CODES/REFERENCES

Child and Family Services Improvement Act of 2006 (P.L. 109-288) Child and Family Services and Innovation Act of 2011 (P.L. 112-34)

J.J. v. Ledbetter Consent Decree

REQUIREMENTS

The Division of Family and Children Services (DFCS) shall:

1. Prepare for each contact to ensure it is planned and has clear purpose.
2. Engage the children, parents/custodians and caregivers involved in a foster care case in a manner that is beneficial for establishing a partnership by:
   
    
   1. Engaging from the viewpoint that families go through developmental stages and encounter common challenges.
   2. Separating the intent from the actions that did or did not take place by:
      
       
      1. Normalizing the challenges families identify as difficult situations in their everyday life routine; and
      2. Externalizing the problem pattern.
3. Establish purposeful contacts in accordance with policy 19.15 Case Management: Developing Contacts Standards for Purposeful Contacts and Collateral Contacts based on the individualized needs of each child and family.
4. Make at least one purposeful face-to-face¹contact each calendar month with:
   
    
   1. Every child under its care and/or custody to assess child safety, well-being, and permanency with the majority (over 50%) of the contacts occurring in the residence of the child. EXCEPTION: Children placed outside of Georgia will have purposeful contacts conducted by a representative of the receiving state in accordance with the Interstate Compact on the Placement of Children (ICPC) (see policy 15.5 Interstate Compact on the Placement of Children (ICPC): ICPC Placement Supervision).
   2. The placement resource for every child in the custody of DFCS to evaluate if the placement continues to meet the needs of the child, caregiver capacity and family functioning to assess child safety. If the placement resource is a two-parent household, ensure both parents are engaged.
   3. Parents/guardians of children in the temporary custody of DFCS to assess progress toward achieving case plan outcomes. This may not be required when a non- reunification court order relieves the agency of this responsibility.
5. Make purposeful face-to-face contact with any child in foster care within seven calendar days of an initial placement and any subsequent placement change to assess the child’s safety, adjustment to the placement, and any needs of the child or caregiver.
6. Make purposeful face-to-face contact with any child in foster care who is seriously injured or has attempted self- injury or suicide within 24 hours of notification to assess for maltreatment, the child’s current condition and future treatment needs.
7. Make face-to-face contact with the children and their caregivers within 24 hours of notification of a screen-out decision to confirm the children’s safety and well-being, when any child in foster care is the subject of a screened-out Child Protective Services (CPS) Intake Report. NOTE: If DFCS was notified of the situation prior to receipt of a screened-out Intake Report, conducted a purposeful contact, and confirmed the children’s safety and well- being, then a subsequent purposeful contact is not required on the screened-out Intake Report.
8. Conduct efforts to locate parents with a permanency plan of reunification, when they cannot be located or have moved to an unknown location (see policy 19.21 Case Management: Unable to Locate).
9. Assess the physical home environment to confirm that it is safe and appropriate to meet the needs of each child in foster care, including an examination of every room in the home and the sleeping arrangements for all household members.
10. Assess and discuss infant safe sleeping practices with any caregiver who has an infant (birth to 12 months of age) in the home and address any unsafe sleeping situations prior to leaving the home.
11. Discuss motor vehicle safety recommendations including hot car safety with caregivers during purposeful contacts (see practice Guidance: Motor Vehicle ‘Hot Car’ Safety in Practice Guidance).
12. Observe all children for physical signs of maltreatment. If there is cause to believe any child may have been harmed, observe areas of the child’s body that may be covered by clothing. Such observation shall occur in the least invasive manner possible, and every effort should be made to ensure children are not fully unclothed during the observation. NOTE: Physical signs of maltreatment may include suspicious injuries, marks, cuts, bruises, areas of swelling, protruding limbs, damaged skin, malnourishment, lethargy, severe tooth decay, matted hair, pungent body odor, etc.
13. Make a child safety determination (safe or unsafe) prior to concluding each purposeful contact with the child, caregiver(s) or placement resource. If unsafe, in consultation with the Social Services Supervisor (SSS), decide if present danger and/or impending danger safety threats exist and take immediate and appropriate action to control the safety threats to ensure child safety by:
    
     
    1. Immediately removing the child from the placement (if the child is in the custody of DFCS); or
    2. Initiating court/legal intervention (if the child is no longer in the custody of DFCS such as instances of aftercare)
14. Immediately report any new known or suspected instances of child abuse/neglect or violations of Foster Care policy to the CPS Intake Communications Center (CICC) as outlined in policy 3.24 Intake: Mandated Reporters.
15. Immediately report (no later than 24 hours) to law enforcement any child or youth who the agency identifies as being a known or suspected victim of sex trafficking.
16. Document purposeful contacts in Georgia SHINES within 72 hours of the occurrence including uploading any pictures to External Documentation. NOTE: The requirements and procedures outlined in this policy also apply to children placed in Georgia in accordance with the ICPC (see policy 15.3 Interstate Compact on the Placement of Children (ICPC): Placement of Children from Other States into Georgia (Georgia as the Receiving State).

PROCEDURES

Preparing for Purposeful Contacts

When preparing for a purposeful contact with the child/youth, parent/guardian and/or caregiver (foster parent or kinship caregiver), the SSCM will:

1. Review:
   
    
   1. Case plans and documentation from previous contacts to understand the significant factors affecting child’s safety, permanency and well-being protective capacities, and a family’s ability to ensure the safety of their children moving forward.
   2. Action plans for progress and effectiveness.
   3. Supervisor staffing notes to ensure that any needed follow up is addressed during the purposeful contact.
   4. External Documentation in Georgia SHINES for verification that both the Health Insurance Portability and Accountability Act (HIPAA) Notice of Privacy Practices and the Notice of Case Record Information Available to Parents/Guardians were provided to parents. If either is missing, explain and provide to the parents at the next purposeful contact.
   5. Caregiver’s or child’s recently completed assessments/evaluations for insight into family functioning and recommendations. NOTE: Only the child’s assessments or evaluations can be discussed or shared with the placement resource.
2. Develop a plan for the purposeful contact:
   
    
   1. Determine the frequency of contacts needed. Although a minimum of one contact every month is required, more frequent contacts may be necessary to address the needs of the child and family.
   2. Determine whether the contact should be announced or unannounced based on the case circumstances.
   3. Determine interviewing technique and other information gathering approaches, including persons to be interviewed, order and location of interviews, and when interviews will occur.
      
       
      1. Complete contacts in different settings when there is concern that the child is fearful or hesitant to speak in the home around the parent/caregiver; and
      2. Choose a setting which affords the child(ren) an opportunity to speak freely.
   4. Prepare a list of questions to ensure all issues/concerns are addressed.
   5. Determine the need for interpretation services for non-English speaking individuals or auxiliary aids for sensory impaired individuals. If required, Limited English Proficiency and Sensory Impaired Customer Services (LEP/SI) is used to assist DFCS in providing meaningful language access to customers. Contact LEP/SI via lepsi@dhs.ga.gov. The use of family members as interpreters is not appropriate.
   6. Identify potential child, parent or caregiver needs and possible service interventions.
3. If the purposeful contact will occur in a correctional facility, familiarize with the procedures of the correctional facility around contact and visitation:
   
    
   1. Who must initiate the process and how?
   2. Are liaisons provided by the correctional facility to work with child welfare professionals?
   3. How far in advance does the visit need to be scheduled?
   4. What are the visiting hours of the facility?
   5. Does the facility have a dress code when visiting?
   6. What types of contact are allowed (e.g., physical touch, telephone, face-to-face)?
4. Gather forms and other material for the purposeful contact, including but not limited to:
   1. Copy of the current case plan and action plan; NOTE: Only the child’s portion of the case plan can be discussed or shared with the placement resource.
   2. Authorization for Release of Information;
   3. Consent to Receive Targeted Case Management Services;
   4. Suggestions for Parents/Tips Sheet; and
   5. Safe Sleep for Your Baby (Brochure).

Purposeful Contact – Child/Youth

The SSCM will:

1. Visit with each child privately as well as in the presence of the caregivers to:
   
    
   1. Assess child safety; and
   2. Directly observe the parent/placement resource and child interaction as well as communication patterns.
2. Engage the child in a private face-to-face conversation outside of the presence of the parents, foster parents, kinship caregiver, facility staff, siblings, etc. as part of the assessment of child safety, permanency, and well-being. Use age and developmentally appropriate language and questions. Examples of areas to be explored are included below.
   
    
   1. The child’s daily routine.
      
       
      1. What is the child’s morning routine?
      2. What does the child do to get ready for school (if applicable)?
      3. Does anyone make the child breakfast? If so, who? What are some things the child usually eats for breakfast?
      4. Who makes lunch for the child (if the child does not eat lunch at school)?
      5. Where does the child go after school (if applicable)? How does the child get there?
      6. Who makes dinner for the child and what does the child usually eat?
      7. What does the child do after dinner?
      8. What time does the child go to bed?
      9. What does the child do for fun? Does the child participate in any extracurricular, social, recreational, or spiritual activities (e.g. sports, music, art, clubs, church, etc.)?
   2. The child’s adjustment to their current living arrangement.
      
       
      1. How does the child feel about the caregivers and the stability of the placement?
      2. How does the child get along with other household members (e.g. other children or other adults)?
      3. Does the child ever feel angry, sad, or afraid in the placement setting? If so, what things cause these emotions?
      4. Does the child feel they have anyone they can talk to when something is really worrying or bothering them? If yes, who?
      5. Does anyone other than the foster parents provide supervision for the child? How does the child feel about it?
      6. How is the child disciplined and by whom?
      7. Who does the child seek comfort from when he/she is sick, frightened or when things are not going well?
      8. Are there any changes in the child’s physical appearance (e.g. weight loss, hair loss)?
      9. Are there any changes in the child’s personality or emotional state (e.g. a formerly jovial and outgoing child has become sad and withdrawn)?
      10. How does the child feel about the permanency plan?
   3. The continuity of family relationships and other connections.
      1. Who does the child call family?
      2. What is the frequency and quality of the child’s contact with parents, siblings, friends, and other members of their support network?
      3. Does the child feel his/her connections with family, friends, etc. are being preserved?
      4. Is there someone the child wants to see or talk to with whom the child currently has no contact?
   4. Whether the child is receiving adequate services to meet his/her physical and mental health needs.
      1. When was the last time the child saw a doctor or a dentist? Why?
      2. Does the child see a counselor or a therapist? Why?
      3. When was the last time the child saw a counselor or a therapist?
      4. Does the child feel counseling or therapy is helpful?
   5. Whether the child is receiving adequate services to meet his/her educational needs.
      1. How does the child feel about school?
      2. Does the child like or dislike any particular subject(s)? Why?
      3. What are the child’s educational goals or aspirations?
      4. Does anyone review the child’s homework?
      5. Does the child need additional educational support (e.g. tutoring)?
   6. Whether the physical home environment is safe and appropriate to meet the needs of the child.
      1. Where does the child say he/she sleeps?
      2. Does the child share a room or bed with anyone? If so, who? How does the child feel about it?
      3. Are there any pets/animals in the home? How does the child feel about the pets? Is the child comfortable or uncomfortable and why?
   7. The Written Transitional Living Plan (WTLP) with ILP eligible youth (ages 14-21)
      1. What progress has been made toward WTLP goal achievement:
         1. Acknowledgment and celebration of completed tasks and outcomes; and
         2. What, if any barriers exist that may be influencing goal achievement and potential solutions.
      2. If applicable, what progress has been made toward goal achievement of the child’s Action Plan to include:
         1. Child’s ability to prevent high risk or difficult situations;
         2. Child’s ability to identify early warning signals of unproductive behaviors;
         3. Child’s ability to prevent loss of focus / direction;
         4. Child’s ability to interrupt unproductive behaviors; and
         5. Child’s ability to escape difficult situations that were not prevented or interrupted;
      3. Acknowledgment and celebration of completed tasks and outcomes;
      4. What, if any barriers exist that may be influencing WTLP outcome achievement and potential solutions;
      5. The extent to which the youth is participating in any services being provided and an evaluation of the effectiveness of the services;
      6. The youth’s participation in any formal Independent Living Program activities;
      7. Identification of potential members of the youth’s support system (peers, family members, and other responsible caring adults youth can rely on for assistance in times of crisis and everyday life situations);
      8. The extent to which the youth’s rights and responsibilities are being honored;
      9. Any issues with the youth’s placement;
      10. Benefits and opportunities available as a participant in the EYSS program;
      11. The importance of transition planning;
      12. Any changes that need to be made to the WTLP; and
      13. All other relevant factors that may impact the youth’s overall progress.
3. Observe the child’s body language for non-verbal cues of how they may be feeling or adjusting.
4. Observe all children for physical signs maltreatment. If there is cause to believe a that a child has been harmed:
   
    
   1. In the least invasive manner possible, observe areas of the body that may be clothed.
      
       
      1. Explain to the caregiver and child the reason for observing areas of the body that may be covered by clothing.
      2. Arrange for another adult to be present (e.g. caregiver, non-offending parent or legal guardian, kin, foster parent, school nurse, daycare staff, etc.).
      3. If the child is four years old and under, ask the caregiver to adjust one area at a time (e.g. raising a shirt sleeve, pant leg, raise the shirt to view their back, etc.), ask them to replace the clothing before proceeding to the next area of the body. Take pictures of any injuries observed.
      4. If the child is older than four and is capable, ask the child to adjust their own clothing as outlined above. NOTE: If a full examination is needed, a medical provider should be used.
5. If observation of the child uncovers injuries or other signs of maltreatment:
   
    
   1. Determine whether there are any additional injuries that are not immediately apparent. Is there bruising or is the area sensitive to the touch? Does the child complain of discomfort or pain?
   2. Gather information around the circumstances surrounding the injury and the caregiver’s knowledge and response to the injury asking who, what, when, where and how. What was used to cause the injury (ex: hand, fist, belt, bat, extension cord)? Describe the object that was used to cause the injury? Where did the incident that resulted in the injury occur (ex: bedroom, bathroom, grandma’s kitchen)?
   3. Evaluate and determine whether the injuries to the child or condition of the child requires an immediate medical or psychological evaluation or medical treatment. Whenever there is a question of whether a child needs to be examined by a medical professional obtain a medical consult (e.g. 24-hour nurse helpline or poison control center). If medical treatment is recommended or if an accidental injury seems suspicious take the child to be examined by a medical professional.NOTE: If the child is not in DFCS custody request the parent/guardian seek a medical consultation and if medical treatment is recommended insist the parent/guardian take the child to be examined by a medical professional.
   4. Document any observed injuries or physical signs of maltreatment by taking quality pictures and/or a detailed written description. NOTE: Pictures can also be used to document a lack of maltreatment, injury, or condition.
   5. Consult with the Social Services Supervisor regarding making a report to the CPS Intake Communications Center (CICC) as outlined in policy 3.24 Intake: Mandated Reporters.
6. Prior to concluding each purposeful contact with a child/youth, make a child safety determination (safe or unsafe) (see policy 19.11 Case Management: Safety Assessment). If unsafe, in consultation with the SSS, decide if present danger and/or impending danger safety threats exist and take immediate and appropriate action to control the safety threats to ensure child safety by:
   
    
   1. Immediately removing the child from the placement (if the child is in the custody of DFCS); or
   2. Initiating court/legal intervention (if the child is no longer in the custody of DFCS such as in aftercare, etc.).
7. Take pictures of each child periodically to document changes in the child’s appearance, capture milestones for the child’s Life Book, etc.

Purposeful Contacts – Parent/Guardian (Custodian and Non-custodian)

1. Have a private face-to-face conversation with each parent/guardian (custodial or non- custodial) to assess child safety, permanency, and well-being. Review, assess and discuss:
   
    
   1. The reason for DFCS involvement:
      
       
      1. Consensus developed with the family around the everyday life situation(s) that is challenging for the family to manage that makes the child unsafe;
      2. Safety management strategies and interventions; and
      3. Plan of Safe Care requirements, when applicable.
   2. The permanency plan and any change, if applicable.
   3. Progress toward achieving case plan outcomes, specifically as it relates to behavioral change needed to enhance parental protective capacities and ensure child safety (see policy 10.23 Foster Care: Case Planning).
   4. Action plan progression regarding relapse prevention skills being utilized to manage unwanted behaviors and the need to update the action plan (see policy 19.14 Case Management: Action Planning):
      
       
      1. Ability to prevent high risk or difficult situations that may have surfaced since the last visit;
      2. Ability to identify their early warning signals;
      3. Ability to prevent high risk situations;
      4. Ability to interrupt risk situations; and
      5. Ability to escape situations not interrupted.
   5. Services provided to the family as part of their case plan and progress or barriers with services (see policy 19.17 Case Management: Service Provision).
   6. Information obtained from collateral contacts, as appropriate, related to child safety, permanency, and well-being, and to evaluate case plan progress. Possible collateral contacts that have not been identified.
   7. Results and/or recommendations of any assessments or evaluations conducted.
   8. Areas of family functioning (for a detained explanation of each area of family functional see policy 19.13 Case Management: Family Functioning Assessment):
      1. Maltreatment/presenting problem
      2. Maltreatment context and circumstances
      3. Family developmental stages and tasks
      4. Family’s pattern of discipline their children
      5. Family support
      6. Child/youth development
      7. Individual caregiver patterns of behavior
   9. The child’s placement setting (e.g. family foster home, group home, etc.) and adjustment.
   10. The child’s educational status (e.g. grade level, performance, etc.).
   11. The need to modify contact standards for the parent/guardian, when applicable.
2. If the parent/guardian is incarcerated also:
   
    
   1. Explore barriers to the parent having contact with the child such as:
      
       
      1. The parent poses a threat to the child’s safety or well-being;
      2. A court has ordered that the parent have no contact with the child;
      3. Paternity has not been established and this is a putative father;
      4. The parent is not incarcerated in close proximity to the child or the institution is not set up to adequately support parent-child visitation;
      5. If there are barriers, support types of contact that is allowable and appropriate²(e.g. cards, letters, photographs).
   2. Make an effort to understand the parent’s situation in a non-judgmental manner.
   3. Explore the role the parent has played or may possibly play in the future parenting of the child in foster care.
   4. Discuss the parent’s possible release date and plans regarding the child in care.
3. If injuries or signs of maltreatment to child were discovered during a visit (supervised or unsupervised) or in the care of the parent/custodian (aftercare):
   
    
   1. When did the injury take place? Who was present during the incident that resulted in the injury?
   2. Was an object used to cause the injury (ex: hand, fist, belt, bat, extension cord)? Describe the object that was used to cause the injury (example: black belt with studs)? Observe the object used to cause the injury.
   3. Where did the incident that resulted in the injury occur (ex: bedroom, bathroom, hallway, etc.)? Observe the specific location in the home where the incident occurred.
   4. Document the observed object or location of the incident where the injury occurred by taking quality pictures and/or a detailed written description.
   5. What was the caregiver’s response of the injury or being notified of the injury? Was medical treatment sought out?
   6. Has the child suffered any other injuries or does the child have a history of injuries?
   7. Whenever there is a question of whether a child needs to be examined by a medical professional obtain a medical consult (e.g. 24-hour nurse helpline or poison control  center). If medical treatment is recommended take the child to be examined by a medical professional. NOTE: If the child is not in DFCS custody request the parent/guardian seek a medical consultation and if medical treatment is recommended insist the parent/guardian take the child to be examined by a medical professional.
4. Assess the physical home environment to determine if it is safe and appropriate to meet the needs of each child:
   
    
   1. Examine every room in the home for present or potential environmental concerns or hazards. Take appropriate action to remedy environmental concerns or hazards (i.e. loose wires or cords, alcohol or beer bottles, any drug paraphernalia, broken glass or windows, medications or toxic cleaning items that are in reach of small children) prior to leaving the home where children reside.
   2. Never leave a child in a home without addressing present or potential environmental concerns or hazards.
   3. Review the sleeping arrangements for all household members.
   4. When an infant (birth to 12 months of age) is in the home assess and discuss safe sleep practices with the parent/guardian. Take appropriate action to remedy unsafe sleep situations prior to leaving the home such as helping a parent/guardian to prepare a safe sleeping area for an infant (see Infant Safe to Sleep Guidelines and Protocol in Practice Guidance).
   5. Take pictures and/or document in writing the condition of the home when concerns or hazards are identified.
5. Observe the interaction and family functioning around everyday task:
   
    
   1. Parent/guardian-child interaction:
      
       
      1. How the parent/guardian(s) relates to the child.
      2. Whether the parents/guardian(s) appears to be calm, gentle, relaxed, and confident about parenting or if the caregiver appears anxious, easily frustrated, inattentive, indifferent, or detached.
      3. What the parents/guardian(s) communicates to the child non-verbally (e.g. looks, touches, and gestures).
   2. Interactions of all household members.
   3. Parent/guardian’s ability to meet the needs of all children under their care and supervision, if applicable.
6. Celebrate the parent/guardian’s behavioral change (i.e. achieving a case plan goal or satisfying elements of the conditions for return);
7. Provide a copy of the HIPAA Notice of Privacy Practices and the Notice of Case Record Information Available to Parents/Guardian (as needed). Document sharing the information and upload a copy into External Documentation in Georgia SHINES.
8. Prior to concluding each purposeful contact with the parent/guardian make a child safety determination (safe or unsafe) (see policy 19.11 Case Management: Safety Assessment). If unsafe, in consultation with the SSS, decide if present danger and/or impending danger safety threats exist and take immediate and appropriate action to control the safety threats to ensure child safety by:
   
    
   1. Immediately removing the child from the placement (if the child is in the custody of DFCS); or
   2. Initiating court/legal intervention (if the child is no longer in the custody of DFCS such as in existences of aftercare).
9. Summarize any strengths and/or barriers to goal completion identified during the visitwith the parent/guardian and any new strategies discussed at the visit; and
10. Review commitments agreed upon and next steps, and confirm future visits.

Purposeful Contacts - Caregiver (Placement Resource)

The SSCM will:

1. Engage each caregiver in a private face-to-face conversation to assess child safety, permanency, and well-being. Review, assess and discuss:
   
    
   1. How the child is functioning and adjusting in the home. Examples of questions are below:
      
       
      1. What is it like for the caregivers to care for the child and how does it compare to what they expected? What about the child do the caregivers find most and least pleasurable?
      2. How does the child comply with requests or follow directions?
      3. Do the caregivers feel the child has changed since coming to live there? If so, in what way?
      4. How do the caregivers think the child has adjusted to the placement? How does the child get along with others in the home?
      5. What is the child’s sleeping pattern? What is the child’s eating pattern?
      6. Have the caregivers seen any changes in the child’s weight since being placed with them?
      7. What things does the child like to do?
      8. Who does the child seek comfort from when hurt, frightened, or sick?
         
          
         1. Does the child show a preference for a particular adult?
         2. How easy is it to soothe the child when the child is upset?
      9. What do the caregivers think about the effectiveness of the services the child is receiving? What services do they think the child needs?
      10. What feedback do the caregivers have regarding visits between the child and the birth family?
      11. Is there anything the caregivers feel they need that they are not receiving?
   2. Family developmental stages and tasks:
      
       
      1. Is there a regular schedule for the children regarding eating, sleeping, bathing, etc.?
      2. How are meals handled?
      3. How does the child reach the caregivers when either the caregivers or the child is away from home?
      4. Does the child know the caregivers’ address and telephone number?
      5. Does the child know what to do in case of an emergency?
      6. Is there a list of emergency phone numbers (e.g. doctor, local hospital, police, poison control center, friend or neighbor) near the telephone?
      7. Do the caregivers know any of the child’s friends?
      8. What types of extracurricular, social, recreational, or spiritual activities has the child been allowed or encouraged to participate? How is the child doing in these activities?
   3. Pattern of discipline:
      
       
      1. Who usually disciplines the child? For what types of behavior has the child been disciplined?
      2. What types of discipline has been used? Have they been effective?
   4. Supports
      1. Are there any supports or services needed?
      2. Do the caregivers use substitute caregivers? Who and how often?
   5. Medication management:
      1. How is medication stored? Who administers medication?
      2. If a child is taking psychotropic medication³ or other prescribed medication, view the Foster Care Individual Medication Log to ensure it is being maintained by the caregiver.
   6. Motor vehicle safety recommendations to prevent children from being left unattended in hot vehicles (see Practice Guidance: Motor Vehicle ‘Hot Car’ Safety).
   7. Any issues or concerns not previously resolved or any newly identified issues or concerns.
   8. The permanency plan for the child and any changes including progress or barriers to returning the child(ren) to their guardian/custodian.
   9. Visitation plans for the child and legal custodian.
   10. Any upcoming scheduled appointments (court reviews, medical, assessments, etc.).
2. Assess the physical home environment to determine if it is safe and appropriate to meet the needs of each child:
   1. Examine every room in the home for present or potential environmental concerns or hazards. Take appropriate action to remedy environmental concerns or hazards (i.e. loose wires or cords, broken glass or windows, medications or toxic cleaning items that are in reach of small children) prior to leaving the home.
   2. Review the sleeping arrangements for all household members;
   3. When an infant (birth to 12 months of age) is in the home assess and discuss safe sleep practices with the parent/guardian. Take appropriate action to remedy unsafe sleep situations prior to leaving the home such as helping the caregiver to prepare a safe sleeping area for an infant or locating a resource for a crib or other safe sleeping apparatus (see Infant Safe to Sleep Guidelines and Protocol in Practice Guidance);
   4. Take pictures and/or document in writing the condition of the home when concerns or hazards are identified.
3. Observe the interactions and family functioning around everyday tasks to assess the caregiver’s ability to meet the needs of all children under their care and supervision. Interaction with all household members present in the home on the day of the visit and engage them in discussions around family functioning and roles. Inquire about household members not present during the visit and ensure every household member is engaged face to face at least quarterly.
4. Prior to concluding each purposeful contact with the caregiver(s) or adult household member make a child safety determination (safe or unsafe) (see policy 19.11 Case Management: Safety Assessment). If unsafe, in consultation with the SSS, make a decision if present danger and/or impending danger safety threats exist and take immediate and appropriate action to control the safety threats to ensure child safety by immediately removing the child from the placement (if the child is in the custody of DFCS).
5. Review any commitments agreed upon and confirm any timelines set for accomplishing certain action steps.

Analyzing Information Obtained During the Purposeful Contact

Upon completion of each purposeful contact with the child, caregiver/guardian or adult household member the SSCM will:

1. Immediately report to the CICC any new known or suspected instances of child abuse or neglect using the guidelines outlined in policy 3.24 Intake: Mandated Reporters.
2. When information gathered indicate a child/youth is a known sex trafficking victim or red flags indicate a child/youth might be a sex trafficking victim:
   
    
   1. Contact the Georgia Bureau of Investigation immediately to within 24 hours to provide notification and to discuss next steps, if the information was not previously reported by DFCS;
   2. Follow the procedures outlined in the Human Sex Trafficking Case Management Statewide Protocol in Forms and Tools: and
   3. Obtain sex trafficking specific services for the child and family (see policy 19.17 Case Management: Service Provision).
3. Review and analyze the information gathered during the interview(s).
   
    
   1. Identify inconsistencies or any information that requires clarification and a manner to resolve any inconsistencies or discrepancies.
   2. If injuries were observed or discussed:
      
       
      1. Does the caregiver appear truthful during your interview with them?
      2. Is any injury observed consistent with the story the caregiver provided?
      3. Is the care givers and child’s story consistent with each other?
      4. Was medical attention needed and provided?
      5. If medical attention was provided is follow up clear and planned?
      6. Does the medical team have any concerns regarding the injury and caregiver’s explanation regarding the injury?
      7. Is there a history of injuries with this child or any other children in the home?
   3. What does the interaction between the parent-child, placement resource-child, and other family members indicate regarding the child’s adjustment, progress made or lack thereof, etc.
   4. Identify areas for discussion and follow up during the next visit.
   5. Make necessary safety decisions in response to information gathered during the contact.
4. Consult with the Social Services Supervisor and/or subject matter expert (Field Assessment and Support Team, Field Program Specialists, Safety Master Practitioners, etc.) for assistance as needed.
5. Document purposeful contacts in Georgia SHINES within 72 hours of occurrence, including uploading any pictures, safety plans or documents to External Documentation.
6. Conduct safety screenings on new household members or caregivers revealed during purposeful contact as outlined in policy 19.9 Case Management: Safety Screenings and update the Person Detail Page in Georgia SHINES.
7. Engage individuals identified as collateral contacts to obtain pertinent and purposeful information for determining progress towards case plan goals, child safety, well-being and permanency; follow up on concerns identified during the purposeful contact to confirm or clarify information obtained, assessing caregiver protective capacities of the parent/guardian and caregiver, satisfying the conditions of return (see policy 19.16 Case Management: Collateral Contacts).
8. Work with the correctional facility if reunification services are available to the incarcerated parent.
9. Follow up on services provided to the caregiver or family as a part of their case plan by formal and/or informal service providers.
10. Make appropriate referrals necessary to implement needed services as outlined in policy 19.17 Case Management: Service Provision).
11. Follow up on commitments made during the visit.

Supervisor’s Role in Purposeful Contacts

The Social Services Supervisor (SSS) will:

1. Ensure purposeful contacts are occurring according to policy or as frequent as necessary to assess progress toward case plan outcomes to ensure safety and determine family functioning.
2. Use any or all following reports to track purposeful contacts:
   
    
   1. Case Worker Visitation Compliance Report (Lenses)
   2. Case Worker Child Visit Report (Georgia SHINES)
   3. Case Worker Child Visit Statewide Report (Georgia SHINES)
   4. Every Child Every Month (Georgia SHINES)
   5. Every Child Every Month – ECEM Visit Tracking (Lenses)
   6. Every Child Every Month – ECEM In-Home Visitation Percentage (Lenses)
   7. Cases without Case Manager Parent Visit List Report (Georgia SHINES)
   8. Cases without Case Manager Parent Visit Status Report (Georgia SHINES)
   9. Log of Contacts (Georgia SHINES)
3. Assist the SSCM in preparing a plan to ensure purposeful contacts are focused on the everyday life situations the family is having difficulty managing and safety, permanency and wellbeing.
4. Ensure he/she is accessible to the SSCM to provide guidance and consult with the SSCM in “real time” to discuss:
   
    
   1. Information gathered concerning areas of family functioning;
   2. Making a safety determination (safe or unsafe); and/or
   3. Present danger situations that exist or indications of impending danger safety threats.
5. Discuss the SSCM’s ongoing engagement with the family and ability to develop a partnership to ensure purposeful contacts can move the family toward achieving case plan outcomes and gathering the necessary information to assess child safety.
6. Ensure purposeful contacts are documented timely in Georgia SHINES within 72 hours of the occurrence, including pictures and observations.
7. Review purposeful contacts documented in Georgia SHINES to determine the sufficiency of the purposeful contacts, consider the following:
   
    
   1. To ensure the documentation meets guidelines as outlined in Documenting Purposeful Contacts in Practice Guidance.
   2. Does the documentation support the purposeful contact(s) is sufficient to progress the family toward achieving case plan outcomes to secure child safety?
   3. Is the information gathered sufficient to support the safety decision?
   4. Was the family engaged in manner that is conducive to building a partnership?
   5. Was the discussion with the family focused on the everyday life tasks the family is struggling with?
   6. Are inconsistencies documented that need to be resolved?
   7. Identification of any needed linkage of services for the family.

PRACTICE GUIDANCE

All contacts made with parents and their children provide an opportunity to build a trusting and supportive partnership. However, contacts are more than friendly visits. They should be well planned and have a clear purpose. In order to thoroughly assess a child’s safety, permanency, and well-being, it is important to assess the functioning of the family that is caring for the child. Some key principles around good practice to keep in mind when performing purposeful contacts include:

1. Recognizing the family providing care as a system - Each member of the family, including the child, has a role and responsibilities within the family. If any one person is unable to fulfill their responsibilities, then the whole family is impacted.
2. Engagement and partnership building - Purposeful contacts are not only about engaging and building a relationship with the caregiver, but also about engaging and building a relationship with the entire family including parents absent from the home.
3. Involvement of families and youth - Because each member of a family has a role and responsibilities, it is essential to obtain input from all family members when assessing family functioning. When family members are engaged, this will re-affirm their importance in ensuring the success of the family system.
4. Recognizing all members are individuals – Each family member will adjust differently to challenges to everyday life tasks. It is important to recognize the individuality of each family member and the impact DFCS involvement has on their lives.
5. Cultural awareness - Each family has their own culture. Culture impacts family rituals and traditions. As family functioning is assessed, we must be respectful of all cultures involved and how they impact the functioning of the family.
6. Empathy, authenticity, and transparency - During purposeful contact with family, we should be mindful of these three words: empathy, authenticity, and transparency. When engaging, we must be able to identify with their thoughts and feelings even though we may not always agree. We also must be genuine and open in our communication with all family members and recognize that we have some accountability regarding the success or failure of the family. Purposeful contacts are also a time for the family to hold us accountable for what we may or may not be doing on behalf of the family who has joined in partnership with us.
7. Remaining focused on safety, permanency, and well-being throughout the process.

Observing Children for Physical Signs of Maltreatment

Observing children for physical signs of maltreatment is an important part of ensuring child safety. To determine if there is cause to believe a child has been harmed, consider the following:

1. Non-verbal cues from the child or the caregiver that raise concern.
2. The age and special needs of the child. Young children and those with certain special needs are especially vulnerable and may not be able to verbalize when they are being abused or neglected. Therefore, the SSCM cannot depend on the child to say how they are feeling and must be keenly aware of non-verbal cues. For instance, if the child is wincing or drawing back slightly, it may be an indication of pain.
3. Statements made by the child, other children/household members/collaterals, etc. that indicate him/her may have been subjected to physical harm, etc.
4. Physical indicators of maltreatment such as suspicious injuries, marks, cuts, bruises, areas of swelling, protruding limbs, damaged skin, malnourishment, unexplained weight loss, lethargy, severe tooth decay, matted hair, pungent body odor, etc.
5. The child resides with the caregiver or other individual that harmed the child or another child.
6. The child indicates that physical discipline is being used; or that inappropriate methods of discipline is utilized by the caregiver or others in the home.

The SSCM may need to view areas of a child’s body that are covered by clothing to observe for signs of maltreatment and determine if the child needs medical treatment. This may require that the child (or caregiver for younger children) adjust their clothing. This can be embarrassing and anxiety provoking for the child. SSCMs must be sensitive to the child’s level of comfort and make every effort to reduce their discomfort. This can be accomplished by having an adult present that the child knows and trusts, and by asking the child or the caregiver (for children four years and under or those with special needs) to adjust one area of a child’s clothing at a time. Asking the child or the caregiver to raise a child’s pant leg or shirt sleeve one at a time, is less invasive, while allowing the SSCM to observe for signs of maltreatment. The child should never be fully unclothed. When possible arrange for a staff person of the same sex as the child to conduct the observation.

Assessing Injuries

Some characteristics of injuries are considered red flags and warrant further scrutiny, these include but are not limited to:

1. Injuries on children who are not mobile, especially infants.
2. Injuries on protected surfaces of the body, such as the back and buttocks, ears, inside the mouth, the neck, arms or legs, and underarms.
3. Multiple injuries in various stages of healing (i.e. skin injuries, lesions of varying ages, bruises).
4. Patterned trauma, even if the object used to commit the abuse cannot be determined.
5. Injuries that routine, age-appropriate supervision of the child should have prevented.
6. Significant injury with either no explanation or an explanation that is not plausible.

The SSCM may also need to observe the scene of the injury, to ascertain whether the caregiver and/or child’s statement of what happened is plausible.

1. Ask the caregiver and/or child to show him/her exactly what happened, and where.
2. Note anything about the physical environment that refutes the statement(s) provided. For example, if the caregiver claims that the child fell out of bed and hit their head on the floor, causing a severe bruise, the SSCM should look at the bed, the floor, and height from the bed to the floor. Is the floor carpeted? Is it plausible that the injury occurred on the carpeted floor?
3. Obtain a detailed, precise timeline of events surrounding the incident or track the sequence of events. The more detailed the history, the more likely the assessment of the injury will be accurate. This can be helpful when communicating with medical staff to determine if the injury could have been caused in the manner described by the caregiver and/or child.

Deliberate Information Gathering (DIG)⁴

Seek to understand the caregiver, his/ her point of view, story, and experience. That means to dig deeper for the information needed in order to understand the person, the situation and how these help explain both threats to child safety and caregiver protective capacities. The DIG idea is to be very deliberate in gathering information and seeking to understand while behaving very naturally. The following interpersonal techniques can be used while gathering information:

1. Attending Behavior

Attending behavior refers to focusing attention on the caregiver rather than the SSCM’s agenda or line of questioning. Attending behavior involves “matching” a caregiver’s nonverbal behavior by consciously manipulating and controlling the SSCM’s own nonverbal skills and responses. Primary attending behaviors include eye contact, facial expressions, body language, posturing and gesturing, following, reflecting and vocal qualities-tone and pace.

1. Open Questions

Open questions help to remove the SSCM from the responsibility of “carrying” the interview by establishing a conversational quality to the interaction. Open questions cannot be answered “yes” or “no” or in just a few words. Open questions require the caregiver to elaborate with a wider range of responses. Open questions are the “what” and “how” type questions.

1. Closed Questions

Closed questions should be used to restrict or narrow the focus of a caregiver’s response. Closed questions should be used purposefully when precise detail and greater clarity is needed from the caregiver. As an exception, closed questions may be used more frequently when there are time constraints or when the SSCM is interviewing a caregiver who is very concrete or is not very verbal.

1. Paraphrasing

The primary intent of paraphrasing is to facilitate the clarification of statements, issues, and concerns. Paraphrasing may involve the SSCM selecting and using a caregiver’s own keywords. Paraphrasing involves formulating the essential message that the caregiver is conveying and then stating that message back to the caregiver in the SSCM’s own words. When paraphrasing, check for accuracy of the statement by concluding the paraphrase with a simple question such as, “Is that correct?” or “Does that sound accurate?”

1. Encouraging

This technique serves to keep people talking about a particular topic, issue or concern. Encouraging may be as simple as using a slight verbal prompt, such as “uh-huh”, “I see”, “go on”, or “then what?”

1. Conversational Looping

Conversational looping is a skill for gathering information that first involves the SSCM identifying some key general topic or area for discussion with a caregiver (e.g., approach to parenting, problem-solving, dealing with stress, etc.). Once a topic has been identified, begin the conversation with a broad non-threatening open question. As the conversation progresses related to the identified topic, continue with a line of questioning (primarily open-ended) based on previous caregiver responses that progressively moves the discussion toward a more specific and intimate inquiry. A key to effective conversational looping is the ability of the interviewer to maintain a caregiver’s focus on a particular topic, which will then enable the interviewer to gather more detailed information from the caregiver about the issue, concern or topic inquiry.

Example: Parenting Approach

“So, how would you describe yourself as a parent?”

“Where do you learn parenting skills from?”

“What brings you the most satisfaction as a parent?”

“How does what you’re saying relate to your feelings about being a single parent?” The content areas that are explored through conversational looping or for any technique are the six family functioning areas.

1. Reflective Listening Statements

Reflective listening statements involve the SSCM’s attempts to interpret what a caregiver believes, thinks and/or feels, and then state the SSCM’s interpretation back to the caregiver. The interpretation of what the caregiver is communicating is based on both verbal responses and nonverbal cues from the caregiver. A statement is used rather than a question because the statement is less likely to produce caregiver resistance, and, further, a statement triggers the caregiver to re-examine the accuracy of his/her perceptions and thoughts. Example:

Caregiver: “I may have a couple of beers every once in a while, with my friends, but I don’t have a drinking problem.”

SSCM: “For you, drinking is no big deal…it’s just something you do socially with your friends?”

Separating Intentions from Actions

The human brain is very complex and an individual can experience differing even conflicting feelings about any given situation. It is not uncommon to have two thoughts on the same subject “I would like to..., but I am scared”. This same concept can also be interpreted to the individuals who may has caused harm to a child. “He deserved to be punished for not following the rules…, but I didn’t mean to hurt him. “He just would not stop crying, I was exhausted and wanted to sleep…., but I didn’t mean to shake him that hard.”

Separating intentions from actions means joining a partnership with the part of the person’s intentions that does not wish to have this event occur again in the future. Two methods used to help separate intentions from actions are:

1. Normalizing Family Struggles

Normalizing is a form of empathy (understanding) that acknowledges the family’s problems is part of the struggle of negotiating difficult life cycle stages, as well as strengths and efforts in coping with the problems. It also helps families learn that many others are in the situation. It does not downplay or dismiss the problem. It also does not condone or endorse the harmful behavior.

For example, can you remember failing a test in college to only find out the majority of the class failed the test too? It does not remove the failing grade, but deep down it does make you feel a little better that others are in the same situation. Sometimes knowing others failed too provides confirmation that the test was difficult.

It is not unusual for families to start of defensively in their relationship with the case manager. It also does not require much provoking from the case manager to create additional defensive behavior; sometimes a simple introduction can evoke a defensive response from the family. Normalizing can enable an assessment to be more complete by minimizing the possibility of the family or individual becoming defensive and refusing to engage with the case manager. When a partnership is not established information is

not being shared openly obstructing the gathering information process (assessment). Normalizing a family’s struggles can reduce the risk of defensive behavior by the family by attributing the family’s problems to struggles of negotiating difficult life cycle stages.

Parents who are not involved in their child’s life or have limited interactions with their child often say it is difficult

to just show up when you have nothing tangible to offer. Tell me about this.”

1. Externalizing the Problem Pattern

Externalizing the problem allows the family or individual to detach themselves from their problem. The individual can now view the problem as something that is separate from their identity as a person. In short, the person is not the problem, the problem is the problem. Language that externalizes the problem can reduce criticism, blame, and guilt. If one of the family members has an “anger” problem, externalizing the problem will free up the family to work on the problem rather than exhausting energy opposing each other or defending themselves. This creates the opportunity for the SSCM to work together with the family as a team to address the problem. Externalizing the problem does not mean minimizing the personal responsibility or shifting blame

For example, asking the individual, “How long have you struggled with the problem of controlling your temper?” Has the anxiety problem been around for a while?” Can you see how anxiety has limited your family from engaging in fun activities?” “If your family wasn’t plagued with the anxiety problem, what kind of activities would your family enjoy?”

Engagement of the Noncustodial Parent

Engagement of noncustodial parents is more than inquiring as to their interest in being involved with the child(ren). It requires making an effort to understand their situation and why they may feel the way they do. It is important to be aware of certain dynamics that may come into play in this process. Their behavior may be in response to previous negative experiences they have had with the custodial parent, preconceived notions about how they are perceived by others regarding the status of their parental involvement, or they may be reluctant because of their views about the child welfare system. Engagement of noncustodial parents can be facilitated by educating them on the process and exploring with them their possible role and how they can be a resource for the child(ren). The discussions with the custodial parent surrounding the involvement of the non-custodial parent need to occur during the development

of the case plan. Engagement should revolve around the noncustodial parent’s presence/engagement in the child’s life, care-giving abilities, cooperative parenting and emotional contributions to the child. A determination must be made about the non-custodial parent involvement with the child and their ability to contribute the outcomes of the case plan prior to establishing contact standards for the non-custodial parent Observing Parent/Guardian/Placement Resource and Child Interaction

Direct observation of parent/placement resource and child interactions can provide valuable insight into family functioning. Using what is directly observed as a major component of case decision-making is vital. Case decisions based on behavioral changes observed and documented are desired. If service provision is effective, there should be evidence of enhanced parenting skills. A case decision based only on compliance and/or what is reported by the parent/placement resource is never sufficient. Direct observation of parent/placement resource and child interactions can provide valuable information regarding:

1. The parent/placement resource-child relationship.
   
    
   1. What is the quality of the parent/placement resource and child bonding?
   2. Does the parent/placement resource engage the child in developmentally stimulating activities?
   3. Does the parent/placement resource handle the child roughly or is there an apparent comfort level in providing for the child's needs?
   4. Does the parent/placement resource identify the child's needs and respond to them in a nurturing way?
   5. Does the child seem fearful of the parent/placement resource?
2. Communication between the parent/placement resource and the child.
   
    
   1. Is communication verbal, non-verbal, physical, positive, negative, passive, more negative than positive?
   2. Does the child appear comfortable in communicating with the parent/placement resource?
3. Progress on the specified steps of the case plan.
   
    
   1. What changes in the parent's/placement resource’s interaction with a child are observed since the previous meeting and/or the implementation of service provisions (i.e. counseling, parenting skills training)?
   2. Is the parent/placement resource learning and practicing better ways of parenting this child?
   3. Are parents utilizing their action plan to avoid, interrupt or escape situations that would usually lead to high risk behaviors?
   4. Does the parent/placement resource redirect the child when unwanted behaviors are noticed?

How to Tell When a Family Is Functioning Well

Some characteristics identified with a well-functioning family include support, love, mutual caring, feeling secure, feeling a sense of belonging, open communication, and making each person within the family feel valued. Some questions to consider when determining whether a family is functioning well include:

1. Does the family have fun together despite their daily demands? What activities do they do together? What were they doing the last time they laughed together as a family? Does the family sit down to meals together?
2. Are there clear family rules that apply equally to all members? Are these rules flexible

enough to adapt to a change in the family dynamics/situation?

1. Are family members’ expectations of each other realistic, mutually agreed upon, and usually met?
2. Do family members achieve their goals, and are their needs being met?
3. Do all the children in the home have the same opportunities to participate in extracurricular activities?
4. How does caregiver spend individual time with each child?
5. Is there genuine respect between the parents and children? How do they demonstrate love, trust, and concern for one another? Do they demonstrate these the same way even when disagreements occur?
6. How does the family adapt to change? Do household members get upset or unhappy with change?

Why Make Contacts in the Home?

It is important to visit children in the home environment to assess safety and gain an understanding of the child’s living conditions. It is recommended that contacts be made in the home as often as possible. There is helpful information that may be gathered when interacting with parents and children in their home environment and it is important to make firsthand observations of the home environment to which the child may be returning. Despite having a child in foster care, parents may still have other children in their household. Moreover, if the permanency plan is reunification, it is important to make firsthand observations of the home environment to which the child may be returning

Announced or Unannounced Home Visits⁵

The nature of the reported allegations and the initial indication of the existence of a present danger situation or impending danger safety threat must be the first consideration when determining whether to make an announced or unannounced visit. If there is a present danger situation, this requires an immediate response, regardless of where the child is located. When a present danger situation is not apparent initially, the nature of the allegations and DFCS history, as well as the consideration of whether an interview could be tainted by an adult are important considerations when determining whether to do an announced or unannounced visit. Making an unannounced visit should be associated with timeliness, immediacy, or emergency situations. Unannounced visits are not discouraged when they are appropriate, but they should be necessary and justified based upon the individual circumstances of the case and its history. Supervisory consultation and guidance are an integral part of the discussion when preparing to engage a family during CPS intervention. A family needs to know that CPS is not there to “catch them doing something”, but to take action to protect a child. Therefore, there needs to be a specific, immediate, and clearly observable reason that a case manager makes an unannounced visit.

When a case manager is trying to build a partnership and consensus with a family he/ she must remember that courtesy and mutual respect is a core component of building effective and sustainable solutions to the difficult tasks or situations identified by a family. When possible a scheduled visit with a family can be an effective, convenient, and efficient process for all parties. The visit can be set to a time that is mutually convenient and include all household

5 Developed from the Administration for Children and Families; Unannounced Home Visits – Critical Assessment Tool or Barrier to Family Engagement? Centennial Topical Webinar Series September 26, 2012, Theresa Costello, Presenter

members. This alleviates the need to make multiple visits to complete interviews; saving time and effort for the case manager and caregiver(s) and shows an effort to be courteous and respectful of the family and their time.

Pictures

Pictures help enhance documentation related to the child safety and well-being assessment. When injuries are alleged or observed, photograph the area – whenever possible. In addition, use measurable objects (i.e., ruler, coin, pencil) to depict the size of the injury. When the allegations of maltreatment include that home conditions are a safety hazard to children, take pictures of the home and, when applicable, the yard.

Consideration for Additional Purposeful Contacts

1. Child is moved and adjusting to a new placement;
2. Permanency plan is changing;
3. Child is not adjusting to his/her placement;
4. Child vulnerability is increased because of age, disability, or behavior;
5. Child is transitioning to a pre-adoptive home;
6. Child is on a trial home visit;
7. Child is being prepared for reunification or other permanent living arrangement;
8. Placement provider is on a Corrective Action Plan (CAP) or is the subject of an active Child Protective Services (CPS) investigation;
9. Any other situations or circumstances where additional visits are warranted.

Contacts made by Contracted Agents (Private Providers)

DFCS now requires each private provider to conduct monthly purposeful visits with each child placed with their agency. Visits performed by the private provider do not replace those required of the assigned SSCM. The assigned SSCM must continue to make monthly face-to-face purposeful contact with children in DFCS custody. Prior to the visit the private agency staff member should contact (e-mail, telephone, fax or mail) the assigned SSCM to discuss the visit agenda. It is the responsibility of the SSCM to provide direction and structure regarding the visitation format and to ensure documentation of the visit is received within 72 hours of visit completion.

Safe Sleeping Recommendations for Infants up to One Year of Age

Caregivers of infants (birth to 12 months old) must be informed of conditions that constitute a safe sleeping environment and that reduce the risk of Sudden Infant Death Syndrome (SIDS), also known as “crib death”. At minimum, caregivers should be advised of the three primary safe sleep recommendations of the American Academy of Pediatrics (AAP) commonly referred to as the ‘ABCs’ of safe sleep:

Alone – The baby’s sleep area should be close to, but separate from, where caregivers and others sleep. The sleep area should be free of soft objects, toys, and loose bedding.

Back – Infants should always be placed on their back to sleep for naps and at night.

Crib – Place infants on a firm sleep surface, such as on a safety approved crib mattress, covered by a fitted sheet.

Further additional information and guidance regarding safe sleeping and SIDS/SUIDS see Infant Safe to Sleep Guidelines and Protocol in Practice Guidance.

Motor Vehicle ‘Hot Car’ Safety

Children are sensitive to heat as their body temperature can heat up three to five times faster than an adult’s. Children will die if their body temperature exceeds 107 degrees. Even at a temperature of 60 degrees outdoors, the temperature inside a car can exceed 110 degrees. The U.S. Department of Transportation (DOT) National Highway Traffic Safety Administration (NHTSA) recommends the following precautions to take in order to avoid child heatstroke.

1. Never leave a child unattended in a vehicle – even if the windows are partially open or the engine is running and the air conditioning is on;
2. Make a habit of looking in the vehicle – front and back – before locking the door and walking away;
3. Ask the childcare provider to call if the child does not show up for care as expected;
4. Do things that serve as a reminder that a child is in the vehicle, such as placing a phone, purse or briefcase in the back seat to ensure no child is accidentally left in the vehicle, or writing a note or using a stuffed animal placed in the driver's view to indicate a child is in the car seat;
5. Always lock your vehicle when not in use and store keys out of a child’s reach, so children cannot enter unattended. Teach children that a vehicle is not a play area;
6. A child in distress due to heat should be removed from the vehicle as quickly as possible and rapidly cooled.

Pictures

Pictures are useful for documenting injuries and/or the condition of the home environment; and may be used as evidence in an investigation or in court.

1. When taking pictures to document injuries, ensure the following:
   
    
   1. The caregiver and the child are informed of the need for taking the pictures.
   2. Each photograph should have one identifier present (i.e. piece of the child’s clothing), at least one photograph should include the child’s face and the clothing, to assure that the evidence collected demonstrates the series of pictures of the same child.
   3. Use measurable objects (i.e., ruler, coin, pencil) to depict the size of the injury. Photograph the object that caused the injury (whether the injury was accidental or not).
2. When taking pictures of the condition of the home related to safety hazards to the children, include all the areas that demonstrate a safety hazard, such as inside and outside the home, including the yard, when applicable.

NOTE: If the safety hazard is an infant unsafe sleep situation, take a picture of the area in which the infant currently sleeps.

1. All pictures should be identified with the following information: the individuals who took the photo, the date it was taken, name and date of birth of the alleged child victim, and if applicable the address where the injury occurred or the home with the safety hazards.

Documenting Purposeful Contacts

All visits must be documented on the Contact Detail page in Georgia SHINES within 72 hours of the contact. A narrative must be completed for each Contact Detail. At a minimum, the documentation entry must include:

1. The type of contact (e.g., face-to-face, announced, unannounced, etc.);
2. The date the contact occurred;

3. Person(s) present at the visit;

• Purpose of the visit;
• Where the visit occurred;
• Whether the caregiver or child was interviewed privately. If the child was not interviewed privately document the reason(s) why this did not occur.
• Summary of information:
  
   
  1. Progress toward action plan outcomes
  2. Progress toward case plan outcomes
  3. Sequencing of the event/situation that is causing concern;
  4. Safety, permanency, and well-being issues discussed;
  5. Consensus developed with the caregivers;
  6. Adjustments of the child in the placement resource home;
  7. Family functioning around everyday tasks (parent or placement resource)
  8. Safety determination (safe or unsafe)
  9. Safety plan management;
  10. Change that was noticed and celebrated with the caregiver(s).
• Observations of the home environment, children for injuries or signs of maltreatment and interactions of family members.
• Any concerns or red flags identified;
• Next steps: the plan for addressing identified issues or concerns and documentation of issue resolution.

FORMS AND TOOLS

Human Trafficking Case Management Statewide Protocol 

Infant Safe to Sleep Guidelines and Protocol