Complaint Date: / GEORGIA DEPARTMENT OF HUMAN RESOURCES STRENGTHS AND NEEDS ASSESSMENT SCALE / Initial / Reassessment
Case Name: / County #: / Case #:
Date: / Case Manager: / Case Manager ID#:

Select the highest score that applies to each caretaker under each category. A low score indicates a Strength. A high score indicates a need.

S1. /

COPING SKILLS/EMOTIONAL HEALTH

/ Primary Caretaker / Secondary Caretaker
a.  Superior Skills / 1
b.  Appropriate Skills / 2
c.  Some Problems / 3
d.  Lacks Coping Skills / 4
S2. /

PARENTING SKILLS

a.  Strong Skills

/ 1

b.  Adequate Skills

/ 2

c.  Improvement Needed

/ 3

d.  Lacks Parenting Skills

/ 4
S3. /

SUBSTANCE ABUSE

a.  No Evidence of Problem

/ 1

b.  Some Substance Abuse Problem

/ 3

c.  Serious Substance Abuse Problem

/ 5
S4. /

DOMESTIC RELATIONS

a.  Supportive Relationship (or not involved in domestic relationship)

/ 1

b.  Occasional Discord

/ 2

c.  Domestic Disputes, Lack of Cooperation

/ 3

d.  Serious Discord/Domestic Violence

/ 4
S5. /

SOCIAL SUPPORT SYSTEM

a.  Strong Support System

/ 1

b.  Adequate Support System

/ 2

c.  Limited Support System

/ 3

d.  No Support or Harmful Relationships

/ 4
S6. /

COMMUNICATION/INDERPERSONAL SKILLS

a.  Exceptional Communication, Interpersonal Skills

/ 1

b.  Appropriate Skills

/ 2

c.  Some Skills

/ 3

d.  Lacks Communication/Demonstrates Combative Skills

/ 4
S7. /

DECISION MAKING/PROBLEM SOLVING SKILLS

a.  Excellent Skills

/ 1

b.  Adequate Skills

/ 2

c.  Some Skills/Needs Improvement

/ 3

d.  Lacks Skills/Makes Harmful/Injurious Decisions

/ 4
S8. /

HOUSING

a.  Excellent Housing

/ 1

b.  Adequate Housing

/ 2

c.  Some Housing Problems, but Correctable

/ 3

d.  No Housing/Eviction Notice

/ 4
S9. /

EMPLOYMENT

a.  Employed

/ 1

b.  No Need

/ 2

c.  Unemployed, but Looking

/ 3

d.  Unemployed, but Not Interested or Not Looking

/ 4
S10. /

PHYSICAL HEALTH

a.  No Health Problem

/ 1

b.  Health Problems/Handicap in One Caretaker in Two Caretaker Family

/ 2

c.  Health Problems/Handicap in All Caretakers

/ 3

d.  Serious Health Problem/Handicap

/ 4
S11. /

RESOURCE AVAILABILITY/MANAGEMENT

a.  Strong Management Skills

/ 1

b.  Adequate Skills to Meet Needs

/ 2

c.  Some Management Skills/Needs Improvement

/ 3

d.  No Skills/Financial Crisis

/ 4
S12. /

CHILD CHARACTERISTICS

a.  Age Appropriate

/ 1

b.  Minor Problems

/ 2

c.  One Child has Severe/Chronic Problems

/ 3

d.  Children have Severe/Chronic Problems

/ 4

Based on the above information, list all identified needs and strengths in order of the greatest need and strength o the least need and strength of the family. The needs and strengths that have not been identified must be documented on the Case Plan. Use 452’s if necessary for documenting additional needs and strengths.

List all Needs:
List all Strengths:

CPS_458 – Strength and Needs Assessment Scale (Revised 09/06) 1 of 1