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Free Sfn 960 PDF Template

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The SFN 960 form, officially titled "Report of Suspected Child Abuse or Neglect," serves as a crucial document for reporting concerns regarding the welfare of children in North Dakota. This form is utilized by individuals who suspect that a child may be experiencing abuse or neglect. It requires detailed identifying information about the child or children involved, including names, ages, and contact details of parents or caretakers. Additionally, the form prompts the reporter to provide specific information about the suspected maltreatment, including the nature and extent of the abuse, any prior incidents, and relevant family dynamics. This thorough documentation is essential for ensuring the safety and well-being of the child, as it assists social workers in assessing the situation. The form also includes sections for the reporter's information, allowing for follow-up communication if necessary. Once completed, the SFN 960 must be submitted to the North Dakota Child Protection Services Central Intake Unit or the local county human service zone office, ensuring that reports are handled promptly and effectively.

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Similar forms

The SFN 960 form, used for reporting suspected child abuse or neglect, shares similarities with several other important documents in child welfare and protection. Below are six documents that resemble the SFN 960 form in purpose or content:

  • Child Abuse Report Form: This document is utilized to formally report suspected cases of child abuse. Like the SFN 960, it collects identifying information about the child, the suspected abuser, and details regarding the nature of the abuse.
  • Child Neglect Report Form: Similar to the SFN 960, this form focuses specifically on instances of neglect. It gathers information about the child's situation and the circumstances that may indicate neglectful behavior by a caregiver.
  • Incident Report Form: Often used in schools and childcare settings, this form documents specific incidents involving children. It serves a similar purpose by detailing what occurred, who was involved, and any actions taken following the incident.
  • Aaa International Driving Permit Application: Completing this form is essential for U.S. residents looking to drive legally abroad. For more information on how to apply, visit Top Forms Online.
  • Referral Form for Child Protective Services: This document is submitted to initiate a review by child protective services. It contains information about the child, the family, and the reasons for the referral, paralleling the information requested in the SFN 960.
  • Family Assessment Form: Used during investigations, this form collects detailed information about family dynamics and child welfare. It aligns with the SFN 960 in its aim to assess the safety and well-being of children within a family context.
  • Safety Assessment Form: This form evaluates immediate safety concerns for a child. Like the SFN 960, it requires detailed information about potential threats to the child’s safety and well-being.

How to Use Sfn 960

After completing the SFN 960 form, it is essential to submit it to the appropriate authorities. This ensures that the information provided is reviewed and acted upon by the relevant child protection services. The next steps involve ensuring that the form is filled out accurately and then submitting it via fax or in person.

  1. Obtain the SFN 960 form from the North Dakota Department of Human Services or an authorized source.
  2. Fill in the Name of Child(ren) and their Age or Birthdate in the designated fields.
  3. Provide the Name of Parent(s)/Caretaker, their Telephone Number, and Address, including City, State, and ZIP Code.
  4. Enter the Name of Subject (the person suspected of causing maltreatment) along with their Telephone Number and Address, including City, State, and ZIP Code.
  5. Detail the nature and extent of the suspected abuse or neglect. Include information about previous incidents, family composition, and any other relevant details that may assist in protecting the child(ren).
  6. If more space is needed, attach additional pages with the necessary information.
  7. Provide the Name of Reporter, their Relationship to Children, Telephone Number, Address, including City, State, and ZIP Code.
  8. Sign the form in the designated area and include the Email Address and Date of submission.
  9. Review the completed form for accuracy and completeness.
  10. Fax the completed form to the ND Child Protection Services Central Intake Unit at 701-328-0361 or submit it to the local county human service zone office where the child is currently located.

Dos and Don'ts

When filling out the SFN 960 form, it’s important to ensure accuracy and clarity. Here are some dos and don’ts to keep in mind:

  • Do provide complete identifying information for the child or children involved.
  • Do include specific details about the suspected abuse or neglect.
  • Do ensure your contact information is accurate for follow-up questions.
  • Do sign and date the form before submission.
  • Don't leave any sections blank; fill out all required fields.
  • Don't provide vague descriptions; be as detailed as possible.

Following these guidelines will help ensure that your report is processed efficiently and effectively.

Document Example

REPORT OF SUSPECTED CHILD ABUSE OR NEGLECT

NORTH DAKOTA DEPARTMENT OF HUMAN SERVICES CHILDREN AND FAMILY SERVICES

SFN 960 (7-2022)

Clear Fields

Name of Child(ren)

Age or Birthdate

Name of Child(ren)

Age or Birthdate

IDENTIFYING INFORMATION

Name of Parent(s)/Caretaker

 

 

 

 

 

 

 

 

Telephone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

City

 

 

 

 

State

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Subject (Person(s) Suspected to be Causing Maltreatment)

 

 

 

 

Telephone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

City

 

 

 

 

State

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Give nature and extent of the suspected abuse or neglect, including any information of previous abuse or neglect; family

 

composition; and any other information which may be helpful in protecting the health and welfare of the child(ren). If

 

additional space is needed, attach additional pages. (BE SPECIFIC. ANSWER WHO, WHAT, WHEN, WHY, HOW

 

OFTEN).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Reporter

 

Reporter's Relationship to Children

Telephone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

City

 

 

 

 

State

ZIP Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature of Reporter

 

Email Address

 

 

 

 

 

Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AGENCY USE ONLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date and Time Received by Agency

Name of Intake Social Worker

Source

Date of Entry

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Report Number

Assessment Number

 

 

 

Case Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Social Worker Assigned to Case

Received By

 

 

 

 

 

Initial Category

 

 

 

 

 

In Person

 

 

Telephone

 

Written

 

 

A

 

B

 

C

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please fax the completed form to the ND Child Protection Services Central Intake Unit at 701-328-0361 or submit to the local county human service zone office where the child is currently physically located. Contact information for county human service zone offices can be found at: www.nd.gov/dhs/locations/countysocialserv

File Breakdown

Fact Name Detail
Form Title Report of Suspected Child Abuse or Neglect
Governing Authority North Dakota Department of Human Services
Form Number SFN 960
Version Date July 2022
Purpose To report suspected child abuse or neglect
Submission Method Fax to 701-328-0361 or submit to local county human service zone office
Required Information Details about the child, parent/caretaker, suspected maltreatment, and reporter
Confidentiality Reporter’s identity is protected under North Dakota law
Click for Sfn 960 PDF

Common mistakes

When completing the SFN 960 form, individuals often make critical errors that can hinder the reporting process. One common mistake is failing to provide complete identifying information for both the child and the suspected perpetrator. Incomplete details, such as missing names, ages, or addresses, can delay the investigation and affect the child's safety. It is essential to ensure that all sections are filled out accurately and thoroughly.

Another frequent error involves insufficient details regarding the nature and extent of the suspected abuse or neglect. Reporters sometimes provide vague descriptions, which do not adequately convey the seriousness of the situation. It is important to be specific about the incidents, including who was involved, what occurred, when it happened, and how often it has taken place. This information is vital for the agency to assess the situation effectively.

Additionally, many individuals overlook the significance of including their relationship to the child in the report. This detail helps authorities understand the context of the information being provided. Without this context, the report may not be taken as seriously, potentially impacting the response from child protection services.

Lastly, some reporters neglect to sign and date the form. This oversight can lead to complications in processing the report. A signature not only verifies the authenticity of the report but also indicates that the reporter acknowledges the seriousness of the allegations. Ensuring that the form is signed and dated is a simple yet crucial step in the reporting process.

FAQ

What is the purpose of the SFN 960 form?

The SFN 960 form is used to report suspected child abuse or neglect in North Dakota. It serves as a formal document to provide information to the Department of Human Services, specifically the Children and Family Services division. By filling out this form, individuals can help ensure that children at risk receive the necessary attention and protection from potential harm.

Who should fill out the SFN 960 form?

The form can be completed by anyone who suspects that a child is being abused or neglected. This includes family members, teachers, healthcare professionals, and even neighbors. If you have concerns about a child's safety or well-being, it is your responsibility to report those concerns using this form.

What information is required on the SFN 960 form?

When filling out the SFN 960, you will need to provide identifying information about the child or children involved, such as their names and ages. Additionally, you must include details about the suspected abuser, including their name and contact information. The form also requires a description of the suspected abuse or neglect, including any relevant history and the family composition. Being specific and thorough in your answers will aid in the investigation process.

How should I submit the SFN 960 form?

Once you have completed the SFN 960 form, it should be faxed to the North Dakota Child Protection Services Central Intake Unit at 701-328-0361. Alternatively, you can submit it to the local county human service zone office where the child is currently located. It is crucial to ensure that the form is submitted promptly to facilitate a timely response.

What happens after I submit the SFN 960 form?

After the form is submitted, it will be reviewed by an intake social worker. They will assess the information provided and determine the appropriate next steps. This may include an investigation into the allegations of abuse or neglect. Your report is taken seriously, and confidentiality is maintained throughout the process to protect both the child and the reporter.