New Jersey Department of Children and Families Policy Manual
Manual:
Volume:
Chapter:
Subchapter:
CP&P
II
E
1
Child Protection and Permanency
Intake, Investigation and Response
Allegation Based System
Allegations
Issuance:
900
Cuts, Bruises, Welts, Abrasions And Oral Injuries
Effective
Date:
12-30-2004
ALLEGATION OF HARM 12-30-2004
A cut, bruise, welt, abrasions or oral injury can be due to abuse -- allegation of harm
#11.
A cut, bruise, welt, abrasions or oral injury can be due to neglect -- allegation of harm
#61.
DEFINITIONS
12-30-2004
"Cut" (Laceration) means –
An opening, incision or break in the skin made by some external agent.
"Bruise" means –
An injury which results in bleeding under the skin, where the skin is discolored
but not broken. Also referred to as a contusion.
"Welt" means –
An elevation on the skin produced by a lash, blow or allergic stimulus. The skin is
not broken and the mark is reversible.
"Abrasion" means –
A scraping away of the skin.
"Oral Injuries" means –
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Injuries to the child's mouth including broken teeth.
TAKING A REPORT
12-30-2004
Usage –
The Reporter has reason to believe that the cuts, bruises, welts, and abrasions resulted
from one of the following:
ABUSE –
A direct action of the parent, caregiver, immediate family member, the parent's
paramour, or other person responsible for the child's welfare. OR
The failure of the parent, caregiver, immediate family member, the parent's paramour,
or other person responsible for the child's welfare to make reasonable efforts to stop an
action by another person which resulted in cuts, bruises, welts, and abrasions.
NEGLECT –
Blatant disregard of parental (or other person responsible for the child's welfare)
responsibilities which resulted in the child sustaining cuts, bruises, welts, and abrasions.
(NEGLECT)
Factors to Be Considered –
Not every cut, bruise, welt, abrasion or oral injury constitutes an allegation of harm. The
following factors should be considered when determining whether an injury that resulted
in cuts, bruises, welts, abrasions or oral injuries constitutes an allegation of harm:
•
the child's age;
•
the child's medical condition, behavioral, mental, or emotional problems,
developmental disability, or physical handicap, particularly as they relate
to the child's ability to seek help;
•
a pattern or chronicity of similar incidents;
•
the severity of the cuts, bruises, welts, abrasions or oral injuries (size,
number, depth, extent of discoloration);
•
the location of the cuts, bruises, welts, abrasions or oral injuries;
•
whether an instrument was used on the child; and
•
the previous history of substantiated abuse or neglect.
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INVESTIGATING A REPORT
12-30-2004
Required Documentation/Evidence Needed to Support a Finding –
•
Verify that the victim currently has cuts, bruises, welts, abrasions, or oral
injuries or has sustained them in the past. Documented supervisory
approval is necessary to substantiate a case based on bruises not
observed by the investigator (past bruises).
•
Verify the typology of the injury including the exact location of the cuts,
bruises, welts, or abrasions, age, pattern, color, percent of body affected
and source.
•
Identify possible/plausible etiology (e.g., hand, belt, electrical cord, board,
and switch) based on available information. Document the parent’s or
caregiver’s explanation, including scene observation and mock
demonstration. Carefully document the child's statement.
•
Document match of injury and explanations.
•
If police have conducted an investigation, the final finding must be
obtained and documented. If the police report is not available, a case note
must be included indicating the report has been requested along with
documentation of the verbal statements. The supervisor must review the
police report when it is received to ensure findings do not conflict with
previously documented information received verbally.
•
If multiple possible perpetrators are identified, identify circumstantial
evidence which identifies the most likely perpetrator. Document evidence
that the cuts, bruises, welts, or abrasions are a direct result of some action
by a parent/caregiver (ABUSE) or the failure of a parent/caregiver to stop
the action of another person which results in cuts, bruises, welts, or
abrasions (ABUSE), or blatant disregard by a caregiver which results in
cuts, bruises, welts, or abrasions (NEGLECT).
•
Any other conflicting evidence has been resolved; when conflicting
evidence exists, include a detailed analysis of evidence.
•
Apply and document the application of the "Factors to Be Considered.”
Assess each factor as to relevance to the specific case and document on
a NJ SPIRIT Contact Activity Note, printable as a Contact Sheet, CP&P
Form 26-52.
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Written approval -- The above elements are required for every investigation into a cut,
bruise, welt, abrasion or oral injury. Your approval is required, in writing, if it is
acceptable for any of the above steps to be eliminated from the investigation process.
Formal documentation – The Supervisor documents his or her approval on a NJ SPIRIT
Contact Activity Note, printable as a Contact Sheet, CP&P Form 26-52.
REQUIREMENTS FOR INVESTIGATION
10-3-2011
The Child Protective Investigator shall:
•
Complete a safety assessment in accordance with policy. See CP&P-III-B6-600. Use CP&P Form 22-22, Safety Assessment (In-Home Cases).
•
Hold in-person, individual interviews with the parents/caregivers. Parents
should be contacted on the same day as contact with the child victim(s) if
at all possible.
•
Hold an in-person, individual interview of parent(s), other adults in the
home, the child's siblings, and other children residing in the victim’s home.
Non-verbal children must be observed.
•
Complete a CARI check of household members and other subjects
regularly frequenting or living in the home; criminal background check if
the alleged perpetrator is a paramour of the parent.
•
If a paramour-involved report, conduct Promis/Gavel check to determine
record of criminal history. For policy regarding the procedure to request
adult probation records from the Probation Services Division, see II A
1214, Procedures to Request Adult Probation Records.
•
Thoroughly read and review prior investigations.
•
Interview the reporter and others identified in the current report or related
information as having knowledge of the incident.
•
Hold an in-person, individual interview with alleged child victim(s); assess
the child's physical injury, including photographs and/or body chart.
•
If marks are found on victim, individually interview other children in home.
•
Interview physician or other medical personnel who treated current injury if
other than reporter.
•
Hold an in-person or phone interview with law enforcement, if police have
had contact on report.
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•
Interview the assigned primary Worker, if a service case is currently open.
•
Interview the alleged perpetrator in person.
•
Complete a risk assessment in accordance with policy. See CP&P-III-B-6600. Use CP&P Form 22-23, New Jersey CP&P Family Risk Assessment.
•
Refer the child to the Regional Diagnostic and Treatment Center. See
CP&P-II-C-2-600.
•
Complete a Caregiver Strengths and Needs Assessment in accordance
with policy. See CP&P-III-B-6-600. Use CP&P Form 22-24, New Jersey
CP&P SDM™ Caregiver Strengths and Needs Assessment.
•
Complete a Child Strength and Needs Assessment in accordance with
policy. See CP&P-III-B-6-600. Use CP&P Form 22-25, New Jersey CP&P
SDM™ Child Strength and Needs Assessment.
•
Hold an in person, individual interview with parents/caregivers. If the
safety assessment is marked unsafe, parents must be interviewed
immediately to ensure the child's safety.
•
Hold an in person, individual interview with alleged perpetrators.
•
Hold an in person, individual interview with all other adults and verbal
children of the perpetrator's household. Non-verbal children must be
observed.
•
Observe the environment where maltreatment occurred.
•
Interview physicians or other medical personnel directly involved with the
treatment of the reported injury.
•
Interview all identified witnesses who are reported to have knowledge of
the incident that resulted in the injuries.
•
If the family or the subjects identify two or more possible collateral
contacts, interview at least two, either by phone or in person. This includes
character witnesses.
•
Interview the prior Worker, if a service case is currently closed but has
been open within the past two years.
•
Interview other community professionals who have knowledge of the
incident.
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•
When there are other children in the home, interview school personnel
and/or child care provider who has knowledge of the child and/or the level
of parental care provided to the child.
•
Interview primary care physician or physician who has seen the victim
within the past six months.
•
Interview child protective services in other states in which the family
members have resided in the previous five years.
Written approval -- The above elements are required for every investigation into a cut,
bruise, welt, abrasion or oral injury. The Supervisor’s approval is required, in writing, if it
is acceptable for any of the above steps to be eliminated from the formal investigation
process.
Formal documentation – The Supervisor document his or her approval on a NJ SPIRIT
Contact Activity note, printable as a Contact Sheet, CP&P Form 26-52.
REQUIRED MEDICAL INFORMATION AND/OR CONSULTATIONS
10-3-2011
•
The Worker must ensure the child victim receives an immediate medical
exam if evidence exists the child is in need of urgent medical care.
•
Medical records of current treatment/diagnosis and relevant past
treatment.
•
A medical contact may be necessary to rule out naturally occurring
cutaneous marks confused with abuse such as Mongolian spots, Maculae
cerulean, Salmon patches, and Strawberry marks, or if a medical exam is
needed to match the injury with a potential cause (etiology).
Note: The opinion of the physician with the most relevant specialization and
experience should be given the greatest regard.
LAW ENFORCEMENT NOTIFICATION AND INVOLVEMENT
10-3-2011
Child Protective Investigator is responsible for making the following notifications when
applicable.
•
Law enforcement and the Prosecutor's shall be notified if the child is taken
into protective custody, or if the alleged perpetrator is a paramour.
•
Notify the Prosecutor if the report constitutes a second, or more,
substantiated report of abuse.
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•
Investigations must be coordinated with the Child Advocacy Centers in
areas served by them, unless the center is unwilling to work with this
allegation.
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