such as business cards, pamphlets, or other similar identifying information if there is reason to believe:

- No person is present in the home at the time of the home visit; and
- The alleged perpetrator resides in the home or the physical safety of the child may be compromised if the alleged perpetrator becomes aware of the attempted visit; or
- The alleged perpetrator will be alerted regarding the attempted visit; or
- The family has a history of domestic violence or fleeing the community.

Once safety is assured and contact is made with the alleged perpetrator, staff may schedule home visits or leave notice of attempted visits.

Pursuant to Section 210.145, RSMo., staff shall provide written material to the alleged perpetrator informing him or her of his or her rights, including but not limited to the right to contact an attorney. For Juvenile Assessments, staff shall provide written material to the parents of the alleged child initiator (ACI). The alleged perpetrator shall be given a reasonable amount of time to read such written material or have such material read to him or her by staff before the visit commences, but in no event shall such time exceed five minutes; except that, such requirement to provide written material and reasonable time to read such material shall not apply in cases where the child faces an immediate threat or danger, or staff feels threatened or in danger of physical harm.

5.2.4.3 Paperwork to be Provided

Staff should provide information informing parent(s)/caregiver(s), ACI parent(s), and alleged perpetrators of the Investigation, Family Assessment, or Juvenile Assessment process, their rights, and grievance procedures. All parties that are entitled to receive the disposition of the conclusion of the Investigation, Family Assessment, or Juvenile Assessment should be given the following paperwork at the initial contact, or as soon as possible thereafter:

- Description of the Investigation Process (CS-24), the Description of the Family Assessment (CS-24a), or the Juvenile Assessment (CS-24c), whichever is applicable;
- Know Your Rights Brochure (CS-132);
- Service Delivery Grievance (CS-131);
- Notice of the Privacy Practices Regarding Your Protected Health Information/HIPAA (MO886-4061)

If staff are not able to interview the parent(s)/caregiver(s), ACI parent(s), or the alleged perpetrator(s), this paperwork should be mailed.

For Investigations, staff should inform the alleged perpetrator they may receive the Investigation Disposition Notification Letter (CD-21) electronically at the conclusion of the report. Staff should ask the alleged perpetrator their preference, electronic or postal, when the CS-24 is provided to the alleged perpetrator. If the alleged perpetrator requests to receive correspondence electronically, staff should ensure the alleged perpetrator provides a valid e-mail address and capture the information on the Contact List in FACES.

5.2.5 Initial Safety Assurance of Victim

Staff shall contact family and victim child personally, according to Response Priority Level required timeframes. Staff must show a photo ID card when interviewing clients he/she has never met. For Investigations, Family Assessments, and Juvenile Assessments every child identified as an alleged victim on the CA/N-1 must be seen face to face within the following Response Priority Level timeframes:

Priority Level 1 = three (3) hours

Priority Level 2 = twenty-four (24) hours

Priority Level 3 = seventy-two (72) hours

Response time begins at the time that report is made. The Begin Date/Time can be found in FACES on the CAN1/Ref1 and the New Call Information Worksheet (NCIW). It is imperative that staff begin working CA/N reports as soon as feasible in the event multiple attempts are needed to make contact with victim children within timeframes. Staff should make every effort possible to see children within timeframes, including but not limited to multiple attempts at varying times of the day. Staff should consult with their supervisor when they are unable to make contact prior to the timeframe expiration. Initial safety assurance may need to be assigned to other staff to assist in making timely initial contact, such as during after hour coverage.

When the safety decision is ‘unsafe’, staff must follow the policies within Section 1, Chapter 9, Safety Planning.

Reports Concluded by the County office (not through the Central Consult Unit)

When children’s safety is initially assured for every child involved in the CA/N Investigation, Family Assessment, or Juvenile Assessment, staff must clearly document:

- The actions taken to assure child(ren)’s safety;
- The knowledge or information obtained to assure child(ren)’s safety (whether by direct face to face contact or through the assistance of a multidisciplinary team member and specify how children’s safety was assured);
- The safety decision of whether the child is safe or unsafe;
- The initial contact which reflects whether initial safety was assured by staff or a multidisciplinary team member; and
- All physical evidence that corroborates the allegations of abuse/neglect.

Staff shall document verification of safety in the Contact Communication Log in FACES within 72 hours of the receipt of the report. Supervisors should verify that the initial contact has been documented in FACES at the 72 Hour Supervisor Consult. If the child(ren) is not found within the required timeframes, staff must document all attempts to locate the child(ren) in FACES. Staff should consult with their supervisor prior to the response time elapsing to strategize efforts that could still be completed to ensure timeframes are met. Staff are encouraged to enter all contacts into FACES as the report progresses.

5.2.5.1 Use of Multi-Disciplinary Team Member for Initial Safety Assurance of Victim

Direct face to face contact should be made by staff whenever possible. However, the initial face to face contact may be made by a multidisciplinary team (MDT) member, as long as the MDT member has verified the child’s safety until such time as staff can make contact. MDT team members include, but are not limited to: law enforcement, the juvenile office, physicians, relevant school officials and service providers. The MDT member should be aware of the reported concern and have the ability to assess whether the child will be safe until staff can make contact. Staff should always consult with their supervisor or circuit manager regarding the use of a MDT member for initial safety assurance.

When an alleged victim child’s initial safety is assured by an MDT member, staff must still complete direct face to face contact with the child as soon as practicable but no later than seventy-two (72) hours from the date and time of the reported concern in order to further assure safety and to begin identifying any safety concerns for the child.

Examples of appropriate use of MDT Initial Safety Assurance:

- A Level 1 Response Priority report is received at 9:00 a.m. The worker contacts the school counselor to verify the child is at school and appears to be functioning well. The worker makes contact with the child at school before school lets out.
- A Level 1 Response Priority report is received at 2:00 a.m. The child has been admitted to the hospital and medical personnel confirms the child will not be discharged for several days and the hospital will be responsible for supervising contact between the child and the alleged perpetrator. The worker makes contact as soon as possible during regular business hours, and no later than seventy-two (72) hours from the report date/time.
- A Level 2 Response Priority report is received alleging sexual abuse. Law enforcement has already responded and confirmed that the alleged perpetrator will have no contact with the victim for over seventy-two hours and the child is not in need of any medical attention. The worker makes contact as soon as possible, but no later than seventy-two (72) hours of the report date/time.

Examples of inappropriate use of MDT Initial Safety Assurance:

- A Level 1 Response Priority report is received at 9:00 a.m. The worker contacts the school secretary for attendance verification. The worker makes contact with the child the following day.
- A Level 1 Response Priority report is received at 10:00 a.m. The worker contacts law enforcement who verifies they responded to the incident and arrested the alleged perpetrator, but believes the alleged perpetrator will bond out of jail soon. The worker waits to make contact until the end of the day.
- A Level 2 Response Priority report is received at 6:00 p.m. from law enforcement after they were called to the home to complete a well-child check due to a concern of a malnourished infant. They laid eyes on the child, but did not seek medical attention. The worker waits to make contact for two days.

Staff must clearly document how the MDT member assured safety prior to making face to face contact.

When using a MDT member for initial child contact on a hotline report, staff shall enter the contact in the following manner in FACES:

- Contact Type must be either:
  - “In Person – Initiated by CD” or,
  - “Phone – Initiated by CD.
- Purpose must be “Initial Visit”,
- For the question “Multi-Disciplinary Team Member ensured initial safety of the following children” to display, the worker must document an in-person or phone contact with a participant/case member with the role of
  - Guardian ad Litem,
  - Court Appointed Special Advocate,
  - Law Enforcement,
  - Service Provider,
  - School Liaison.
- This question will be followed by two checkboxes: “Yes” and “No”. The worker would mark “Yes”.
- A victim and non-victim household children box will display and list all the children on the call/case.
  - Select the children for whom safety was assured by the MDT member.
- The names of the children must also be included in the field “Other Individuals Involved”. This communicates the children were seen in person by the MDT member and the contact will appear on the Contact Communication Log for the children.

It is important to document contacts shortly after they occur; best practice would be the same day or within twenty-four (24) hours.

5.2.5.2 Interviewing the Child

Children should be interviewed alone whenever possible when conducting an Investigation, Family Assessment, or Juvenile Assessment. The specific circumstances of the report will dictate whether the child interview will happen before or after the family interview; however, whenever possible the interview with the child should be completed prior to any other interviews.

Although children’s safety and well-being are paramount, staff should respect the rights and roles of parents, whether custodial or non-custodial. If Division personnel are unable to voluntarily establish a means by which to interview children outside the presence of the alleged perpetrator, they should work with law enforcement and/or the juvenile court as needed to establish children’s safety and interview all alleged victim and household children.

When interviewing the child, staff should consider the following:

- Explain to the child why the staff is there to talk to them in an age and developmentally appropriate manner;
- Build rapport with the child;
- Assess the child’s development;
- Ask open ended questions;
- Minimize the number of interviews a child has to undergo;
- Unless needed to assure safety, do not do a full interview of child who will receive a forensic interview at a Child Advocacy Center (CAC);
- Ensure the child is interviewed in private where they cannot be overheard by the parent/caretaker or alleged perpetrator;
- Avoid interviewing the child in the same location in which the incident(s) took place.

Staff may choose to use the Three Houses Tool (CD-217), the My Safety House tool (CD-216), or a developmentally appropriate version of these tools when interviewing the child to give them an opportunity to talk about what they are worried about, what makes them happy, and what they would like to see happen in their family and community to keep them safe. Refer to Section 1, Chapter 7, Engaging Children and Youth.

5.2.5.2.1 Interview with Students at School Setting When Parents/Guardians Named as Alleged Perpetrator

Division staff frequently find it necessary to interview students during the school day when an emergency situation may exist or when interviewing in the home setting would be inappropriate. Staff should contact the school principal or designee prior to going to the school to arrange the interview. Arrangements for interviews should be made to keep the disruption to a student’s schedule to a minimum.The following points should be resolved with the principal/designee prior to the interview:

1. 1. Who will conduct the interview? The interviewer will be Children’s Division staff and/or the law enforcement officer (when involved), although the special needs of the child and his/her relationship with the school personnel may be taken into consideration.
  2. Who may be present in the interview? The number should be kept to an absolute minimum. A teacher, counselor, principal, nurse, etc. who has a relationship with the child may be present, if deemed necessary by Children’s Division staff, law enforcement, and/or school administrator. School personnel participants should be limited to one person, and preferably someone with whom the child feels comfortable. The child’s ability to decide whom to have present should also be considered. Anyone present during the interview should be aware they could be served with a subpoena to testify in court. If there are concerns voiced by the school administrator about the process and format of the interviews, the school administrator has the ability to ask that the interview not take place on school grounds.
  3. Confidentiality mandates should be discussed. The confidentiality statutes concerning child abuse investigations are contained in Section 210.150 RSMo. The statute states that disclosure of information concerning the abuse and neglect is made only to persons or agencies that have a right to such information.
  4. Where and when the interview will be conducted. The interview must be in a private setting and, cause minimal disruption to the child’s schedule. The child’s right to privacy must be respected.

5.2.5.3 Injuries to the Child

All reports indicating physical injuries due to CA/N require an examination of the reported child. Other children should be examined when there are visible signs of abuse or additional information indicates that abuse has occurred.

Refusal on the part of a parent/caretaker to allow an examination, depending upon the seriousness of the situation, should be referred to the juvenile court or law enforcement personnel.

Any physical injury to a child should be taken seriously, regardless of the caregiver’s explanation of how the injury occurred. Staff should defer to medical professionals in determining whether an injury is accidental or abusive. The following are highly concerning for abuse and should always be referred for medical examination, preferably by a SAFE-CARE provider:

- Injuries to non-mobile children. “Those who don’t cruise, rarely bruise.”
- Significant injury with either no explanation or an explanation that is not plausible, such as significant injury from a short fall off a couch.
- Injuries to areas that are generally protected from accidental bruising, or areas of soft tissue of the body, such as injuries to the back of the thighs, calves, genitals, buttocks, cheeks, abdomen (stomach), angle of the jaw, ears, lips, neck, chest, and back.
- Multiple injuries in various stages of healing.
- Patterned injuries.

The mechanism of injury is the manner in which the physical injury occurred (i.e. fall from a height, falling down stairs, etc.). Staff should get as much information as possible from witnesses to the incident about what the child was doing, position when they fell, etc. This information should be shared with the medical professional to help determine if the injury is plausible in relation to the reported mechanism of injury.

5.2.5.3.1 Cursory Physical Examinations by Children’s Division Staff

A cursory physical examination is the observation of a child’s external physical condition which may require that the child’s clothing be removed or rearranged.

If the allegations involve sexual abuse, staff may not complete a cursory physical examination. A SAFE-exam referral should be made any time documentation of injuries related to sexual abuse is necessary.

Staff may only conduct cursory physical examinations of areas of the child not readily visible with the consent of the parent/caretaker. If the injury is visible without moving clothing, staff may document their observations and do not need to obtain consent from the parent/caregiver. If the child refuses the examination, staff should not proceed, even if the parent/caregiver has consented. Staff must document that the parent/caretaker gave consent for the cursory physical examination. Staff should complete the examination in the least intrusive manner possible that is sensitive to the child’s age, gender, and emotional well-being.

Staff may conduct a cursory physical examination of the genital area of a child three (3) and under in the presence of the parent/caretaker. If the genital area needs to be observed and the allegations are not sexual abuse in nature, staff should refer the child for a medical examination by a physician for children over the age of three (3).

Staff should conduct all examinations in the presence of another adult, such as the parent/caregiver, law enforcement, etc.

5.2.5.3.2 Medical Examinations

When it is necessary for a child to be examined by a medical provider, staff should take the following steps:

- - Assist the family in seeking the most appropriate medical provider, depending on the circumstances of the situation. If the parent/ caretaker agrees to take the child to a medical provider, an appointment time and date must be established before staff leave the home. If the parent/caretaker may be responsible for the injury to the child, staff should accompany family to the medical examination, or should develop a safety plan with the family for another party to take the child to medical examination;
  - Contact the medical provider prior to the child arriving in order to inform the provider of the allegations, observations, need for photographs of the child’s injuries, and any other relevant concerns.
  - As soon as possible, follow up with the medical provider after the examination to obtain the provider’s impression of the child’s injuries.
  - Request medical records.
  - If the parent/caretaker failed to keep the appointment, staff must immediately contact the family to locate the child and determine the reason the child was not taken. If the parent caretaker refuses to cooperate, staff may need to contact the juvenile office to request assistance in ensuring appropriate measures are taken for the child to receive the examination.

5.2.6 Contact with Non-Victim Children and Other Household Members

Non-Victim Household Children

Pursuant to 13 CSR 35-31.020, every child residing in the household must be seen face to face by the Children’s Service Worker within seventy-two (72) hours of the CA/N report to assure safety. However, there may be situations in which safety of the non-victim child(ren) should be assured much sooner than seventy-two (72) hours, as determined by the assigned worker and supervisor.

Multi-disciplinary team members may be utilized to assure initial safety of non-victim household children, but Children’s Division staff must still make in person contact with all non-victim children within seventy-two (72) hours.

Non-Victim Children Residing Outside of the Household

Any child identified as a non-victim child on the CA/N-1/Ref-1 must be seen within seventy-two (72) hours, even if they do not reside in the household. There may also be times when it is necessary to interview other non-victim children who do not reside in the household, either to assure their safety, as witnesses, or to corroborate information.

Child Abuse/Neglect Concerns for Non-Victim Children

If staff identifies concerns of child abuse or neglect, involving a child initially reported as a non-victim/household child, staff should explore concerns as presented throughout the course of conducting the CA/N Investigation. Depending on the information ascertained, staff may need to update the role of a non-victim/household child to that of an alleged victim child in FACES, or make a new hotline report to the Child Abuse and Neglect Hotline Unit (CANHU) if the child of concern resides in another household.

Other Household Members

In order to conduct a thorough Investigation, Family Assessment, or Juvenile Assessment, staff must interview all adults who are considered part of the child(ren)’s household. Per the Structured Decision Making Safety Assessment’s definition of household, staff must assess all persons who have significant in-home contact with the child, including those who have a familial or intimate relationship with any person in the home. This may include persons who have an intimate relationship with a parent in the household (boyfriend or girlfriend) but may not physically live in the home or a relative where the legal parent allows the relative authority in parenting and child caregiving decisions. Staff must assess whether any member of the victim child’s household poses any safety threats to the child(ren), and to ascertain their knowledge of the reported concerns.

5.2.7 Involving the Non-Custodial, Non-Resident, and/or Non-Offending Parent

It is important for staff to consider and document the role of all parents when conducting Child Abuse/Neglect (CA/N) Investigations, Family Assessments, or Juvenile Assessments. Staff are encouraged to inquire about the role of the non-custodial, non-resident, and/or non-offending parent with more than one family member, and at least one of them should be the child if deemed age appropriate by staff. Staff should also make good faith efforts to understand and document the involvement of the non-custodial, non-resident, and/or non-offending parent in the life of his/her child.

Staff can talk to whomever he/she needs to in order to do a comprehensive safety and risk assessment and discuss knowledge of the reported concerns. This includes a non-custodial, non-resident, and or non-offending parent. Staff should use administrative data resources in order to locate the non-custodial, non-resident, and/or non-offending parent if that information is not made available through other sources.

Good faith efforts should be made to provide all parents with a disposition notice at the conclusion of any Child Abuse/Neglect Investigation, Family Assessment, or Juvenile Assessment involving his/her child. Should the non-custodial, non-resident, and/or non-offending parent present a request for additional information, staff should only disclose information which pertains to his/her child. In the event that staff are informed by household members, multidisciplinary team members, or collateral contacts that information shared with the non-custodial, non-resident, and/or non-offending parent may place a child or their family at imminent risk of harm, staff should seek supervisory consultation prior to releasing any information.

5.2.8 Safety Assessment, Safety Planning, and Safety Re-Assessment

The SDM Safety Assessment tool assists staff in assessing whether a child is likely to be in imminent danger of serious harm that may require protective intervention. The SDM Safety assessment is required for all Investigations, Assessments, Newborn Crisis Assessments, and Out of Home Investigations (OHI). The SDM Safety Assessment will not be required for Non-caretaker Referrals, Juvenile Assessments, or Preventative Service Referrals. The SDM Safety Assessment link is found on the Investigation/Assessment (IA) Home Page and will be available from the IA Monitoring Screen, Family Centered Services (FCS) Monitoring Screen, and Alternative Care (AC) Monitoring Screen. The SDM Safety Assessment may also be referred to as a “safety assessment” throughout policy.

The safety decision of Safe, Safe With Plan or Unsafe must be clearly documented in either the initial contact with the victim child or in the 72 Hour Chief Investigator Consult, or both.

Refer to Section 1, Chapter 5, Understanding and Assessing Child Safety

When the safety decision is “Safe”, staff will contact the Central Consult Unit as outlined in Section 1, Chapter 9, Safety Assessment Outcomes and Safety Planning.

When the safety decision is ‘”Safe with Plan or “Unsafe’, staff must follow the policies within Section 1, Chapter 9, Safety Assessment Outcomes and Safety Planning.

5.2.9 Alleged Perpetrator Interviews

Whenever possible, the alleged perpetrator should be interviewed after everyone else has been interviewed and after all other pertinent information has been gathered. This allows the worker to confront him/her with the facts and evidence collected if he/she denies responsibility for the incident and abuse/neglect appears evident.

Staff shall offer every alleged perpetrator an opportunity to tell his/her side of the story and to submit any information that he or she wishes to the worker to consider when reaching his/her conclusions. However, alleged perpetrators are not required to speak with or provide information to the worker if they do not choose to do so. In some instances, law enforcement may assume the lead role and conduct the alleged perpetrator interview. However, the fact that law enforcement has taken a lead role does not excuse the Division from its obligation to offer the alleged perpetrator the opportunity to speak with or provide information to the Division.

The alleged perpetrator, or their legal counsel, may provide a request to the Division to conduct follow-up interviews with witnesses or other collateral contacts suggested by the alleged perpetrator. Staff should contact witnesses or other collateral contacts at the request of the alleged perpetrator. While doing so, staff should disclose the minimum necessary information in order to complete these interviews, subject to Protected Health Information (PHI).

5.2.9.1 Right to Counsel

Alleged perpetrators have the right to be represented by an attorney. If an alleged perpetrator states that he/she is represented by an attorney and wants the Division to contact him/her through this attorney, staff should respect the request. Staff should make contact with his/her attorney to arrange the interview. Staff should ask the attorney to submit a written authorization to release information signed by the alleged perpetrator before the worker can release information about the merits of the report to the attorney. Upon being informed by the attorney that they are representing the alleged perpetrator, staff should direct communication and correspondence to the alleged perpetrator’s attorney of record in order to set up an interview. The attorney’s response communication and correspondence should be documented in the case record.

5.2.9.2 Interviewing an Alleged Perpetrator in Law Enforcement Custody: Mandatory Miranda Warnings

Staff must exercise caution when interviewing an alleged perpetrator who has been taken into custody and issued a Miranda Warning by law enforcement. Children’s Division interviews with the alleged perpetrator may be used during criminal prosecution proceedings. Failure to comply with the procedures outlined below will likely result in any statements made by the alleged perpetrator to be inadmissible in the criminal proceeding. These procedures are applicable any time staff interview an alleged perpetrator who is in custody, even if the detention is unrelated to an incident of child abuse/neglect.

When the alleged perpetrator is in custody, staff must request law enforcement Mirandize the alleged perpetrator prior to conducting an interview regarding the allegations. Examples of ‘in custody’ include an alleged perpetrator having been arrested and taken to the police department for an interrogation, or when the alleged perpetrator has been detained and is currently in jail.

The alleged perpetrator may not understand that statements made to Children’s Division staff could be self-incriminating if those statements are used in a criminal proceeding. Therefore, interviews should take place immediately after law enforcement has interviewed the alleged perpetrator. If the law enforcement interview has already taken place, staff must request law enforcement to re-issue the Miranda warning.

Once law enforcement has issued the Miranda warning, they can remain while Children’s Division staff proceeds with the interview, but they do not have to stay.

Staff are discouraged from questioning an alleged perpetrator without a Miranda warning. However, in extreme circumstances, staff may question an alleged perpetrator while in custody about issues not pertaining to the allegations without a Miranda warning, such as gathering information to complete an Immediate Safety Intervention Plan (CD-263) or asking about possible placement options for their children. If conducting such an interview, staff must warn the alleged perpetrator they may not discuss the allegations without law enforcement issuing a Miranda warning. If the alleged perpetrator begins discussing the allegations, staff should cease the interview until law enforcement can re-issue the Miranda Warning.

If an alleged perpetrator, while in custody, states that they wish to remain silent or invokes their Miranda rights, staff must respect the request and cease all questioning.

Once released from custody, staff may interview the alleged perpetrator about the allegations without a Miranda warning. However if the alleged perpetrator has obtained legal counsel, staff must contact their attorney to ask permission to conduct an interview. If an alleged perpetrator states that he/she is represented by an attorney and wants staff to contact him/her through this attorney, staff must respect the request. Staff should make contact with his/her attorney to arrange the interview. Staff should ask the attorney to submit a written authorization to release information signed by the alleged perpetrator before the worker can release information about the merits of the report to the attorney. Upon being informed by the attorney that they are representing the alleged perpetrator, staff should direct communication and correspondence to the alleged perpetrator’s attorney of record in order to set up an interview. The attorney’s response communication and correspondence should be documented in the case record.

5.2.10 Home Visit

A home visit must be made for all Investigations, Family Assessments, and Juvenile Assessments. Staff should document all concerns regarding the household conditions related to:

Child’s Safety;
Family household safety;
Worker safety; and
Dangerous environmental concerns.

If during the home visit staff identifies there are children one year old or younger in the home or if the family is expecting a new baby in the home, staff should provide education, resources, and discuss safe sleep practices identified in the CD-278 Safe Sleep Flyer with all families and individuals caring for children . Staff should document the conversation in the case record. For more information on Safe Sleep see Section 2 Chapter 4 Subsection 4.4.5.

Staff should offer Home Visiting Services to families if there are children in the home under the age of 3 years old or if the mother is expecting on all Child Abuse/Neglect Reports. Staff should document the conversation in the case record. If the family agrees to Home Visiting Services staff should use the MO 500-3352 (CD-261) to refer the family for services.

Multiple home visits may be necessary to complete a thorough assessment of the family and/or to re-assess ongoing safety concerns. It may also be necessary to complete home visits on multiple households, depending on the circumstances of the report.

5.2.11 Courtesy Assists

During the course of an Investigation, Family Assessment, or Juvenile Assessment it may be necessary to request courtesy interviews from other county/ circuit offices or from another state CPS agency in order to complete a CA/N report. Courtesy requests may be made under the following circumstances:

To make the required face-to-face contact with victims or other children in the household within mandated timeframes;
To make face-to-face contact with an alleged perpetrator;
To obtain face-to-face interviews from other significant individuals for the purpose of making a determination;
To confirm the safety and well-being of children of families who have reportedly moved out of the state;
To collect or obtain signed documents.

5.2.11.1 Requesting Courtesies

Courtesy requests should be sent as soon as possible after determining a courtesy is necessary. When a courtesy request has been made to make required face-to-face contact with victims within mandated timeframes, the worker completing the courtesy request should make every effort to respond back to the requesting worker within twenty-four (24) to seventy-two (72) hours of receiving the request.

To request an in-state courtesy, the requesting worker should complete the Courtesy Request form (CPS-2) and send it to the appropriate Circuit Courtesy/Service Request email address. Email addresses can be found at http://dssweb/cs/admin/circuit-courtesy-service-request-email-listing.pdf. Supervisors may review the CPS-2 prior to sending the request to ensure it is thorough and being completed in a timely manner. The requests will be prioritized by the level of need and applicable timeframes as follows:

1. During work hours: If the courtesy request is an emergency or requires immediate action, staff should make phone contact with the receiving circuit to ensure the request has been received and is being addressed.
2. After work hours: Some situations may require after-hours/on-call staff to respond immediately. In such situations, the requesting worker should contact on-call staff directly, utilizing the County/Office Coverage screen in FACES. If necessary, the requesting worker can also contact CANHU to have an on-call worker contacted.
3. For all other non-emergent requests: Staff should send the Courtesy Request form (CPS-2) to the appropriate Circuit Courtesy/Service Request email address. The Circuit Courtesy/Service Request email boxes should be used for initial requests only. Once the requesting staff is informed the request has been assigned, further correspondence should be made directly to the assigned staff member.
4. Prison Courtesy Requests: When the individual needing to be interviewed is in prison, the assigned worker should attempt to make arrangements with prison personnel to interview incarcerated individuals via telephone. Prison courtesy requests should only be made when these arrangements are not possible or it is absolutely necessary to conduct the interview in person.

For out of state courtesy requests, staff should make phone contact with the appropriate state Child Protective Services agency and proceed in arranging an assist according to that state’s procedure.

5.2.11.2 Monitoring Circuit Courtesy/Service Request Email Boxes

Every Circuit must develop a protocol for:

- Managing access to the Circuit Courtesy/Service Request email box. This includes adding and updating an adequate number of staff to be available to monitor and respond to emails received during the day. It is suggested that a primary and back up staff check the inbox 3 to 5 times a day to make sure requests are received and acted on in a timely manner. Assigning courtesy requests in a timely manner is essential to ensure timeframes are not missed.
- Circuits will also need a system of assigning the emails to field staff who perform the requested action.
- Once the courtesy request is assigned, the requesting worker should be notified who the request was assigned to.
- If more than one staff are monitoring the Circuit Courtesy/Service Request email box, circuits will need to develop a way to designate that an email request has been assigned to avoid duplication of responses.

5.2.11.3 Documentation

Thorough documentation of any interviews and contacts made to complete the courtesy request is essential to assist the requesting worker. Supervisors should review the completed CPS-2 prior to the completed courtesy request being sent to the requesting worker to ensure it has been thoroughly addressed and documented. Every effort should be made to document the completed courtesy request within the requested timeframes.

5.2.12 Safety Network, Witness, and Collateral Contacts

Safety Network: Individuals who may be able to help support the family in developing and carrying out the safety plan. These individuals may include witnesses and collaterals identified during the CA/N report.

Witness: An individual who may have direct knowledge of the allegations of child abuse/neglect.

Collateral: An individual, not the reporter and/or a household member, who is knowledgeable of the family’s situation and serves to support, corroborate, or refute information provided by the family.

Interviewing other individuals helps the worker to see families more accurately and provides valuable information about the following:

The validity of the allegations;
The validity of the family’s account of the allegations;
The child’s safety, health and well-being;
Existing safety;
The family’s location;
The family’s current support system;
Individuals who are willing to be a part of the family’s safety network;
The family’s parenting skills;
The child’s/parent’s behavior, mental health, development, etc.;
The family’s social connectedness, safety, stability, mastery, and meaningful access to relevant resources;
The family’s trauma history.

Staff shall contact and interview as many individuals, other than the reporter and/or household members, as is reasonably necessary to conduct a thorough and complete CA/N Report. These contacts may include face to face contact, phone contact, mail correspondence and/or e-mail correspondence.

Particularly important in Investigations, staff should follow the evidence as it develops by interviewing all pertinent individuals who may have knowledge of the allegations. Staff should interview all individuals who may have first-hand information regarding the allegations. This may lead staff to contact multiple witness and collateral contacts.

When conducting the CA/N report, staff should pay attention for any possible safety network contacts, witnesses, and collateral contacts. Contact with these individuals should relate to the area of concern. Staff should thoughtfully choose contacts from among those people who have enough contact with the family and/or child to give pertinent information. These contacts should be able to address the particular concern.

For example, if the CA/N report alleges an injury or medical condition, a professional health care provider, close family member, or neighbor might be contacted. If there are educational concerns reported, a teacher or school official might be contacted to gather pertinent information regarding the child. If, during the Investigation, Family Assessment, or Juvenile Assessment, the parent indicates he/she is receiving help from a friend or family member, that person may provide additional information about family’s level of functioning and potential for continued support for the family.

Staff should exercise professional judgment in the selection of information sources. When interviewing pertinent sources of information is critically important, staff should be cognizant of the family’s right to privacy and the confidentiality of the report, the worker should not randomly interview the family’s neighbors, friends, or other non-professional, non-related persons. When it is necessary to disclose the nature of the allegations, disclosure should only include information that is absolutely necessary to complete the CA/N Report. Staff should be careful not to release Protected Health Information (PHI) under the Health Insurance Portability and Accountability Act (HIPAA).

Supervisors must assure that staff have thoroughly identified and interviewed all individuals with pertinent information regarding the CA/N Report, and that the information provided by collateral sources has been given appropriate consideration.

In the narrative, staff should clearly document the identity of the individual interviewed, their relationship to the family, and their contact information. These individuals may be called upon later to testify, or to be included in the family’s safety network, therefore it is imperative that they be easily identifiable.

5.2.13 Family Risk Assessment Tool (CD-14E)

The investigator must complete the Family Risk Assessment Tool (CD-14E) prior to submitting the report for approval. The Family Risk Assessment Tool should assist the investigator in the collection and analysis of information to determine what key factors are present that increase the likelihood of future threats to a child. By completing the risk assessment, the worker obtains an objective appraisal of the likelihood of child abuse or neglect within the next 18 to 24 months.

Things to consider when discussing and completing the Family Risk Assessment Tool in relation to the current report:

How does the family’s past history relate to the current report?
What services have been previously provided to the family?
Were the services successful in reducing safety concerns?
How do the biological and developmental ages of the children affect their ability to protect themselves?
Does the parent/caretaker(s) exhibit protective capacities consistent with the child(ren)’s needs?
Is there a history of mental health or substance abuse needs within the family?
Is mental health or substance abuse a current concern within the family?
Is there a history of domestic violence within the family?
Is there a current concern for domestic violence within the family?
What was the parent/caretaker(s) response to the current report?

The Family Risk Assessment Tool (CD14-E) must be completed in FACES as part of the case record by the investigator. The score calculated from completing the Family Risk Assessment Tool should assist in determining safety and risk to the child and not solely used in decision making on whether to open a case. An additional supervisor consult is not required, but may be needed to help determine case decisions. The investigator will document why a score was high/low, what safety factors were identified, and what future risk there may be to a child(ren) in the conclusion summary.

5.2.14 Chief Investigator Duties

Missouri law identifies the role and responsibility of a Chief Investigator in Section 210.145, RSMo. Each circuit must identify at least one Chief Investigator in each county who is responsible for supervising staff responding to hotline reports. Each county must develop procedures to ensure the tasks listed below are completed by the Chief Investigator, or substitute, in the Chief Investigator’s absence. Substitutes might include the circuit manager, social work specialist, or other experienced supervisor.

“Safe” SDM Safety Assessment Determination

If the investigator determines the child(ren) to be “Safe” after completing the SDM Safety Assessment, they will contact the Central Consult Unit within seven calendar days and follow policy as outlined in Section 1, Chapter 9, Safety Assessment Outcomes and Safety Planning

Frontline supervisors should only staff CA/N Reports with a SDM Safety Assessment decision of “safe” in the following circumstances:

Frontline staff are unsure whether the children are safe or not. These are considered “grey area” cases.
Frontline staff believes the SDM Safety Assessment decision is “unsafe” or “safe with plan” but after staffing, the frontline supervisor believes the children are safe.
A frontline supervisor provides consultation to frontline staff and determines it is ready to close. The frontline supervisor may go ahead and conclude the report utilizing the parameters outlined in this guide–as if CCU was completing the consultation.

“Safe with Plan” or ‘Unsafe” Safety Assessment Determination

If the investigator determines the child(ren) to be “Safe with Plan” or “Unsafe” after completing the SDM Safety Assessment, they will consult with their local supervisor within seventy-two hours as outlined below.

Chief Investigator 72 Hour Consults

Within 72 hours of a hotline being reported, the Chief Investigator MUST clearly document how the worker assessed the safety of the child(ren) and provide a summary of how the child was determined “Safe with Plan” or “Unsafe”. The Chief Investigator will review the SDM Safety Assessment in FACES and discuss safety threats with the investigator. The Chief Investigator will also review any safety interventions, such as an Immediate Safety Intervention Plan (CD-263) or TAPA, that were put in place or may still be needed to assure the safety of the child(ren). This applies to Assessments, Investigations, Juvenile Assessments and Newborn Crisis Assessments.

The Chief Investigator shall document their 72 Hour Chief Investigator Consult by entering a contact into FACES as:

Purpose: Consult with CD Staff

Status: Actual Communication

Type: Phone or In-Person Contact

The Chief Investigator shall document their 72 Hour Chief Investigator Consult in FACES and must include the following regarding assuring safety of the child(ren) as applicable:

Did a worker or multi-disciplinary team member have face to face contact with the child?
Was face to face contact made within timeframes?
How was safety assessed and verified?
If the child was seen by a multi-disciplinary team member, how did they assess and verify safety of the child(ren)?
Where was the child(ren) seen?
Was the child found to be safe/unsafe?
If unable to locate the child(ren) within timeframes, what further efforts will be made to locate the child(ren)?
Are there any medical concerns for the child(ren) that have not been addressed and have all victim children under the age of four been referred to a SAFE-CARE provider for all investigations?
Has a SAFE-CARE provider made any recommendations for medical intervention for the child(ren)?
Is the parent/caretaker(s) aware of the report?
Was an Immediate Safety Intervention Plan (CD-263) completed or TAPA completed?
Were all requirements and timeframes for a Safety Intervention Plan made?
Did the Immediate Safety Intervention Plan appropriately address the safety concerns?
Are the parent/caretaker(s) in agreement with the Immediate Safety Intervention Plan?
What is the plan for monitoring the ongoing safety of the child and reassessment of the Immediate Safety Intervention Plan?
What safety network members will be involved in the Immediate Safety Intervention Plan?
Are safety network members aware they are part of the Immediate Safety Intervention Plan?
What circumstances will allow the Immediate Safety Intervention Plan to no longer be needed?
Were witnesses to the alleged abuse and/or neglect identified and interviewed?
Were other relevant collaterals identified?
Was there a diversion to a non-residential parent?
Was an Immediate Safety Intervention Plan completed with the non-residential parent?
Was a TAPA determined to be needed?
Was the TAPA Form (CD-295) completed within three (3) business days?
Was the Diversion/TAPA entered into FACES?
Was the Juvenile Office notified of the TAPA within three (3) business days?
Was a TDM held or planned to be held within ten (10) business days for a TAPA?
Was a FCS case opened or is one planned to be open within ten (10) business days for a TAPA?

The Chief Investigator should develop a tracking mechanism to ensure that there is follow up with staff on the Immediate Safety Intervention Plan by the tenth (10^th) day after the plan is developed.

Additional tasks of the Chief Investigator at the 72 Hour Chief Investigator Consult include:

Verify the report was appropriately screened as an Investigation, Family Assessment, or Juvenile Assessment;
Verify the reporter was contacted, or attempts have been made to initiate contact with the reporter, if their identity is known to the Division;
Verify that all children in the household have been seen within appropriate timeframes, not to exceed seventy-two (72) hours of the report, unless sufficient documentation indicates the reason(s) for a delay in initial contacts;
Verify that any additional safety concerns presented (in addition to reported allegations) have been explored and addressed as needed;
Verify that all family history with the Division has been considered as it relates to the hotline report and/or the overall assessment of the family;
Verify and review the case record documentation of all contacts made to the point in the case at which the Chief Investigative review takes place;
Verify that all reported concerns have been explored and addressed as needed;
Ensure that co-investigative efforts have been implemented for CA/N Investigations and/or ensure that sufficient documentation is received from law enforcement if they decline to co-investigate the reported concern;
Ensure all victim children under the age of four have been referred to a SAFE-CARE provider for all Investigations and any recommendations made by the provider are being implemented;
Support Children’s Service Workers as they establish and maintain relations with multidisciplinary team members;
When the report is an Investigation involving a child enrolled in school, ensure information regarding the status of reports is provided to the public school district liaison. Should the subject child attend a non-public school, the principal of that school should be notified of the report.

Local protocols must be developed to ensure supervisory coverage and accessibility to Children’s Service Workers to provide 72 Hour Chief Investigator Consults and for any safety concerns which may develop during the completion of a CA/N Report. The Chief Investigator is expected to communicate with the worker to discuss the case whenever possible or necessary, and to provide guidance to the Children’s Service Worker regarding the completion of the reported concern.

County offices will develop local protocol to ensure required information obtained for reports received after normal business hours, on weekends and holidays is made available to the Chief Investigator for review within seventy-two (72) hours of the report. Some portions of the Chief Investigator review may be conducted over the telephone in cases of emergency situations. When these situations occur, staff should document the date and time of the consultation in the case narrative in FACES.

Due to holidays, there are times when there are more than seventy-two (72) hours between business days. Staff may use their discretion on whether to complete the Chief Investigator consultation during non-business hours in these situations if the investigator has made contact and assured safety of the child(ren). All attempts should be made to complete the Chief Investigator consult prior to the holiday weekend, or if this is not feasible, completed as soon as possible following the holiday. If the investigator has been unable to make initial contact or has determined the child(ren) to be unsafe, the Chief Investigator consultation must still be held within seventy-two (72) hours of the report date.

5.2.15 Collection of Evidence

Evidence of child abuse/neglect presents itself in a variety of forms: verbal evidence, such as witness statements, and physical evidence, such as clothing, instruments, weapons, etc. The collection of evidence is a critical element in conducting a thorough CA/N Investigation. Each piece of evidence should be carefully evaluated for credibility and consistency. In addition, it should be carefully preserved by way of a factual summary placed in the case record or placed in a storage area, which is not readily accessible by others. Staff are authorized/expected to collect the following types of evidence using the methods prescribed:

Statements/Records

The most common type of evidence available to staff is statements made by the victim, witness(es), alleged perpetrator, and collateral(s). Staff will also obtain or generate a variety of reports/documents during the investigation process, which will serve as evidence to support an investigative conclusion. These statements may be used for judicial proceedings. Generated reports/documents include reports, forms, and records produced by staff. Obtained reports/documents include medical reports, psychological/psychiatric evaluations, police reports, written statements, etc.

Staff should not make notes on or otherwise alter copies or reports/documents so that they can be admitted as evidence in the judicial proceedings.

Medical/Professional Information Request (CS-30)

Staff should use the Medical/Professional Information Request (CS-30) when requesting records pertaining to child abuse and neglect allegations for any victim child or alleged perpetrator.

If requesting relevant records on any other individual, staff should attach a signed Authorization for Disclosure of Confidential Information (SS-6) from the individual to the CS-30.

The CS-30 should only be utilized to obtain records directly related to the CA/N report.

Examples of situations directly related to CA/N allegations include:

- Medical documentation of injuries on a physical abuse report;
- Disclosures of sexual abuse made in therapy on a sexual abuse report. Staff should use either the Authorization for Disclosure of Confidential Information (SS-6) or the Authorization for Release of Non-Medical Records By/To Children’s Division (CD-98), whichever is relevant, when requesting information indirectly related to the child abuse/neglect allegations. Examples of situations indirectly related to CA/N allegations include:
  - During an investigation, mental health needs for the victim child were identified and the child was referred to therapy. Verification of participation is needed prior to concluding the report.
  - During an assessment concerning allegations of neglect, the alleged perpetrator admits to regularly abusing alcohol and agrees to complete a substance abuse evaluation. Documentation of the diagnoses and recommendations are needed to help determine further CD involvement.

Diagrams

Diagrams may be used by the worker to complete a silhouette of the child and mark the location of injuries on the silhouette. Staff should try to approximate the shape and relative size, and write a brief description of the injury next to the silhouette. In describing injuries, staff should avoid words that are open to interpretation such as “old bruises: or “severe cut.” Instead, the coloring, measurements, and precise adjectives should be used to describe the condition.

Photographs

Photographs serve as a record of an incident to show particular items of evidence and their relationship to the scene. Photographs also provide close-up records of significant portions of a scene. Staff have the authority to use photography as a means of recording evidence. The use of photography is not a substitute for written documentation of injuries, staff’s observations, etc. Staff should explain what is depicted in each photograph in the case narrative. Photographs should only be taken on state-issued equipment.

When possible and appropriate to do so, staff should take photographs of children when a parent or legal guardian of the child provides consent to the taking of the photograph. Staff should take photographs in the least intrusive manner possible that is sensitive to the child’s age, gender, and emotional well-being. Staff should take the photograph(s) in the presence of the parent or legal guardian. If a parent or legal guardian refuses or is unable to provide consent, only law enforcement or medical personnel may take photographs. Staff should also ask the child, if age appropriate, permission to take photographs. If the child refuses to be photographed, staff should not proceed, even if the parent/caregiver has consented. Staff shall not take pictures of a child’s genitalia in regards to allegations of sexual abuse. This may only be done by medical personnel. Staff must document that the parent/caretaker gave consent to photography. In addition to using photographs to document injuries, staff should take photographs to show an absence of injuries.

Staff should also take scene photographs, such as household conditions, when a law enforcement officer is not present during the interview. Staff must also obtain consent of the parent or legal guardian of the child to take scene photographs. Photographs should be taken of the home to provide evidence that there are no concerns or if concerns have been found.

The use of photography requires staff to use their prudent professional judgment and use the following guidelines:

Photograph the child’s face along with any injuries to aid in identification of the child;
Be familiar with the photographic equipment and basic photography techniques, which may include the use of digital photography or self-developing film. It is preferred that staff use their state-issued iPads for taking photographs;
Use standard settings on the camera device. Do not alter, enhance, or filter the photographs;
Photograph injuries from both a distance and close-up with an object such as a ruler, coin, or a plain piece of 8.5 x 11 paper to demonstrate the size of the injury;
Take several photographs of each scene to ensure that at least one will be a fair and accurate representation of the scene. The photograph must be properly exposed, well lighted, and technically correct, to be accepted as evidence in judicial proceedings;
Review all photographs taken prior to ceasing photography to ensure everything has been captured appropriately;
Keep all photographs taken, even if they are judged to be of poor quality;
Place the photographer’s name, date the photograph was taken, and the subject on the back of the photograph or in the label of the digital file;
Upload all photographs into document imaging.

Physical Evidence

Staff are not authorized to collect physical evidence. However, they should be knowledgeable of the types of physical evidence which may exist based on the reported incident. In addition, they should be observant and identify, whenever possible, the presence or possible presence of physical evidence when conducting an Investigation. This allows staff to provide an accurate, written description of such evidence and to notify the proper law enforcement officials or juvenile officer and/or to request a co-investigator to search for/seize the physical evidence. If, at any time, staff is voluntarily given an object of the physical evidence, he/she should immediately turn it over to the proper law enforcement authorities or the juvenile officer.

Recording

Staff may not record children or anyone else. This should be reserved for forensic interviews by a Child Advocacy Center (CAC) or law enforcement.

Polygraphs

Alleged perpetrators should contact an attorney or law enforcement to arrange a polygraph, should they want to have one conducted. The alleged perpetrator can arrange to have the outcome provided to staff for inclusion in the Child Abuse/Neglect Report record.

Child Sexual Abuse Material (CSAM)

If staff should obtain any type of child sexual abuse material (CSAM) during an investigation, they shall turn it over to the prosecuting attorney or law enforcement. The prosecuting attorney or law enforcement will retain custody of the CSAM and no CSAM will be retained by the Children’s Division. If staff need to view the CSAM to investigate child abuse or neglect or for child protection, staff may ask the prosecuting attorney or law enforcement to view. Staff does not provide physical evidence of CSAM to the Child Abuse and Neglect Review Boards (CANRB).

5.2.16 Assessing the Need for Services and Ongoing Case Management

Assessing the Need for Services

In large part, the level of Children’s Division’s intervention beyond the CA/N Report is based on the risk of future acts of abuse and/or neglect. The level of intervention may also be impacted by an active Immediate Safety Intervention Plan in which safety interventions developed to control threats of danger may require more frequent contacts. Interventions designed to control identified threats of danger are always a priority. The decision to open a case for Family-Centered Services (FCS) is based on a combination of risk level and the CA/N conclusion:

Agency Responded Refer to FCS or AC Case Opened.
Preponderance of Evidence conclusions: All CA/N reports which are found by a “Preponderance of Evidence” that physical abuse or neglect exists should be opened for Family-Centered Services unless the victim is otherwise protected from future abuse/neglect. In these cases, treatment services are provided because supportive evidence indicated during the child abuse/neglect Investigation that abuse or neglect has occurred or is occurring. In most instances, this will be after the Investigation has been completed, but it does not preclude a family from receiving services prior to the completion of the report.
Unsubstantiated or Agency Responded No Concerns Found conclusions: CA/N reports concluded as Unsubstantiated or Agency Responded No Concerns Found should be closed unless the family requests services to improve family functioning and such services are available through the Division or community resources.
Unsubstantiated-Preventive Services Indicated conclusions: CA/N reports concluded as Unsubstantiated-Preventive Services Indicated should be opened for Family Centered Services. However, case opening is voluntary. If the family declines to participate in FCS, staff should encourage the family to accept services by:
- Asking the family to give their perceptions of problems they may be experiencing and possible solutions;
- Advising the family of problems which the worker identified during the investigative process;
- Advising the family of services available through the Division and community resources which will help to alleviate the stated problems;
- Offering to refer the family for preventive services or community services;
- Offering them time to reconsider and contact you at a later date if the family is hesitant to accept or resistive to services.

The worker should thoroughly document in the case record, the family’s response to an offer of services and the basis for the decision to open/close the case. When staff believes services are warranted during a Family Assessment but the family declines FCS, staff should conclude the report as Family Declined Services, Child Safe if the child can be determined safe. If the family declines services, but staff believe the child(ren) is unsafe, staff should consult with their supervisor to determine whether a referral to the Juvenile Office will be made.

When staff determines services are needed, they should be able to clearly articulate the areas of need including, but not limited to: basic needs, living conditions, the family’s support system; health, mental health, educational concerns, and the overall nature and quality of family interaction and help address them through community resources and/or the family’s safety network. Staff should strive to address the family’s needs during the CA/N report intervention whenever possible and only open FCS if services are needed beyond the CA/N report timeframes.

Ongoing Case Management

When opening an FCS case due to a CA/N report or when the child has been removed from the home staff should, at a minimum, complete a draft of the Family Risk Assessment Map (CD-220) prior to the case being assigned for ongoing case management. Completion of the CD-220 provides clarity for the family and the ongoing case manager as to why the FCS case is being opened or why the child was removed from the home. The scaling question will help the ongoing case manager and their supervisor determine how quickly the initial face-to-face home visit with the family will be made in the FCS case. If the worker who completed the CA/N report and the FCS worker are different, then some family crisis situations may require a joint home visit to:

Ensure the safety of the child(ren);
Provide a consistent view of the crisis situation;
Expedite the provision of treatment services.

Home Visiting

The Home Visiting Program is a voluntary service for the Children’s Division’s most vulnerable families. The Home Visiting Program’s primary focus is on Child Abuse and Neglect Prevention. This program is available to families beginning with prenatal up to the child turning age three (3). When the youngest child approaches age three (3), the Home Visiting program should transition the child and family to Head Start or another early learning program in their area. Home visitation provides overall parenting skills to aid in the reduction of child abuse and neglect. Staff will discuss home visiting with the family and, if the family agrees to the service, staff will complete a Referral for Home Visiting Services (CD-261). This is to be completed on all Newborn Crisis Assessments and any CA/N report in which there is a child under the age of three (3) in the home. This service is available statewide. Instructions for completing the CD-261 can be found here.

More information about home visiting services can be found at https://dese.mo.gov/childhood/home-visiting

Intensive In-Home Services

Intensive In-Home Services (IIS) are designed to prevent the out-of-home placement of children. IIS is targeted to families that have a child at imminent risk of removal from the home due to neglect, abuse, family violence, mental illness, delinquency, or other circumstances. When staff identifies that the family’s situation may necessitate a recommendation for out-of-home placement, they should first assess the situation to determine if an IIS referral is appropriate to attempt to avoid the unnecessary removal of the child.

Referral to Head Start and Early Head Start Programs

Staff are encouraged to refer children and families, who may be eligible, to their local Head Start agency by completing the Head Start/Early Head Start Referral Form (CD-200). Head Start serves children ages birth to five years of age.

5.2.17 Unable to Locate

The “unable to locate” determination may be used only after all three of the following criteria have been met:

Only when not one single child or any parent/caretaker included in the report is located;
Only after staff have searched all available resources that can help to locate the family and children;
- Examine the Division’s internal sources of information such as:
  - Children’s Division family records in all known counties having current or past family involvement via personal contact with workers, review of physical case records, or review of FACES information;
  - Income Maintenance, Food Stamp, Child Support Enforcement records via DSS Search on the Call/Case Prior History Search screen in FACES;
  - Documented calls in the CA/N Hotline Unit Information section of the Call/Case Prior History Search screen in FACES.
  - Employer records from the IMES screen in PROD
  - MO HealthNet to determine if child has been recently been seen by a medical provider to then check with the provider for alternate contact information.
- Examine external sources of information such as:
  - Local, county, and state law enforcement agencies
  - Case Net
  - Child’s school
  - Neighbors
  - Known friends or extended family members of the child/family
  - The internet (sites such as Spokeo, Whitepages, etc.)
  - Social media
  - Vinelink
  - Missouri Department of Corrections Offender Search at https://web.mo.gov/doc/offSearchWeb/. This site also provides information regarding Probation and Parole office assignment.
  - Postmaster: The local post office will have a form for requesting address information. This may be completed and sent to the postmaster of the post office serving the parent’s last known address.
  - Contact STAT for assistance if local law enforcement is unable or unwilling to assist. STAT may be able to assist in locating the family on a case by case basis.
  - Public utilities: If previous address and name on account are known.
  - Directories: Telephone, city, street, trade, labor, and professional, etc.
  - Other public agencies in Missouri
  - TLO search: subscription service to locate people through numerous public records. (Designated Regional Office staff, CANHU staff, and CA/N PDS have access to TLO)
  - Department of Revenue/Division of Motor Vehicles (DMV) (Designated Regional Office staff, CANHU staff, and CA/N PDS have access to DMV screens).

Staff should be careful to not disclose the reason for the inquiry unless absolutely necessary out of consideration for the client’s right to confidentiality.

Staff may use the “unable to locate” conclusion only after the supervisor agrees that sufficient attempts have been made and staff have exhausted all available resources to locate the family. If the supervisor is in agreement with the determination of “unable to locate”, the report must be forwarded to the Regional Director or their designee for review prior to the approval of the conclusion.

All efforts to locate the family and children must be clearly documented in the record.

5.2.18 Inappropriate Report Conclusion

This determination is applicable when a report is received that does not contain allegations of abuse or neglect specified in Missouri State Child Abuse and Neglect statute (Section 210 RSMo). An inappropriate report conclusion may also be appropriate, if under further review, it does not meet the definition of the CA/N Condition it was screened in under (refer to Section 2, Chapter 2.1.2.1, CA/N Conditions).

It is important to differentiate between an unsubstantiated Investigation or a no services needed Family Assessment/Juvenile Assessment and the inappropriate report conclusion. Failure to find evidence of abuse or neglect does not constitute an inappropriate report. A report should be coded as inappropriate only if it does not meet criteria for an Investigation, Family Assessment, or Juvenile Assessment response.

If the investigator determines that the report should be concluded as an “inappropriate report”, they may contact the Central Consult Unit for case closure within 72 hours.

If consulting locally, staff may use the “inappropriate report” conclusion only after the supervisor agrees criteria has been met. If the supervisor is in agreement with the determination of “inappropriate report”, the report must be forwarded to the Regional Director or their designee for review prior to the approval of the conclusion.

Some examples of reports that DO meet the criteria as an Inappropriate Report include:

Upon initiating the report, find that there are no children involved in the allegation;
Upon initiating the report, find that the child(ren) is over 18;
A fatality report was prematurely called in and the child(ren) is not deceased.

Listed below are examples of reports that DO NOT meet the criteria as an Inappropriate Report:

Example #1 – A report is taken on a non-custodial parent on his spouse alleging lack of supervision. Similar allegations had been reported in prior hotlines. The worker feels the report should be considered an inappropriate report because the allegations had already been unsubstantiated in prior reports and regarded this Investigation as a duplicate report.

NOTE: In this example, the report should have been concluded as “Unsubstantiated” or “Agency Responded No Concerns Found” because the allegations were addressed and determined to be unfounded. Regarding the duplicate report issue, the investigator should review the report to determine if the report meets the duplicate report criteria.

Example #2 – A report is taken on a child care worker alleging scratches and bruises on the victim. The worker found no evidence of physical abuse and a review of prior reports reveals the reporter has a history of exaggerating allegations. The investigator concludes the report as Inappropriate Report so that the allegations will not remain in the system.

NOTE: Although the reporter has a history of exaggerating the allegations, the incident must be looked into. The conclusion must be based on the worker’s findings obtained through interviews, documents and other information. In this situation, the worker did not find any evidence of physical abuse so the report should be concluded as “Unsubstantiated” or “Agency Responded No Concerns Found”. Inappropriate reports are expunged on the next system expungement sweep. Coding this report as inappropriate would also mean the loss of this historical information in the automated system.

Example #3 – A reporter alleges lack of supervision on her neighbor. The investigator reviews the prior history on the family and finds the reporter has made these allegations numerous times and that each Investigation was concluded as “Unsubstantiated” or “Agency Responded No Concerns Found”. The Investigation reveals that neglect did not occur and is coded as harassment by the investigator and concluded as Inappropriate Report.

NOTE: In this situation, the worker should use the information provided from previous reports to assist in the determination. The worker concluded there was no lack of supervision so the conclusion must be “Unsubstantiated” or “Agency Responded No Concerns Found”. If the report meets the harassment indicators, the report should be coded as “Harassment” in the CA/N automated system and a referral made to the prosecuting attorney, if warranted.

Example #4 – A report is taken alleging educational neglect on a 15 year old. The worker documents the youth had dropped out of high school but verifies that he had enrolled in military school in another city. The worker notified the school of the change and concluded the report as an inappropriate report.

NOTE: The worker determined there was no educational neglect because it was verified that the youth is enrolled in another school. The conclusion for this report is “Unsubstantiated” or “Agency Responded No Concerns Found”.

5.2.19 Out of State Reports

Pursuant to Section 210.145, RSMo., the Children’s Division may accept a CA/N report if either the child or alleged perpetrator resides in Missouri, may be found in Missouri, or if the incident occurred in Missouri. If the Children’s Division receives a report in which neither the child nor the alleged perpetrator resides in Missouri or may be found in Missouri and the incident did not occur in Missouri, the Children’s Division shall document the report and communicate it to the appropriate agency or agencies in the state where the child is believed to be located, along with any relevant information or records as may be contained in the Children’s Division’s information system.

Therefore, the Children’s Division has the authority to conduct CA/N reports, and make findings, in most situations involving another state. The Children’s Division maintains a commitment to keeping Missouri children safe and holding perpetrators accountable when an act of child abuse and neglect is committed within the state.

Out of state reports are screened in at the Child Abuse/Neglect Hotline Unit (CANHU) if the child’s location and incident are in another state, but the residence is in Missouri and the child will be returning. CANHU will also accept a report if the incident and alleged perpetrator are in Missouri and the child’s location out of state is known. CANHU does not accept a CA/N report if it is known at the time of the call that the other state also has a report. If the assigned worker determines that a report should not have been screened in based on this criteria, the Located Out-of-State conclusion is appropriate. Staff must ensure there is a CA/N report in the other state.

Example: A report is screened in alleging abuse of a child located in Missouri with the incident occurring in another state. Upon initiating the report, the worker discovers the child is currently in another state and will not be returning to Missouri. The worker makes a hotline to the other state and concludes the report as Located Out-of-State.

The Located Out-of-State conclusion should not be used when the incident occurred in Missouri. The exception to this is when the alleged perpetrator and the victim child(ren) reside in another state. In this situation, the Located Out-of-State conclusion may be appropriate only if a child abuse/neglect hotline is accepted in the other state.

Example: A report is screened in alleging abuse occurred in Missouri while the victim child and alleged perpetrator were visiting from another state. The family has returned to their state of residence. The worker makes a hotline to the other state, but it is not accepted. The Located Out-of-State conclusion is not appropriate, and the worker completes the report.

For Investigations where the incident occurred in another state, staff must be cognizant of the laws regarding the definitions and the burden of proof in the other state. The incident must also meet the other state’s definitions in order to make a Preponderance of Evidence finding. Out-of-state perpetrators may be placed on Missouri’s Central Registry.

The Located Out-of-State conclusion is similar to the inappropriate report conclusion in that this conclusion is used when a full CA/N report cannot be completed. If it is determined that the report can be concluded as an out of state report, the investigator may contact the Central Consult Unit for case closure.

5.2.20 Missing Children Not in Care

Staff should report all children known to be missing to law enforcement and NCMEC, not just those in the custody of the Division.

Reporting missing children not in care to NCMEC may only be done through the NCMEC hotline, 1-800-THE-LOST. For children not in care, staff should only contact NCMEC if they are able to provide the name, age, address, and all identifying characteristics of the missing child and the length of time the child has been missing.

Staff do not need a signed release of information from the child’s custodian in order to make a report. Staff will be required to provide contact information for the child’s legal guardian and information regarding the law enforcement agency involved, including the case number, and assigned law enforcement officer’s contact information.

Staff should advise the child’s guardian of the legal reporting requirement prior to making a report to NCMEC. NCMEC will contact the legal guardian for follow up information and coordination. Legal guardians may choose to provide the missing child’s photograph to NCMEC by either:

Emailing ‘_imaging@ncmec.org’ and listing the child’s name and date of birth in the subject line; or
Providing a photograph to the case manager and signing an Authorization for Release of Non-Medical Records by/to Children’s Division (CD-98) authorizing the case manager to provide the photograph to NCMEC.

5.2.21 Human Trafficking

Staff must complete the CD-288 Human Trafficking Assessment Tool in the following instances to determine whether a child/youth may be a victim of, or is at risk of being a victim of, human trafficking:

Within 24 hours for a victim(s) and non-victim(s) listed on a CA/N report with allegations of human trafficking
Within 24 hours of a child/youth in state custody returning from being on the run, missing, or abducted
Within 24 hours for any child/youth that is involved with Children’s Division through a CA/N report, FCS case, or AC case in which there is suspicion of human trafficking, history of human trafficking, and/or new concerns of human trafficking
Within 24 hours of contact with an unaccompanied youth
Within 72 hours for children/youth that are involved with Children’s Division through a CA/N report, FCS case, or AC case in which it is learned that there is a known history of running away from home/placement
When a child’s circumstances change or new information is learned about the child/youth which warrants the usage of a more comprehensive screening of human trafficking
Immediately when imminent safety concerns are present in which there are immediate concerns for a child/youth being trafficked

For information regarding Human Trafficking, please refer to Section 4, Chapter 4, Sub-Section 4.6, Special Populations- Human Trafficking.

Related Practice Alerts and Memos:

6-10-2020 – PA20-IA-03 Instructions for Initial Contact Entry for Multi-Disciplinary Team Members

09-15-2020 – CD20-39- Timely Initial Contact with Victim Child(ren)

CHILD WELFARE MANUAL

Section 2, Chapter 5 (Child Abuse and Neglect Reports), Subsection 2 – General Procedures for Completing a CA/N Report

Section 2 (Intake)