Culture is a system of shared actions, values, beliefs, and traditions that guide the behavior of families and communities. For this item, cultural identity may refer to a family member’s race (African American/Black, American Indian/Alaska Native, Asian/Pacific Islander, Latino/a, multiracial, White, other), ethnicity, tribal affiliation, sexual orientation (heterosexual, gay, lesbian, bisexual), gender identity/expression (female, male, transgender, other), religious/spiritual affiliation, disability, or other social identity that reflects the family’s unique characteristics.

Keep in mind that family members may identify with multiple cultures and that a person’s dominant cultural identification may shift with the context. For example, in some situations, it may be more important to the caregiver to identify as a disabled person than to identify with an ethnic group. Cultural identity is not limited to identification with a nonmainstream culture and may refer to the mainstream culture.

Connecting culture, identity, and caregiving/parenting

Consider how the family’s culture, cultural identity, norms, and past/current experiences of discrimination/oppression may influence or shape parenting and caregiving.

In particular, consider the following.

• How the caregiver identifies themself (see culture and cultural identity above);
• Any historical experiences of oppression/discrimination that are important or relevant to this caregiver;
• Any current experiences of oppression/discrimination this caregiver might be experiencing; and
• Any coping skills, strengths, and survival skills this caregiver has developed or demonstrated in facing oppression/discrimination.

How do all of the above influence or shape the caregiver’s beliefs about parenting or childrearing? How do all of the above influence or shape the caregiver’s actions with their children?

The caregiver's perspective of culture and cultural identity:

a. Actively helps create safety, permanency, and child/youth/young adult well-being. The caregiver draws upon their culture to respond to challenges in ways that create safety for the child/youth/young adult.

b. Is not a strength or barrier for safety, permanency, or child/youth/young adult well being. The caregiver is connected to a culture and/or identifies with a culture and this has no impact on child/youth/young adult safety.

c. Is a barrier to safety, permanency, or child/youth/young adult well-being. The caregiver is connected to a culture and/or identifies with a culture in ways that cause struggles for the child/youth/young adult, such as mild to moderate conflict with the caregiver over culture/cultural identity or disrupted relationships with the child/youth/young adult based on cultural differences.

d. Contributes to imminent danger of serious physical or emotional harm to the child/youth/young adult. The caregiver is connected to a culture and/or identifies with a culture in ways that cause danger for the child/youth/young adult, such as physically or emotionally harming the child/youth/young adult over differences in culture/cultural identity.

Consider the caregiver's management of available financial resources to meet basic care needs related to the child/youth/young adult's health and safety.

The caregiver's resources and management of resources:

1.  Actively help create safety, permanency, and child/youth/young adult well-being. The caregiver has a history of consistently providing adequate housing, food, and clothing. The caregiver has the ability to problem solve and proactively seek resources to meet the family's ongoing needs.
2. Are not strengths or barriers for safety, permanency, or child/youth/young adult well-being. The caregiver has adequate housing, food, and clothing. The caregiver adequately and/or successfully manages available resources to meet basic care needs related to health and safety.
   OR
   The caregiver may have limited/no income, but he/she is able to secure assistance independently (e.g., use of food pantries, Temporary Assistance to Needy Families, Supplemental Nutrition Assistance Program/food stamps, etc.) that will be sufficient for the long term (e.g., caregiver has a plan for the next six months).
3. Are barriers to safety, permanency, or child/youth/young adult well-being.
   • The caregiver provides housing, but it is in poor repair due to inadequate utilities or housekeeping.
   • Caregiver may have limited/no income, and he/she is unable to secure assistance independently (e.g., food pantry) OR has been able to secure only short-term assistance (e.g., motel vouchers, limited-time food pantry, etc.)
   • Food and/or clothing may sometimes not meet child/youth/young adult's basic needs.
   • The family may be homeless; however, there is no evidence of harm or threat of harm to the child/youth/young adult.
   • The caregiver does not adequately manage available resources, which results in difficulty providing for basic care needs related to health and safety (e.g., getting to necessary medical appointments, purchasing needed medications, providing supervision). However, this condition is not chronic, and the child/youth/young adult has not experienced harm or threat of harm.
4. Contribute to imminent danger of serious physical or emotional harm to the child/youth/young adult. Considering the age and vulnerability of the child/youth/young adult, resource conditions exist in the household that have already caused illness or injury to family members, or are immediately likely to cause illness or injury, such as:
   • Inoperable plumbing, heating, or wiring, causing an imminent threat of harm to the child/youth/young adult;
   • No food, food is spoiled, or family members are malnourished;
   • Child/youth/young adult chronically presents with clothing that is unclean, not appropriate for weather conditions, or in poor repair to the extent that the child/youth/young adult experiences physical harm (e.g., rash from soiled clothing, frostbite from inappropriate clothing);
   • Family is homeless, which results in harm or threat of harm to the child/youth/young adult; or

Caregiver lacks resources, or severely mismanages available resources, which results in unmet basic care needs related to health and safety. Caregiver may consistently leave child/youth/young adult's basic needs unmet while using resources for other priorities.

When assessing, consider both the diagnosed or suspected condition AND the impact that such conditions have on the caregiver’s ability to adequately parent and protect the child/youth/young adult. The condition itself does not necessitate the selection of “d.”

The caregiver’s physical health:

a. Actively helps create safety, permanency, and child/youth/young adult well-being. The caregiver has no current health concerns that affect family functioning. The caregiver proactively seeks preventive health care for themself and the family. The caregiver promotes a healthy lifestyle, including nutrition, physical activity, and recreational activities that promote overall health and well-being.

b. Is not a strength or barrier for safety, permanency, or child/youth/young adult well being. The caregiver has no current health concerns that affect family functioning. The caregiver accesses regular health resources for self-care (e.g., medical/dental), or caregiver is in good health and is physically able to meet most of the child/youth/young adult’s needs. Caregiver may have a medical condition, but they are consistently able to meet the child/youth/young adult’s needs (e.g., caregiver with mild or well-controlled lupus who is able to participate in most of the child/youth/young adult’s activities, and child/youth/young adult is not experiencing a sense of loss).

c. Is a barrier to safety, permanency, or child/youth/young adult well-being. Examples of caregiver conditions include but are not limited to the following.

• The caregiver has health concerns or conditions that affect family functioning and/or family resources; or
• Caregiver may occasionally struggle to meet child/youth/young adult’s needs because of health limitations (e.g., chronic medical condition, physical disability), and child/youth/young adult’s needs are sometimes unmet.

Caregiver conditions have not resulted in serious harm to child/youth/young adult and are not likely to result in serious harm, but the child/youth/young adult experiences some adverse impact.

Examples of impact on the child/youth/young adult include but are not limited to the following.

• Child/youth/young adult may occasionally worry or feel stress about caregiver’s health, but such worry does not interfere with their participation in school or community life (e.g., caregiver has chronic diabetes that is not well-managed and the caregiver’s related mood variations have some nonsignificant impact on the child/youth/young adult; caregiver’s lupus makes it impossible for them to participate fully in child/youth/young adult’s activities, and child/youth/young adult feels sad).
• Child/youth/young adult may sometimes assume some parenting responsibilities for self or siblings, but such responsibilities do not interfere with development.
• Child/youth/young adult’s basic needs may sometimes be unmet due to caregiver incapacity, but the child/youth/young adult has not experienced injury and is not likely to experience serious harm.

d. Contributes to imminent danger of serious physical or emotional harm to the child/youth/young adult. Examples of caregiver conditions include but are not limited to the following.

• The caregiver has serious/chronic or potentially life-threatening health problem(s) or condition(s) that affect the caregiver’s ability to care for and/or protect the child/youth/young adult.
• The caregiver has one or more health conditions that limit the caregiver’s ability to meet the child/youth/young adult’s needs to the extent that a child/youth/young adult has already experienced significant physical/emotional harm or is likely to.

Examples of threats of serious harm to the child/youth/young adult include but are not limited to the following.

• Child/youth/young adult may spend substantial time worrying about the caregiver’s health, to the extent that the child/youth/young adult is not engaging in play or is struggling in school.
• Child/youth/young adult may assume parenting responsibilities for self or siblings in ways that interfere with development or functioning.
• Child/youth/young adult may experience intense loss/grief when caregiver is not emotionally or physically available (e.g., repeated caregiver hospitalizations, a caregiver so incapacitated that they cannot respond to child/youth/young adult).

Caregiver cannot meet child/youth/young adult’s needs for food, shelter, or supervision (e.g., caregiver has severe lupus and has been unable to feed infant, and infant has been diagnosed with failure to thrive, or there have been so many missed feedings that infant would likely develop failure to thrive; caregiver has diabetes that is not well-managed and sometimes becomes unable to notice or respond to child/youth/young adult needs).

Parenting practices include knowledge, skills, and abilities demonstrated by the parent or caregiver.

Note: Safe and appropriate parenting may be demonstrated differently in different cultures. For example, in some cultures, overt displays of affection or a parent who engages in physical play with the child/youth/young adult may be frowned upon. This should not be interpreted as inappropriate parenting unless there is evidence that this behavior is harmful to the child/youth/young adult.

The caregiver’s parenting practices:

a. Actively help create safety, permanency, and child/youth/young adult well-being. The caregiver displays exceptional parenting patterns that are age-appropriate for the child/youth/young adult in the areas of expectations, discipline, communication, protection, and nurturing. The caregiver has the basic knowledge and skills to provide care. Examples of such parenting include but are not limited to the following.

• Caregiver recognizes and expresses hope for the child/youth/young adult’s abilities/strengths.
• Caregiver has the ability to recognize and respond to the child/youth/young adult’s cues.
• Caregiver has an understanding of age- and developmentally appropriate expectations for the child/youth/young adult and promotes and encourages activities such as (but not limited to):
  • Developmental play groups;
  • Occupational/physical therapy or other developmental services; or
  • School-, church-, or community-based activities appropriate for the child/youth/young adult’s age.
• The caregiver spends quality time with the child/youth/young adult and supports the child/youth/young adult when they are upset.

b. Are not a strength or barrier for safety, permanency, or child/youth/young adult well-being. The caregiver displays adequate parenting patterns that are age appropriate for the child/youth/young adult in the areas of expectations, discipline, communication, protection, and nurturing. The caregiver has the basic knowledge and skills to provide care. Examples of such parenting include but are not limited to the following.

• When the child/youth/young adult errs, caregiver provides nonviolent intervention. Interventions and communication of expectations may not be perfectly consistent, but, at a minimum, they are generally effective in helping the child/youth/young adult understand limits and self-regulate behavior (as age-appropriate).
• Child/youth/young adult is growing to have a developmentally appropriate sense of behavioral expectations and is learning to manage their behavior well.
• Caregiver provides adequately for child/youth/young adult’s basic needs.
• Minimally, caregiver periodically spends time with child/youth/young adult, supports child/youth/young adult when child/youth/young adult is upset, and lets child/youth/young adult know that they are loved and valued.

c. Are a barrier to safety, permanency, or child/youth/young adult well-being. Examples of such parenting include but are not limited to the following.

• Caregiver seldom sets limits or expectations for the child/youth/young adult in advance or sets limits/expectations that are somewhat outside of the range of child/youth/young adult’s potential; and/or when child/youth/young adult errs, caregiver often fails to respond at all or responds by blaming child/youth/young adult, calling child/youth/young adult names, using physical discipline that does not injure, etc.
• Caregiver frequently fails to meet some of child/youth/young adult’s basic needs, often because caregiver did not notice or was unaware of the child/youth/young adult’s need. Child/youth/young adult experiences so much worry over basic needs that they are developing symptoms such as lack of concentration, difficulty sleeping, hoarding, or stealing food.
• Caregiver seldom expresses love or value for the child/youth/young adult. Child/youth/young adult may worry about their place in the life of the caregiver and/or may frequently experience self-doubt. However, child/youth/young adult is able to function on a daily basis in developmentally expected ways.

d. Contribute to imminent danger of serious physical or emotional harm to the child/youth/young adult. Examples of such parenting practices include but are not limited to the following.

• Caregiver is unable or unwilling to protect the child/youth/young adult from harm by another.
• Caregiver sets no limits/expectations or sets limits/expectations that are far beyond the range of child/youth/young adult’s potential, and when child/youth/young adult errs, caregiver intervenes with physical or verbal violence, resulting in serious physical or emotional harm to the child/youth/young adult.
• Caregiver has not set limits/expectations for the child/youth/young adult to the extent that the child/youth/young adult has no sense of commonly acceptable behavior and no ability to manage their own behavior; child/youth/young adult has already or is likely to engage in delinquent behaviors.
• Caregiver is unaware of the child/youth/young adult’s needs to the extent that the child/youth/young adult has become seriously ill or injured due to unmet basic needs.
• Caregiver rarely, if ever, expresses love or value for the child/youth/young adult AND the child/youth/young adult is showing signs of emotional harm. Symptoms of emotional harm to the child/youth/young adult include but are not limited to: fear of the caregiver, nightmares, aggression toward siblings/peers, anxiety, unusual protective behaviors toward siblings, thumb sucking (and other indicators of developmental regression), and Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnoses related to experiences of caregiver behavior.

A social support system is a network of individuals (other than intimate partners or members of the household) or organizations (e.g., religious organizations, community organizations, professional providers) who provide or share concrete support (e.g., financial help, transportation, babysitting) or emotional support (e.g., listening, advice). Contact may include in-person or other means, including social media.

The caregiver’s social support system:

a. Actively helps create safety, permanency, and child/youth/young adult well-being. The caregiver has frequent contact with an extensive mutual support system. A mutual support system means that the caregiver is able to engage in providing support to members of their support network and is able to access support from members when needed.

AND

This contributes to child/youth/young adult safety in that many people work together to create safety for the child/youth/young adult.

b. Is not a strength or barrier for safety, permanency, or child/youth/young adult well being. The caregiver has a sufficient social support system and is able to get concrete or emotional support when needed.

OR

The caregiver is able to maintain child/youth/young adult safety despite lack of social support.

c. Is a barrier to safety, permanency, or child/youth/young adult well-being. At times, the caregiver needs concrete or emotional support and their social support system is not able to provide what the caregiver needs. As a result, the child/youth/young adult experiences some isolation or unmet needs; however, this has not created danger for the child/youth/young adult. This may include:

• Lack of a sufficient social support system;
• Not using the support that is available; and/or
• The support provided either contributes to child/youth/young adult distress or adversely impairs the caregiver’s ability to create long-term safety.

d. Contributes to imminent danger of serious physical or emotional harm to the child/youth/young adult. The caregiver is unable to resolve conditions that create danger for the child/youth/young adult because of limits in the ability of their social support network to help in ways that would keep the child/youth/young adult safe. This may include the following:

• No one is able to help provide concrete support that is needed, and this has contributed to danger (e.g., needed medical care for child/youth/young adult is not sought due to lack of transportation).
• The caregiver’s lack of support contributes to the caregiver’s experience of being overwhelmed and as a result, the caregiver cannot meet the needs of the child/youth/young adult, which has resulted in danger (e.g., caregiver cannot get respite care and as a result either leaves child/youth/young adult unattended in a dangerous situation or stays with child/youth/young adult but loses control and hurts child/youth/young adult).
• Involvement of the social support system directly creates danger for the child/youth/young adult (e.g., while providing concrete support, system member encourages caregiver to use drugs).

Include relationships between caregiver and other adults in the household, including intimate relationships, but do not rate presence or absence of physical violence or intimidating/controlling behaviors in this item.

The caregiver's relationships with other adult household members:

1. Actively help create safety, permanency, and child/youth/young adult well-being. Caregiver and other adult household members have and demonstrate healthy interpersonal relationships, including communication, shared agreements, mutual respect, empathy, and safe conflict resolution.
2. Are not strengths or barriers for safety, permanency, or child/youth/young adult well-being. Caregiver and other household members have relationships that do not adversely affect child/youth/young adult.
3. Are barriers to safety, permanency, or child/youth/young adult well-being. Caregiver and other household members or child/youth/young adult's other parent experience conflict to the extent that child/youth/young adult is aware of and troubled by conflict.
   OR
   Child/youth/young adult is confused and/or upset by frequent introduction of new intimate partners of the caregiver.
4. Contribute to imminent danger of serious physical or emotional harm to the child/youth/young adult. Conflict among adult household members is so persistent and severe that child/youth/young adult's needs are unmet to the extent that the child/youth/young adult has been seriously harmed or is in danger of being seriously harmed.
   OR
   Caregiver allows individuals who are violent or sexual toward the child/youth/young adult to be part of the household.
   OR
   Caregiver's relationship with child/youth/young adult's other parent(s) continues to involve child/youth/young adult in conflict to the extent that child/youth/young adult is seriously emotionally harmed and/or caused to experience repeated medical/legal examinations due to repeated unfounded allegations against the other parent.

Household violence means physical violence or a pattern of threats/intimidation or controlling behavior between the caregiver and any adult household member, including intimate relationships. This does not include violence between a caregiver and a minor child/youth/young adult.

The caregiver’s intimate relationships:

a. Actively help create safety, permanency, and child/youth/young adult well-being. The caregiver consistently responds nonviolently to situations involving conflict and frustration and works with other adults in the household to make choices.

AND

This contributes to safety for the child/youth/young adult by effectively protecting the child/youth/young adult from violence and teaching/demonstrating nonviolence to the child/youth/young adult.

The caregiver may have a history of violent relationships, but they had developed new patterns of behavior and consciously chooses relationships that are not violent.

b. Are not strengths or barriers for safety, permanency, or child/youth/young adult well-being. The caregiver is not currently in and has not been in a relationship that includes violence, threats/intimidation, or controlling behavior.

OR

The caregiver is or has been in a relationship that includes a minimal degree of violence, threats/intimidation, or controlling behavior, but the child/youth/young adult is unaware and/or untroubled AND has not experienced harm.

Violence that has resulted in injury to a caregiver or involved use of a weapon cannot be rated “b” even if the child/youth/young adult is unaware or reports being unaffected.

c. Are barriers to safety, permanency, or child/youth/young adult well-being. The caregiver is in or has been in a relationship characterized by violence or a pattern of threats/intimidation or controlling behavior, and the child/youth/young adult is aware of and troubled by this.

OR

The violence, threats/intimidation, or controlling behavior is ongoing and increasing in frequency or severity.

OR

The caregiver has ended a violent relationship but has not developed behaviors to prevent repeating being either a victim or an aggressor.

d. Contribute to imminent danger of serious physical or emotional harm to the child/youth/young adult. The caregiver is in or has recently left a relationship characterized by severe household violence and the child/youth/young adult has been seriously hurt, physically or emotionally, by the violence.

OR

The caregiver remains in a violent relationship and at least one partner is unwilling to address the violence.

Include alcohol, other illegal drugs, and prescription drugs that are not used according to prescription.

The caregiver’s actions regarding substance use:

a. Actively help create safety, permanency, and child/youth/young adult well-being. The caregiver has no history of substance abuse (whether or not caregiver uses alcohol or legal drugs) OR the caregiver may have a history of substance abuse but is in recovery to the extent that they help support the recovery of others;

AND

The caregiver, by words and actions, actively promotes a healthy, addiction-free lifestyle and environment for their children.

b. Are not a strength or barrier for safety, permanency, or child/youth/young adult well-being. The caregiver has no history of substance abuse (whether or not caregiver uses alcohol or legal drugs) OR has a history of substance abuse but is in recovery and able to maintain recovery without formal support (may continue to participate in self-help groups);

HOWEVER

Alcohol and drug use or history of use does not negatively affect parenting or the caregiver’s ability to maintain child/youth/young adult safety.

c. Are a barrier to safety, permanency, or child/youth/young adult well-being. The caregiver’s alcohol or drug use results in behaviors that impede their ability to meet the child/youth/young adult’s basic needs (food, clothing, shelter, supervision, and hygiene) or emotional well-being on a consistent basis and/or have contributed to a current, nondangerous incident;

OR

The caregiver is in recovery from drug or alcohol abuse and requires minimal to moderate continuing support to preserve child/youth/young adult safety, e.g., caregiver remains in day treatment or other outpatient intervention;

HOWEVER

Caregiver’s alcohol or drug use has not resulted in serious harm to the child/youth/young adult (e.g., malnutrition, homelessness, physical harm due to insufficient supervision).

d. Contribute to imminent danger of serious physical or emotional harm to the child/youth/young adult. The caregiver’s use of alcohol or drugs results in behaviors that consistently impede their ability to meet the child/youth/young adult’s basic needs to the extent that the child/youth/young adult has been seriously harmed by abuse or neglect, or serious harm is imminent.

OR

Caregiver is just beginning recovery and needs intensive support to preserve child/youth/young adult safety, e.g., caregiver is in detox or inpatient treatment or residential setting to support recovery.

AND

• Caregiver is physically or attentively absent to the extent that child/youth/young adult is in danger.
• When caregiver is under the influence of alcohol or drugs, they forget to feed the child/youth/young adult to the extent that the child/youth/young adult has experienced growth disruption, malnutrition, or dehydration.
• When caregiver is under the influence of alcohol or drugs, they become violent toward or near the child/youth/young adult.

Mental health includes a diagnosed condition (which is not automatically a need) and also the caregiver’s coping to the extent that some behaviors may not rise to the level of diagnosis but nonetheless affect family functioning. For example, severe unmanaged stress may not indicate a mental health diagnosis, but may negatively impact the child/youth/young adult. Similarly, a caregiver with exceptional coping skills may be able to parent and protect the child/youth/young adult through extraordinarily stressful family conditions.

When assessing the caregiver’s mental health and coping skills, consider whether the caregiver has any diagnosed or suspected mental health conditions AND whether these conditions affect the caregiver’s ability to parent and protect the child/youth/young adult.

The caregiver’s mental health:

a. Actively helps create safety, permanency, and child/youth/young adult well-being. The caregiver demonstrates the ability to cope with adversity, crises, and long term problems in a constructive manner. The caregiver demonstrates realistic, logical judgment and demonstrates emotional responses that are consistent with circumstances. Caregiver understands their own emotional needs and is effectively meeting them in ways that do not interfere with ability to provide care. Caregiver demonstrates ability to think about what the child/youth/young adult needs, and caregiver has/acquires the knowledge needed to respond to child/youth/young adult’s needs most of the time.

b. Is not a strength or barrier for safety, permanency, or child/youth/young adult well being. Caregiver may struggle from time to time, but caregiver is always able to manage sufficiently so that child/youth/young adult does not experience significant stress, worry, or unmet needs. For example, caregiver may experience some depression or anxiety, but they are managing through medication, therapy, or self-help so that while child/youth/young adult may be aware, child/youth/young adult is not significantly worried and the caregiver’s condition does not interfere with caregiving.

c. Is a barrier to safety, permanency, or child/youth/young adult well-being. Examples of caregiver behavior include but are not limited to the following.

• Caregiver displays periodic mental health symptoms, including but not limited to depression, low self-esteem, or apathy. The caregiver has occasional difficulty dealing with situational stress, crises, or problems.
• While caregiver may have moments of being overwhelmed and temporarily distracted from the child/youth/young adult’s needs, the caregiver is able to rally and continue.

Examples of impact on the child/youth/young adult include but are not limited to the following.

• Child/youth/young adult may occasionally worry about how caregiver is coping, but such worry does not interfere with their participation in school or community life.
• Child/youth/young adult may sometimes assume some parenting responsibilities for self or siblings, but such responsibilities do not interfere with development.
• Child/youth/young adult may have a periodic sense of loss/grief when caregiver is not available.
• Child/youth/young adult’s basic needs may sometimes be unmet due to caregiver incapacity, but the child/youth/young adult has not experienced injury and is not likely to experience serious harm.

d. Contributes to imminent danger of serious physical or emotional harm to the child/youth/young adult. Examples of caregiver behaviors or conditions include but are not limited to the following.

• The caregiver displays chronic, severe mental health symptoms, including but not limited to: bipolar disorder, schizophrenia, suicidal ideation, personality disorders, depression, etc. These symptoms impair the caregiver’s ability to perform in one or more areas of parental functioning, employment, education, or provision of food and shelter.
• Caregiver has been repeatedly hospitalized for mental health concerns.

Examples of threats of serious harm to the child/youth/young adult include but are not limited to the following.

• Child/youth/young adult may spend substantial time worrying about how the caregiver is coping, to the extent that the child/youth/young adult is not engaging in play or is struggling in school.
• Child/youth/young adult may assume parenting responsibilities for self or siblings in ways that are interfering with development or functioning.
• Child/youth/young adult is falling significantly behind developmentally due to prolonged caregiver unavailability/absence.
• Caregiver could not meet child/youth/young adult’s needs for food, shelter, or supervision to the extent that it was dangerous.

Trauma may occur when a person has experienced, witnessed, or been confronted with an event(s) of actual or threatened death or serious injury, a threat of serious physical harm to themself or others, or emotional abuse. Trauma may be caused by many experiences, e.g., serious physical harm; sexual abuse; bullying; domestic violence; natural disasters; and long-term exposure to extreme poverty, neglect, or verbal abuse.

The caregiver’s response to prior adverse experiences/trauma:

a. Actively helps create safety, permanency, and child/youth/young adult well-being. Caregiver has not experienced trauma OR the caregiver has a prior experience of trauma, but that prior trauma provides the caregiver with additional skills to improve daily functioning.

b. Is not a strength or barrier for safety, permanency, or child/youth/young adult well being. The caregiver may or may not have a prior history of trauma; however, any traumatic experiences do not impact care for the child/youth/young adult (either because there is no impact on the caregiver’s functioning or because the caregiver has learned to manage the impact on their functioning effectively).

c. Is a barrier to safety, permanency, or child/youth/young adult well-being. Caregiver has experienced trauma AND the caregiver’s response involved intense fear, helplessness, or horror, which sometimes impairs functioning and sometimes causes distress, but not harm, to the child/youth/young adult. The caregiver has learned some strategies to manage these responses, and the caregiver sometimes uses them.

Caregiver sometimes experiences intrusive, distressing recollections of the event, including images, thoughts, or perceptions; has distressing dreams of the event; or acts or feels like the traumatic event is recurring, BUT caregiver has learned some skills and interventions to manage these thoughts and caregiver sometimes uses them.

d. Contributes to imminent danger of serious physical or emotional harm to the child/youth/young adult. Caregiver has experienced trauma AND the caregiver’s response involved intense fear, helplessness, or horror, causing impaired functioning and significant distress/harm for the child/youth/young adult. For example, the caregiver has not accessed services and/or cannot use coping strategies or has not received intervention to help manage their responses, AND this has resulted in significant harm to the child/youth/young adult. Caregiver may deny the traumatic experience or how it affects them or the child/youth/young adult.

Include diagnosed or suspected cognitive conditions, including developmental disabilities, traumatic brain injury, or dementia/Alzheimer’s disease. When assessing, consider both the diagnosed or suspected condition AND the impact that such conditions have on the caregiver’s ability to adequately parent and protect the child/youth/young adult. The condition itself does not necessitate the selection of “d.”

The caregiver’s developmental and cognitive abilities:

a. Actively help create safety, permanency, and child/youth/young adult well-being. Caregiver demonstrates ability to think about what child/youth/young adult needs and has or acquires the knowledge needed to respond to child/youth/young adult’s needs. Caregiver has demonstrated creative thinking to overcome challenges and has created child/youth/young adult safety as a result.

b. Are not strengths or barriers for safety, permanency, or child/youth/young adult well-being. Caregiver has no cognitive limitations;

OR

Caregiver may struggle to understand some aspects of parenting knowledge but has always been able to work out solutions that meet the child/youth/young adult’s needs. Caregiver may struggle from time to time, but they are always able to manage sufficiently so that the child/youth/young adult does not experience significant stress, worry, or unmet needs. For example, the caregiver may have some cognitive limitations, but they are able to meet the child/youth/young adult’s basic needs with the assistance of family or other non agency-provided help.

c. Are barriers to safety, permanency, or child/youth/young adult well-being. Examples of caregiver behavior include but are not limited to the following.

• Caregiver has some difficulty understanding essential child/youth/young adult care information. Caregiver’s difficulty understanding makes it harder to parent effectively and/or has some adverse impact on the child/youth/young adult, but has never resulted in serious harm AND is not likely to result in serious harm.
• Caregiver requires additional efforts to acquire knowledge, such as repetition, creating visual cues, or other approaches, and with these approaches, caregiver is able to acquire necessary information.

Examples of impact on the child/youth/young adult include but are not limited to the following.

• Child/youth/young adult may occasionally worry about how caregiver is coping, but such worry does not interfere with participation in school or community life.
• Child/youth/young adult may sometimes assume some parenting responsibilities for self or siblings, but such responsibilities do not interfere with development.
• Child/youth/young adult’s basic needs may sometimes be unmet due to caregiver incapacity, but the child/youth/young adult has not experienced injury and is not likely to experience serious harm.

d. Contribute to imminent danger of serious physical or emotional harm to the child/youth/young adult. Examples of parental behaviors or conditions include but are not limited to the following.

• Caregiver has significant difficulty understanding fundamental parenting information, such as how much to feed and how often, how to decide when a child/youth/young adult needs medical care, or whether it is reasonable to expect a 6-month-old to be fully potty-trained. Despite numerous efforts to help the caregiver understand vital information, they do not appear to comprehend and cannot apply information to parenting tasks.

Examples of threats of serious harm to the child/youth/young adult include but are not limited to the following.

• Child/youth/young adult may spend substantial time worrying about how the caregiver is coping, to the extent that the child/youth/young adult is not engaging in play or is struggling in school.
• Child/youth/young adult may assume parenting responsibilities for self or siblings in ways that are interfering with development or functioning. Child/youth/young adult is falling significantly behind developmentally due to prolonged caregiver unavailability/absence.
• Caregiver cannot meet child/youth/young adult’s needs for food, shelter, or supervision.

Select “not applicable” if the caregiver does not have any strengths or needs that are relevant for case planning, beyond those captured in the domains above.

OR

An additional need or strength has been identified that:

a. Actively helps create safety, permanency, and child/youth/young adult well-being. A caregiver has an exceptional strength and/or skill that has a positive impact on family functioning. The family perceives this strength as something they can build on to achieve progress in identified areas of need.

b. Is not a strength or barrier for safety, permanency, or child/youth/young adult well being. A caregiver has an area of strength or need that is not included in other domains, but this area is not relevant for case planning.

c. Is a barrier to safety, permanency, or child/youth/young adult well-being. A caregiver’s need has a moderate to significant impact on family functioning but has not resulted in harm or threat of harm to the child/youth/young adult. The family perceives that they would benefit from services and support that address the need.

d. Contributes to imminent danger of serious physical or emotional harm to the child/youth/young adult. A caregiver has a need that has a serious impact on family functioning, placing the child/youth/young adult at imminent threat of serious harm.

Culture is a system of shared actions, values, beliefs, and traditions that guide the behavior of families and communities. For this item, cultural identity may refer to a family member’s race (African American/Black, American Indian/Alaska Native, Asian/Pacific Islander, Latino/a, multiracial, White, other), ethnicity, tribal affiliation, sexual orientation (heterosexual, gay, lesbian, bisexual), gender identity/expression (female, male, transgender, other), religious/spiritual affiliation, disability, or other social identity that reflects the family’s unique characteristics.

Keep in mind that family members may identify with multiple cultures and that a person’s dominant cultural identification may shift with the context. For example, in some situations, it may be more important to a family member to identify as a disabled person than to identify with an ethnic group. Cultural identity is not limited to identification with a non-mainstream culture and may refer to the mainstream culture.

Connecting Culture and Identity

Consider how the family’s culture, cultural identity, norms, and past/current experiences of discrimination/oppression may influence or shape the child/youth/young adult’s perspective.

In particular, consider:

• How the child/youth/young adult identifies themself (see culture and cultural identity above);
• Any historical experiences of oppression/discrimination that are important or relevant to this child/youth/young adult;
• Any current experiences of oppression/discrimination this child/youth/young adult might be experiencing; and
• Any coping skills, strengths, and survival skills this child/youth/young adult has developed or demonstrated in facing oppression/discrimination.

How do all of the above influence or shape the child/youth/young adult?

a. Help them create safety, permanency, and well-being for themself. The child/youth/young adult draws upon their culture to respond to challenges in ways that create safety for the child/youth/young adult.

b. Have no effect on their safety, permanency, or well-being. The child/youth/young adult is connected to a culture and/or identifies with a culture and this has no impact on their safety.

c. Make it difficult for them to experience long-term safety, permanency, or well being. The child/youth/young adult is connected to a culture and/or identifies with a culture in ways that cause struggles, such as mild to moderate conflict with the caregiver over culture/cultural identity or disrupted relationships with the caregiver based on cultural differences.

d. Contribute to imminent danger of serious physical or emotional harm to the child/youth/young adult. The child/youth/young adult is connected to a culture and/or identifies with a culture in ways that cause danger for the child/youth/young adult, such as physically or emotionally harming themself over differences in culture/cultural identity.

a. The child/youth/young adult’s emotional/behavioral health contributes to their safety. The child/youth/young adult displays coping skills/responses at or above the developmentally expected ability in dealing with crises, disappointment, and daily challenges and contributes to their own safety.

The child/youth/young adult routinely manages their own behavior at or above developmentally expected ability.

The child/youth/young adult is developing a sense of acceptable social norms valued by their family and/or community, and the child/youth/young adult is able to weigh the positives and negatives of conforming to or deviating from such norms.

b. The child/youth/young adult does not have an emotional/behavioral concern OR the child/youth/young adult has an emotional/behavioral health concern, but no additional intervention is needed. The child/youth/young adult’s coping skills/responses do not interfere with school, family, or community functioning. The child/youth/young adult is able to develop and maintain trusting relationships. The child/youth/young adult may be able to identify the need for, seek, and accept guidance. The child/youth/young adult may demonstrate some situationally related depression, anxiety, or withdrawal symptoms. However, the child/youth/young adult maintains situationally appropriate emotional control.

OR

The child/youth/young adult has emotional or behavioral health concerns that are being effectively managed through a treatment program that does not require additional caregiver support (e.g., child/youth/young adult receives limited in-school support and is not on medication).

c. The child/youth/young adult has an emotional/behavioral health concern, AND it is an ongoing unmet need. The child/youth/young adult must display one of the following.

• Periodic mental health symptoms (e.g., depression, somatic complaints, antisocial behavior, hostile behavior, apathy). OR
• Some difficulties dealing with situational stress, crises, or problems. AND one of the following must also be true.
• This is interfering with the child/youth/young adult’s sense of well-being, development, and/or ability to form relationships. OR
• The child/youth/young adult’s emotional or behavioral health condition is being managed through a treatment program that requires minimal to moderate caregiver support.

d. The child/youth/young adult has an emotional/behavioral health concern that directly contributes to danger to the child/youth/young adult. The child/youth/young adult must display one of the following.

• Functioning in one or more areas is severely impaired due to chronic/severe mental health symptoms. OR
• Behavior is/may be harmful to self or others, including self-injury, extreme risk-taking, persistent violence toward others, inappropriate sexual behaviors, cruelty to animals, running away, curfew violations, stealing, inappropriate use of social media (e.g., sexting, cyberbullying), defiant behaviors, truancy, or fire-setting.

AND one of the following must be true.

• The child/youth/young adult is in danger of serious harm to self or others. OR
• The child/youth/young adult’s emotional or behavioral condition is being managed through a treatment program that requires extensive caregiver support and/or frequent crisis intervention.

Trauma may occur when a person has experienced, witnessed, or been confronted with an event(s) of actual or threatened death or serious injury, or a threat of serious physical harm to themself or others. Trauma may be caused by many experiences, e.g., serious physical harm; sexual abuse; bullying; domestic violence; natural disasters; and long-term exposure to extreme poverty, neglect, or verbal abuse.

a. The child/youth/young adult’s response to prior trauma contributes to their safety. The child/youth/young adult has a prior experience of trauma, but that prior trauma provides the child/youth/young adult with additional skills to improve daily functioning.

b. The child/youth/young adult has not experienced trauma OR the child/youth/young adult has experienced trauma but no additional intervention is needed. The child/youth/young adult may or may not have a prior history of trauma; however, any traumatic experiences do not impact care for the child/youth/young adult, either because there is no impact on the child/youth/young adult’s functioning or because the child/youth/young adult has learned to manage the impact on their functioning effectively.

c. The child/youth/young adult’s response to prior trauma is a concern AND it is an ongoing unmet need. The child/youth/young adult has experienced trauma AND the child/youth/young adult’s response involved intense fear, helplessness, or horror that sometimes impairs their functioning and sometimes causes distress. They do not have long-term indicators of permanent harm/distress but could learn to manage the impacts of trauma on their functioning, or they begin to learn to apply some strategies to manage these responses and sometimes use them.

d. The child/youth/young adult’s response to prior trauma is a concern that directly contributes to danger to the child/youth/young adult. The child/youth/young adult has experienced trauma AND the child/youth/young adult’s response involved intense fear, helplessness, or horror, causing impaired functioning and significant distress/harm for the child/youth/young adult. For example, the child/youth/young adult has not accessed services, cannot use coping strategies, and/or has not received intervention to help manage their responses, AND this has resulted in significant harm to the child/youth/young adult. The child/youth/young adult may deny the traumatic experience or how it is affecting them.

For a chart of average development by age, consult the Physical and Cognitive Developmental Milestones in the FSNA policy and procedures section of the manual.

a. The child/youth/young adult’s development is advanced. The child/youth/young adult’s physical and cognitive skills are above their chronological age level.

b. The child/youth/young adult’s development is age-appropriate. The child/youth/young adult’s physical and cognitive skills are consistent with their chronological age level.

c. The child/youth/young adult’s development is limited. The child/youth/young adult does not exhibit most physical and cognitive skills expected for their chronological age level.

d. The child/youth/young adult’s development is severely limited. Most of the child/youth/young adult’s physical and cognitive skills are two or more age or developmental levels behind chronological age expectations. If “d” is selected, also indicate whether a regional center referral has been completed.

a. The child/youth/young adult has outstanding academic achievement. The child/youth/young adult is working above grade level and/or is exceeding the expectations of the specific educational plan.

b. The child/youth/young adult has satisfactory academic achievement OR the child/youth/young adult is not of school age. The child/youth/young adult is working at grade level and/or is meeting the expectations of the specific educational plan, or the child/youth/young adult is not of school age.

c. The child/youth/young adult has academic difficulty. The child/youth/young adult is working below grade level in at least one, but not more than half, of their academic subject areas, and/or the child/youth/young adult is struggling to meet the goals of the existing educational plan. The existing educational plan may need modification.

d. The child/youth/young adult has severe academic difficulty. The child/youth/young adult is working below grade level in more than half of their academic subject areas, and/or the child/youth/young adult is not meeting the goals of the existing educational plan. The existing educational plan needs modification.

When considering adult relationships, consider the child/youth/young adult's relationships with adults who are not immediate family members or foster family members. This domain would include coaches, neighbors, child welfare workers, club leaders, teachers, mentors, etc. Specify in the narrative who these adults are. When considering peer relationships, consider the child/youth/young adult's relationships with other children in school and the community. Exclude relationships with siblings.

1. The child/youth/young adult has strong social relationships. The child/youth/young adult enjoys and participates in a variety of constructive, age-appropriate social activities. The child/youth/young adult enjoys reciprocal, positive relationships with others.
2. The child/youth/young adult has adequate social relationships. The child/youth/young adult demonstrates adequate social skills. The child/youth/young adult maintains stable relationships with others; occasional conflicts are minor and easily resolved.
3. The child/youth/young adult has limited social relationships. The child/youth/young adult demonstrates inconsistent social skills and has limited positive interactions with others. Conflicts are more frequent and serious, and the child/youth/young adult may be unable to resolve them.
4. The child/youth/young adult has poor social relationships. The child/youth/young adult has poor social skills, as demonstrated by frequent conflictual relationships or exclusive interactions with negative or exploitative peers, or the child/youth/young adult is isolated and lacks a support system.

For children in voluntary or court-ordered placement, score the child/youth/young adult’s family of origin, not their placement family.

a. The child/youth/young adult’s relationships within their family contribute to their safety. The child/youth/young adult experiences positive interactions with family members and has a sense of belonging within the family. The family defines roles, has clear boundaries, and supports the child/youth/young adult’s growth and development.

b. The child/youth/young adult’s relationships within their family do not impact their safety. The child/youth/young adult experiences positive interactions with family members and feels safe and secure in the family, despite some unresolved family conflicts.

c. The child/youth/young adult’s relationships within their family interfere with long-term safety. Stress/discord within the family interferes with the child/youth/young adult’s sense of safety and security. The family has difficulty identifying and resolving conflict and/or obtaining support and assistance on their own.

d. The child/youth/young adult’s relationships within their family contribute to danger of serious physical or emotional harm to the child/youth/young adult. Chronic family stress, conflict, or violence severely impedes the child/youth/young adult’s sense of safety and security. The family is unable to resolve stress, conflict, or violence on their own and is not able or willing to obtain outside assistance.

Physical health means physical well-being, which includes dental and vision care. Also indicate whether the child/youth/young adult's immunizations are current.

1. The child/youth/young adult has no health care needs or disabilities. The child/youth/young adult demonstrates good health and hygiene care, involving awareness of nutrition and exercise. The child/youth/young adult receives routine preventive and medical/dental/vision care and immunization.
2. The child/youth/young adult has minor health problems or disabilities that are being addressed with minimal intervention and/or medication. The child/youth/young adult has adequate health. Minimal interventions are those that typically require no formal training (e.g., oral medications).
3. The child/youth/young adult has health care needs or disabilities that require routine interventions. The child/youth/young adult has minor health/disability needs. Routine interventions are those that are typically provided by lay persons after minimal instruction (e.g., glucose testing and insulin, cast care).
4. The child/youth/young adult has serious health/disability needs that require ongoing treatment and interventions by professionals or trained caregivers AND/OR the child/youth/young adult has an unmet medical need. Those who provide treatment/interventions have received substantial instruction (e.g., central line feeding, paraplegic care, or wound dressing changes).

Drugs include illegal substances as well as misuse of prescription and over-the-counter medications, inhalants, synthetic drugs, incense when used for intoxicating properties, etc.

1. The child/youth/young adult actively chooses an alcohol- and drug-free lifestyle. The child/youth/young adult does not use alcohol or other drugs and is aware of consequences of use. The child/youth/young adult avoids peer relations/social activities involving alcohol and other drugs, and/or chooses not to use substances despite peer pressure/opportunities to do so.
2. The child/youth/young adult does not use or experiment with alcohol/drugs. The child/youth/young adult does not use alcohol or other drugs. The child/youth/young adult may have experimented with alcohol or other drugs, but there is no indication of sustained use. The child/youth/young adult has no demonstrated history or current problems related to substance use.
3. The child/youth/young adult's alcohol and/or other drug use results in disruptive behavior and conflict. This conflict may occur in school/community/family/work relationships. Use may have broadened to include multiple drugs.
4. The child/youth/young adult's chronic alcohol and/or other drug use results in severe disruption of functioning. Disruption of functioning may be indicated by the loss of relationships or jobs, school suspension/expulsion/drop-out, problems with the law, and/or physical harm to self or others. The child/youth/young adult may require medical intervention to detoxify.

Delinquent behavior includes any action that would constitute a crime. Consider this domain to include both offenses for which the child/youth/young adult has been arrested/charged and those which have not yet come to the attention of law enforcement.

1. The child/youth/young adult has no delinquent behavior. There is no indication of delinquent history or behavior. The child/youth/young adult may be involved in community service and/or crime prevention programs and takes a stance against crime.
2. The child/youth/young adult has no criminal behavior in the past two years. There is a history of delinquent behavior but the child/youth/young adult has successfully completed probation, and there has been no criminal behavior in the past two years.
3. The child/youth/young adult is/has engaged in delinquent behavior and may have been arrested or placed on probation in the past two years. The child/youth/young adult may have been arrested or placed on probation within the past two years.
4. The child/youth/young adult is or has been involved in any violent, or repeated nonviolent, delinquent behavior. This behavior has or may have resulted in consequences such as arrests, incarcerations, or probation. Violent behavior includes aggressive behavior in any form that has resulted or is likely to result in an injury to another person. Repeated nonviolent delinquent behavior includes situations where a youth has more than one contact for delinquent behavior, but none of the contacts included violent behavior, as defined above.

Consider the wishes and feelings of the child/youth/young adult as appropriate. Indicate whether the wishes and feelings of the child/youth/young adult assist in the development of strengths or create struggles for the child/youth/young adult.

When assessing this item, keep in mind that the child/youth/young adult may have different relationships with adults and with children in the home. Please consider both when documenting strengths and struggles.

Not applicable; child/youth/young adult is not in care. The child/youth/young adult is currently in his/her home.

a. The child/youth/young adult has developed a healthy attachment to at least one substitute care provider. The child/youth/young adult has developed a nurturing/supportive relationship with at least one substitute care provider. There is positive interaction/attachment between the child/youth/young adult and caregiver or others in the caregiver’s household; the child/youth/young adult is supported and has a sense of belonging.

b. The child/youth/young adult has no conflicts with the substitute care provider. Adequate relationships exist with all family members. Interactions between the child/youth/young adult and substitute care provider (and others in the caregiver’s household) are generally positive; age-appropriate attachments exist despite some problems.

c. The child/youth/young adult has some conflicts with the substitute care provider that have resulted or may result in the child/youth/young adult feeling unsafe or unaccepted in the placement; however, with support, these issues can be mitigated. The child/youth/young adult has limited relationships with the substitute care provider and family members. Problems limit positive interactions and appropriate attachments with one or more members of the substitute care provider’s household.

d. The child/youth/young adult has serious conflicts with one or more members of the current substitute care provider’s household. There are significant problems/conflict in the placement. Chronic problems severely interfere with the child/youth/young adult’s interactions and attachments with one or more members of the substitute care provider’s household.

Includes:

• Financial knowledge (e.g., handling money, banking, budgeting, bill payment);
• Work skills (e.g., having self-supporting employment) OR secondary education preparation;
• Time management;
• Housing; and
• Completing daily activities (e.g., hygiene, laundry, housekeeping, grocery shopping, cooking, basic health care, etc.).

a. The youth/young adult is prepared to function as an adult. The youth/young adult has demonstrated and practiced skills necessary for independent living and is prepared.

b. The youth/young adult is making progress toward being prepared for adulthood. The youth/young adult has had an opportunity to demonstrate and/or practice the skills included in independent living. It may be considered a strength if the youth/young adult is aware that they are not fully prepared but is making progress. Youth/young adult is participating in formal or informal independent living services.

c. The youth/young adult is attempting to prepare for adulthood but lacks the confidence, emotional maturity, and/or sufficient skills to live independently. The youth/young adult may have developed only some or none of the skills necessary for independent living. The youth/young adult may be fully confident of their ability to live independently, contrary to their actual skills/abilities (e.g., youth/young adult may be delaying completion of tasks to receive an extension; youth/young adult may lack a support system to provide advice after aging out).

d. The youth/young adult is not prepared or is refusing to prepare for adulthood. The youth/young adult is actively not participating in plans for preparation for adulthood or is unable to prepare in key areas that may include but are not limited to the following:

• Youth/young adult has sex offense charges and is ineligible for federal housing programs.
• Youth/young adult is in an out-of-state facility where independent living planning is impeded.
• Youth/young adult has developmental delays that impede independent functioning.

For youth/young adults age 15.5 and older, check all that apply to preparation for adulthood.

• The youth/young adult is receiving assistance from a regional center.
• The 15.5-year-old assessment has been completed.
• For youth/young adults age 16 or older, a referral to formal services and a credit check application have been completed.
• For youth/young adults age 17 and older, an independent living plan has been completed.
• A 90-Day Transition Meeting has been held.
• An Emancipation Conference has been held.
• The youth/young adult is participating in the extension foster care program (AB 12).

Select “not applicable” if the caregiver does not have any strengths or needs that are relevant for case planning, beyond those captured in the domains above.

OR

An additional need or strength has been identified that:

a. Actively helps them create safety, permanency, and well-being for themself. A child/youth/young adult has an exceptional strength and/or skill that has a positive impact on family functioning. The family perceives this strength as something they can build on to achieve progress in identified need areas.

b. Is not a strength or barrier for their safety, permanency, or well-being. A child/youth/young adult has an area of strength or need that is not included in other domains, but this area is not relevant for case planning.

c. Is a barrier to their safety, permanency, or well-being. A child/youth/young adult has a need that has a moderate impact on family functioning. The family perceives that they would benefit from services and support that address the need.

d. Contributes to imminent danger of serious physical or emotional harm to the child/youth/young adult. A child/youth/young adult has a serious need that has a significant impact on family functioning.