Family & Friends Assessment

Part A – Child and Birth Family

Child1

Forename / Surname
Other names the child is known by
Date of birth
Place of birth
Gender
Ethnicity
Religion
Language
Nationality
Immigration status
Legal status (include type of order name of court and date of order)

Physical Description and Personality

Please give a physical description of the child and include a current photo of the child
Please describe the child’s personality, likes, dislikes and interests.

Chronology of the child’s care since birth3

Include any periods looked after by the local authority.

Age of Child (yrs & mths) / From / To / Placement details

Health

Describe the child’s health history, current needs and what is required to meet these.

Education

The child’s current school
Does the child have a statement of needs under the Education Act 1996?
Yes/No (if yes provide details)
Does the child require additional help in school?
Yes/No (if yes provide details)
Describe the child’s educational needs and what is required to meet these

For SGO applications only - all school placements including playgroup and nursery provision with dates and the child’s educational achievements

From / To / Name of provider and address / Type of educational provision & achievements

Emotional and Behavioural Development

Describe the child’s emotional and behavioural development, their needs arising from this and what is required to meet those needs.

Identity

Describe the child’s identity and what is required to meet needs arising from this. Provide information about the child’s religious persuasion and including details of baptism, confirmation or equivalent ceremonies

Family and Social Relationships

Describe the child’s current and historical relationship with family members and others.
What are the current arrangements for contact between the child and family members and others who the local authority consider relevant? Who is responsible for arranging and supporting these arrangements?
What are the proposed future arrangements for contact between the child and family members and others who the local authority consider relevant? Who will be responsible for setting up and supporting these arrangements?

Social Presentation

Describe the child’s social presentation and what is required to meet any needs arising from this

Self Care Skills

What are the child’s self care skills and what is required to meet any needs arising from these?

Reasons for proposed placement

Why is the child unable to live with a birth parent currently? What are the identified risks? What is required from the carer to keep the child safe from these risks?

Wishes and feelings of the child

What are the child’s wishes and feelings in relation to any proposed plans including plans for contact (as set out above) and in relation to his religious and cultural upbringing. Please include the date on which the child’s wishes and feelings were ascertained.

Sibling’s details (Not included in this assessment)

SIBLING 1 / SIBLING 2 / SIBLING 3
Forename(s)
Surname
Other names used
Name of carer
Current address:
Local Authority Area
Date of birth
Place of birth
Gender
Ethnicity
Religion
Name of Mother
Name of Father
Are they looked after by a local authority - if so, which? / Yes/No / Yes/No / Yes/No

Birth parents background and history

Birth Mother

Surname / Forename
Name used at the time of the child's birth
Date of Birth
Place of birth
Address
Date address confirmed
Local Authority area
Nationality
Ethnicity
Religion (include if practising)
Language
Name of Current Partner
Physical description including photograph where available.
Please describe the birth mother’s health history, including details of any serious physical or mental illness, any hereditary disease or disorder or disability
Please describe the birth mother’s educational history
Please describe the birth mother’s employment history
Please give a description of the birth mother’s personality and interests

Birth Father

Does Birth Father have PR / Y/N
Surname / Forename
Name used at the time of the Child's birth
Date of Birth
Place of birth
Address
Date address confirmed
Local Authority area
Nationality
Ethnicity
Religion (include if practising)
Language
Name of Current Partner
Physical description including photograph where available.
Please describe the birth father’s health history, including details of any serious physical or mental illness, any hereditary disease or disorder or disability
Please describe the birth father’s educational history
Please describe the birth father’s employment history
Please give a description of the birth father’s personality and interests
Name of anyone else who has PR

Birth parents relationship

Please describe the past and present relationship between the birth parents

Parental responsibility

Provide details of whether the child’s parents married to each other at the time of the child’s birth or have they subsequently married?
Date of marriage
If the parents were not married, please indicate if birth father has parental responsibility and how this was acquired?
If the child’s parents have been previously or are currently married or civilly partnered to another person please give dates/details.
Is there any other person who holds parental responsibility for the child? (please include date acquired and details)

Views of the birth family

Please give an assessment of the wishes and feelings of each parent regarding [the proposed plan, that might include] (i) special guardianship; (ii) the child’s religious and cultural upbringing; and (iii) contact with the child, and the date on which the wishes and feelings of each parent were last ascertained.
Birth Mother
Birth Father (of child 1)
Birth Father (of child 2)
Birth Father (of child 3)
An assessment of the wishes and feelings of any of the child’s relatives, or any other person the local authority consider relevant regarding the child and the dates on which those wishes and feelings were last ascertained.
Name / Relationship
Name / Relationship
Name / Relationship

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