Newborn Crisis Assessment Supervisor Guide
Considerations for Assignment:
Is the assigned worker a seasoned worker with experience assessing high risk situations? If the worker is not seasoned, consider re-assigning to a seasoned worker to ensure thorough assessment of risk factors. If the assigned worker is not seasoned and it is not possible to re-assign to a seasoned worker, did the supervisor meet/speak with the assigned worker prior to initial contacts to discuss prior history, potential risk factors, and how to begin assessing the family/situation?
Verification of Safety:
Did a CD worker or multi-disciplinary team (MDT) member have face to face contact with the infant of concern within three (3) hours from the time the NCA was screened in by CANHU? How was safety verified by the Children’s Division or MDT member? If a MDT contact was used to verify initial safety of the infant, did a CD worker have face to face contact with the infant of concern within seventy two (72) hours from the time the NCA was screened in by CANHU? If there are other children in the home, did a CD worker have face to face contact with the other children within seventy two (72) hours from the time the NCA was screened in by CANHU? Is safety noted SAFE or UNSAFE in the worker’s documentation? Where was the infant seen? What information was provided by the other children in the home (if applicable)? What evidence is there of existing safety? What are the vulnerabilities of the infant and other children in the home (if applicable)? If unable to locate the infant and/or other children in the home within timeframes, what efforts have been made and what further efforts will be made to locate the child(ren)? If unable to locate the infant and/or other children in the home within timeframes, are attempts being made daily to locate them by the CD worker? Was the supervisor notified of the infant and/or other children in the home not being located within timeframes? Has initial contact with the infant and other children in the home (if applicable) been entered into FACES within seventy two (72) hours? If not, why? If unable to locate the infant and/or other children in the home (if applicable), have the attempts to locate them been entered into FACES within the seventy two (72) hour period? If not, why? Has the supervisor checked FACES to verify that initial contacts with the infant and other children in the home (if applicable) has been entered correctly?
Contact with Parent(s):
Did the CD worker have face to face contact with the parent(s) to discuss concerns noted in the NCA? Have the parent(s) been provided the Description of Newborn Crisis Assessment Process (CS-24b)? Have the parent(s) been provided the Safe Sleep Flyer (CD-278)? How was safe sleep information discussed with the parent(s)? Was it through an open dialogue? What are the potential barriers to practicing infant safe sleep (ex: substance use, breast feeding, lack of supplies, lack of knowledge, lack of buy-in from parent(s)/caretaker(s), etc)? If barriers to practicing infant safe sleep exist, how were those barriers discussed and worked through? What are the parents’ plans for practicing infant safe sleep (especially during night time feedings)? Was there a conversation about Home Visiting services in the area? Did the parent(s) agree to participate in local Home Visiting services? If so, did the CD worker submit a Referral for Home Visiting Services (CD-261) to the local Home Visiting provider? What was the discussion surrounding the concerns in the NCA with the parent(s)? Are the parental protective capacities sufficient? Why or why not? If the parent protective capacities are insufficient, what is CD doing to address? Did the CD worker complete an in person home visit at the home where the infant will be residing? Did the CD worker ensure the family had all supplies needed to meet the needs of their infant and other children in the home? Was the infant safe sleep environment observed and discussed with the family?
Determining the Need for a Plan of Safe Care:
Is the infant exhibiting or being observed for symptoms of withdrawal? Was the infant born with Fetal Alcohol Spectrum Disorder? Was the infant born suffering from Neonatal Abstinence Syndrome? Does the Mother have a recent history of misusing substances? What are the toxicology results for the Mother and infant? What are the parent(s) position on substance misuse? Has Mother recently been referred to substance use services or is she currently involved with substance use services? What was discussed between CD worker and medical professionals (preferably Mother’s assigned Obstetrician and infant’s assigned Pediatrician) as it relates to a Plan of Safe Care and/or substance use? Did the assigned Obstetrician begin a Plan of Safe Care prenatally with Mother? Including referrals for substance use services or documentation of discussions around substance use? Has CD worker had conversations with existing substance use service providers for Mother? Is there a potential for continued substance misuse by Mother or other primary caretaker(s)? Is there a possibility that substance use or possible continued substance use could impact the practice of infant safe sleep? If there is a concern for positive toxicology results, recent substance use during pregnancy, and/or possible continued substance usage, what does the Plan of Safe Care include to ensure the immediate and continued safety of Mother and the infant? This plan should include referrals for substance use services (including those made prenatally by Obstetrician or other medical providers), active substance use services, and a practical plan to ensure the continued safety of the Mother and infant. If it has been determined that a Plan of Safe Care is needed, has the Obstetrician or other medical providers working with the family been included in the planning process? If a Plan of Safe Care has been determined as needed, has the supervisor checked FACES to verify that the Plan of Safe Care has been thoroughly documented on the Newborn Crisis Assessment Tool (NCAT) and that the NCAT has been uploaded to OnBase?
Safety Planning:
Is an Immediate Safety Intervention Plan (CD-263) needed? What are the terms of the safety plan? Who will be involved in the safety plan? If the Immediate Safety Intervention Plan is not working to resolve the identified safety threat(s), what steps will be taken to ensure safety of the child(ren)? Does the Immediate Safety Intervention Plan include the family support network (both informal and formal)? Are all individuals involved in the Immediate Safety Intervention Plan aware of the terms of the safety plan and agree to the terms? Who will monitor the safety plan? How long will the safety plan be in place? When will the safety plan need to be reassessed? Are there any supervisor recommendations or modifications regarding the safety plan? Has the supervisor reviewed and signed the safety plan? Has the Immediate Safety Intervention Plan (CD-263) been uploaded into OnBase?
Risk Assessment:
How does the family`s prior history relate to the current concerns in the Newborn Crisis Assessment? What services have been previously provided to the family? What services are the family currently involved with? Were prior services successful in reducing safety concerns? Is the family actively engaging in services? How do the biological and developmental ages of the infant and other children in the home 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 use needs within the family? Is mental health or substance use 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 Newborn Crisis Assessment? The risk assessment was completed and entered in FACES within 72 hours of the report date and time, and yielded a neglect score of ___, and an abuse score of ___, putting the risk in the overall ______ range. This level is being influenced by the following: If the risk assessment score was high or very high, discuss why or why not you will be opening a FCS case.
Additional Supervisor Recommendations/Responsibilities:
Has the NCAT been thoroughly completed and uploaded to OnBase? Has a medical professional (preferably the assigned Obstetrician and infant’s assigned Pediatrician) been included in FACES contacts as collateral contacts? Has the Newborn Crisis Assessment remained open at least twenty (20) days? Are there continued areas of need and/or concerns that would warrant this assessment becoming a Differential Response Assessment? Has the supervisor conducted a seventy two (72) hour supervisory consultation, as well as a closing supervisory consultation prior to approving the conclusion of a Newborn Crisis Assessment? Has the family been referred for all services that would be of benefit to them?