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Structure

In the realm of child welfare and protection, the role of mandated reporters is crucial. They serve as the eyes and ears on the ground, identifying and communicating potential cases of child abuse and neglect to the relevant authorities. The DCFS CW CPI-2 form stands at the heart of this critical reporting process, facilitating a streamlined and directed method for these individuals to fulfill their legal and ethical obligations. Designed by the Department of Children and Family Services (DCFS), this form not only aids mandated reporters in Louisiana in making their initial written reports to either DCFS or law enforcement but also offers a structured format for follow-up to previous oral reports. With comprehensive sections that guide the reporter through documenting essential details about the suspected child victim(s), the suspected perpetrator(s), and the nature and extent of the abuse or neglect, this form emphasizes the gravity and sensitivity of the information being reported. Moreover, it balances the need for thoroughness with the urgency of the situations it addresses, requiring that any known or pertinent information be shared, while also acknowledging the practical limitations reporters may face in collecting data. The ultimate aim of the DCFS CW CPI-2 form is clear: to safeguard the well-being of children by ensuring that reports of abuse and neglect are made in an informed, timely, and effective manner, underscoring the vital collaboration between mandated reporters, DCFS, and law enforcement in the protection of vulnerable children.

Form Example

Confidential

Department of Children and Family Services/Child Welfare

Written Report Form for Mandated Reporters of Child Abuse/Neglect

I understand that I am making a report of child abuse and/or neglect in good faith and in accordance with the Louisiana Children’s Code, Article 610 D. which requires me, as a mandated reporter, to send a written report to the Department of Children and Family Services (DCFS) or law enforcement within five days of having made an initial oral report. I understand that I may report suspected abuse and/or neglect in writing instead of an oral report.

Use: This form is available for you to use to make a written report of child abuse and/or neglect to DCFS or law enforcement. If you are unable to print out the form, contact any DCFS parish or regional office and one will be sent to you.

Completion: Complete each item with information known by you that may be pertinent to the suspected abuse/neglect. If there are items for which you have no information, please complete with “Unknown”. It is not necessary for you to try and get all information requested. If you need more space, please add a page. Once completed, it may be printed out and mailed or faxed to the DCFS office for the parish where the child lives or where you made the report. The local offices, addresses and fax numbers are on this web site (www.dcfs.la.gov.). If you have not yet made a report to DCFS, please fax this form as soon as possible. Thank you for your interest and commitment to the safety and well being of children.

This Written Report is:

Initial Written Report to DCFS

Report to Law Enforcement

Follow-up to oral report to DCFS on: (Date)

to (Parish)

DCFS Office

 

 

 

 

Is there any danger to a worker?

None known

Yes, Explain

Suspected Child Victim(s):

 

 

 

 

 

1.

Name:

 

DOB/Age:

 

Race:

 

Sex:

2.

Name:

 

DOB/Age:

 

Race:

 

Sex:

3.

Name:

 

DOB/Age:

 

Race:

 

Sex:

Home Address:

 

 

 

 

 

 

Telephone:

 

 

 

Parents/Caretakers Names:

 

 

 

 

 

 

 

 

 

 

 

Others in Home:

 

 

Age:

 

 

 

Race:

 

 

Sex:

 

(Children & Adults

 

 

 

 

 

 

 

 

 

 

 

if known)

 

 

Age:

 

 

 

Race:

 

 

Sex:

 

 

 

 

 

 

Age:

 

 

 

Race:

 

 

Sex:

 

 

 

 

 

 

Age:

 

 

 

Race:

 

 

Sex:

 

Suspected Perpetrator(s):

 

 

 

 

Relationship to Child:

 

 

Suspected Perpetrator(s):

 

 

 

 

Relationship to Child:

 

 

Suspected Perpetrator’s Address:

Nature, extent and cause of each child’s injuries, neglect or endangered condition, including any previous known or suspected abuse to this child or the child’s siblings:

Page 1

DCFS/CW Form CPI-2

 

 

Reissued: 01/12

Replacing: 6/08

Suspected Child Victim’s Name (from Page 1):

What is current circumstance/condition of the child victim and are they currently in danger of serious injury or harm? Why?

Identity of any child or adult who gave any explanation of the child’s injury or condition, along with the date and details of the explanation:

How and when did this child(ren) victim come to your attention?

What services and/or referrals have been provided to the child/family by you or your agency/facility?

Have you previously reported abuse/neglect on this child or any of his siblings?

No

Yes

If yes, please give number of times, approximate dates, persons reported, office to which reported and outcome, if known:

What is going well for the family; areas of parenting they handle adequately; and, was there a time when they adequately cared for or protected the child(ren), if known?

Other Pertinent Information (other persons with information about the family and way to contact)

Reporter’s Printed Name:

 

 

 

 

 

 

Phone # to Contact:

 

Signature:

 

 

 

 

Date:

 

 

Best Contact Time:

 

Position/Type of Reporter:

 

 

 

Agency/Provider:

 

 

 

 

Reporter’s Address:

 

 

 

 

 

 

 

 

 

 

 

Page 2

DCF/CW Form CPI-2

 

 

Reissued: 01/12

Replacing: 6/08

Document Breakdown

,
Fact Detail
Form Name DCFS/CW CPI-2
Purpose Written report for mandated reporters of child abuse/neglect
Governing Law Louisiana Children’s Code, Article 610 D
Reporting Requirement Mandated reporters must send a written report within five days of an initial oral report
Alternative to Oral Report Can be used for writing instead of an oral report
Completion Instructions Fill with known information, add pages if necessary. Use “Unknown” where information is not available
Submission Method Mailed or faxed to the DCFS office for the parish where the child lives or where the report was made
Finding Local Offices Addresses and fax numbers on www.dcfs.la.gov
Sections of the Report Includes sections on suspected child victims, perpetrator(s), nature of injuries or neglect, current child condition, explanations for conditions, how the victim came to attention, services provided, previous reports, family strengths, other pertinent information
Reporter Information Requires reporter’s name, phone, signature, date, best contact time, position/type, agency/provider, address

Instructions on Filling in Dcfs Cw Cpi 2

Once an individual has made an oral report of child abuse or neglect, subsequent written documentation becomes a critical next step to ensure the report is thoroughly recorded and acted upon. The DCFS CW CPI-2 form serves as an official written report to either the Department of Children and Family Services (DCFS) or law enforcement, in line with the requirements set out in the Louisiana Children’s Code, Article 610 D. Filling out this form accurately and completely adds to the effectiveness of the investigation into the reported child abuse/neglect, aiding in the protection and welfare of the child or children involved. Here are detailed steps on how to fill out the form:

  1. Read the entire form first to understand the type of information required.
  2. Indicate the nature of the report at the top of the form by selecting either "Initial Written Report to DCFS," "Report to Law Enforcement," or "Follow-up to oral report to DCFS" and fill in the date and the parish DCFS office the oral report was made to, if applicable.
  3. Under "Is there any danger to a worker?" check the appropriate response and provide details if there is known danger.
  4. In the "Suspected Child Victim(s)" section, list each child's name, date of birth or age, race, and sex. Include their home address and telephone number if known. For multiple children, use the space provided and add additional sheets if necessary.
  5. Fill in the names, ages, races, and sexes of the parents/caretakers and other individuals living in the home.
  6. For the "Suspected Perpetrator(s)" section, provide their name, relationship to the child, and address if known.
  7. Describe the nature, extent, and cause of each child’s injuries, neglect, or endangered condition in detail, including any previous instances of known or suspected abuse to this child or siblings.
  8. On page 2, continue with the suspected child victim's name. Explain the current circumstances of the child, including whether they are in immediate danger, and why.
  9. Record any explanations given for the child’s injuries or condition, including who provided the explanation, along with the date and details.
  10. Detail how and when the child(ren) came to your attention.
  11. Describe any services and/or referrals provided to the child/family by you or your agency/facility.
  12. If you have previously reported abuse/neglect on this child or siblings, provide details including the number of times, approximate dates, persons reported, office to which reported, and outcome if known.
  13. Highlight what is going well for the family, areas of parenting they handle adequately, and times they adequately cared for or protected the child(ren), if known.
  14. Under "Other Pertinent Information," list any other individuals with information about the family and how they can be contacted.
  15. Complete the reporter section with your printed name, best contact phone number, signature, date, best contact time, position/type of reporter, agency/provider, and your address.
  16. Review the form to ensure all information is accurate and no section has been missed. Attach additional sheets if you needed more space for any sections.
  17. Follow the instructions for submitting the form, which may be printed and mailed or faxed to the DCFS office for the parish where the child lives or where the report was made. Refer to the DCFS website for local office addresses and fax numbers.

After submitting the form, it is important to keep a copy for your records and await further instructions from DCFS or law enforcement. Your diligence and accuracy in filling out the form play a crucial role in the protection and well-being of children at risk of abuse or neglect.

Listed Questions and Answers

What is the purpose of the DCFS CW CPI-2 form?

This form serves a critical role in safeguarding children's welfare. It is a structured document for mandated reporters to report instances of child abuse and/or neglect to the Department of Children and Family Services (DCFS) or law enforcement. This form ensures that the details of the suspected abuse or neglect are thoroughly documented and that all necessary information is conveyed to the relevant authorities, facilitating a prompt and appropriate response to protect the child or children involved.

Who is required to fill out the DCFS CW CPI-2 form?

Mandated reporters are required to complete and submit the DCFS CW CPI-2 form. These are individuals who, due to their profession, are legally required to report any suspicion of child abuse or neglect. Mandated reporters typically include teachers, doctors, nurses, social workers, and law enforcement personnel, among others. Their position enables them to observe and interact with children regularly, making them crucial to early detection of issues that may harm a child.

How can I submit the DCFS CW CPI-2 form?

The completed DCFS CW CPI-2 form can be submitted either by printing it out and mailing or faxing it to the local DCFS office for the parish where the child resides or where the report is being made. The addresses and fax numbers for these local offices can be found on the DCFS website (www.dcfs.la.gov). Submitting the form promptly is essential to ensure that any potential risk to the child is addressed in a timely manner.

What information is needed to complete the DCFS CW CPI-2 form?

Completing the form requires detailed information about the suspected case of child abuse or neglect, including:

  • The child(ren)'s name(s), date of birth/age, race, and sex.
  • The home address and contact information of the child(ren).
  • Details of the parents or caretakers, as well as other individuals living in the home.
  • Information about the suspected perpetrator(s), including their relationship to the child and address.
  • Detailed descriptions of the nature, extent, and cause of the child's injuries, neglect, or endangered condition, including any previous instances of suspected abuse or neglect.

If certain pieces of information are unknown, it's essential to complete those sections with "Unknown" rather than leaving them blank. The form also provides space for any additional details that might assist in the investigation.

What happens after the DCFS CW CPI-2 form is submitted?

Upon submission, the form is reviewed by DCFS or law enforcement officers, who will then initiate an investigation into the reported concerns. The investigation aims to assess the child's safety and well-being, understand the circumstances around the reported abuse or neglect, and determine what actions or interventions are necessary to protect the child. The person who submitted the report may be contacted for further information or clarification. The process is designed to act in the best interests of the child, ensuring their safety and well-being are paramount.

Common mistakes

When filling out the Department of Children and Family Services/Child Welfare Written Report Form for Mandated Reporters of Child Abuse/Neglect (DCFS CW CPI-2 form), people often make several common mistakes that can impact the effectiveness and efficiency of the reporting process.

  1. Not reporting orally before filling out the form. Mandated reporters are required to make an initial oral report to DCFS or law enforcement.
  2. Omitting the date of the initial oral report to DCFS when completing the form for a follow-up written report.
  3. Failing to specify if there is any danger to a worker, which is critical for ensuring the safety of DCFS staff and other involved parties.
  4. Leaving sections blank instead of indicating "Unknown" for items where information is not available. This mistake can lead to unnecessary confusion and delay in the investigative process.
  5. Not providing detailed information about the nature, extent, and cause of the child’s injuries, neglect, or condition, which is essential for a thorough assessment and appropriate response.
  6. Forgetting to add additional pages for extra space if the provided space is insufficient for complete answers, potentially leaving out crucial information.
  7. Overlooking the necessity to outline previously reported abuse/neglect on the child or the child’s siblings, if applicable. This information is vital for understanding the full context and history.
  8. Incorrectly listing or failing to provide the suspect perpetrator’s relationship to the child, which is crucial for the investigation.

Adhering to the instructions and ensuring all pertinent information is accurately entered can expedite the process and enhance the protection provided to the child or children in question.

Documents used along the form

When professionals engage in the critical task of reporting child abuse and/or neglect, it's essential they have a comprehensive understanding of the tools at their disposal. Alongside the principal document, the Department of Children and Family Services/Child Welfare Written Report Form for Mandated Reporters of Child Abuse/Neglect (DCFS CW CPI 2), there are several other forms and documents that support and enhance the reporting and investigation process. Each plays a distinct role in ensuring that the well-being and safety of children are thoroughly protected.

  • Child Intake/Affidavit Form: This document is critical in gathering initial information about the child in question. It serves as a preliminary account, collecting basic identification details, the nature of the alleged abuse or neglect, and any immediate action taken. This form provides a structured way to document the child's circumstances at the time of report.
  • Family Composition Form: To understand the context in which a child lives, it's important to have a detailed overview of the household. This form catalogs the members of the child's household, including names, ages, relationships to the child, and any relevant historical information. Such insights are crucial for assessments and planning appropriate interventions.
  • Investigation Summary Report: After an initial report is made, an investigation is often the next step. The Investigation Summary Report encapsulates the findings from this inquiry. It includes observations, statements from interviews, results from home visits, and any evidence collected. This document is instrumental in building a case and deciding on the next steps for the child’s safety.
  • Service Plan/Action Plan Form: Following an investigation, it may be determined that the child and family require support services. This document outlines the specific interventions planned for the child and family members, setting goals and detailing the responsibilities of each party involved. A clear, actionable plan is essential for ensuring the child’s needs are met and risks are mitigated.

Together, these documents create a robust framework for addressing and managing cases of child abuse and neglect. By using these forms in conjunction with one another, mandated reporters and child welfare professionals can ensure that every child’s situation is thoroughly assessed, monitored, and acted upon with the highest level of care and precision. It's a collaborative and comprehensive approach to safeguarding vulnerable children and supporting families in need.

Similar forms

The DCFS CW CPI 2 form is similar to other documentation used in child welfare reporting and case management. Specifically, it shares characteristics with the Child Abuse Mandated Reporter Form used in other states and the Child Welfare Services Report Form. Each of these documents is designed to collect comprehensive information regarding suspected cases of child abuse or neglect, enabling a coordinated response from child protection agencies.

The Child Abuse Mandated Reporter Form, found in various states, is one such document that shares a purpose with the DCFS CW CPI 2 form. Like the DCFS form, the Mandated Reporter Form is intended for individuals who are legally obligated to report suspicions of child abuse and neglect—such as teachers, healthcare providers, and social workers. Both forms require the reporter to provide detailed information about the suspected victim(s), the suspected perpetrator(s), the nature of the suspected abuse or neglect, and any known prior incidents. They also emphasize the importance of timely reporting to the appropriate authorities and ensuring that all known information is conveyed to support the child's safety and well-being.

The Child Welfare Services (CWS) Report Form is another document with similarities to the DCFS CW CPI 2 form. This form is typically used by child welfare agencies to document and manage cases of suspected or confirmed child abuse and neglect. Similar to the DCFS CW CPI 2 form, the CWS Report Form collects detailed information on the child victims, such as their names, dates of birth, and home addresses. It also requires information on the nature and extent of suspected injuries or neglect, the identities of the perpetrators, and any actions taken by the reporting individual or agency to address the child's needs. Both forms are vital tools in the process of investigating child abuse and neglect reports and initiating interventions to protect vulnerable children.

In summary, the DCFS CW CPI 2 form shares key features with both the Child Abuse Mandated Reporter Form and the Child Welfare Services Report Form. They are all centered on the collection of crucial information necessary for the effective response to and management of child abuse and neglect cases. While each form may be used in different jurisdictions or contexts, their common goal is to ensure the safety and well-being of children by facilitating the accurate reporting and documentation of suspected abuse or neglect.

Dos and Don'ts

When filling out the Department of Children and Family Services/Child Welfare Written Report Form for Mandated Reporters of Child Abuse/Neglect, also known as the DCFS CW CPI 2 form, attention to detail and compliance with its instructions are paramount. Observing the following guidelines will ensure that the submission of this critical report is both accurate and effective in aiding the intended child welfare investigations. Here is a concise list of the dos and don'ts:

  • Do make your report in good faith, adhering strictly to the requisites outlined in the Louisiana Children’s Code, Article 610 D.
  • Do complete all items with any information known to you that might be pertinent to the case of suspected abuse/neglect. If the information for certain items is not available to you, fill in with “Unknown”.
  • Do include additional pages if the space provided on the form is insufficient for your report.
  • Do send the completed form via mail or fax to the DCFS office for the parish where the child resides or where the report was made, using the contact information available at www.dcfs.la.gov.
  • Don't attempt to gather all requested information if it's not readily available to you or if doing so would delay the reporting process.
  • Don't overlook the necessity of submitting an initial oral report to DCFS or law enforcement before sending your written report, should circumstances warrant immediate attention.
  • Don't disregard the question regarding any potential danger to a worker—it's crucial for ensuring the safety of all involved.
  • Don't delay sending your written report after making an initial oral report. The form should be faxed or mailed as soon as possible in compliance with the requirement to submit within five days.

This concise guide aims to ensure a thorough and timely submission process, ultimately contributing to the protection and well-being of children. The commitment to meticulous reporting reflects a shared responsibility toward the safeguarding of vulnerable individuals and supports the efforts of child welfare services.

Misconceptions

Many misconceptions surround the Department of Children and Family Services/Child Welfare Written Report Form for Mandated Reporters of Child Abuse/Neglect (DCFS CW CPI-2 form). Understanding these misconceptions is vital to ensuring that mandated reporters are both informed and effective in the important role they play in protecting children. Here are five common misunderstandings:

  • Misconception 1: The form can only be submitted after making an oral report.
    Many believe that the DCFS CW CPI-2 form can only be filled out and submitted after a mandated reporter has made an initial oral report. However, this form allows for the initiation of a report through written means instead of orally, though it's often recommended to follow up an oral report with this written document for thorough documentation.
  • Misconception 2: All information must be fully detailed and complete.
    While completing the form, some reporters might feel pressured to provide comprehensive details for every section. The guidance on the form encourages reporters to fill in each item with information known to them and to mark "Unknown" where information is not available. The mandate is to report suspicion based on available knowledge, not to complete an exhaustive investigation.
  • Misconception 3: You need special permission or credentials to access the form.
    There's a false belief that access to or use of the DCFS CW CPI-2 form is restricted by certain credentials or permissions. In reality, the form is available for all mandated reporters who suspect child abuse or neglect. If someone cannot print out the form, they can easily contact a DCFS office to have one provided to them.
  • Misconception 4: The form is only for reporting new cases.
    Another misconception is that the DCFS CW CPI-2 form is exclusively for the reporting of new instances of abuse or neglect. The form actually serves multiple purposes, including acting as a follow-up to an oral report or reporting to law enforcement, as indicated directly on the document.
  • Misconception 5: The form's submission is an end in itself.
    Some might think that once the form is submitted, their role and responsibility end there. It's essential to recognize that the submitted form is part of an ongoing process. Reporters may be contacted for further information, and they may play a crucial role in the continued protection of the child or children involved.

Understanding these misconceptions about the DCFS CW CPI-2 form clarifies the responsibilities and expectations placed on mandated reporters. It also ensures that they can effectively contribute to the safety and well-being of children in potentially harmful situations.

Key takeaways

When handling the DCFS Cw Cpi 2 form, it's essential to understand its importance and the correct way to fill it out. This document plays a crucial role in the process of reporting child abuse and neglect. Below are five key takeaways to consider:

  • Mandated reporters are required by law to submit a written report to the Department of Children and Family Services (DCFS) or law enforcement within five days after making an initial oral report of suspected child abuse or neglect.
  • The form serves both as an initial written report to DCFS or law enforcement, and as a follow-up to an oral report previously made. This flexibility allows for a thorough documentation process of the suspected abuse or neglect.
  • It is crucial to complete each item with as much detail as known, but it's also important to mark items with "Unknown" if specific information is not available. This helps to ensure that no detail is overlooked while acknowledging the limits of the reporter's knowledge.
  • If additional space is needed for any section, reporters are encouraged to add extra pages. This ensures that all pertinent information is included, providing a comprehensive view of the situation.
  • The form can be submitted by printing it out and mailing or faxing it to the DCFS office for the parish where the child lives or where the report was made. Timely submission is crucial for the safety and well-being of the child involved.

Understanding and properly completing the DCFS Cw Cpi 2 form is a step towards ensuring the safety and welfare of children. Reporters play a vital role in this process, and their commitment to detail and adherence to submission guidelines can make a significant difference in the lives of children in need.

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