North Carolina Department of Health and Human Services Division of Social Services Child Protective Services Structured Intake FormSection I: Demographics Date: Time: Received by (Name): County: Screening.
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How to fill out the NC DHHS DSS-1402 online
The NC DHHS DSS-1402 form is essential for reporting child protective services cases in North Carolina. This guide provides step-by-step instructions on how to complete the form online, ensuring that all necessary information is accurately submitted.
Follow the steps to fill out the NC DHHS DSS-1402 form online.
- Click the ‘Get Form’ button to access the NC DHHS DSS-1402 form online.
- Begin by filling out Section I, Demographics. Enter the date and time of the report, the name of the person who received it, the county, and other pertinent information regarding the screening decision.
- In Section II, Reporter Information, provide your full name, relationship to the child, address, and phone number. Indicate whether you waive the right to notification and whether you are available for further information.
- Proceed to Section III, Maltreatment Information. Fill in details about the children involved, including their names, ages, and relationship to any alleged perpetrators.
- Continue to provide information on the alleged perpetrator and other household members in the designated fields.
- In Section IV, Family Strengths, describe the strengths of the family and how they typically resolve issues.
- Section V covers Safety Factors. Note any safety concerns regarding a social worker visiting the home and any potential risks to the children.
- Fill out Section VI, Health Insurance Information, to provide details about the children's health coverage and where they receive care.
- Complete Section VII through Section X, detailing any allegations of abuse or neglect, mandated reports, and providing necessary signatures.
- Once all sections are completed, save any changes made to the form. You can then download, print, or share the form as required.
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Get answers to your most pressing questions about US Legal Forms API.
Can you anonymously report someone to CPS in NC?
A report of suspected child abuse or neglect should be made to the local Department of Social Services (DSS) in the county where the child lives or is found. The report can be made in person, by the telephone, or in writing. The report can be anonymous.
What are the 4 types of child maltreatment in NC?
North Carolina General Statute 7B-101 defines: • Physical Abuse; • Sexual Abuse; • Emotional Abuse; • Neglect; and • Dependency. The law applies to any juvenile under 18 years of age.
What are 4 examples of child neglect?
But broadly speaking, there are 4 types of neglect. Physical neglect. A child's basic needs, such as food, clothing or shelter, are not met or they aren't properly supervised or kept safe. Educational neglect. A parent doesn't ensure their child is given an education. Emotional neglect. ... Medical neglect.
What falls under the category of child neglect?
General neglect is the negligent failure of a parent/guardian or caretaker to provide adequate food, clothing, shelter, or supervision where no physical injury to the child has occurred. Severe neglect refers to those situations of neglect where the child's health is endangered, including severe malnutrition.
What is considered child neglect in North Carolina?
What is neglect? A child is neglected if the child does not receive proper care, supervision, or discipline, from the child's parent, guardian, custodian, or caretaker; or the child has been abandoned. A child is neglected if the child lives in an environment injurious to the child's welfare.
What happens when DSS takes a child in NC?
If the child is placed in the custody of DSS then the child will be placed in a licensed foster care home. If DSS substantiates neglect against you they will request that your name be placed on a Responsible Individuals List (RIL), which is state registry of people who DSS believes neglected or abused children.
Can you report child neglect anonymously in NC?
A report of suspected child abuse or neglect should be made to the local Department of Social Services (DSS) in the county where the child lives or is found. The report can be made in person, by the telephone, or in writing. The report can be anonymous.
What counts as child neglect in NC?
What is neglect? A child is neglected if the child does not receive proper care, supervision, or discipline, from the child's parent, guardian, custodian, or caretaker; or the child has been abandoned. A child is neglected if the child lives in an environment injurious to the child's welfare.
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