ABSTRACT
Authors’ note: Th e following Parental Assessment has been modifi ed to preserve the parent’s confi dentiality. All identifi able data have been altered.
Child Maltreatment Parental Assessment
Name : Jane Doe Date of birth : 06.09.80 Age : 24 years old Evaluator : XXXX Date of evaluation : 05.01.06
Reason for Referral
On 01.02.06, an Initial Safe Family Home Report and Service Plan identifi ed harm toward Jo Smith (date of birth: 09.15.05) via “threat of physical abuse, and threat of neglect” by mother, Jane Doe, and father, Jo Smith (date of birth: 06.17.55). Th e report identifi ed the mother’s problematic behaviors perpetuating the maltreatment of her child including the areas of mental health, substance abuse, and parenting style.
