Identify the number of assigned physical abuse, sexual abuse, emotional abuse, and/or neglect investigations prior to the investigation resulting in the current case, regardless of whether the allegations were substantiated, inconclusive, or unfounded.

Do not include referrals that were not assigned for investigation or investigations of out-of-home perpetrators (e.g., daycare) unless one or more caregivers failed to protect.

1. Choose "a" if there were no prior assigned investigations.
2. Choose "b" if there were one or two prior assigned investigations.
3. Choose "c" if there were three or more prior assigned investigations.

Identify whether the household has had an open CPS case prior to the investigation resulting in the current case. This applies to the household that has been investigated and opened in the current case. Service history includes voluntary or court-ordered family services, but not delinquency services.

1. Choose "a" if the household has not had a prior open CPS case.
2. Choose "b" if the household has one or more prior open CPS cases.

Identify whether the primary caregiver was a victim of child abuse/neglect as a child. Are there credible statements by the primary caregiver or others and/or documentation that indicate the primary caregiver was maltreated as a child? (Maltreatment includes neglect or physical, sexual, or emotional abuse.)

1. Choose "a" if the primary caregiver was not maltreated as a child.
2. Choose "b" if the primary caregiver was maltreated as a child.

Identify whether any child in the household has a developmental, learning, and/or physical disability, or is diagnosed as medically fragile or failure to thrive. Base identification on credible information from a caregiver that a child has been diagnosed, statements from a physician or mental health professional, or review of records.

Choose “a” if no child in the household exhibits characteristics listed below.

Choose “b” if any child in the household exhibits characteristics listed below and select all types present.

• Developmental disability. A severe, chronic condition diagnosed by a physician or mental health professional due to mental and/or physical impairments. Examples include mental retardation, autism spectrum disorders, and cerebral palsy.
• Learning disability. Child has an individualized education plan (IEP) to address a learning problem such as dyslexia. Do not include an IEP designed solely to address mental health or behavioral problems. Also include a child with a learning disability diagnosed by a physician or mental health professional who is eligible for an IEP but does not yet have one, or who is in preschool.
• Physical disability. A severe, acute, or chronic condition diagnosed by a physician that impairs mobility, sensory, or motor functions. Examples include paralysis, amputation, and blindness.
• Medically fragile or failure to thrive. “Medically fragile” describes a child who has any condition diagnosed by a physician that can become unstable and change abruptly, resulting in a life-threatening situation; AND that requires daily, ongoing medical treatments and monitoring by appropriately trained personnel, which may include parents or other family members; AND that requires the routine use of a medical device or assistive technology to compensate for the loss of usefulness of a body function needed to participate in activities of daily living; AND the child lives with an ongoing threat to their continued well-being. Examples include a child who requires a trach-vent for breathing or a g-tube for eating. “Failure to thrive” is a diagnosis of failure to thrive by a physician.

Identify whether there was at least one investigation initiated since the initial risk assessment or last reassessment. This includes open or completed investigations, regardless of the investigation's conclusion, that have been initiated since the initial assessment or last reassessment. Do not include duplicate referrals.

Identify alcohol/drug use by the caregiver(s) during the review period, whether there is a current problem that interferes with caregiver functioning or family functioning, and if so, how the caregiver(s) has addressed the problem during the review period.

Non-abusive use of legal prescription drugs or over-the-counter medications should not be identified as an issue.

If both caregivers have a substance abuse problem, rate the more negative behavior of the two caregivers.

Not addressing the problem since the last assessment/reassessment includes:

• Substance use that affects or affected employment, criminal involvement, or marital or family relationships; and/or that affects or affected caregiver's ability to provide protection, supervision, and care for the child;
• An arrest since the last assessment/reassessment for driving under the influence or refusing breathalyzer testing;
• Self-report of a problem;
• Treatment received currently or in the past;
• Multiple positive urine samples;
• Health/medical problems resulting from substance use and/or abuse; or
• The child's diagnosis with fetal alcohol syndrome or exposure, or the child's positive toxicology screen at birth and the primary caregiver was the birth parent.

1. Choose "a" if there is no history of alcohol or drug abuse.
2. Choose "b" if there is a history of alcohol or drug abuse that is not current and did not require intervention during the review period.
3. Choose "c" if there is alcohol or drug abuse, and the problem is being addressed.
4. Choose "d" if there is alcohol or drug abuse, and the problem is not being addressed.

Identify the current status of adult relationships in the household.

1. Choose "a" if not applicable or there are no problems observed.
2. Choose "b" if there are harmful/tumultuous adult relationships or domestic violence.
   • Harmful/tumultuous relationships. There are adult relationships in the household that are harmful to domestic functioning or to the care the child receives (but not at the level of domestic violence). Internal or external stressors are present, and the household is experiencing increased disruption of positive interactions, coupled with lack of cooperation and/or emotional or verbal abuse.
   • Domestic violence. The household has had, since the most recent assessment, physical assault(s) or periods of intimidation/threats/harassment between caregivers or between a caregiver and another adult.

Determine the primary caregiver’s current mental health status. Does the caregiver have a current diagnosis of a significant mental health problem that impacts daily functioning, as determined by a mental health clinician, and if so, is the problem being addressed?

Not addressing the problem includes a caregiver who during the review period:

• Has a mental health condition that affects or affected the caregiver’s employment, criminal involvement, or marital or family relationships; or that affects or affected their ability to provide protection, supervision, and care for the child;
• Has had referrals for mental health/psychological evaluations; or
• Was recommended for treatment/hospitalization or treated/hospitalized for emotional problems.

Choose “a” if the primary caregiver does not have a current or past mental health problem.

Choose “b” if there is a history of mental health problems, but within the last year, there is no mental health problem that requires intervention.

Choose “c” if there is a mental health problem, and the problem is being addressed.

Choose “d” if there is a mental health problem, and the problem is not being addressed.

Determine whether the child's physical care is consistent with the child's needs (age-appropriate feeding, clothing, shelter, hygiene, and medical care). Physical care that is not consistent with the child's needs threatens the child's well-being or results in harm to the child. Examples of physical care that is not consistent with child need include but are not limited to:

• Repeated failure to obtain physician-recommended immunizations;
• Failure to obtain medical care for severe or chronic illness;
• Repeated failure to provide the child with weather-appropriate clothing;
• Persistent rat or roach infestations;
• Inadequate or inoperative plumbing or heating;
• Poisonous substances or dangerous objects lying within reach of small child;
• The child wears filthy clothes for extended periods of time; or
• The child is not being bathed on a regular basis, resulting in dirt caked on skin and hair and a strong odor.

1. Choose "a" if physical care is consistent with child needs.
2. Choose "b" if physical care is not consistent with child needs.

Compliance with/attendance of services is not sufficient to indicate behavioral change.

Identify whether a caregiver is actively engaged in achieving the case plan objectives specified in the case plan and is demonstrating skills/behaviors that will enable the caregiver to create, and maintain, safety for the child (e.g., ability to manage substance use/abuse; ability to resolve conflict constructively and respectfully; using age appropriate, non-physical discipline in conjunction with appropriate boundary setting; developing a mutually supportive relationship with a partner).

“Case plan objectives” specifically refers to the service objective type in the CWS/CMS case plan, identifying the changes in caregiver behavior necessary to create and maintain safety.

If there are two caregivers, rate progress for each. If progress differs between caregivers, score the item based on the caregiver who is demonstrating the least amount of participation/progress.

a. Demonstrates new skills and behaviors consistent with all family case plan objectives and is actively engaged to maintain objectives. Choose “a” if the caregiver is regularly demonstrating all behavioral changes identified in the case plan objectives and is able to create long-term safety for children in the household. The caregiver is actively engaged in activities to maintain the objectives.

b. Demonstrates some new skills and behaviors consistent with family case plan objectives and is actively engaged in activities to achieve objectives. Choose “b” if the caregiver is demonstrating some new skills and behavioral change consistent with case plan objectives and is actively engaged in achieving the objectives, but is not regularly demonstrating the behaviors necessary to create long-term safety in all areas.

c. Minimally demonstrates new skills and behaviors consistent with case plan objectives and/or has been inconsistently engaged in obtaining the objectives specified in the case plan. Choose “c” if the caregiver is demonstrating minor behavioral change consistent with family case plan outcomes but has made little progress toward changing their behavior and is not actively engaged in achieving the objectives. Caregiver behavior continues to make it difficult to create safety or may contribute to immediate danger of serious harm.

d. Does not demonstrate new skills and behaviors consistent with case plan objectives and/or refuses engagement. Choose “d” if the caregiver has not demonstrated behavioral change consistent with family service plan objectives. The caregiver refuses services, sporadically follows the case plan, or has not demonstrated the necessary skills/behaviors due to a failure or inability to participate. The caregiver is unable to create or maintain safety or their behavior is likely to contribute to immediate danger of serious harm.

Indicate whether a policy override condition exists. Consider only the most recent review period. Presence of one or more mandatory override conditions increases the risk level to very high.

1. Sexual abuse case AND the perpetrator is likely to have access to the child. One or more of the children in this household are or have been victims of sexual abuse AND the perpetrator is likely to have unmanaged access.

2. Non-accidental injury to a child under age 2. Any child under 2 years old in the household has any kind of physical injury resulting from the actions or inactions of a caregiver.

3. Severe non-accidental injury. Any child in the household has a serious physical injury resulting from the action or inaction of the caregiver. The caregiver caused serious injury, defined as brain damage, skull or bone fracture, subdural hemorrhage or hematoma, dislocations, sprains, internal injuries, poisoning, burns, scalds, or severe cuts, AND the child requires medical treatment.

4. Caregiver action or inaction resulted in death of a child due to abuse or neglect. Any child in the household has died as a result of actions or inactions by the caregiver. This child fatality may have occurred prior to the current case.

A discretionary override is used by the assigned worker whenever the worker believes that the risk score does not accurately portray the household’s actual risk level. Unlike the initial risk assessment, in which the worker could only increase the risk level, the risk reassessment permits the worker to increase or decrease the risk level by one level. The reason a worker may now decrease the risk level is that after a minimum of six months, the worker has acquired significant knowledge of the household. If the worker applies a discretionary override, the reason should be specified and the final risk level should be selected.