200. General protocols for Child Protective Services (CPS) assessments and investigations

340:75-3-200. General protocols for Child Protective Services (CPS) assessments and investigations • 4, 6 through 13, 15, 17 through 19, & 25

Revised 2-1-22

(a) Assessment and investigation process. The CPS safety assessment and investigation process allows Child Welfare Services (CWS) to have direct involvement with a family to identify problems and provide services, either directly or indirectly, that protect children and assist the family. Per Section 1-2-105 of Title 10A of the Oklahoma Statutes (10A O.S. § 1-2-105), Oklahoma Human Services (OKDHS) responds promptly to a report of child abuse or neglect by initiating an assessment of the family or an investigation of the report per OKDHS priority guidelines. The process includes gathering information:

(1) regarding the reported allegations and family dynamics that jeopardize the child's safety; and

(2) to assess the person responsible for the child's health, safety, or welfare (PRFC) protective capacities. • 1

(b) Assessment and investigation protocols. Protocols provide:

(1) continuity when addressing allegations of abuse or neglect;

(2) a family functioning assessment of possible safety threats; and

(3) continuity related to CWS contact with the family. • 2 & 3

(c) Multidisciplinary investigation protocol. Investigations regarding physical abuse, serious neglect, and sexual abuse are conducted utilizing a multidisciplinary approach when possible per the Oklahoma Administrative Code 340:75-3-440. Each child sexual abuse, physical abuse, or neglect investigation and child victim interviews are conducted by appropriate personnel using the protocols and procedures per 10A O.S. § 1-9-102. The investigation may proceed without full participation of all personnel:

(1) when trained personnel are not available timely and, in the judgment of the law enforcement officer or OKDHS, there is reasonable cause to believe a delay in investigation or interview of the child victim could place the child in jeopardy of harm or threatened harm to the child's health or welfare; and

(2) for only as long as reasonable danger to the child exists. • 16

(d) Assessment and investigation requirements.

(1) Per 10A O.S. § 1-2-105, the assessment or investigation requires:

(A) a visit to the child's home, unless:

(i) there is reason to believe an extreme safety risk to the child or OKDHS employee exists; or

(ii) it appears the referral was made in bad faith;

(B) an interview with, and examination of, the child;

(C) the visit to be conducted at any reasonable time and at any place including, but not limited to, the child's school; and

(D) when a child is interviewed at school that OKDHS notify the PRFC that the child was interviewed at school.

(2) The assessment or investigation may include:

(A) an interview with, and examination of, any child in the home; and

(B) interviews with the child's parents or any other PRFC. • 5

(e) Disclosure of specific complaint or allegation to PRFC. At the initial contact with the PRFC, who is the subject of the investigation pursuant to the Oklahoma Children's Code, OKDHS advises the person of the specific complaint or allegation made against the PRFC per 10A O.S. § 1-2-106.

(f) Description of the investigation process provided to the PRFC. Per 10A O.S. § 1-2-106, OKDHS provides a brief and easily understood written description of the investigation process. The notice includes a statement that:

(1) OKDHS is undertaking the investigation pursuant to Oklahoma Children's Code requirements in response to a report of child abuse or neglect;

(2) the identity of the person who reported the incident of abuse or neglect is confidential and may not be known to OKDHS since the report may have been made anonymously;

(3) the investigation is required by law to be conducted enabling OKDHS to identify incidents of abuse or neglect in order to provide social services to the family in need of protective or preventive services;

(4) upon completion of the investigation, OKDHS sends the PRFC a letter stating:

(A) OKDHS found insufficient evidence of abuse or neglect; or

(B) there appears to be probable cause to suspect the existence of child abuse or neglect in the judgment of OKDHS;

(5) the procedures OKDHS uses to conduct an investigation of alleged child abuse or neglect, include:

(A) a description of the circumstances that would cause OKDHS to seek judicial approval to remove the child from the home; and

(B) an explanation that the law requires OKDHS to refer all reports of child abuse or neglect to a law enforcement agency for a separate determination of whether a criminal violation occurred;

(6) the procedures to follow when:

(A) there is a complaint regarding OKDHS actions; or

(B) requesting a review of the findings OKDHS made during or at the conclusion of an investigation;

(7) the PRFC has a right to review unsealed records filed with the court in the event an action is filed;

(8) the PRFC has a right to seek legal counsel;

(9) the PRFC may obtain copies of the statutory and regulatory provisions governing child abuse and neglect and an explanation of how to obtain copies of the provisions;

(10) the PRFC may request visitation or family time and an explanation of the process to use to acquire visitation or family time with the child when the child is removed from the home; and

(11) failure to appear for court proceedings may result in the termination of the person's parental rights to the child.

(g) Assessment or investigation report forwarded to district attorney (DA). OKDHS, per 10A O.S. § 1-2-102, forwards the completed assessment or investigation report and findings to any DA office that may have jurisdiction to file a petition per 10A O.S. § 1-4-902. • 21

(h) Referral to law enforcement.

(1) Per 10A O.S. 1-2-102, OKDHS immediately makes a referral, either verbally or in writing, to the appropriate local law enforcement agency for the purpose of conducting a possible criminal investigation when, upon receipt of a report alleging abuse, neglect, or during the assessment or investigation, OKDHS determines the alleged:

(A) perpetrator is someone other than a PRFC; and

(B) abuse or neglect of the child does not appear attributable to failure on the part of a PRFC to provide protection for the child. • 20

(2) OKDHS, after making the referral to law enforcement, is not responsible for further investigation unless:

(A) OKDHS has reason to believe the alleged perpetrator is a parent of another child, not the subject of the criminal investigation, or is otherwise a PRFC of another child;

(B) notice is received from a law enforcement agency that has determined the alleged perpetrator is a parent or PRFC of another child, not the subject of the criminal investigation; or

(C) the appropriate law enforcement agency requests OKDHS, in writing, to participate in the investigation. When funds and personnel are available, as determined by the OKDHS Director or designee, OKDHS may assist law enforcement in interviewing children alleged to be victims of physical or sexual abuse. • 24

(i) Court order for access to or examination of child. The assessment or investigation may include a medical, psychological, or psychiatric examination of any child in the home. When the PRFC refuses to cooperate with arranging an examination, or when admission to the home, school, or any place where the child may be located cannot be obtained, OKDHS may request the DA apply, per 10A O.S. § 1-2-105 for a court order to compel access or examination of the child. The court may order that a child be transported to a court-approved location for the interview or examination and designate an appropriate person or persons to transport the child. The persons may include, but are not limited to: a relative of the child, a PRFC, law enforcement, an OKDHS employee, or an Office of Juvenile Affairs (OJA) employee if the child is in OJA custody. The court will consider safety protocols based on the child's gender. It is the PRFC's responsibility to secure medical examinations that may be necessary due to abuse or neglect of the child by a third party. • 14

(j) Obtaining the child's medical records. As necessary in the course of conducting an assessment or investigation, OKDHS may request and obtain, without a court order, copies of a child's current and prior medical records including, but not limited to, hospital, medical, and dental records. The physician-patient privilege does not constitute grounds for failure to produce the requested records, per 10A O.S. § 1-2-105.

(k) Requests for the child or PRFC's behavioral health records relevant to the assessment or investigation. Per 10A O.S. §§ 1-2-105 and 1-6-103, the assessment or investigation may include an inquiry into the possibility the child or PRFC has a history of mental illness. When the PRFC denies OKDHS access to their personal behavioral health records or treatment plans requested by OKDHS that may be relevant to the alleged abuse or neglect, OKDHS requests the DA apply for a court order allowing OKDHS access to the records pursuant to terms and conditions prescribed by the court. • 14

(l) Failure to report child abuse or neglect. Per 10A O.S. § 1-2-101, any person who knowingly and willfully fails to promptly report suspected child abuse or neglect, or who interferes with the prompt reporting of suspected child abuse or neglect, may be reported to local law enforcement for criminal investigation, and upon conviction, is guilty of a misdemeanor. • 22

(m) False reports of abuse or neglect made knowingly and willfully. Any person who knowingly and willfully makes a false report of child abuse or neglect, per 10A O.S. § 1-2-101, or who makes a report the person knows lacks factual foundation, may be reported to local law enforcement for criminal investigation, and upon conviction is guilty of a misdemeanor. • 23

(n) Restraining order prohibiting child's removal from Oklahoma. Per 10A O.S. § 1-2-105, when OKDHS has reason to believe the PRFC may remove the child from Oklahoma before the investigation is completed, OKDHS may request the DA file an application for a temporary restraining order in any district court in Oklahoma without regard to continuing jurisdiction of the child. Upon cause shown, the court may enter a temporary restraining order prohibiting the parent or other person from removing the child from Oklahoma pending completion of the assessment or investigation.

INSTRUCTIONS TO STAFF 340:75-3-200

Revised 2-2-24

1. Assessment or investigation purpose. During the assessment or investigation process the child welfare (CW) specialist gathers information from family members or other persons. The purpose of the assessment or investigation is to:

(1) explain the CW function;

(2) explain the allegations to the family;

(3) gather information for decision making;

(4) determine if abuse or neglect occurred;

(5) assess the behaviors of the person responsible for the child's (PRFC) health, safety, or welfare to determine protective capacities;

(6) assess the presence or absence of safety threats to each child in the home;

(7) determine what safety response is indicated;

(8) reduce trauma to each child;

(9) intervene for child safety; and

(10) identify appropriate services for the family.

2. Safety precautions when conducting an assessment or investigation. Safety precautions during an assessment or investigation include, but are not limited to:

(1) taking any threat by a parent seriously; and

(2) seeking the assistance of law enforcement when the CW specialist is at risk of harm, such as when:

(A) there is a history of violence;

(B) firearms or other weapons are present or reported to be present;

(C) illegal substance manufacturing or distribution is reported to be present. Refer to Oklahoma Administrative Code (OAC) 340:75-3-450; or

(D) the family's geographic location is isolated or dangerous.

3. Initiation and safety determination requirement when three or more reports of abuse or neglect were assigned. When three or more reports are pending concerning the same child and family, the CW supervisor reviews each report and all information known about the family with the CW specialist.

(1) The most recent report is assigned as an investigation.

(2) The CW supervisor sets specific time requirements for completion of the safety determination and within no more than five-calendar days from receipt of the most recent report for completion of the investigation.

4. Assessing background information.

(1) When there is prior CW history involving the adults and children listed in the current or pending abuse or neglect reports, the history is reviewed prior to initiating the assessment or investigation unless:

(A) an urgent response is required and there is no time to review prior to initiating;

(B) it is outside of business hours and not possible to access the paper file or KIDS. In these instances, the history is reviewed as soon as possible; or

(C) the current report is case connected to the appropriate case in KIDS or connected to a new case without history on the adults and children listed in the referral. The CW history is reviewed as soon as possible following assignment, but no more than 48-hours from initiation.

(2) Background information includes if the child and family are:

(A) known to Oklahoma Human Services (OKDHS) and Child Protective Services (CPS);

(B) currently receiving OKDHS or CW services;

(C) known to another state's CPS; or

(D) known to law enforcement due to reports of violent crimes, domestic violence, substance use or abuse, or sexual abuse.

(3) The CW specialist contacts the CPS Programs Unit immediately for additional information when a CPS alert is found during a search.

(4) When there is an open CW case regarding the family, the assigned CW specialist obtains the name of any current OKDHS employee involved with the family. The CW specialist initiates contact with any assigned OKDHS employee, when possible, prior to the first contact with the child and family to determine the case status and to request the case records.

(5) When it is determined the family had CPS involvement in another state, the CW specialist contacts CPS in the other state, and:

(A) makes a verbal request for records;

(B) follows up with a written request for the records;

(C) scans the records into the KK case document management system upon receipt. When volume makes scanning difficult, the CW specialist documents in KIDS Contacts that the records are located in the case paper file. The contact contains a brief summary of the information and a contact number for the jurisdiction with the records; and

(D) ensures the new report is properly case connected to the history in KIDS.

(6) The CW specialist contacts law enforcement and obtains police records when the report alleges domestic violence, substance use or abuse, or sexual abuse.

5. Assessment and investigation requirements.

(1) The report assigned as an investigation has a response time of five-calendar days or less.

(2) When a report is assigned as an assessment, the first contact may be with the non-perpetrating parent to arrange a time to see the child within the time requirements.

(3) Priority 1 investigations require:

(A) two diligent, face-to-face attempts to contact the child victim on the date the report is received; and

(B) a minimum of one diligent, face-to-face attempt to contact the child victim every calendar day thereafter until:

(i) the child victim is located, interviewed, and his or her safety is established;

(ii) a decision is made that diligent efforts were made and failed to locate the child and family, per OAC 340:75-3-200 Instructions to Staff (ITS) # 20; or

(iii) the CW specialist staffs the efforts to locate the child victim or the special case circumstances with the CW supervisor, and a decision is made regarding the continued face-to-face efforts to locate the alleged child victim based on the current information. The CW specialist documents the decision to modify the requirement in the KIDS Victim Interview screen.

(4) Priority 2 assessments or investigations require:

(A) two diligent, face-to-face attempts to contact the child victim on or before the response time indicated in KIDS; and

(B) a minimum of one diligent, face-to-face attempt to contact the child victim every subsequent business day until:

(i) the child victim is located, interviewed, and his or her safety is established;

(ii) a decision is made that diligent efforts were made and failed to locate the child and family, per OAC 340:75-3-200 ITS # 20; or

(iii) the CW specialist staffs the efforts to locate the child victim or the special case circumstances with the CW supervisor, and a decision is made regarding the continued face-to-face efforts to locate the alleged child victim based on the current information. The CW specialist documents the decision to modify the requirement in the KIDS Victim Interview screen.

(5) After three-calendar days of unsuccessful diligent attempts to make face-to-face contact with the alleged child victim, the CW specialist may mail a contact letter to the PRFC. When there is no response to the contact letter after 10-calendar days, refer to OAC 340:75-3-200 ITS # 20.

(6) The CW specialist documents efforts to locate a child victim other than actual face-to-face attempts in the Child Victim screen in KIDS – Type of Contact - Other with detailed information regarding efforts made to locate the alleged abuse or neglect victim. Examples of documented efforts to locate the child victim include contact with law enforcement, the child's school or child care, or the local utility company to locate the family. After the CW specialist staffs the efforts to locate the child victim or the special case circumstances with the CW supervisor, a decision is made regarding the continued face-to-face efforts to locate the alleged child victim based on the current information. The CW specialist documents the decision to modify the requirement in the KIDS Victim Interview screen.

(7) The CW specialist completes assessment and investigation reports and submits to the district attorney (DA) , per OAC 340:75-3-510.

(8) The CW specialist documents child victim and PRFC interviews in KIDS within five-calendar days from the interview date.

6. Safeguarding reporter identity. To prevent unintended disclosure of the reporting party, the CW specialist leaves all KIDS- or OKDHS-generated documents regarding the reporter in a secure location. The reporting party is not disclosed to the family, PRFC, or collaterals.

7. Gathering information during the assessment or investigation. The primary methods used in gathering information during the assessment or investigation are listed in (1) through (3) of this Instruction.

(1) Interviewing. The interview is a face-to-face contact between the CW specialist and a person who has or may have information pertinent to assessing safety.

(A) Face-to-face interviews with the alleged victim(s), other children in the home, PRFC(s), and the alleged perpetrator are required, unless an exception is granted per ITS # 17 of this Instruction.

(B) Interviews with other witnesses or collaterals can be conducted in person or by phone.

(C) Interviews are conducted in private, and sufficient time is allowed to elicit information and make observations relative to assessing safety;

(2) Observing. Observing the physical and cultural environment is critical in assessing safety. The CW specialist observes the:

(A) home's physical setting;

(B) sleeping arrangements for all family members;

(C) degree to which the house is safe and healthy for a child;

(D) physical appearance of the PRFC(s) and child, including hygiene, affect, and injuries; and

(E) differences in culture and lifestyle that may affect the response of the family.

(3) Documentary evidence. Documentary evidence provides factual information in assessing safety. Documents may include, but are not limited to:

(A) written records of interviews and observations;

(B) medical reports;

(C) psychological or behavioral health evaluations or records;

(D) law enforcement reports, call logs, or both;

(E) Medical Examiner's Report of Autopsy;

(F) photographs;

(G) public information from sources, such as the Oklahoma State Courts Network, the On Demand Court Records (ODCR), or the Oklahoma Department of Corrections;

(H) victim protective orders;

(I) non-directory education records;

(J) court record documents, such as guardianship or custody orders and related documents, available from the court file or provided by a witness; or

(K) Developmental Disabilities Services (DDS) records.

8. Contact protocol. Talking to the alleged child victim is the most critical step in the safety determination process.

(1) When necessary, discussion with and examination of the alleged child victim may be conducted at any reasonable time and at any place including, but not limited to, the child's school, per Section 1-2-105 of Title 10A of the Oklahoma Statutes (10A O.S. § 1-2-105). It may be necessary to talk to the child in a neutral setting first due to the nature of the allegations.

(2) The child's age, developmental level, and emotional state guide the CW specialist's approach to gathering information. It may be necessary with some children to have an older sibling or another significant person present to obtain information. The use of collaterals is critical in assessing the safety and well-being when the child is not able to verbalize his or her circumstances.

(3) All children must be observed. Even non-verbal children can provide information when observed. An attempt must be made to talk to every verbal child victim. Although a very young child may not have extensive verbal skills, the child may provide critical statements or phrases that assist in the assessment.

(4) Family members are observed interacting together.

9. Initial contact with the PRFC or family in the home. The assessment or investigation includes a visit to the child's home, per 10A O.S. § 1-2-105, unless there is reason to believe there is an extreme safety risk to the child or CW specialist.

(1) The CW specialist makes contact with the family by an unannounced home visit.

(2) The CW specialist introduces himself or herself and explains the reason for the visit in a non-accusatory, courteous manner and shows the family an OKDHS employee identification card.

(3) The CW specialist explains the specific reported allegations to the PRFC, per 10A O.S. § 1-2-106.

(4) The CW specialist gives the PRFC OKDHS Publication No. 87-02, Questions and Answers for Parents about Child Protective Services.

(5) During the assessment or investigation, the CW specialist gathers, per OAC 340:75-1-26 ITS and OAC 340:75-19-8, demographic information for each family member that includes the person's:

(A) accurate date of birth;

(B) full legal name, including any other names or nicknames used;

(C) Social Security number;

(D) race and ethnicity; and

(E) when the child may be an Indian child, the place of the parent(s)' birth.

(6) The CW specialist does not enter the home when an adult is not present. The CW specialist does not interview children found at home alone, but leaves contact information for the PRFC. When young children are found alone, the CW specialist immediately contacts law enforcement. The CW specialist conducts an investigation rather than an assessment when young children are left alone.

(7) The CW specialist asks to observe or interview each child and family member in the home.

(8) When hostility, anger, or other defensive reactions are encountered, the CW specialist assures the family their concerns about the process will be addressed, although the assessment or investigation must be conducted.

(9) When ordered out of the home, the CW specialist leaves immediately.

10. Attempted home visit. When the CW specialist attempts a home visit during the assessment or investigation, the alleged child victim has not been located, and the family is not home, the CW specialist and supervisor determine what diligent efforts are needed to determine child safety. The CW specialist makes diligent efforts to locate the child, per ITS # 5 of this Instruction, prior to leaving a contact letter when the family is not home.

11. Phone contact at PRFC's place of employment. When the CW specialist makes attempts to contact the family, is unsuccessful, and determines the PRFC or perpetrator is employed, the CW specialist:

(1) may attempt to phone the PRFC or perpetrator at work;

(2) when calling the PRFC's or perpetrator's place of employment, identifies himself or herself by name only. No information about the nature of the call is discussed with the employer; and

(3) when the employer does not allow personal calls or the PRFC or perpetrator is unavailable, leaves a message giving only the CW specialist's name and phone number. No letter is sent to the employer.

12. Visual inspection of the child.

(1) The CW specialist obtains the child's and either the PRFC's or caregiver's permission prior to the visual inspection of the child.

(2) Regardless of whether an injury is alleged, the CW specialist conducts a full-body inspection by asking the PRFC or caregiver to remove or rearrange the child's clothing, including diapers, for any child younger than 12 months of age.

(3) When one child is alleged to have serious or non-accidental injuries, the CW specialist checks the siblings for injuries.

(4) When non-accidental injuries are alleged or injuries are observed that may not be consistent with normal childhood play or development to any child in the home, the CW specialist, after obtaining permission, conducts:

(A) a full-body inspection of any child 5 years of age and younger that requires removal or rearrangement of the child's clothing, including diapers; and

(B) an informal inspection of the child 6 years of age and older, rather than a full-body inspection by rearranging the child's clothing.

(i) When injuries or alleged injuries are not observable without a full-body inspection, an examination is conducted by medical personnel.

(ii) The child is observed by the CW specialist in the presence of the PRFC unless the observation is made while in a setting outside of the home, such as child care or school.

(I) When the child is verbal, the reason for the visual inspection is explained to the child.

(II) Visual inspections are conducted in a manner that is sensitive to the child's feelings, privacy needs, and gender.

(III) When the child requires assistance undressing due to age, physical condition, developmental level, or emotional discomfort, the CW specialist asks the PRFC or caregiver to remove or lift the child's clothing allowing the child to be observed.

(IV) When the injuries on a child of any age indicate the need for a medical examination, or the child's age limits the CW specialist's ability to conduct an inspection of alleged injuries, the child is taken for a medical examination. Refer to OAC 340:75-3-200 ITS # 14.

(5) When a PRFC or caregiver refuses to permit the CW specialist to visually inspect the child victim or siblings, the CW specialist consults with the CW supervisor regarding whether to submit a request to the DA for a court order, per 10A O.S. § 1-2-105(B)(2).

(6) When a child refuses to permit the CW specialist to conduct an inspection, the CW specialist consults with the CW supervisor regarding arrangements for a medical examination.

13. Photographing child victim injuries. When injuries appear indicative of child abuse or neglect, the CW specialist:

(1) arranges for the child to be photographed. The CW specialist may take the photographs or, when possible, law enforcement or medical professionals take the photographs;

(2) maintains conventional photographs in the child's paper case record;

(3) does not enhance or alter and stores the digital photographs; and

(4) makes any photograph available to law enforcement and the DA.

14. Medical or behavioral health examination. Information gathered during the assessment or investigation may indicate a need for medical, psychological, or psychiatric examination or treatment of any child in the PRFC's home, per 10A O.S. § 1-2-105(B)(2). Subsequent inquiry may reveal that the child or PRFC has a history of behavioral health issues.

(1) As necessary in conducting an assessment or investigation, the CW specialist requests and obtains, without a court order, copies of the child's prior medical records including, but not limited to, hospital, medical, and dental records, per 10A O.S. § 1-2-105(C)(2), and copies of the child's prior behavioral health records including, but not limited to, hospital, psychological, and treatment records, per 10A O.S. § 1-6-103(B)(3).

(2) When a PRFC does not allow CW access to behavioral health records or treatment plans, the CW specialist consults with the CW supervisor regarding whether to submit a request to the DA for a court order, per 10A O.S. § 1-2-105(B)(3).

(3) When a medical examination is required, the CW specialist assists the PRFC with the arrangements, accompanies the PRFC and child to the medical examination, and remains available during the examination for consultation with the physician or appropriate licensed medical professional. A medical examination or consultation with a physician or appropriate licensed medical professional is required for:

(A) all injuries on a child 3 years of age and younger that are unexplained or implausibly explained, and do not appear to be caused by normal play or toddling;

(B) a child of any age with unexplained or implausibly explained bruises, burns, or fractures;

(C) all of a non-ambulatory child's bruises, burns, or fractures;

(D) all referrals of sexual abuse in non-verbal children whose behavior mimics adult sexual behavior, such as simulated intercourse or oral stimulation of another's genitals;

(E) all sexual abuse cases in which oral or genital skin-to-skin contact is alleged or suspected;

(F) all cases of:

(i) sexually transmitted infections in a prepubescent child;

(ii) malnutrition and failure-to-thrive;

(iii) medical neglect; or

(iv) fabricated or induced illness, formerly referred to as Munchausen by Proxy Syndrome;

(G) the child's observable injury, when the caregiver admits responsibility for the injury, and medical documentation is necessary to determine if there are internal or old injuries;

(H) a child who exhibits a need for an immediate psychological or psychiatric evaluation; or

(I) all bruises or injuries to a child with a diagnosed or perceived disability who is unable to communicate effectively about the alleged abuse, neglect, or both.

(4) When the PRFC refuses to secure needed medical, psychological, or psychiatric attention for the child, the CW specialist evaluates the level of risk to the child and determines whether to make a request to the DA for a court order application to secure needed services.

(5) Although a second medical opinion is suggested for all serious child abuse and neglect, it is particularly crucial in cases of head trauma or fractures in a child 5 years of age and younger. Consultation with the CPS Programs Unit is available.

(6) Reimbursement to the vendor for the child abuse examination or treatment is made, per OAC 340:75-13-64. The CW specialist, not the medical provider, determines if other resources are available to the child and advises the hospital, physician, or appropriate licensed medical professional regarding procedures for payment, per OAC 340:75-13-64.

(7) The CW supervisor approves exceptions to medical examination procedures as soon as possible after the child victim is observed. The CW specialist documents the exception in the Summary/Recommendation Section of Form 04KI003E, Report to District Attorney, and good cause is shown for the modification.

15. Professional consultation.

(1) The CW specialist consults, as needed, with those who have additional expertise in child abuse or neglect, or in areas related to the family's service needs.

(2) When a child victim, his or her sibling, or any child living in the home:

(A) has a diagnosed or perceived developmental disability;

(B) is unable to communicate effectively about abuse, neglect, or other safety threats; or

(C) is vulnerable due to an inability to communicate effectively, the:

(i) CW specialist must seek consultation with DDS that includes resource coordination, medical consultation, or medical evaluation related to developmental disabilities when needed, per 10A O.S. § 1-2-105;

(ii) consultation process with DDS is for information and referral services for the family and is in addition to the requirement that the CW specialist contact all medical, educational, and therapeutic providers for the child; and

(iii) assigned area DDS intake staff provides information about needed, recommended, and available services within the community, based upon the child's reported needs. When an emergency exists and the child is placed in OKDHS custody, the CW specialist follows procedure for identification, application, and needs assessment, per OAC 340:75-8-36.

(3) When a child has a physical disability or an acute life threatening or chronic medical condition, CW staff must:

(A) consult with a Child Welfare Services (CWS) nurse on all cases with allegations of "Failure to Obtain Medical Attention," "Fabricated or Induced Illness," "Failure to Thrive," or with any injury characteristic of "Failure to Thrive," "Malnutrition," or "Medical Condition Untreated";

(B) consult with a certified child abuse pediatrician on all cases with allegations of "Fabricated or Induced Illness," also described as child abuse in a medical setting and formerly referred to as Munchhausen Syndrome by Proxy;

(C) consult by phone or face-to-face with the child's primary care physician, specialist, and any other treating medical provider when a child is reported to have ongoing medical conditions; and

(D) obtain all medical records necessary to adequately assess the child's safety with a perceived or diagnosed developmental or physical disability or any ongoing medical condition. CW staff must ensure the obtained medical records provide information regarding the diagnosis and compliance with treatment and recommendations. When a child has a diagnosed genetic disorder, medical records must be obtained from all treating physicians.

(4) The CW supervisor ensures compliance with the protocols in this paragraph on all investigations or assessments with an element of medical concern.

(5) The CWS nurses are available to assist CW staff with:

(A) understanding medical concerns;

(B) medication reviews;

(C) medical chart reviews;

(D) parent and foster parent education on medical issues;

(E) home visits; and

(F) hospital visits.

16. Access to a registered sex offender.

(1) When a PRFC, or adult whom the child has access to, is required to register as a sex offender, per the Sex Offender Registration Act, 57 O.S. § 584, and the report is accepted for CPS investigation, the CW specialist:

(A) verifies if the person is a required registrant and when so, the offense that led to the registry requirement;

(B) obtains the state and county of jurisdiction for the offense;

(C) obtains the applicable criminal records, such as, but not limited to the;

(i) arrest affidavit pertaining to the offense;

(ii) law enforcement report pertaining to the offense; and

(iii) victim's order of protection pertaining to the offense;

(D) checks law enforcement records of each state or county the registrant inhabited, when known, for any offenses similar in nature, such as, but not limited to:

(i) sexual crimes against a child, adult, or animal;

(ii) indecent exposure; and

(iii) voyeurism;

(E) obtains the victim's name, age, and relationship at the time of the offense;

(F) requests out-of-state CW records pertaining to the offense, when applicable;

(G) obtains any recommendations or treatment records pertaining to any services the registrant participated in specifically related to the offense; and

(H) interviews the current probation or parole officer and treatment provider, when available, as collaterals.

(2) When a child is living in the home with, or has continued access to, a registered sex offender, the child's vulnerability is considerably increased.

(3) The PRFC who is a registered sex offender due to an offense toward a child, is viewed as unable to provide basic care or supervision of the child.

17. Modifying assessment or investigation protocol. Assessment and investigation protocol is followed unless good cause exists for modification.

(1) Modifications:

(A) to the required home visit are not authorized unless it is determined contact in the home jeopardizes the safety of the CW specialist or child;

(B) are approved by the CW supervisor;

(C) are not authorized when there are two or more reports regarding the same child and family in the preceding 12 months; and

(D) may include:

(i) altering the required order in which interviews are conducted, when:

(I) emergency conditions exist that require immediate action to protect the child. Protocol is reinstated after the child is safe;

(II) the emotional atmosphere is volatile, for example, people are emotionally immobilized or violent; or

(III) key persons are not available;

(ii) mandatory approval from the district director is required to omit required interviews with individuals other than the child victim or alleged perpetrator when:

(I) all allegations are obviously and unquestionably false;

(II) it is determined the report was made in bad faith;

(III) the report was a result of an absolute misperception of the child's condition or circumstances; or

(IV) information collected in the six key questions of the Form 04KI030E, Assessment of Child Safety, from the child victim and alleged perpetrator does not indicate a possible safety threat;

(iii) substituting required face-to-face interviews with phone contact or virtual conference when the interviewee's circumstance or location makes the person unavailable for a face-to-face interview; or

(iv) authorizing joint interviews for required separate interviews when a separate interview is declined by the person interviewed. The CW specialist is aware that information gathered during joint interviewing may not accurately provide representation of the incident or the family's actual functioning.

(2) When a modification is authorized, at a minimum, the six key questions on Form 04KI030E are completed from interviews with each child victim and the alleged perpetrator with a determination of no safety threats.

(3) A modification and the reason for the modification to the investigation or assessment protocol is documented in the Summary/Recommendation Section of Form 04KI003E for investigations and in Section IV, Safety Decisions, Comments/Summary, Form 04KI030E for assessments.

(4) Any modification request not listed above requires consultation with and approval from the CPS Programs Unit.

18. Documenting the assessment or investigation. The CW specialist documents in KIDS:

(1) each attempted contact with the alleged child victim or other family member;

(2) when the alleged child victim is deceased by selecting Face-to-Face (NA) Child Death from the drop-down menu; and

(3) all completed contacts in the appropriate screens.

19. Refusal to cooperate or respond to protocol.

(1) When a family refuses to cooperate or respond in an assessment or investigation by:

(A) refusing to be interviewed;

(B) refusing to allow access to the child for observation and interview; or

(C) removing the child from Oklahoma before the assessment or investigation is completed, the CW specialist:

(i) evaluates the available information, including assessing information from pertinent professional and personal collaterals, and determines the most appropriate action; and

(ii) when the child is in present danger:

(I) immediately contacts law enforcement for assistance in interviewing and observing the child; and

(II) when the PRFC continues to refuse to allow access to the child and law enforcement declines to place the child in protective custody, immediately documents information obtained from collaterals or witnesses and submits the information on Form 04CP008E, Child Protective Services Affidavit or Form 04KI003E, requesting that the DA make application for a court order to allow access to the child.

(2) When the PRFC denies access to his or her behavioral or mental health records or treatment plans that may relate to abuse or neglect, the CW specialist requests that the DA file an application for a court order to obtain the records.

(3) When the CW specialist believes a PRFC or other person may remove the child from Oklahoma before the assessment or investigation is completed, the CW specialist requests that the DA file an application for a temporary restraining order prohibiting the PRFC or other person from removing the child from the state pending completion of the assessment or investigation.

(4) When a relative or non-relative caretaker is granted guardianship or power of attorney and a referral is assigned regarding the parent, legal guardian, or custodian alleging abuse, neglect, or both, a complete and thorough safety evaluation of the child referenced in the assigned report is required. The safety evaluation is conducted in the home of the guardian or person having power of attorney. Each PRFC, including parents, is included in the safety assessment.

20. Unable to locate protocol. When the CW specialist is unable to locate the child and family, diligent efforts are made to locate the family through additional sources of information.

(1) When all known collaterals are contacted and the alleged victim is not located, the CW specialist:

(A) contacts the reporter and advises of the difficulty in locating the family and asks the reporter for additional sources of information;

(B) contacts the public school associated with the given address and requests any transfer or locating information for each child in the household who is eligible to receive education services or known to the public school system;

(C) searches KIDS to determine if previous addresses or those likely to have knowledge of the family’s whereabouts are available; and

(D) makes another computer inquiry to determine if the family is receiving OKDHS services.

(i) When the family is receiving OKDHS services, the CW specialist contacts the assigned worker to determine if there is a new address for the family or other information to assist in locating the family.

(ii) The assessment or investigation does not affect eligibility for other OKDHS services.

(2) When a new address is provided and the assessment or investigation was not closed, the assessment or investigation protocols continue regardless of when the completion time was exceeded.

(3) When the report indicates the child's safety is, or will be, at risk and it appears the family relocated and the address is unknown, a statewide or nationwide protective service alert may be initiated by contacting the CPS Programs Unit. Refer to OAC 340:75-3-300 ITS # 11.

(A) When the family moved to another state, the CW specialist calls the state's CPS and makes a report regarding the child's safety.

(B) Any requested copies of child abuse or neglect records may be forwarded to the requesting state, per OAC 340:75-1-44.

(4) When a family is found after an assessment or investigation is closed due to unable to locate, the allegations in the child abuse or neglect report that led to the assessment or investigation are documented on a new Form 04KI001E, Referral Information Report.

(A) Critical thinking and sound judgement are used with any allegation previously made that resulted in a finding of unable to locate.

(B) When it is determined the previous allegation needs to be addressed, the allegations and any new allegations are assigned for investigation or assessment.

(5) No report is closed as unable to locate until the protocol per this ITS is followed.

21. Referral to law enforcement.

(1) Form 04Kl001E, may be sent to law enforcement for written documentation with Form 04CP002E, Notification to Law Enforcement Agency of Child Abuse or Neglect Report, attached.

(2) When forwarding Form 04Kl001E to law enforcement, the reporter's name is deleted. The reporter's name is maintained on the copy that remains in OKDHS files and may be provided verbally to law enforcement, when requested.

(3) Examples of when a CW specialist makes a referral to law enforcement include, but are not limited to, when:

(A) a child has unexplained or implausibly explained bruising to the body;

(B) a child discloses physical or sexual abuse by a PRFC or third party;

(C) a child is malnourished as the result of PRFC neglect;

(D) a child has unexplained or implausibly explained head trauma;

(E) a child was intentionally burned;

(F) a non-ambulatory child has a bodily fracture;

(G) labor, sex, or drug trafficking involving a child or a child's home of origin;

(H) a child is drug-endangered;

(I) a PRFC is aware of ongoing abuse to a child in the home and fails to protect the child from further abuse; or

(J) there is reason to believe a crime occurred that impacts a child's safety.

22. Assessment and investigation report submitted to appropriate DA. All reports of assessment recommendations and investigation findings are submitted to appropriate DAs, per 10A O.S. § 1-2-105. When multiple jurisdictions are involved, the report is provided to each appropriate DA's office.

23. Failure to report child abuse or neglect. When it is determined during an assessment or investigation that there is a person who may have knowingly and willfully failed to make a report of child abuse or neglect, the CW specialist discusses the information with the CW supervisor. The information may be forwarded to local law enforcement using Form 04CP002E for the purpose of a criminal investigation.

24. False reports of abuse or neglect made knowingly and willfully. When, in the course of the assessment or investigation, the CW specialist determines a false report concerning child abuse or neglect was knowingly and willfully made, the CW specialist discusses the information with the CW supervisor. With supervisory approval, information regarding the false report is forwarded to law enforcement for consideration of a criminal investigation, using Form 04CP002E. Form 04Kl001E may be sent to law enforcement attached to Form 04CP002E. When forwarding Form 04Kl001E to law enforcement, the reporter's name is deleted. The reporter's name is maintained on the copy that remains in the OKDHS file and may be provided verbally to law enforcement, when requested.

25. Requests to assist law enforcement on non-OKDHS related investigations. When a law enforcement agency submits a written request for OKDHS to participate in an investigation, the CPS Programs Unit is contacted for guidance.