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CPS social worker home visit checklist

CPS social worker home visit checklist

CPS workers use this form template for their home visit inspections. The minimum criteria that must be fulfilled are listed.

Use this template
or download pdf
CPS social worker home visit checklist

CPS workers use this form template for their home visit inspections. The minimum criteria that must be fulfilled are listed.

Use this template
or download pdf

About the CPS social worker home visit checklist

When conducting home visits, CPS social workers need a thorough and reliable system for documenting observations, safety checks, and family dynamics. A CPS social worker home visit checklist gives you a structured approach to collect vital information efficiently so that you can capture critical details.

Whether it’s assessing the safety of the living environment or documenting child welfare concerns, this template is designed to make your reporting process clear, organized, and effective.

Key elements of the CPS social worker home visit checklist

The checklist features the following sections for ensuring a home meets child safety and welfare standards:

  1. Home environment assessment: This section focuses on checking the physical conditions of the home, such as cleanliness, presence of hazards, and overall safety measures in place. Evaluating these factors helps you determine if the home provides a secure and supportive space for the child.
  2. Family dynamics and interaction: Observing how family members interact with the child is crucial. In this part of the checklist, you’ll assess parent-child relationships, caregiver behaviors, and any signs of neglect or conflict.
  3. Child’s physical and emotional state: Next, document the child’s physical health, emotional behavior, and general appearance to identify any immediate concerns that need addressing. This component is essential for tracking the child’s development and ensuring their needs are consistently met.
  4. Compliance and follow-up actions: Finally, you’ll note areas needing improvement and assign actionable tasks to caregivers. You can then schedule follow-up visits so issues are resolved promptly and t monitored over time.

Why you should use the CPS social worker home visit checklist

The best welfare of the child is the primary concern of CPS investigators and their agency. When a home visit must be made to parents, many different areas must be checked to properly assess whether the child or children are growing up in a hazard-free and child-friendly environment.

This CPS home visit checklist helps the inspector step by step to take care of all points and to evaluate them according to the requirements of the authority. With Lumiform’s digital tools, there is also the possibility to work with parents on inspection issues that need to be improved. To do this, actions are triggered and time-stamped.

This allows CPS investigators to track via the dashboard when a next home visit needs to be conducted to check if failed inspection points have been cleaned up.

Download Lumiform’s CPS social worker home visit checklist today

Simplify your home visit process by using this CPS social worker home visit checklist. This template empowers you to document crucial details without missing a step. Track family interactions, assess safety conditions, and organize tasks conveniently, making your workflow smoother and more reliable.

 

Related categories

Preview of the template
CPS Home Visit Inspection
General Information
Application/Provider Name
Address
City
ZIP Code
Telephone Number
General
The facility is clean, sanitary, and free of hazards including window blind cord hazards.
Adequate handrails and ramps provided.
Operating emergency lighting available.
Age appropriate furnishings and activities for children.
Bathroom, kitchen floors are washable.
Electrical outlets are tamper-proof if needed.
Premises are free from pests.
Address is clearly visible and location is accessible.
Pets and animals are safe and free from disease.
Light fixtures provide children good visibility and comfort.
Room temperatures at reasonable levels.
Home has adequate ventilation.
Home has adequate laundry facilities and storage.
The children have plenty of clothes.
Home Safety & Health
Knives, tools, matches, and other potentially hazardous materials are not accessible based on age, and identified safety concerns and behaviors specific to each child.
Chemicals, detergents, and other toxic substances are not stored with food products or accessible in any way that poses a risk to children.
Pools and hot tubes are secured and inaccessible to children.
Pools are adequately fenced to discourage climbing.
A supervision plan is in place when the home has a pool or bodies of water.
Combustible items are properly stored at least 36” from any heating sources.
Alcoholic beverages are inaccessible.
Smoking is prohibited in all living spaces and in car with children.
Guns and other weapons are secure and inaccessible to children.
Ammunition is inaccessible and separate from weapons if not in a gun safe.
Family vehicles have seatbelts. All drivers have a current license and insurance.
Family has car seats for the age range as needed.
Wheeled baby walkers will not be used.
Individual clean bed linens, towels, and wash cloths are provided for each foster child.
Home has at least one working telephone for emergencies.
Fire Safety
Flammable materials and poisons are inaccessible to children.
Stoves, heaters or obstacles do not block exit way.
Any barrier to exiting is easily opened and does not cause delay.
Lock on outside exit doors unlock when knob is turned from inside.
Home has one swinging exit door that is hinged or pivoted on the side.
The house has two exit doors.
Bedroom windows for children are large enough for emergency rescue.
Fireplaces, wood stoves, heatings systems have barriers for under age 6.
Smoke alarms are in good working condition and mounted correctly.
Home has at leats one working 2A10BC-rated 5lb. or lager fire extinguisher.
Multi-level homes must have escape from upper floor.
Family conducts regular fire drills with children.
Family has a written fire evacuation plan for the home.
Bedrooms
Bedrooms have adequate ceiling heights.
Bedrooms have unrestricted direct access to common rooms.
Room has adequate floor space for safety and comfort.
No more than 4 children per bedroom.
80 square meter if mother/father and her/his infant share bedroom.
Only one mother and newborn per bedroom.
Each child has at least a 27 inch wide clean, comfortable bed of their own.
All beds and cribs used for sleeping have waterproof mattress materials if needed.
Toddler beds have standard crib mattresses sufficient in length and width for the comfort of the child under age 6.
Crib meets all safety requirements.
Cribs must have no more tha 2 3/8 inches between slats.
Crip bumpers, stuffed toys, pillows not placed in cribs with infants.
Infants are placed on their backs for sleeping.
Upper bunks not used by anyone who might be endangered.
Sleeping arrangements for the kids are exist and fit to their ages.
Medical Care and Medications
First aid supplies are on hand.
Poison Control number with first aid supplies and posted on or near telephone.
All medications are in locked storage with pet medications separate from human medications and external medications separate from internal.
Prescription medications are given to children recorded.
Medications are given only according to prescription lables.
Food/Diet
Food served to children and infants meets needs of the children.
Enough healthy food is in the house.
Food is readily available to children.
Food is handled and properly stored to prevent contamination, spoilage, or a threat to the health of children.
Confirmation
Supervision plan is in place if hazardous conditions exist.
Applicant's Signature
Parents' Signature
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Frequently asked questions

What can I do to make sure I’m fully prepared for a home visit?

Before the home visit, review the case file, including any prior home visits, reports, and concerns raised. Familiarize yourself with the specific safety regulations and family dynamics involved. Always have your checklist ready, along with any necessary forms or documentation to record observations.

What should I focus on during a CPS home visit?

During a home visit, your focus should be on the child’s safety and well-being. Assess the home environment for hazards, observe family interactions, and check for signs of neglect or abuse. Pay close attention to the child’s physical condition, emotional behavior, and the overall living conditions.

What paperwork or documentation should I always bring to a CPS home visit?

Always bring your home visit checklist, previous reports, and any required forms for documentation. These include safety checklists, interview notes, and any relevant court orders or case plans. Having a digital form on hand, like those available through Lumiform, can make real-time documentation more efficient and reduce errors.

What are my next steps if I identify safety concerns during the home visit?

If safety concerns are identified, it’s important to take immediate action. First, document the issues thoroughly and clearly. Discuss these concerns with the caregivers, providing actionable steps for improvement. Depending on the severity, you may need to escalate the case for further intervention or request temporary placements for the child.

How do I determine the need for follow-up visits?

This depends on the severity of the concerns identified during the initial visit. If there are unresolved safety issues, or if actions have been assigned to caregivers, a follow-up visit is essential. Always monitor deadlines for improvements and reassess the living conditions until compliance with safety standards is met.

This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.