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Pre-Service Training for Contracted Providers

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1 Pre-Service Training for Contracted Providers
VISIT SERVICES Pre-Service Training for Contracted Providers Children’s Administration (CA) 2014 This pre-service training is for Contracted Providers to help increase the quality and consistency of training and visit services statewide. It will give you basic information about Children’s Administration (CA’s) visit service contract requirements and orient you to service expectations, roles and responsibilities. Additional training will be provided on specific topics to help supplement this training.

2 Training Goals By the end of this training you will understand:
The purpose of parent-child and sibling visits. The levels of supervision. The roles and responsibilities of the parent, Children’s Administration(CA) social worker, visit service worker and contracted agency supervisor. How to set up a visit based on the information in the referral. When to consider intervening or ending a visit early. How to write reports using behaviorally specific language. How to communicate with CA social workers and caregivers. The resources available to support you. Read this slide

3 What are Contracted Visit Services?
Sometimes it is necessary to remove children from the care of their parents for a period of time due to allegations of child abuse or neglect. In these situations, Children’s Administration may ask a contracted provider to facilitate parent-child or sibling visits so the family can safely interact with one another. Read Slide

4 Why are Visits Important?
Frequent and consistent visits are crucial to maintain appropriate connections between parents and their children separated by out of home placement. Structured visits between siblings placed separately help maintain family bonds. Consistent, positive visits improve safety, permanency, and well-being for children in foster care. The law states (RCW ) that parents and children have a right to visit, except when it is not in the best interest of the child. The fact that a parent may have abused or neglected the child, or is currently incarcerated or failing to engage in services, is not sufficient grounds to deny visits. Your job is to provide visits between parents and their children and also between siblings. A visit is a planned event on a predictable schedule that maintains the safety and well-being of children in out of home care.

5 Types of Visit Service Requests
Parent- Child Sibling Transport Only Definitions: A Parent-child visit is a visit between a parent and their child(ren) that is placed in out of home care A Sibling visit is a visit between siblings placed separately in out of home care. A Transport only request is transportation of a child placed in out of home care to and from a visit with a parent or sibling

6 Levels of Supervision - Parent Child Visits
Supervised: The visit service worker maintains sight and sound contact with the child and all parties to the visit at all times. Highest level of supervision Monitored: The visit service worker is ON SITE and within line of sight OR within hearing distance of the parent-child interaction at all times.  The Service Worker will conduct periodic checks where they are able to both see and hear the parent-child interaction.    Unsupervised: The visit service worker transports a child to and from agreed upon locations and leaves the child with the designated caregiver. The social worker and/or court determines the level of supervision. Supervised At no time shall the child be allowed to be in the presence of the parent without the contractor’s staff present. You are in the space where the parent child interaction is taking place. The visit service worker shall be within sight and sound of the child and all parties to the visit at all times during the visit. The visit service worker shall be able to intervene at any moment. If you cannot clearly hear and see everything that is happening, either you or the family need to change your position. If the visit service worker must leave the room, they must take the children with them, or have another approved supervisor step in. (CASA’s are not allowed to fill this role.) Visits supervised behind a two way mirror are considered monitored not supervised because the child could potentially be left alone with the parent while the visit service staff is coming from the two-way mirror area to the room where parent and child are located.  While that might be only for a few moments, it does not meet the definition as written that “at no time shall the child be allowed to be in the presence of the parent without the contractor’s staff present.” Monitored Be on-site throughout the entire parent-child visit but not in the families personal space. On-site means in the same building or the same general part of the park or mall. If the visit is in a family home, then you must be inside that dwelling, but can be in another room. You are close enough to continually see or hear the parent child interaction. You must be available to intervene so you may not go off site. Be within line of sight or within hearing distance of the parent/child/sibling interaction and provide periodic checks ( at least every 10 minutes )to both see and hear the parent child interaction simultaneously. The visit service worker can sit outside the room (to hear) or sit at a distance away in a community setting to observe the visit and provide periodic checks at a distance where they can both see and hear the interaction simultaneously. Visit service workers can turn a monitored session into a fully supervised one at any time if there are signs that the child’s safety or well-being needs are not being met. *Supervised and monitored visits are different because for a supervised visit the visit service worker is in the family’s personal space, monitored allows for the family to have their personal space and unobtrusive interaction between family members unless there is a safety issue. Unsupervised- Pick up and deliver the child to and from the agreed upon locations for visits. Visit service workers are NOT responsible for supervising or monitoring the actual visit itself. Definition: Unattended: Children should never be left unattended in a vehicle at all, no matter if the visit provider is within line of sight of the vehicle or not.

7 Levels of Supervision – Sibling Visits
Highest Level- Sight, Sound, and Touch Visit service worker actively engages with the children at all times to insure their basic needs are met and facilitates positive sibling interactions. Moderate Level - Sight and Sound Visit service worker engages with the children as needed to ensure positive sibling interaction and is within sight and sound of the children and is readily available for intervention and redirection as needed. Lowest Level - Sight Visit service worker maintains line of sight supervision, but allows some private conversations, and is readily available for intervention and redirection as needed. The required level of supervision will be determined by the social worker based on the children’s ages and needs. The visit service worker is the “parent” for the purposes of these sessions, which means actively engaging with the children to facilitate and maintain positive interactions between siblings.

8 Parent Social Worker Visit Service Worker Contracted Agency
Roles and Responsibilities Parent Social Worker Visit Service Worker Contracted Agency

9 Role of the Parent Should Should not
Meet child's basic physical and well-being needs. Provide snacks and activities during the visit. Redirect the child. Engage the child in an activity. (read, play games) Give time outs or use other skills learned in CA provided parenting interventions. Explain to the child why their behavior was wrong and give a positive alternative. Be verbally or physically aggressive, threatening, or demeaning to visit participants and/or providers. Engage in activities that do not include the child.(phone, text) Use physical discipline (hitting, spanking, grabbing, or shaking the child). Ignore potentially dangerous behaviors of the child. Ignore child’s physical or well-being needs. Review the slide. A parents role is to parent the child during a visit. A providers role is to look after child safety and well being.

10 Role of the CA Social Worker
Provides all necessary information on referral. Authorizes initial referral and subsequent changes. Updates the provider with new relevant information. Reviews all reports. Offers additional services to parents to support visits. Addresses areas of concern with the parent and caregiver. Transports child to any new placement. Conducts the final visit between parent and child. The social worker completes the referral and provides you with all the information needed to provide visit services (how, when, where and with whom) If the information is unclear or if you have questions contact the social worker. The social worker reviews all reports, your reports become part of the court record and may be seen by the Guardian ad litem CASA, judge and attorneys. Authorizes initial referral and subsequent changes.  “It is critical that the social worker make all of the decisions about when and where visits occur.  They are the one ultimately responsible for the welfare of the child, and compliance with the court’s orders.  They are also the individual with the most information about all aspects of the case.  As the Visit Service Worker you can share information or make a suggestions about a plan you believe might work better for the visits, but it is up to the social worker to approve this and gain the consent of other parties before the change occurs.” Addresses areas of concern with the parent and caregiver.  “The Visit Service Worker must maintain confidentiality and strong boundaries with individuals in the case.    If a parent or caregiver is sharing information with you about their situation not immediately related to that day’s visit, or if they are asking questions about future events or other aspects of the case, you need to politely inform them you cannot discuss that matter and they must speak with the assigned social worker.”  Visit service workers should not transport a child to a new placement after a visit or supervise a child’s final visit with a parent. A final visit is also referred to as a “good-bye” visit because parental rights have been terminated by the court or another permanent plan has been established for the child., this is the assigned social worker’s role and responsibility.

11 Role of Agency Staff Supervisor
Provides ongoing supervision at minimum every two weeks. Ensures employees meet all training requirements to begin employment and as they continue with the agency. Reviews and approves all visit narratives, incident reports, and other documentation before submission to CA. Maintains all reports in agency file. Immediately addresses visit service worker’s performance. Supervision should include quality of visits, concerns regarding the visits and appropriate response to risk and safety, and maintaining professional boundaries. It is recommended that agency supervisors: Shadow new workers with different types of visit requests and families prior to letting them provide visit services unsupervised. Periodically drop-in to observe visit service workers doing visits. Be available to back up staff in an emergency. This includes being able to make an alternative plan if your staff cannot do the visit that day, and also being available for consultation in a crisis. if your visit service worker cannot reach you, then who do they call? Outline your agency’s emergency plan. Visit Service Worker reports are the property of the agency and must be reviewed before submission to the social worker and kept at the agency.

12 Role of the Visit Service Worker
Be on time. No Cell Phone use. Follow the visit referral. Give the family your full attention during the visit. Supervise for child safety and well-being throughout the transport and visit period and intervene when necessary. Document interaction between the parent and child during the visit using the format prescribed by CA. Maintain professional boundaries. Communicate health and safety information about the child to the caregiver. Maintain confidentiality. Submit the Visit Narrative, Incident Report and No-show reports to staff supervisor. Be on time. This means planning extra time for traffic and picking up the child. Cell phone use (talking, texting, , Facebook, web browsing, etc) is not permitted unless there is an emergency. The role of the provider is to observe the visit and be readily available to intervene. Always follow the instructions and direction on the referral, any changes must have prior approval of the CA social worker. Safety of the child is the visit service worker’s primary responsibility. Parent(s) and children should walk beside or ahead of you, not behind. If a parent does not take their young child’s hand, or put them in a stroller when walking in a parking lot or similar setting, then you need to intervene and ask the child to hold their parent’s hand or yours. Agency identification badges should be worn at all times while providing services. Schools and day cares should look at your ID before releasing the child. Be respectful to parent and caregivers, but keep strong boundaries. You are not a friend, rather someone hired to provide a professional service. If a parent repeatedly tries to engage with you redirect them to interact with their children. Do not share your personal information, keep your professional boundaries! Do not have any contact with a birthparent or caregiver you are working with outside of what is necessary to do the visits.  Do not have contact with them once a case is over. Confidentiality is critical. Do not discuss the case with anyone other than your supervisor, and the assigned social worker or their supervisor. Laptops or paperwork should not be left unattended. If personal laptops are used, client data needs to be  segregated and workers should not discuss their cases with anyone not associated with their agency. Always use the secure system for referrals and reports. Submit all reports to your supervisor for review.

13 Role of the Visit Service Worker
Transportation Requirements Follow all the Rules of the Road Car seats and seat belt laws: No Cell phones – Hands Free Law: RCW Child passenger restraints and penalties: RCW Children unattended in vehicle: RCW Speeding and maximum speed limits: RCW Texting while driving: RCW Do not transport any unauthorized adults or children. Do not transport a child to any other service. Get authorized caregiver’s signatures at pick up and drop off of a child. Follow the LAWS! Make sure you have approved car seats and restraints for each child, the referral provides the weight of each child needing to be transported. Do not use your phone or text while driving- PULL OVER. Do Not leave a child unattended in the car at anytime! Definition: Unattended: Children should never be left unattended in a vehicle at all, no matter if the visit provider is within line of sight of the vehicle or not. Drive the speed limit- remove A child safety come first- Providers may only transport and supervise children who are currently in state care and custody. If the parent has another child not in state custody, the parent is totally responsible for their care. Sibling Visit: A provider may not transport, supervise, and pay for child not currently in state care and custody. The only adult who can be in your car while transporting children is another staff member from your agency. Do not transport a parent even on your own time, you must not compromise your professional role in the child’s case. Do not transport a child to therapy or any other service that is not a visit with a parent or sibling. (E.g. school, physical or mental health appts, or parenting classes.) ALWAYS share information with the caregiver about the child’s safety and well being. If you have any concerns (e.g. child talking about harming themselves, child unable to be consoled, self harm, etc), contact the social worker or supervisor and immediately contact your agency supervisor. Transportation logs -- The caregiver must sign their name and write down the time on your log for every pick-up and drop-off. Visitation supervisors may also need to sign a log maintained by the school, day care, or group care facility. The times on the two logs must match.

14 Visit Services with Evidence-Based Practice (EBP) Providers
The visit services worker may be asked to provide visit services for a family receiving a therapeutic intervention during the visit, in these cases your role is to: Transport the child to and from the visit. Monitor the visit when the professional is working with the family. Supervise the visit when the professional has finished their session with the family. When a social worker identifies the need for an EBP Evidence Based Practices to support reunification and the family is willing to participate in an EBP: PCIT, Triple P, SafeCare and PFR, the Visit Services Contract can be used when: The court ordered each parent child visit to be at least 1 ½ hr. in duration. EBP sessions typically vary from 45 minutes to an hour The social worker will receive prior approval from the family agreeing that a portion of the parent child visit will be with the EBP provider and the remainder of the visit will be with the visit service staff. Visit Contract may be used to transport the children to the visit. The visit provider will monitor the visit during the EBP part of the visit, and then transport the child(ren) back to the caregiver at the end of the visit. Visit Services contract may not be used to transport children to visits where the visit will only consist of the EBP session. The total visit MUST include a minimum of 30 minutes parent child visit without the EBP provider. Visits Services Contract may not be used to transport children to any other professional service. Document EBP provider name in visit report and check their ID The role of the visit service provider is to monitor the visit while the EBP provider is in the room with the parent and child(ren)

15 How to Set Up a Visit Review, understand and follow the terms and conditions of the visit service contract. Review each referral for all of the necessary information. Determine the agency’s ability to facilitate the visits. Assignment to service worker whose skills and abilities meet the request. Communicate with the assigned social worker about visit details. Sends the Provider Notification form to social worker. Notify all parties at least 24 hours in advance to confirm the first visit. Receive written notification from the social worker prior to making any changes. Thoroughly read each new and updated CA approved referral to make sure you clearly understand the requirements of this visit. Assign Service Worker that can best meet the needs of the family (bilingual, special needs). If you have questions or need clarification CALL the social worker. Do not make any changes without social worker approval. Verbal requests from the social worker must be followed up in writing and placed in the client file. Update the Visit Referral upon notification of any changes. Promptly pass that document to the Service Worker doing the visits. NOTE: Trainer should use the referral form as a handout.

16 REFERRAL FORM The form can be viewed in the Visit Service section of the Contracted Provider’s webpage: Provide each participant with a copy of the referral form and review the information that is required in each section. Type of Visit Children’s names and ages. Where do I pick up and drop off the children? What happens if school is out that day? (Having a copy of the school / day care calendar helps.) Who is the responsible adult signing for the child on both ends? Who is allowed at the visit? What level of supervision is requested? Is the family able to visit in the community or must they be in a CA facility? What are the rules around children using the bathroom? Be sure to read the section on Safety Issues and Case Specific Instructions very carefully. If the referral is not complete, inform the gatekeeper you cannot accept the case until it is revised. If you have other questions, or want more information, call the social worker. Provider Notification Form/Visit Transport Schedule Return the Provider Notification Form to the social worker.

17 Scheduling Considerations
Meal Time Nap or Bedtime School Time Appointment Time Activity Time Parent’s Court Ordered Services Cultural Considerations It can be tough to find a time that will work with everyone’s schedule, especially for school-aged children. In addition to the clinical requirements of a CA case, children may be participating in extracurricular activities, their caregiver likely has a work schedule and other children to care for and would like some kind of normal family life, and the birth parents will have their own appts and may be working. Meal times should be avoided unless there is verified plans for a parent to feed the child a meal (not just snacks). Visit service workers need to be patient, persistent, and creative in discussing with parties when the visits can occur. If no solution is found after 3-4 attempts, or parties seem reluctant to discuss alternatives, ask the SW for assistance in mediating a solution.

18 Visit Preparation - Checklist
Agency Badge Gas in Car Car Seats Charged Cell Phone Visit Referral with Contact Information Caregiver signature form Directions A list of phone numbers for your agency staff First Aid Kit Prepare ahead of time Before going on a visit make sure you have these things.

19 Safety is Critical Have a plan: Know who to call
If the caregiver is not home If a visit ends early If the parent abducts the child If a child gets hurt If a parent threatens a service worker Know where you can go Develop an exiit strategy Have a plan on what to do if things become unstable: Make sure there is no one between you and the door. Move to where there are other people around. Who in the vicinity can help you? Who will you call? If the parent is acting out, put a barrier between them versus where you & the child are. If you or the children are feeling unsafe, end the visit and leave the area. When calling 911: Know the name and address where you are at. Be prepared to concisely describe why you need help In the case of an abduction, be able to describe the clothing, height, weight, hair color & style, and ethnicity of the children and the parent. Make sure your car keys are on your person at all times. A child locked in a car can face emergency temperatures within a couple of minutes, so if this happens, call 911. If the caregiver is not home & cannot be reached to take the children in a reasonable time frame, call your agency supervisor and CA staff for help in problem solving. (You will be paid for the extra time with the children.) Children can not be taken to your home at anytime or for any reason.

20 Visit Session Verify participants
Review contracted agency visit guidelines Survey room and sit in direct line of sight and sound in least intrusive location Supervise visit as directed in the referral Remain focused on safety and well-being of the child Document observed behaviors Intervene or redirect as needed Follow bathroom guidelines Allow time for transition and closure Verify who is at the visit using your referral form, person not identified on the referral have to be asked to leave. Tell the person to contact the social worker who is the only one who can approve their participation in a visit. Review with the parent your agency visit guidelines Survey the visits area make sure the area is suitable to provide the level of supervision on the referral, if not, find another area Understand the requirements of the level of supervision you are providing. You want the least intrusive environment. Stay focused on the parent-child-sibling interaction. Do not text, play games on your phone or engage in any activity that may distract from your job, child’s safety is your responsibility. Document what you see and what you hear. When necessary intervene or redirect the parent or child especially when the child’s safety or well-being is at risk. Follow the bathroom protocol, with more than one child you will likely need assistance. To support a child’s transition back to foster care you can let the parent and child know when 15 minutes is left in the visit. The parent can help the child get his or her things together. Depending on your comfort level or if otherwise directed by the social worker the parent can help you put the child in your car.

21 Bathroom Guidelines for Supervised Visits
Supervised visits require the visit service worker to supervise the parent while they take all children into the bathroom if one needs to go. The parent assists the child who needs changed/to use the toilet. First off, attend to personal needs / bathroom breaks prior to a visit or transportation whenever possible Bathroom Guidelines are for supervised visits. If visits are held at the Contractors location, make arrangements ahead of time with other peers to support supervision in the bathroom if there is a large sibling group. No child should be left alone at anytime. For children who do not need assistance with toileting, you can check to make sure the bathroom is unoccupied then stand outside the bathroom door if it is only one stall to ensure no one goes in. If the referral is confusing/conflicting information i.e. the visit is supervised but the referral states the parent can take the child to the bathroom without supervision ask the SW. Always choose the safest route until it is clarified with the social worker.

22 Cancelled-Missed-No Shows
The goal is to avoid transporting a child unnecessarily. PARENTS must notify the social worker and visit provider 24 hours before a visit if they are going to cancel, or it will count against them. Providers are only to wait 15 minutes for a parent to arrive, and then take the child home. Three (3) parent no shows/cancelled visits require the case to be returned to the CA social worker to create a new referral. CAREGIVERS must notify the social worker and visit provider as soon as they know a child will not be available to visit. PROVIDERS cannot cancel a visit unless there is an emergency and no agency backup is available. Immediately notify all parties and coordinate with the social worker to schedule a make up visit. If the parent fails to arrive within 15 minutes of the scheduled start time, take the child back to the pick-up point, or to a location negotiated with the caregiver. If a parent calls to say they are on their way, you must leave 15 minutes after the visit was due to start, unless you meet the parent in the parking lot. Cancellation means the client cancels a confirmed visit with less than 24 hours notice. No Show means the client missed the appointment and did not call to cancel. It is not a cancellation or a no show when a parent cancels with more than 24 hours notice. Notify the SW and discuss whether the visit should be re-scheduled. A total of Three (3) parent no shows/cancelled visits require the case to be returned to the CA social worker to create a new referral.

23 Re-scheduling Guidelines
Visits will be made up when: Provider emergency Child is unexpectedly unavailable Court hearing Caregiver takes the child on a planned vacation Bad weather Visit will not be made up when: Parent no showed or cancelled with less than 24 hours notice Visit ended early because of the parent’s behavior The SW can consider whether it is appropriate for the parent to attend School functions and athletic events with the child. If so, that will usually take the place of that scheduled visit, and most likely the child’s caregiver will supervise that interaction, not your agency. Clearly inform all participants which holidays your agency will and will not do visits on. Ask the social worker whether missed holiday visits will be made up

24 Parent’s Intervention
Parents Can: Redirect the child to another activity. Give time outs or use other skills learned in CA provided parenting interventions. Explain to the child why their behavior was wrong and give a positive alternative. Parents Cannot: Use physical discipline (hitting, spanking, grabbing, or shaking the child). Be verbally or physically aggressive, threatening, or demeaning to visit participants and/or providers. Ignore potentially dangerous behaviors of the child. The parent role is to parent during the visit. The Visit Service Worker’s role is to provide for the safety and well-being of the child.

25 Service Worker Intervention
Intervene When a Parent: Does not notice or does not address a safety issue for the child. Does not meet the basic needs of the child. Is not giving the child their full attention. Is not aware of child well-being. How To: Calmly, respectfully, and discreetly (if possible) remind parent of visit rules and expectations: Try to avoid addressing the parent in front of the children if possible. There may be times when discussing the concern after the visit ends will lead to a more comfortable situation and better results. If you are taking notes during the visit, keep these brief so your attention remains on the family If a parent behaves inappropriately or breaks one of the visit rules, remind them of what is expected. If they continue to break the rules, or the child’s safety or well-being is put at risk, then you must intervene to protect the child. If a child is standing on a chair, playing with a choking hazard, or there are other threats, give the parent a moment to address the situation. If they do not, or the danger is imminent, then intervene. Contact the social worker, describe the situation, ask the social worker to contact the parent, ask for instructions for the next visit. Best practice would suggest the social worker have a conversation with the parent before the next visit. This is a fine balance between letting the parent be responsible for the care of the child, and understanding when intervention needs to happen to ensure safety and well-being of the child The social worker wants parents to parent their children in the visit. Give the parent the opportunity to see, notice, and address the issue independently. BUT, if there is an immediate safety issue (child is running out into traffic) respond immediately. Parents do not have care and custody of their children, and their visits are currently being supervised, for a reason. While we want to support them in learning to care for the child, we can’t allow the child to be neglected or maltreated during that process.

26 End a Visit Early When: Parent attempts to leave the area with the child. The child is at risk of or is experiencing physical or emotional abuse by the parent. Parent ability to care for the child is impaired. Parent does not abide by rules outlined in CA visit plan and agency guidelines. The supervisor of the visit is threatened. Create case examples use in exercise. A discussion around not ending a visit , is it in the child’s best interest to end the visit, use professional judgment. If there is more than one parent attending the visit, the provider can ask the person to leave and allow the visit to continue with the other parent, if the adults cooperate. If they do not, then the visit ends. Unapproved guests arrive: If you are in a CA facility, it is harder for them to get into the visit, and easier to get help in making them leave. If you are in a public place, you or the parent can ask the individual to go to another area; or you can relocate the family to a different area. If the parent won’t cooperate with you in having the guest leave, or the guest is behaving in a fashion you feel may be unsafe, then end the visit. Subsequent visits will occur unless the social worker withdraws the referral or the agency return the referral.

27 Visit Scenario You are supervising a 2 hour visit between10 year old Tommy and his mother. Tommy enters the visit room, runs to his mother and says “hi”. Mom looks up from her magazine briefly and says “hi” to Tommy. Mom continues to read her magazine as Tommy makes several attempts to engage his mother in conversation and activities. After 15 minutes you reflect to the mother that Tommy is attempting to get her attention. Mom replies to you “OK”, in a minute. 30 minutes into the visit, Tommy continues his attempts to get Mom’s attention, Mom says, “in a minute, I am almost done”. Then Tommy decides to play with toys provided at the center. After 5 minutes playing with the toys Mom says abruptly and loudly to Tommy, “you are making too much noise”. Tommy puts the toys down and finds a book. 45 minutes into the visit Tommy sits in the corner with a book by himself. Mom looks up at him a couple of times and they smile at each other. 55 minutes Tommy turns to you and asks if he can go home. When & how would you intervene? Would you end the visit and why? Discuss if you should end the visit and why. Discuss if you are in the role of a visit supervisor should you provide more feedback to the parent. Discuss what conversations you have with Tommy on the transport home. Discuss what information is shared with the caregiver. Discuss what, when and how the visit information is given to the social worker.

28 Once a Visit Has Ended Early
Contact the social worker or their supervisor immediately by phone. Send an incident report to the social worker within 24 hours. Receive instructions from social worker before the next visit. Keep calm and do your best to reassure the child. The CA social worker will contact the parent to address the issue. The social worker may: Offer the parent additional services to support the visits. Review the rules, expectations, and consequences going forward. Make a recommendation to the court to limit visits The Visit Service Worker should contact the social worker and ask about the visit plan.

29 Report Unusual Incidents
Unusual incidents which require an immediate phone call to the social worker and/or their supervisor, and a written Incident Report within 24 hours. Parent or Child: Engages in physical self-abuse or abuse of others Exhibits sexual behaviors Exhibits unusual behavior Leaves or runs away Requires medical attention Makes suicidal threats or behavior Exhibits behavior that causes signs of extreme distress in a child Fails to comfort a child who is showing signs of extreme distress Depending on the situation, these incidents can also be grounds to end a visit early. When the office is closed….you are required to contact CPS intake and/or afterhours (1-800-END-HARM). If it is during business hours and you can not reach the SW or Supervisor continue to press 0 until you speak to a live person. You must speak with a live person! Unusual incidents must be reported via phone immediately to the social worker or their supervisor. The written report must be made within 24 hours to the assigned SW.

30 Report to Caregiver Includes
When and what the child ate or drank Time of last diaper change or toileting Any nap during the visit or transport Any injury to the child Any conversations with or between children that may impact their safety and well being If a visit ended early due to the child’s behavior, briefly describe the behavior from the child’s perspective. If a visit ended early due to the parent’s behavior, only report the visit ended early. May include but is not limited to: A brief statement about what happened, stick to the facts! A general comment about the tone of the visit, was it positive. Keep child focused, do not report on the parent. Only share information pertinent to the child’s successful transition home. Be aware of your professional boundaries. Remember confidentiality of the parent is critical! The caregiver needs to be able to appropriately meet the basic needs of the child after a visit. If a child was not fed by the parent, was overfed, or was fed significant amounts of candy/sugar/snacks—the caregiver needs to understand this so they can accommodate the feeding schedule the rest of the day. Caregivers of very young children need to know when to do the next diaper change, or how to adjust their nap schedule. The caregiver needs to be prepared to respond appropriately with any issues that may arise after a visit. A child may need some special attention from a caregiver after a visit if the visit did not go as expected, or if there were problems. Report any significant negative interactions that the child had during the visit. E.g.: Did the child and sibling get into a fight? Did the child fall and hurt themselves? Did the child cry and fuss during the visit? Was the child disciplined during the visit? If the caregiver has further questions, they can call the social worker. Remember: Visiting with parents can be incredibly stressful for a child and they may have feelings of great sadness when they leave their parents. Children have varying skills at regulating their emotions and naming their feelings depending on their developmental age. Many children are not able to express with words how they feel—and behaviors like tantrums, anger outbursts, etc. are their way of coping and expressing emotions they can’t name. These reactions are generally not “behavior problems” but rather normal responses to a very stressful situation by a child who has endured trauma. Keep calm and do your best to reassure the child. Stay alert of things a child says during the transport, children frequently express distress, suicidal ideation and other concerns during the transport. It is very import these things are reported to the caregiver!

31 Visit Report Requirements
A Visit Report is required for all supervised, monitored, transportation only, and sibling visits. Visit report must be submitted to agency supervisor. Approved visit report must be provided to the social worker within 5 calendar days of the visit. Unusual incidents must be reported via phone to the social worker and/or supervisor immediately. A written Incident Report must follow within 24 hours. No show and cancellation reports must be sent to the social worker within 24 hours. Documentation of all visits must be submitted to the supervisor for review prior to sending them to the social worker. Visit supervisors may change the report to fix grammatical errors or remove a comment that is an opinion or judgment. Copies of reports are not the property of the visit service worker and should only be kept by the agency.

32 Visit Reports Contain confidential information.
Require protection under the data security requirements Are a permanent part of the case record. Provide information about parent’s progress and safety concerns. Help professionals in the case decide if the visit plan should be modified. Informs the CA social worker about other services that may be needed by a family. Informs decisions regarding permanency for the child. All staff, subcontractors and volunteers must ensure that confidential information including all reports, signature pages and other visit information may not be shared in any form except to provide services as required under the contract. Confidentiality applies to voice conversations, data in any electronic format, data in any paper format, and all other forms of communication. Confidential information in any form must not be left unattended and not be physically accessible to unauthorized individuals. Any loss or misplacement of confidential information must be immediately reported to the agency supervisor who will make a report to CA contract manager within one (1) day. Carrie will review contract language. When transporting Confidential Information electronically the Data must be encrypted. This includes any transmission of the Data over the Internet in any manner including, but not limited to, outside of your own network. Storage of the data in any way is not allowed by the subcontractor, volunteer or visit service worker Data stored on hard disks, CDs, DVDs, or USB flash drives, or any form of portable electronic media must be encrypted and stored in an area or place to which only the Contractor or authorized Contractor staff has access. Only authorized Contractor staff may access the data and visit and other reports. You can create a narrative template that has the family’s name, case #, and time & location of the visit; Documentation in Visit Reports of observations must reflect the unique nature of each parent child sibling interaction.

33 Visit Reports Continued
The purpose of the visit report is to “draw an objective picture” of what happened during the visit, so that parties to the case can understand the interactions between the parents and children. Who was present When and where the visit occurred What the family did during their time together What the family said during the visit If the child said or did anything while being transported that others should know about Avoid saying “everything was fine” in your visit narrative, this is an opinion. Describe unusual events, what the child said in the car, or a concrete observation of the parent-child or sibling interactions. Write an incident report or which describes a problem. A Visit Report is NOT a substitute for an incident report. If you have concerns about the caregiver, daycare, school, or something else that occurred outside of the visit & transport itself, document these on an incident report not the Visit Report. Different reports can have varying levels of detail, but they should all present a consistent picture of what happened in the visit. Proof-read your reports before submitting them to make sure all of the individuals are clearly identified, words are correctly spelled, and your description of events will make sense to someone who doesn’t know the case. The use of initials and abbreviations can be particularly confusing.

34 Behaviorally Specific Language vs. Opinion
Only document specific observable behaviors Describe the child and parent behaviors and statements Use objective language Describe unusual incidents, safety concerns Avoid interpretations, perceptions, judgments Avoid drawing conclusions and making assumptions CASA’s, parents, the judge, other professionals, and attorneys may see a copy of every narrative and incident reports you complete; as well as every you send to CA social worker. Remember choose your words carefully, be professional.

35 Exercise: Visit Observation and Report
Mother and son interaction 6 minutes parent child interaction Watch this video which is a couple minutes in duration. Pretend you are supervising the parent child visit. Practice documenting your observations. After the video we will review your notes and help fine tune your documentation skills.

36 Choose Your Language Carefully:
Opinion and Judgment: Parent was rude and vulgar. Parent didn’t have a clue about changing the child’s diaper. Parent’s home was nasty and unsafe. Parent was filthy and drunk. Behaviorally Specific Language: The parent yelled at me and called me a “stupid bitch”. The parent put the diaper on inside out. The parents home had cigarette butts all over the table, dog feces on the floor, and exposed wiring in reach of the toddler. Parent’s pants had food particles on them. Parent had body odor, and her breath smelled of alcohol. It takes time and practice to learn to write factual, behaviorally specific language. While you are writing ask yourself: Would someone need to ask “what do you mean by that?” given my choice of words? Do my words have any emotional or judgmental connotations? If I hadn’t been there, would I have the same picture about what the situation looked, sounded, and smelled like as someone who was present based on what is written here? Review your documentation and circle words you used that would be considered opinion and judgments. Rewrite you narrative using only behaviorally specific language.

37 Redo Exercise
Mother and son interaction – 6 minutes parent child interaction

38 You are Mandated Reporters
REPORT all suspected child abuse and neglect (CA/N). REPORT if you observe CA/N when picking up or dropping off a child. REPORT if you observe CA/N during the visit. REPORT if a child discloses CA/N in the car. CPS Intake: END-HARM You must also submit an Incident Report to the social worker. When in doubt, REPORT! As a visit service worker, you are a mandated reporter of child abuse and neglect. Learn more about the reporting process in this video. (23 min 6 sec) If a parent claims that a child has a mark on them, have the parent show you the spot and document what you do or don’t see. Do not ask the child about the mark, but if they spontaneously say something about it, write it down. Do not ask the caregiver about the mark, that is the social workers job Do not discuss the mark with the parent, let them know they (the parent) can contact the social worker and you will be making a report. Notify CPS intake immediately! Submit a incident report and notify the social worker or supervisor within 24hrs. If you suspect child abuse or neglect you are a mandated reporter call CPS intake, when in doubt report! You are required to complete the CA Mandated Reporter’s training prior to providing visit services and must retake the training every year.

39 Certificate of Completion is hereby granted to
to certify that he/she has completed to satisfaction Pre-Service Training for Visit Services Contracted Providers Date of Completion: Agency Representative: Agency Name: A copy of this certificate will be given to the Visit Service Worker and a copy will go in the agency’s personal file.

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