Safety Plan w/ DV

DANGER THREAT(S) DESCRIPTION:Domestic violence exists between the mother and father of two young children. There is a threat of serious physical and/or emotional harm to the child. There have been two known instances of domestic violence occurring in front of the children, both involving an open hand striking mom’s face. In one instance, the one year old child was dropped by the child’s father as he struck the child’s mother in the face. Another 3 year old daughterwas a witness to both incidents, but not involved directly. It is alleged that domestic violence has been on-going for at least the last 2 years.

  1. SAFETY PLAN

Actions to Keep Child Safe / Who is Responsible for Each Task? / Begin Date / Resources or People Who Will Help / Frequency of Intervention / Who is Responsible for Monitoring / Target/ Follow-up Date
  1. No further visitations with Dad will occur until the visitation plan is created by the CPI and Case Manager,with input from Mom, Dad and the PGPs.
/ PGPs, Mom, Dad, / Today / Case Manager will monitor compliance / Until visitation plan is approved / PGPs, Mom
Case Manager will monitor compliance by twice weekly phone call s to PGPs and Mom / Within 30 days
  1. A visitation plan will be created in collaboration with PGMs, Mom and Dad that will include PGPs’ home as the drop off and pick up point for the children, eliminating direct contact between Mom and Dad. The plan will also include terms of frequency and duration.
/ Case Manager will provide a written copy of the visitation plan to Mom, Dad and the PGPs’.
Mom, Dad and the PGPs’ are responsible for implementation / Within 7 days / CPI, Case Manager / Weekly / PGPs, Mom, Dad, Case Manager / Re-evaluate within 30 days
  1. As soon as a mutually agreeable visitation plan is created, visitation may proceed following the terms of the plan.
/ Signatories of the visitation plan: Case Manager, Mom, Dad, PGPs
PGPs’ will immediately contact law enforcement if there is any physical violence or threat. / Per terms of approved visitation plan / N/A / Weekly / The Mom, Dad, and PGPs’ will contact the Case Manager immediately if there are any violations of the visitation plan.
The visitation plan will not be altered in any way without Case Manager involvement and approval.
If the visitation plan is violated and reported to the Case Manager or CPI, no further visitations will be permitted, pending a family team meeting and/or judicial/LE. intervention. / Re-evaluate within 30 days
  1. Local law enforcement will be briefed on the situation and visitation plan arrangements by the Case Manager.
/ CPI / Immediately and after completion of the visitation plan / Local law enforcement will recognize DV history and be aware of danger threat and child vulnerability / On-going / Police will notify Case Manager if they respond to any DV related incidents / On-going
  1. Mom will be taken by the Case Manager to the local domestic violence service center to learn about her protection options and the feasibility of law enforcement and/or judicial involvement to better insure her protection
/ Mom, Case Manager / Appt. request immediately / DV Center assigned worker / Per DV Center recommendation / Case Manager and DV Center / On-going
  1. Case Manager and the DV Center will create a personal protection plan with Mom so she can better protect herself and her children.
/ Mom, DV Center worker / 1st apt. / Case Manager will receive weekly DV center updates by e-mail / Daily / DV Center worker; Case Manager / Plan creation within 7 days
  1. Mom will implement the personal protection plan upon consultation with DV Center.
/ Mom / Following 1st appt. / DV Center / Daily / Mom will self-report personal protection plan status to DV Center and Case Manager.
Case manager will observe both children and mom once a week. Case Manager will maintain phone contact with mom, dad and PGPs’ weekly to assess the safety of all parties and the implementation of the visitation plan.