MISSOURI DEPARTMENT OF SOCIAL SERVICES CHILDREN’S DIVISION Critical Event Case Review – Open IIS
Name of Child	Case Family Name
Date Opened	Call/Case Number
Intensive In-Home Services (IIS) - (Not applicable when open case was result of current incident)
Name of Provider:
Was initial contact made according to IIS policy guidelines? Yes No
If no, explain?
Was ongoing contact made according to IIS policy guidelines? Yes No
If no, explain?
Last date child was seen by the worker prior to the incident?
How has ongoing safety been assured and assessed? (such as home visit, collaterals, family functioning assessment)
What service needs were identified? (explain)
What services were offered? (explain)
What services have been or are being utilized by the family?
What are the case plan goals?
Do the case plan goals address the needs identified by the family with the worker?
How was progress assessed during supervisory consultations?
Were collateral/professional provider contacts appropriately used and documented to address the identified issue? Yes No
Provide Examples:
Are there written reports from providers in the file? Yes No
Was a written referral made to the Juvenile Court? Yes No
If yes, discuss the request and the outcome.
If no, discuss why not.
Is there evidence in the file the IIS and AC/FCS worker are communicating? Yes No
Additional Reviewer Comments