CHILD SAFETY PLAN
| Risks Posed by Batterer Parent: | ___________________________
Name of Child/Age |
| Times the Risks are Most Dangerous: | ___________________________
Date of Plan |
| Community Systems to Protect the Child are: | ___________________________
Name/Address/Telephone of Protecting Parent |
| ___________________________
Name/Address/Telephone of Abusing Parent |
COMMUNITY SYSTEMS TO PROTECT CHILD
(Community Systems Actions)
| Protective Actions Usually Taken | Problematic Actions to be Stopped of Changed | Additional Protective Actions Desired (List at least 3) |
|
| Police | |||
| School | |||
| Church | |||
| Neighbors | |||
| Court | |||
| Childcare | |||
| Family | |||
| CYS | |||
| Extra Curricular
Activity Leaders |
|||
| Other |