Annex 1: Exemplar: Initial case review notification
Official-Sensitive-Personal (once completed)
The designated person within any agency should complete this initial case review notification and send it electronically by e-mail to the local CPC lead as soon as possible and in any case within 7 calendar days of first informing the agreed lead.
The CPC lead, on receipt of the written notification should alert other services/agencies/practitioners who are involved with the child that the case has been reported as a potential SCR. This alert to other services/agencies/ practitioners can be by telephone, e-mail or fax etc. These other services/agencies will then be asked to submit an initial case review report by the CPC lead. The CPC lead will acknowledge all initial case review notification reports.
Child's date of birth:
Name of child's parents/carers:
Parent/Carer address if different to child:
Sibling names/DOB/Gender/Address if different:
Child's home address:
Child's current residence:
Child's current legal status:
Is the child's name currently on the child protection register? Are any siblings currently on the child protection register? YES/NO
Has the child's name previously been on the child protection register? Have any siblings previously been on the child protection register? YES/NO
Education establishment details:
Grounds on which the criteria for an SCR may have been met (refer to page 9):
Are there any immediate concerns? If so, what are these and have these been passed to the relevant agency for consideration/action?
What action has been taken?
Are there any general concerns? If so what are these and have they been passed to the relevant agency/service for consideration?
Summary of the case:
Name of service/agency/professionals involved with the child:
Any other proceedings underway: