Adoptive Child Assessment

LEGACY CARRY-FORWARD. Migrated verbatim from the pre-T3C (COA/AS-era) corpus for completeness and traceability. It predates the T3C alignment and has not yet been reconciled to the current model. Its operative status is pending review — this is not an assertion that it is either currently in force or superseded. Original code: AS-2. Source: historical-docs/source-documents/AS 2 Adoption Assessment SS.docx.

Original Document Control (verbatim)

• Policy Name: Adoptive Child Assessment
• Originated: 6/04
• Approved By: Board of Directors
• Approved On: 8/1/11
• Effective Date: 8/15/11
• Section: FC 2
• Date(s) of Revision: 4/20/07, 5/26/07, 2/25/08, 8/5/08, 1/22/09, 8/29/09, 1/1/10, 3/23/10, 8/1/11
• Cross Ref #: ICWA Policy

Content (verbatim)

Deleted

POLICY

POLICY Refuge House utilizes a service planning team including the adoptive family and tribal representatives, when applicable, to conduct an initial admission assessment for each child placed in an adoptive home. Assessments are strength-based, family focused and culturally responsive and lay a foundation for service delivery and permanency.

APPROVAL

APPROVAL Board of Directors

Additional Information

Additional Information Refuge House does not have direct contact with an adoptive child’s birth parents. All adoptions are facilitated by the Department of Family and Protective Services or the comparable state agency within the child’s state of origin. All are typically closed procedures. The state agency is responsible for completing all birth parent assessments. The state agency will ensure that these assessments are included in the child’s full case record that prospective adoptive parents are provided. The case record may include birth parent information such as contact information for organization, medical facilities or others involved in services to the birth parents and child prior as well as photographs of the birth family.

PROCEDURE

PROCEDURE

Responsibility

Step

Adoption Worker

1. Review all documentation located in the child’s case file as provided by CPS worker prior to adoptive placement to inform the Adoption Assessment. Information reviewed can include but is not limited to the following: Identifying information – Full name, gender, race, tribal affiliation if applicable, religion, date of birth, and birthplace Current Common Application Health, Education, Social and Genetic History (HSEGH) report Communication Restrictions
   Immunizations Birth Certificate or request Social Security Card/Number or Request Affidavit of Fact All Current Court Orders Attorney Ad Litem information Current Educational Portfolio Current or last Medical Exam Current or Last Dental Exam Current or last Specialist Exam Current or last Psychological Exam Current or last Psychiatric Exam Copy or Current Medicaid Card

2.

Initiate an Admission Assessment within Radius and complete within 7 days of the child’s adoptive placement.

3.

Evaluate and document the following: All identifying information including Name Gender Ethnicity Religion (if applicable) Tribal Affiliation (if applicable) CPS Caseworker name and contact information Adoptive family name and contact information Refuge House Adoption Worker name Therapist Previous Source –matched placement or RH foster home Description of circumstances making placement necessary including What originally brought the child into substitute care including protective factors, history of maltreatment and prior placements What brought child into Refuge House program Medical Information (as provided by child’s CPS worker and HSEGH) Known allergies Known medical conditions Last physical exam Last dental exam Current medications Medical history of child including birth and neo-natal history if known Mental health and substance abuse history of child Child’s current behaviors to include both pro-social and maladaptive behaviors and feelings that the child has toward adoption as presented in the Adoption Readiness section of the child’s HSEGH including the child’s ability to bond and develop a relationship with the new family Evaluation of how the adoptive placement will meet the child’s needs and interests including information related to family resources to assist in providing care Services that will be provided or initiated while in care to Permanency Plan Information Date for achieving permanency Estimated length of stay in adoptive placement Child information Personality, behaviors, interests Needs Tribal affiliation needs Cultural needs Biological family relationship needs Spirituality Social History including information related to the characteristics and strengths of the child’s biological family, past and existing relationships with biological family, extended family members, and other significant individuals Family History (as provided by the child’s CPS worker and HSEGH) Communication Restrictions List adult relative’s name address, phone List sibling’s names, address, phone List other significant relationship name, address, phone Family medical history Family history of suicidal or homicidal behaviors Family history of drug use or criminal behaviors Family achievements and religious preference Emotional and Developmental functioning Recent psychological or developmental evaluation including date of evaluation and evaluator’s name School and Education History of educational achievements Schools and dates of attendance Special education services

6.

Each assessment is submitted to the Adoption Director for review, approval, and signature

REFERENCES

DEFINITIONS

FORMS ATTACHMENTS

Adoption Assessment; Discharge Summary