Assessing Expectant Parents and Parenting Families of Newborns

0070-548.07 | Revision Date: 05/04/22

Overview

This policy guide provides guidelines for assessing the needs and supports of families, including expectant and parenting youth and nonminor dependents (NMDs), during the mother's pregnancy and following the birth of their child. Additionally, this policy provides guidelines for when to make a report to the Child Protection Hotline (CPH) as well as instructions for circumstances when the newborn in not at immediate risk but the family still requires supports and/or services.

TABLE OF CONTENTS

Policy

Preparing Parents and Co-Parents, Including Expectant and Parenting Youth and NMDs, for the Birth of a Child

Supporting Families Upon the Birth of a Newborn

Assessing the Needs of the Parents and Co-Parents, including Parenting Youth and NMDs

Procedure

A Mother in an Existing Referral and/or Case Has Given Birth

CS CSW Responsibilities

CS SCSW Responsibilities

CPH CSW or Designee Responsibilities

When a Referral is Made Following the Birth of a Newborn on an Open Case

ER CSW Responsibilities

ER SCSW Responsibilities

ER ARA Responsibilities

Approvals

Helpful Links

Attachments

Referenced Policy Guides

Statutes

Version Summary

This policy guide was updated from the 05/23/18 version, to clarify the roles and responsibilities of CSWs with regard to newborns in existing referrals and/or cases,including those circumstances involving expectant and/or parenting youth and NMDs. Also, a reminder was added to ensuring that parenting youth and NMDs are not assessed in the same manner as adult mothers as their experiences, needs, supports, etc. will vary, particularly for those in out-of-home care (OHC). Additionally, the policy underwent a title change from "Assessing the Safety and Risk of Newborns for Families Already Under DCFS Supervision" to the current title.

POLICY

Preparing Parents and Co-Parents, Including Expectant and Parenting Youth and NMDs, for the Birth of a Child

Upon learning of a mother's pregnancy, including youth and NMDs , CSWs should work with that parent and co-parent (if applicable), to help prepare them for the birth and care of their newborn, including connecting to existing services for which they may be eligible, that are targeted at supporting, maintaining, and developing both the parent-child bond and the ability to provide a safe and permanent home for the child. CSWs are to use a strengths-based approach in supporting families welcoming a new baby.

Additionally, thecase plan shall be updated to reflectthe services and supports provided to or the parent and co-parent,(if applicable).

• Examples of services and supports may include, but are not limited to, Expectant and Parenting Youth conferences for pregnant and parenting youth, child care, parenting classes, referral for Early Infant Supplement (EIS) program, Nurse Family Partnership (NFP) program or other home visitation program referral, and frequent CSW visits.

Supporting Families Upon the Birth of Newborn

In addition to ensuring support for the parent and co-parent (if applicable) during the mother’s pregnancy,when a CSW becomes aware that a mother or youth/NMD on their caseload has given birth, it is the responsibility of that case-carrying CSW to ensure that an assessment of the newborn's safety and well-being is conducted. An assessment does not require that a referral be made to the CPH unless there is a report/suspicion of abuse and/or neglect.If a referral is generated on the child of a dependent or NMD parent, the parents' (i.e., youth or NMD) attorney must be notified within 36 hours of the referral (AB 670).

• Staff are reminded that parenting youth and NMDs are not to be the
  
  subject of an investigation based solely on their dependency status
  
  The CSW shall use a strengths-based approach to support the parenting
  
  youth or NMD in providing a safe and permanent home for their child.
  
  A risk assessment should not be conducted for the child of a parenting
  
  youth or NMDunless a report has been made alleging abuse and/or
  
  neglect.

Assessing the Needs of the Parents and Co-Parents, including Parenting Youth and NMDs

The assessment should focus on the needs of the parent and co-parent (if applicable) and newborn to determine what supports are applicable and available. Further, the family shall receive assistance in accessing resources to address their needs and strengths, regardless of their dependency status.

Note: Parenting youth and NMDs, especially those in OHC, may have a wide range of needs and may require additional support to access those services to meet those needs. CSWs are to tailor service plans and the level of support provided to access services in the case plan to the unique needs of the family.

When completing the assessment, CSWs are reminded to have a strengths-based approach, particularly for parenting youth and NMDs and to provide services and supports to ameliorate any concerns that arise during an assessment before consideration of detention unless there is a safety concern in which the newborn is unable to remain safely in the home of their parent and/or co-parent (if applicable).

The assessment of a parenting youth or NMD should not be evaluated with the same lens as an adult parent or co-parent since their dependency status provides for a different set of circumstances with regard to supports, experiences, etc.Keeping this in mind,the CSW's assessment shall include , but is not limited to, an evaluation of:

• The newborn's health/physical condition (including bruises and body
  
  marks) and overall development, including but not limited to
  

• Newborn's bio systems: eating, sleeping and pooping
  
  

• Newborn's communication: crying, cooing, eye-tracking, hearing.
  
  Concerns in communication may include glassy eyes, inconsolable or
  
  lack of crying
  
  
• Newborn's movement: stretching, kicking reaching, turning head.
  
  Concerns with mobility or overly rigid or floppy muscle tone.
  
  
• Newborn's relationships: Recognition of the parent/caregiver's voice;
  
  newborn is soothed by the parent/caregiver's voice, tracks them and
  
  there is a notable nurturing relationship and bond. Also, the
  
  parent/caregiver speaks warmly to the child and the child seems to
  
  respond.
  
  Concerns for any of the above should be documented and discussed
  
  with a Public Health Nurse (PHN) and/or other medical professional to
  
  determine if the child is in need of further assessment/evaluation and/or
  
  supportive services.
  
  
• Condition of the home

• This does not apply to parenting youth or NMDs; however, staff are
  
  reminded that the conditions of the home should always be addressed
  
  during home visits. It should be noted that the condition of a home is often
  
  outside of the control of parenting youth and NMD’s, particularly those
  
  placed in OHC. If there are concerns surrounding the condition of the
  
  home, including OHC placements, those concerns should be addressed
  
  with the adult clients (mother and/or co-parent) and the youth/NMD’s
  
  caregiver, or with the youth/NMD and/or co-parent, as applicable (e.g.,
  
  those residing alone, SILPs, etc.).

• Family and/or environmental stressors

• Most parenting youth and NMDs have experienced, or are experiencing,
  
  family and/or environmental stressors. CSWs shall give close
  
  consideration of these stressors and determine what services or supports
  
  may be available to alleviate such stressors.
  
  

• Parent/co-parent (as applicable) capacity (from a trauma-
  
  informed/strength-based lens). Assessments should include, but are not
  
  limited to:

• Feelings about having a newborn, including the adjustment to caring for a
  
  newborn (focusing on emotional reaction and any specific patterns of
  
  emotions that may affect the parent/co-parent's (i.e., adult, youth NMD)
  
  ability to appropriately care for the newborn (e.g., post-partum reactions)
  
  
• What terms does the parent/co-parent use to describe the newborn?

• Parenting skills

• CSWs are reminded that parenting youth and NMDs likely need added
  
  assistance in developing their parenting skills and, lack thereof, shall not
  
  be the sole reason to remove the newborn. Rather, CSWs shall give
  
  close consideration to assisting in enrolling the parent or co-parent in
  
  parenting classes, Partnerships For Families, Nurse Family, Partnership
  
  program, Parent Family Partnerships, or other service to assist in
  
  developing parenting skills.

• Parents’ and co-parents’ (if applicable) current substance use/abuse
  
  and whether or not it has an impact on their ability to parent
  
  
• Support system
  
  
• Staff are remindedthat this will be very different for dependent
  
  children/NMDs, particularly if they are in OHC. Staff should assess this
  
  area and determine what supports may be provided to the adult mother
  
  and to the youth/NMD and newborn, including those in OHC.
  
  
• Safe sleeping arrangements.

• CSWs should provide information about safe-sleeping and are
  
  encouraged to explore available resources to assist parents in obtaining
  
  appropriate bedding, as needed. A parent's choice to co-sleep shall not
  
  be a reason for removal.

• Medical reports (i.e. prenatal care)
  
  
• Current medical/psychological reports from treating therapists/other
  
  service providers, as applicable to determine if there are safety risks
  
  
• Applicable collateral contacts, police reports, etc. that may provide
  
  insight into the care and support of the parenting youth/NMD and the child
  
  
• Ability of the parenting youth/NMD and co-parent (if applicable) to
  
  provide for the safety and well-being of the child
  
  .
• Staff shall be mindfulthat youth/NMD’s are inexperienced parents and
  
  very likely need services and supports to ensure the safety and well-being
  
  of the newborn and shall be considered as a means to ameliorate
  
  concerns in lieu of removal.
  
  
• Risk based upon referral history, case history, etc. (all factors previously
  
  listed above)

• SDM tools are not required for completion of a newborn assessment if
  
  a referral has not been generated; however, use of SDM tools are
  
  strongly encouraged to guide the CSW in their assessment of the
  
  newborn.
  
  
• Note: CSWs are reminded that parenting youth and NMDs are not to be
  
  assessed based on their dependency status or case history.

• The status of the parent and co-parent's (if applicable) visits with their
  
  other children (monitored vs. unmonitored, frequency of visits, quality of
  
  visits, etc.), if applicable

All reports, observations or reasonable suspicion of abuse, neglect, caretaker absence/incapacity or exploitation must be immediately reported to the CPH.

• For parenting youth and NMDs, the newborn must not be considered
  
  to be at risk of abuse or neglect solely on the basis of information
  
  concerning placement history, past behaviors, history of commercial
  
  sexual exploitation (CSE), or health or mental health diagnoses occurring
  
  prior to the pregnancy, although that information may be taken into account
  
  when considering whether other factors exist that place the newborn at risk
  
  of abuse or neglect (WIC 361.8(a)).
  
  

When investigating a reasonable suspicion of abuse, neglect, caretaker absence/incapacity or CSE, the decision regarding whether or not to detain a newborn from the custody of their parent(s), co-parent(s) (if applicable), or legal guardian(s) should be made following a thorough investigation. If there are siblings in the home, the CSW must determine the reasonable cause specific to each individual child in order to remove that child; thus, a thorough investigation for each child is to be completed. CSWs should be mindful that, simply having reasonable cause to remove one child for their safety, does not provide an adequate basis to remove other children. Previous abuse of the newborn's siblings may be sufficient to establish a risk of harm to the newborn, especially where reunification was terminated or not offered. County Counsel should be consulted when the CSW is unsure of how to proceed.

In addition, if the newborn was not detained, the CSW must inform the Court of the birth of the newborn at the next scheduled hearing for the newborn’s sibling(s) or the parenting youth or NMD, whichever is applicable, and what services, if any, are being provided to that child and parenting youth/NMD and co-parent (if applicable).

• If voluntary services are offered, the adult client, parenting youth or NMD must voluntarily accept those services.

Back to Policy

PROCEDURE

A Mother in an Existing Referral and/or Case Has Given Birth

Upon learning that a mother, including parenting youth and NMDs, in an existing referral or case, has given birth, it is the Department's role and responsibility to ensure the safety and protection of that newborn.  The most effective method of ensuring that the newborn is supported in a safe and stable environment is through direct observation by a CSW with consideration of those factors previously mentioned.

CS CSW Responsibilities

1. If, on an open referral and/or case (i.e., Voluntary or Court Family
   
   Maintenance (FM) or Family Reunification (FR) or Another
   
   Planned Permanent Living Arrangement (APPLA/PP),a CSW learns
   
   that a mother, including parenting youth and NMDs, on their
   
   caseload gave birth, anassessment of the newborn's safety and
   
   well-being, through interviews and observations, is to be completed
   
   and documented in the CWS/CMS Contact Notebook.
   
   The assessment shall include, but is not limited to, the mother as well
   
   as any co-parent/caregiver (as applicable).

• Consult with your SCSW regarding the newborn and
  
  determine a course of action (e.g., determine the timeframe for
  
  the CSW to complete a safety and risk assessment and/or
  
  contact the CPH when there is suspicion, or reports, of abuse
  
  and/or neglect).
• A referral cannot be made solely based on the dependency
  
  status of the parenting youth or NMD, including if they are
  
  a victim of CSE.
  
  
• Safety and risk level to the newborn should be considered
  
  in determining the responses time.
  
  
• SDM tools are not required for completion of a newborn
  
  assessment if a referral has not been generated; however,
  
  use of SDM tools are strongly encouragedto guide the
  
  CSW in their assessment.
  
  
• A risk assessment need not be conducted for the child of
  
  a parenting youth/NMD unless a report has been made
  
  alleging abuse and/or neglect.
  

• Contact the CPH to make a referral, if deemed appropriate,
  
  through consultation with your SCSW.  Document in
  
  CWS/CMS Contact Notebook the date and time a referral
  
  was made to the CPH, using the oldest child's case, and, for
  
  parenting youth and NMDs, ensure to document the referral
  
  information in that youth or NMD's case records.
  
  
• CSWs are to assess newborns prior to contacting the CPH
  
  upon learning of a mother giving birth. The newborn is not
  
  considered at risk based solely on a family's dependency
  
  status; however safety should be immediately assessed to
  
  determine next steps, including if the CPH is to be contacted.
  

3. If a CPH referral is made,follow up with the assigned ER
   
   CSW to get the results of the ER investigation.
   
   
4. Pursuant to CDSS MPP 31-101.2, the CPH referral shall
   
   be investigated by an ER CSW.

2. Prior to making a CPH referral: If, during the safety and risk assessment, the newborn is determined to be at immediate risk of abuse and/or neglect, or is being abused and/or neglected, and there is a decision that the child should be detained, determine if a warrant is required:
   
   

Note: If a child is at immediate risk (i.e., There is exigency.), take immediate action to ensure the safety of the child (e.g., removal). Refer to the warrant policy for specific actions related to exigency.

As a reminder, any delay in responding to a child who is believed to be at immediate risk of harm may negate a finding that exigent circumstances existed unless additional information discovered at the scene independently establishes exigent circumstances. An imminent risk of harm requires an immediate response.

1. If the child is not at immediate risk of serious physical harm (i.e., the child is safe and free from risk of serious physical harm and/or sexual abuse; there is not an immediate need for medical care for a serious medical condition; and/or, the child's physical environment does not pose a threat to the newborn's health or safety during the time it would take to obtain and serve a warrant), then you do not have exigency and you should consult the warrant desk and document the consultation in the CWS/CMS Contact Notebook, or.
2. If the childimmediate/imminent risk of serious physical harm, consult with your SCSW to determine if there is a sufficient basis to determine exigency based upon the totality of the circumstances and take the appropriate action to ensure the immediate safety of the child (e.g., removal).
3. Consider, among other things, the nature of the allegations; the risk to each child (as exigency may exist for one child, but not the siblings); the age of each child; the condition of the child's physical environment; the child's medical condition and any need for medical care; whether there is a protective parent or other adult that can protect the child; and, flight risk in cases where there are serious allegations.

• For parenting youth and and NMDs, a history of being away from care (including those instances that occurred prior to pregnancy or the birth of their child) should not necessarily be considered a flight risk.
  
  

3. Document facts in the CWS/CMS Contact Notebook:

1. For exigent circumstances, document that there is an immediate/imminent risk (i.e., A situation that involves immediate/imminent risk of serious bodily injury, such as physical and/or sexual abuse.), where the CSW must take immediate action (i.e., The child will not be safe from risk of serious physical harm and/or sexual abuse during the time it would take to obtain and serve a warrant); or,
   
   
2. If possible, obtain written consent of the parent(s) and co-parent (if applicable) to detain or try to have a colleague present to witness the consent to detain.
   
   

• If the parentis a parenting youth (i.e., minor) or NMD, contact their
  
  attorney to inform them of the intent to detain the newborn child.
  
  Written consent to detain may not be obtained from a minor-
  
  parent without notifying their attorney
  

• Clearly document in the CWS/CMS Contact Notebook Case Notes how the consent was given, including words used by the CSW, responses from the parent(s) and co-parent (if applicable), a description of the parent(s) and co-parent (if applicable) conduct during the conversation, and whether any other people were present at the time. When possible, include verbatim statements.
  
  
• Ensure the parent(s) and co-parent (if applicable) have a clear understanding and freely and voluntarily agree to the following:
  
  

• Limitations will be placed on their care, custody and control of the child(ren)
  
• There will be ongoing Court intervention (if not a voluntary case)
  
• Court will be involved (if not a voluntary case)
  
• The parent(s) and co-parent (if applicable) have the right to limit/withdraw consent at any time
  
  
• Recognize that if a parent or co-parent (if applicable) withdraws their consent at any time, it will be necessary to seek a warrant to justify ongoing detention.
  
  

4. Upon determining that there is exigency, or upon obtaining a warrant or upon obtaining parental consent:

• Take the child into protective custody.
• Contact the CPH to make a referral, if not already done so.  Document in
  
  the CWS/CMS Contact Notebook the date and time a referral was
  
  made using the oldest child's name and, for parenting youth and NMDs,
  
  ensure to document the referral information in that youth or NMD's case
  
  records..
  
  You may take a child into temporary custody prior to contacting the CPH if the child is at immediate risk (i.e., exigency exists), as noted above.
• Initiate a Child and Family Team Meeting (CFTM) as soon as possible.
  
  

5. If a decision is made not to provide services to the newborn, clearly
   
   document in detail in the CWS/CMS Contact Notebookusing the oldest
   
   child's case and,for parenting youth and NMDs, ensure to document the
   
   referral information in that youth or NMD's case records., the reason(s)
   
   why the newborn is not in need of services.

• This decision must be re-evaluated on an ongoing basis as long as child welfare services are being provided to the family.

CS SCSW Responsibilities

1. Discuss the course of action the CS CSW shall take to address the
   
   assessment of the newborn, including but not limited to, concerns of abuse
   
   and/or neglect; contacting the CPH; removal, as applicable.

CPH CSW or Designee Responsibilities

1. For those instances when a referral is made to the CPH, pursuant to WIC
   
   11166.1(b), within 36 hours, provide notice of the CPH referral to CLC.
   

1. Document in the CWS/CMS Contact Notebook the communication
   
   between the CPH and the attorney. This shall include the date, time,
   
   and method of the notification.

When a Referral is Made Following the Birth of a Newborn on an Open Case

ER CSW Responsibilities

1. For those instances when a referral is made to the CPH, follow the steps outlined in the policy on Taking Children into Temporary Custody.

2. If a decision is made to open a VFM or FM, follow the steps outlined in the following policies to ensure that the family meets the criteria
   
   

   1. Court Family Maintenance and Voluntary Family Maintenance
      
      
   2. Investigation, Disposition and Closure of Emergency Response Referrals

ER SCSW Responsibilities

1. Follow the steps outlined in the policy on Taking Children into Temporary Custody.
   
   
2. If a decision is made to open a VFM or FM, follow the steps outlined in the
   
   following policies to ensure that the family meets the criteria.
   
   

1. Court Family Maintenance and Voluntary Family Maintenance
   
   If the newborn is not at immediate risk, or has not been abused and/or
   
   neglected, but there are risk factors present, and DCFS intervention is
   
   warranted:
   
   
   1. Develop a safety/action plan that will enable the newborn to safely
      
      remain home.
      
      
   2. Discuss with parent(s) and co-parent (if applicable) their willingness
      
      to participate in Voluntary Family Maintenance (VFM) Services if
      
      appropriate. Or, discuss court intervention (i.e., Family Maintenance
      
      services), if appropriate.
      
      
   3. If the parent is a parenting youth (i.e., minor), they must be given an
      
      opportunity to consult with their attorney before signing a VFM or
      
      safety plan.
      .
   4. Follow the the appropriate steps to open a VFM or Court FM case,
      
      as applicable, including, but not limited to, developing the initial case
      
      plan and provide ongoing services to the family.

1. Investigation, Disposition and Closure of Emergency Response Referrals

ER ARA Responsibilities

1. Follow the steps outlined in the policy on Taking Children into Temporary Custody.
   
   

2. If a decision is made to open a VFM or FM, follow the steps outlined in the policy to ensure that the family meets the criteria:
   
   

   1. Court Family Maintenance and Voluntary Family Maintenance
      
      
   2. Investigation, Disposition and Closure of Emergency Response Referrals

Back to Procedure

APPROVALS

SCSW

• Removal of newborn

• VFM and FM Services
  
  
  

ARA

• VFM and FM Services

ack to Approvals

HELPFUL LINKS

Attachments

Requirements for Taking Temporary Custody of Children (Warrant, Consent, Exigency)

Referenced Policy Guides

0070-548.01, Child and Family Teams

0070-548.10, Disposition of Allegations and Closure of Emergency Response Referrals

0070-548.20, Taking Children into Temporary Custody

0070-548.24, Structural Decision Making (SDM)

0070, 548.25, Completing the Structured Decision Making (SDM) Safety Plan

0080-502.10, Case Plans

0080-502.25, Family Maintenance Services for Both Court & Voluntary Cases

0100-510.40, Services for Teen Parents

0600-507.10, Youth Reproductive Health and Pregnancy

Statutes

All County Letter (ACL) 17-27 - States that a new allegation on a child in an open case or referral shall be responded to with the same protocols as any other referral

Assembly Bill 670 - Requires child welfare agencies who receive a report alleging abuse or neglect of the child of a minor dependent parent or an NMD parent, to notify the attorney who represents the minor parent or NMD in dependency court within 36 hours of receiving the report.

California Department of Social Services (CDSS) Manual of Policies and Procedures (MPP) 31-101- sets for the terms and conditions regarding responding to ER investigations.

CDSS MPP 31-101.2 - States, in part, that, to avoid impacting

an ongoing case worker’s relationship with a family or caregiver, counties shall ensure FM, FR, licensing and adoptions workers are not tasked with

responding to referrals and investigating allegations when a child in an open case plan is suspected to be the victim of abuse or neglect. The allegation(s) shall be investigated by an ER CSW.

California Department of Social Services (CDSS) Manual of Policies and Procedures (MPP) Division 31-125 – summarizes the protocol for the social worker initially investigating a referral to determine the potential for the existence of any condition(s) which places the child, or any other child in the family or household, at risk and in need of services and which would cause the child to be a person described by Welfare and Institutions Code Sections 300(a) through 300(j).

California Department of Social Services (CDSS) Manual of Policies and Procedures (MPP) Division 31-201 – requires that when it has been determined that child welfare services are to be provided the social worker shall complete an assessment for each child for whom child welfare services are to be provided, and includes gathering and evaluating information relevant to the case situation and appraising case service needs.

Welfare and Institutions Code (WIC) 361.8(a) - The newborn of the parenting minor or NMD parent shall not be considered to be at risk of abuse or neglect solely on the basis of information concerning the their placement history, past behaviors, or health or mental health diagnoses occurring prior to the pregnancy, although that information may be taken into account when considering whether other factors exist that place the newborn at risk of abuse or neglect

WIC 11166.1(b) - When an agency receives a report pursuant to Section 11166 alleging abuse or neglect of the child of a minor parent or an NMD parent, the agency shall, within 36 hours, provide notice of the report to the attorney who represents the minor parent or NMD in dependency court.

WIC 11465 (a) If a child is living with a parent who receives AFDC-FC or Kin-GAP benefits, or, on or after July 1, 2017, Approved Relative Caregiver Funding Program (ARC) payments, the rate paid to the provider on behalf of the parent shall include an amount for care and supervision of the child.

WIC 16002.5 (a) To the greatest extent possible, minor parents and NMD parents and their children shall be provided with access to existing services for which they may be eligible, that are specifically targeted at supporting, maintaining, and developing both the parent-child bond and the dependent parent's ability to provide a permanent and safe home for the child.

WIC 16501.25 (b) (1) When the child of a teen parent is not subject to the jurisdiction of the dependency court but is in the full or partial physical custody of the teen parent, a written shared responsibility plan shall be developed. The plan shall be developed between the teen parent, caregiver, and a representative of the county child welfare agency or probation department, and in the case of a certified family home or resource family of a foster family agency, a representative of the agency providing direct and immediate supervision to the caregiver.

WIC16504 – in part, states that any child reported to the county welfare department to be endangered by abuse, neglect, or exploitation shall be eligible for initial intake and evaluation of risk services.  Each county welfare department shall maintain and operate 24-hour response system.

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