4.1.3  Face to Face Safety Assurance of Victim

The CSW shall contact family and subject child personally.

NOTE:  CSW must show photo ID card when interviewing clients he/she has never met.

Assure safety of subject child through face to face contact, according to Response Priority Level required timeframes.

Related Subject:  Section 2, Chapter 2.2, Response Priority Levels

For investigations as well as family assessments, every child named as a victim on the CA/N-1 must be seen face to face within 24 hours, or immediately in emergencies, to assure the child(ren)’s safety (or within 72 hours in reports solely of educational neglect).  Direct contact should be made by the Children’s Service Worker whenever possible, however, 24 hour face to face contact may be made by a multidisciplinary team member, granted the child’s safety can be assured with such contact.  However, if safety cannot be assured by multidisciplinary team member contact, face to face contact with all listed victims must be made by the Children’s Service Worker.

If the family/child are not seen by the Children’s Service Worker within the first 24 hours, as it has been determined through multidisciplinary team member direct contact with the alleged victim that the child(ren) is safe in the interim, staff must clearly document what actions were taken and what knowledge or information they obtained to ensure the child’s safety in the CPS-1 narrative.  Staff shall document the initial contact code made by the Children’s Service Worker or by the appropriate multidisciplinary team member on the CA/N-1 accordingly.

NOTE:  In investigation reports, it is critical to document physical evidence.  In cases of alleged physical or sexual abuse, it is often difficult to determine severity until the child is actually seen by a professional.  Analysis of the child(ren)’s safety must be documented on the second page of the CPS-1 and the CPS-1A.

Staff shall assure the safety of any child located out of county or state, including face to face contact, by contacting the appropriate county’s or state’s Children’s Division (or Child Protective Service Agency) staff and requesting a courtesy interview (or transfer to other Missouri county as appropriate) within required timeframes.  Additionally, any county assuring safety must complete a safety assessment and, when necessary, a legible signed CPS-1A, Safety Assessment (Part B), which must be sent to the requesting county within specified timeframes.

Related Subject:  Section 2, Chapter 4, Attachment C, Courtesy Requests

Additionally, every child residing in the household, (including the alleged victim(s) whenever initial contact was made by a multidisciplinary team member) must be seen face to face by the Children’s Service Worker within 72 hours of the report in all cases.

Response Priority Level 1:  Three (3) Hour (Emergency) Face to Face Contact

Investigations that are determined to be an emergency (Response Priority Level 1) require an immediate response (within 3 hours).  Safety may be assured through observation of the alleged victim(s) by a multidisciplinary team member, just as it would for 24-hour safety assurance, however, the Children’s Service Worker should make every effort to have direct observation whenever possible.  If immediate safety cannot be determined by a multidisciplinary team member, then direct observation by the Children’s Service Worker with the alleged victim(s) must occur within Response Priority Level timeframes.  All household children must be seen by the Children’s Division within 72 hours on all reports.

For Response Priority Level 3 reports, see the subject child, and all other household children, within 72 hours, when the only allegation is educational neglect.

Related Forms and Instructions:  CPS-1, CPS-1a and CS-16D

4.1.3.1 Investigations Involving Reported Physical Injuries and Sexual Maltreatment

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.  If severe allegations are indicated, the Children’s Division (CD) should encourage and support further medical testing and examinations, if necessary.

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.

Physical Abuse Examinations

In determining how to conduct an examination, the worker should inform the parent/caretaker of the following options available for obtaining the needed examination for the child:

• The parent/caretaker can take the child to a physician or hospital emergency room for a physical examination;

NOTE:  If the child is Medicaid eligible, request the parent take the child to a Medicaid physician, preferably a SAFE/CARE provider (please refer to listing at the end of Section 2, Chapter 4, Attachment A) for a Healthy Children and Youth (HCY) screening.  This examination should be a comprehensive medical examination.  Request a physician’s statement as to whether or not the injuries were due to CA/N.  If the provider is in the SAFE-CARE Network, worker will need to obtain a copy of the SAFE-CARE medical form.

• The worker, with written permission (CS-32) from the parent, will take the child to a physician or hospital emergency room for physical examination;
• Other local options which are available and will assure a child receives an adequate physical examination of reported CA/N injuries by qualified medical personnel;
• The worker and parent/caretaker may conduct a cursory physical examination of a child under age five;

NOTE:  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.

A Children’s Services Worker of the opposite gender to a child, age five years or over, shall not observe or otherwise examine the child’s genitalia.  A Children’s Services Worker of the same gender may observe the child’s genitalia, if the child and parent/caretaker request the exam and an adult is present during the examination.  Genitalia includes:  female breasts, vulva, penis, and testes; and

• If the child is at school, and the parent/caretaker cannot be reached and local procedures have been developed with individual school districts to allow examination by the school nurse, the worker should request that the school nurse examine the child.