NAME OF CHILD:

wbs

Is there any person who has parental responsibility for the child?

YES/NO

Does the child require accommodation as a result of being lost or abandoned?

YES/NO

Is the person who normally cares for the child prevented (whether or not permanently and for whatever reason), from providing the child with suitable accommodation or care?

YES/NO

Did the child know who would care for them on arrival?

YES/NO

Has the support process and duties of the local authority under the Children Act (1989) been explained to the child?

YES/NO

Does the child have sufficient understanding of the type of support; assistance and accommodation that will be provided?

YES/NO

If NO, give further details:

Does the child express and understanding of being “looked after”?

YES/NO

Details:

Has the child expressed any preference regarding accommodation and support?

YES/NO

Details;

Are there any special factors to be considered? (e.g. medical/special needs/emotional issues/cultural needs).

YES/NO

Details:

The assessing officer should make a recommendation regarding location in consideration of the needs and wishes of the child, special factors identified and the level of understanding of the child.

Recommendation:

Signed:

Assessing Officer

Print Name

date

Was interpreter present during this part of assessment?

YES/NO

Name of interpreter

LEGAL STATUS

Signed:

Manager:

Print Name

date