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Complaint Date

:

GEORGIA DEPARTMENT OF HUMAN RESOURCES
Initial
Reassessment
STRENGTHS AND NEEDS ASSESSMENT SCALE
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
a.
b.
c.
d.

S2.

d.

c.
d.

No Evidence of Problem
Some Substance Abuse Problem
Serious Substance Abuse Problem

1
3
5

     

     

Supportive Relationship (or not involved in domestic relationship)
Occasional Discord
Domestic Disputes, Lack of Cooperation
Serious Discord/Domestic Violence

1
2
3
4

     

     

Strong Support System
Adequate Support System
Limited Support System
No Support or Harmful Relationships

1
2
3
4

     

     

Exceptional Communication, Interpersonal Skills
Appropriate Skills
Some Skills
Lacks Communication/Demonstrates Combative Skills

1
2
3
4

     

     

Excellent Skills
Adequate Skills
Some Skills/Needs Improvement
Lacks Skills/Makes Harmful/Injurious Decisions

1
2
3
4

     

     

Excellent Housing
Adequate Housing
Some Housing Problems, but Correctable
No Housing/Eviction Notice

1
2
3
4

     

     

Employed
No Need
Unemployed, but Looking
Unemployed, but Not Interested or Not Looking

1
2
3
4

     

     

No Health Problem
Health Problems/Handicap in One Caretaker in Two Caretaker Family
Health Problems/Handicap in All Caretakers
Serious Health Problem/Handicap

1
2
3
4

     

     

1
2
3
4

     

     

1
2
3
4

     

     

RESOURCE AVAILABILITY/MANAGEMENT
a.
b.
c.
d.

S12.

     

PHYSICAL HEALTH
a.
b.
c.
d.

S11.

     

EMPLOYMENT
a.
b.
c.
d.

S10.

1
2
3
4

HOUSING
a.
b.
c.
d.

S9.

Strong Skills
Adequate Skills
Improvement Needed
Lacks Parenting Skills

DECISION MAKING/PROBLEM SOLVING SKILLS
a.
b.

S8.

     

COMMUNICATION/INDERPERSONAL SKILLS
a.
b.
c.

S7.

     

SOCIAL SUPPORT SYSTEM
a.
b.
c.
d.

S6.

Secondary Caretaker

DOMESTIC RELATIONS
a.
b.
c.
d.

S5.

Primary Caretaker
1
2
3
4

SUBSTANCE ABUSE
a.
b.
c.

S4.

Superior Skills
Appropriate Skills
Some Problems
Lacks Coping Skills

PARENTING SKILLS
a.
b.
c.
d.

S3.

     

Strong Management Skills
Adequate Skills to Meet Needs
Some Management Skills/Needs Improvement
No Skills/Financial Crisis

CHILD CHARACTERISTICS
a.
b.
c.
d.

Age Appropriate
Minor Problems
One Child has Severe/Chronic Problems
Children have Severe/Chronic Problems

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)

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