Adult Protective Services

CHAPTER 3 - INVESTIGATION AND ASSESSMENT

SOP 152:Initial Investigations - Adult Protective Services 
SOP 154 :Spouse or Partner Investigations - Adult Protective Services 
SOP 160 :Investigation In Alternate Care Facilities - Adult Protective Services 
SOP 168 :Death of an Adult - Adult Protective Services  
SOP 170 :Assessment and Documentation on the Adult Continuous Quality Assessment (CQA) - Adult Protective Services 
SOP 172: Determining the Findings of an Investigation for Adult Abuse/Neglect/or Exploitation (Excluding Spouse/Partner and Alternate Care)-Adult Protective Services  
SOP 172.1- Determining the Findings of an Investigation - Adult Protective Services in Alternate Care
 
SOP 172.2 - Determining the Findings of a Spouse or Partner Abuse Investigation - Adult Protective Services

SOP 152: Initial Investigations - Adult Protective Services

The Department for Community Based Services shall conduct an investigation of reports of alleged abuse, neglect or exploitation of a dysfunctional adult or a victim of spouse/partner abuse or neglect and provide protective services upon acceptance, request or court order. 

The investigation shall include contact with the alleged victim and may include contact with the alleged perpetrator and collaterals.

The purposes of conducting an adult protective service investigation are:

To determine through personal contact whether alleged maltreatment of an adult has occurred;

 To assess the need for protective services;

To provide protective services upon request, acceptance or court order; and

To initiate court action in the circuit or district court when:

  1. The adult is in need of protective services;

  2. The adult lacks the capacity to consent and refuses consent to services;

  3. The adult is in a state of abuse or neglect and an emergency exist;

  4. No person is authorized by law or court order to give consent or such person refuses to give consent; and

  5. The intervention is the least restrictive.

Time Frames for Investigation of Abuse, Neglect and Exploitation

If the referral source claims that the adult's condition presents a substantial risk of death or immediate and serious physical harm, then the investigation shall be initiated within (1) one hour of the receipt of the report.

If the report claims the adult is not in a state of emergency, the investigation shall be initiated within 24 hours of receipt of the report.

General Interviewing Guidelines

When conducting interviews in an adult services investigation the worker:

Identifies themselves and states purpose of the interview;

Conducts the interview in private, if possible;

Shares contents of report and explain responsibility to investigate;

Allows the alleged victim/alleged perpetrator to respond to allegations, as appropriate;

Encourages the alleged victim to give a complete account of the situation;

Determines relationships to and attitude toward the alleged perpetrator/victim;

 Determines if a pattern of abuse, neglect or exploitation exists;

Determines severity and frequency of the abuse, neglect or exploitation;

Observes non-verbal communication;

 Identifies physical and behavioral indicators of abuse neglect or exploitation;

Determines what the alleged victim wishes to do about the situation and offer alternatives;

Ascertains if there are other service needs not stated in the report and provide referral information or services;

When appropriate, shares findings and observations with the alleged victim, perpetrator and states the actions or recommendations;

Keeps the name of the informant confidential;

When appropriate, focuses the interview with the alleged perpetrator on actions to be taken to remedy the abuse, neglect or exploitation; and

Gives special needs or consideration due to disabilities.

The investigation of a report of adult abuse, neglect, exploitation, or spouse abuse shall be appropriately acted upon by the worker assigned to investigate based on the following criteria:

Alleged Victim

An adult protective service investigation shall include a personal interview with the alleged victim and may include a face-to-face contact if possible.

Guardian/Conservator

If the alleged victim has a guardian or conservator, an interview with the guardian or conservator is an appropriate part of the investigation.  The purpose of the interview is to explain the worker's role and obtain pertinent information from the guardian/conservator. 

Alleged Perpetrator

An interview with the alleged perpetrator may not be in the best interest of the victim. An alleged victim shall be made aware if the alleged perpetrator is to be interviewed.  In spouse or partner cases the victim shall grant investigations permission before a perpetrator is interviewed.  If there are concerns about whether to interview or share information with the alleged perpetrator, the SSW may discuss the situation with the Family Services Office Supervisor or designee prior to initiation of contact with the alleged perpetrator.

The worker shall advise the perpetrator they are interviewing them as part of a protective service investigation.  If the perpetrator makes an admission regarding the abuse, neglect or exploitation the worker may attempt to get a written statement or have a witness to the admission.

Collaterals

In the course of the investigation collateral contacts may be necessary. Anyone having pertinent information may be interviewed.

Collateral contacts may be family members, neighbors, witnesses, physicians and medical personnel, residents in alternate care facilities, court personnel and law enforcement officials, etc. The following guidelines may be used in conducting interviews with collateral contacts:

Identify yourself;

State the purpose of the interview in accordance with confidentiality guidelines;

Obtain relevant information; and

Determine relationship to and attitude toward the alleged victim and alleged perpetrator.

Administrator or Designee

In alternate care situations, the worker shall inform the administrator or designee that a protective services investigation is being conducted and the alleged victim and any other appropriate individuals are to be interviewed in private.

Mental and Physical Health Records

Mental and physical health records necessary to complete the investigation may be reviewed by the worker and copies obtained, if possible, to be included in the report.

Financial Records

Financial records including savings and checking account statements, financial eligibility and assistance records, disability or retirement income records and property valuation records, may be reviewed by the worker in cases of financial exploitation in accordance with KRS 209.020(14).  If a financial institution does not allow access to financial records, the worker may be able to gain access by utilizing the DCBS-7, Release of Information Form.  In situations where the worker has difficulty assessing records, the Office of the General Counsel may be consulted with supervisory approval.  A petition for a court order to release financial information needed to complete an investigation may be requested through the Office of the General Counsel.

Law Enforcement and Court Records

Police records, mental inquest, disability, probate records and legal documents may be reviewed to complete the investigation by worker and copies obtained, if possible, to be included in the investigative report.  The worker may request a criminal records check at any time during the investigation or provision of ongoing services.  A criminal records check may be requested on any household member, the alleged victim, the alleged perpetrator or caretaker.

Photographs

In some cases it may be appropriate to take photographs of the alleged victim’s injuries or surroundings.  Pictures, audio or video recordings shall not be taken or made by DCBS staff if the alleged victim refuses permission.  It is preferred that staff request assistance of law enforcement agencies in obtaining photographs or recordings. Digital cameras shall not be used since the photographs are not often accepted as evidence in court.

Voluntary Statements

A written voluntary statement regarding the incident may be obtained if it is pertinent to the case that abuse or neglect has occurred and the alleged victim, witness (es), or perpetrator is willing.

The statement is prepared, signed and dated by the person providing the statement and shall be witnessed by the worker. The person making the voluntary statement shall first be advised that the statements may be shared with law enforcement or with the court and the person may be required to testify during the court preceding.

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Sop 154: Spouse or Partner Investigations - Adult Protective Services

All protective service investigations require intervention techniques, which consider the safety of the alleged victim and the worker. Spouse and partner abuse situations may be volatile and therefore should be approached with caution.  In addition to the guidelines in SOP 152: Initial Investigations – Adult Protective Services, the worker shall use these additional considerations in conducting spouse or partner investigations.

Contact With The Victim

When conducting a spouse or partner abuse investigation, the worker shall attempt to arrange a face-to face interview with the alleged victim to conduct the investigation and offer protective services.   Safety of the worker and the alleged victim shall be considered in arranging contact with the victim.  The worker should attempt to obtain information from the reporting source, law enforcement, court, and other appropriate individuals on where the victim can safely be interviewed. 

The following consecutive steps shall be taken and documented when attempting to contact the alleged victim for spouse or partner abuse:

1.      Step 1--Telephone Contact

The preferred approach is telephone contact.  If a phone number is available the worker is to attempt to call the alleged victim to arrange a face-to-face interview at a location which is deemed safe for the alleged victim and the worker (i.e.. DCBS office, shelter, business, or court).  if both home and work phone numbers are available, it is preferable to attempt phone contact at the place of employment.  If unsuccessful, the worker shall attempt to contact the alleged victim at home.  It may be necessary to make numerous phone calls in an attempt to contact the alleged victim.  If the alleged victim is currently residing in a Spouse Abuse Center an attempt may be made to discuss the allegations with the alleged victim at the center.

2.      Step 2--Home Visit

If telephone contact is not successful, or a phone number is not available, the worker may make a visit to the home, when through collateral contacts (i.e.. law enforcement, shelter staff, referral source, courts) it is determined that neither the alleged victim nor the worker may be endangered, and after consultation with the supervisor.

3.      Step 3--Letter

If the worker is unable to successfully contact the alleged victim by phone, no telephone number is available, or if the information indicates a visit to the home is inadvisable, a letter is to be used for the purpose of attempting contact with the alleged victim.  At least one follow up letter shall be sent when no response is received from the alleged victim.  Upon the alleged victim’s response to the letter, the worker shall attempt to arrange a face-to-face interview.  The worker shall use the standardized letter in the Forms Section.

The worker shall document in TWIST all attempts made to contact the victim.

If a spouse or partner abuse report indicates that the alleged victim does not want to be contacted by the Department, staff shall exercise supervisory discretion in determining the appropriate plan of action based on the nature of the report.  Consultation is available from Service Region and Quality Central Staff.

Personal Telephone Interviews for Victims Who Refuse to Meet with the Worker.

If the alleged victim refuses to meet with the worker but agrees to a personal telephone interview, the worker shall discuss the allegations for the purpose of attempting to determine if abuse has occurred and offering protective services.

If children are in the home, the worker shall attempt to assess through the telephone interview the alleged victim’s ability to protect the children. 

The alleged victim is informed of available resources, and offered safety planning for protection and given the worker’s name, office telephone number, and the telephone number of the nearest spouse abuse center.

The telephone interview meets the statutory requirement for a personal interview with the alleged victim who refuses to meet the worker.

Reports of Concurrent Child Abuse or Neglect

If child abuse or neglect is concurrently alleged with the spouse or partner abuse report or there is indication during the interview that the children may be in danger, a child abuse report shall be made and an investigation initiated per DCBS child protective services standards of practice.

Interviewing the Alleged Perpetrator

The worker without the consent of the alleged victim shall not initiate contact with the alleged perpetrator.  If the alleged perpetrator is at home, it is inappropriate to interview the alleged victim without indication from the alleged victim that this is permissible.  If the victim gives permission for the alleged perpetrator to be interviewed it shall be documented in the case.

Safety Planning

A safety plan is the victim’s strategy for getting victim and children physically away from the battering.  The safety plan:

Increases the victim’s ability to protect self and children, particularly when a crisis exists and the lethality potential is high;

Helps to continually assess the degree of danger to victim, worker and others; and

Confronts the minimization and denial regarding the presence and extent of violence.

The plan should be:

Client driven;

Specific;

Detailed;

 Practical; and

Practiced and revised as necessary.

Safety planning shall be discussed with the alleged victim.  The worker may assist with the development of an  “Individual Adult Safety Plan". Refer to SOP 307: Safety Planning - Adult Protective Services.  The safety plan may be verbal or written. If a written safety plan is developed and the alleged victim agrees that a copy may be kept be the SSW, the worker shall use the Individual Adult Safety Plan form and maintain it the case record. 

Referrals to Spouse Abuse Center

The SSW shall discuss the services of the area spouse abuse center with the alleged victim during the investigative interview.  If the alleged victim requests assistance in securing shelter in the area spouse abuse center, the SSW shall assist in making the necessary arrangements.  In rare instances staff may provide transportation to the spouse abuse center. After obtaining permission from the SRA or designee, the worker is to contact the spouse abuse center and make arrangements for accessing the shelter.

If a request is made to DCBS for the address or phone number of a spouse abuses shelter, the worker is to provide the crisis line number only. Staff shall not disclose the location of a spouse abuse shelter.

When a worker has contact with an alleged victim prior to the alleged victim entering a spouse abuse shelter the worker shall complete the investigation.  The worker may contact a social service worker in the county where the shelter is located to request a courtesy interview with the alleged victim

When an alleged victim enters a spouse abuse center without assistance or contact with the Department staff, the worker from the county where the spouse abuse center is shall conduct the investigation.

If an incident occurs outside the county where the alleged victim resides the worker in the county of residence of an alleged victim shall conduct the investigation.

If an alleged victim request services upon departure from a spouse abuse center, the worker from the county where the spouse abuse is notifies the worker in the county of relocation as to the need and request for ongoing services.

If the alleged victim relocates, the worker in the county where the alleged victim resided at the time of referral forwards the referral to the county of relocation if the worker in the county has not had personal contact.  If personal contact was made the worker in the county prior to relocation request a courtesy interview from the worker in the county of relocation. 

In situations where the referral source alleges abuse of an adult by a former spouse, former co-habiting partner, non-cohabiting adult victim who has a child in common with the alleged perpetrator, a general adult services referral may be considered or accepted at the discretion of the supervisor.  Refer to Standards of Practice for General Adult Services.

Kentucky Temporary Assistance (K-TAP) Referral Concerning Domestic Violence

When an individual applying for K-TAP benefits claims an exemption due to a domestic violence situation, the individual must have an individual assessment and a domestic violence service plan completed.  Each region has established the procedures for conducting the assessments and the service plans. These reports shall be assigned as determined by the Service Region Administrator.

If the worker assigned is a SSW, the worker is to complete an investigation or an assessment using the Adult CQA.  The results of the investigation are to be forwarded to the Family Support Worker using the “Domestic Violence Determination” letter. See Forms Section

The participant and a worker, trained in domestic violence, which is designated by the Service Region, complete the domestic violence service plan.  The plan lists what services, actions, etc. that are needed to assist the family to escape the violence, lead the adult safely to employment and eventually to self-sufficiency.

A monthly report of all Domestic Violence/K-TAP investigations or assessments is to be submitted to the Family and Adult Consultative Services Branch, Quality Central utilizing the protocol established in the Service Region Office.

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SOP 160: Investigation In Alternate Care Facilities - Adult Protective Services

The worker shall conduct investigations of alleged abuse, neglect and exploitation in all levels of care. In addition to the guidelines in SOP 152, Initial Investigations, Adult Protective Services, SSW shall use these additional considerations in conducting investigations in alternate care settings.

The Department for Community Based Services is the lead agency when the allegations meet the standard for intake under KRS 209 including reports involving state operated facilities. The worker shall notify the Office of Inspector General (OIG); Division of Long Term Care of all reports received involving a licensed health care facility or provider. When other investigating agencies, i.e. the OIG or Medicaid Fraud, or the State Long Term Care Ombudsman (SLTCO) are notified of allegations in alternate care facilities the referral source is not given except upon request.

When the investigation is completed and approved by the supervisor, and it involves facility or provider staff or corrective action needs to be taken to remedy or prevent abuse, neglect or exploitation the worker shall share the finding with and may make recommendations to the administrator, operator or designee.

Copies of the investigations are to be maintained at the local office.

Report of Resident-to-Resident Allegations in Alternate Care Settings

When a report is received alleging abuse or exploitation of one resident by another resident in an alternate care setting, the initial focus of the investigation shall be on caretaker neglect. The finding is to be documented under the category of caretaker neglect if the worker determines that the facility is depriving the residents of necessary services such as supervision.

The report also may be taken as adult abuse or exploitation depending on the allegation. If the worker determines that the facility or home was not neglectful but abuse or exploitation did occur, the worker shall assess the adult who committed the act and determine if the adult has the capacity to knowingly abuse or exploit. In the cases, where the worker finds that the abuse or exploitation was knowingly committed, the finding is to be documented as found and substantiated reports of adult abuse.

In the cases when the determination is made that the resident who committed the act does not have the capacity to knowingly abuse or exploit, the findings of some indication of Adult Abuse shall be documented in TWIST.

Reports in a Licensed Health Care Facility Receiving Medicaid Funds

All Kentucky facilities that provide health care are licensed by the Office of the Inspector General. Many, but not all, of these licensed health care facilities receive Medicaid funds.

Medicaid is a medical assistance program for certain low-income people. Facilities that receive Medicaid funds include most of the Nursing Facilities, Hospitals, Intermediate Care Facilities, and Home Health Agencies.

When an investigation is conducted in licensed health care facilities that receive Medicaid, the following steps shall be taken:

  1. The worker is to send the DCBS-284 to the Medicaid Fraud and Abuse Control Division in the Attorney General’s Office. The referral source is not given except upon request. When the Medicaid Fraud and Abuse Control Division make the original report to DCBS it is not necessary to send a DCBS-284. The telephone number for the Medicaid Fraud unit is 502-696-5405. The fax number is 502-573-8316;
  2. The worker is to submit to the Medicaid Fraud and Abuse Division a copy of the written investigation upon request;
  3. Preliminary findings and recommendations may be shared with representatives from the Office of Inspector General, Division of Long Term Care prior to exiting with the facility in potential Nurse Aide Abuse Registry investigations or in any other investigations in an alternate care facility;
  4. Findings and recommendations may be shared with a representative from the Medicaid Fraud and Abuse Control Division at any time during or after the investigation when the Medicaid Fraud and Abuse Control Division is preparing a case for prosecution;
  5. Findings and recommendations may be shared with a representative from the SLTCO. Prior to sharing findings and recommendations, the worker shall determine, on a case by case basis, that the SLTCO has a legitimate interest in the investigation.

Reports in Licensed Health Care Facilities Not Receiving Medicaid Funds

Licensed Health Care Facilities that do not receive Medicaid funds include but are not limited to, Personal Care Homes and Family Care Homes. When an investigation is conducted in a Licensed Health Care facility the worker:

Sends the DCBS-284 to the appropriate regional office of the OIG, Division of Long Term Care. When the worker receives a report from the OIG, Division of Long Term Care it is not necessary to send a DCBS-284. The telephone numbers for the OIG regional offices are:
Region A in Hopkinsville 270-885-6143,extension 480;
Region B in Louisville 502-595-4079;
Region C in London 859-878-7827; and
Region D in Lexington 859-246-2301.
May share the preliminary findings and recommendations with representatives from the Office of Inspector General, Division of Long Term Care prior to exiting with the facility in potential Nurse Aide Abuse Registry investigations or in any other investigations in an alternate care facility;
May share the findings and recommendations with a representative from the OIG, Division of Long Term Care at any time during or after the investigation when they are involved in a case.
May share the findings and recommendations with a representative with the SLTCO. Prior to sharing findings and recommendations, the worker shall determine, on a case by case basis, that the SLTCO has a legitimate interest in the investigation; and,
Shall submit a copy of the written investigation (DCBS-115, Adult CQA, and documents collected that pertain to the investigation) to the OIG, Division of Long Term Care, when the alleged perpetrator is a Certified Medications Aide or a Nurse Aide. In all other situations, when the OIG, Division of Long Term Care requests a written copy of a specific investigation, and has a legitimate interest in the information therein, then the worker shall provide a copy of that investigation to the OIG, Division of Long Term Care.

Reports in State Operated Facilities

State Operated Facilities are licensed by the Office of the Inspector General, Division of Long Term Care and receive Medicaid Funds. They also receive direction from the Department for Mental Retardation or Department of Mental Health. State Operated facilities include Oakwood, Hazelwood, Glasgow State Hospital, and Western State Hospital. When an investigation is conducted in a state operated facility the following procedures apply:

    1. The Service Region Administrator or designee shall review the report to determine if it meets standards of practice for investigation under KRS 209;
    2. If the report meets standards, the Service Region Administrator or designee is to assign the report for investigation using the DCBS-115;
    3. If the report does not meet the standard, the Service Region Administrator or designee is to document the reason(s) why the report did not meet standards for investigation. Documentation shall be maintained for one year. Notification not to accept a report shall be forwarded to the Facility Administrator using the "Report Not Accepted" letter. (see forms section) This step applies ONLY to state operated facilities;
    4. The worker is to complete the DCBS-284 and forward the original to the OIG, Division of Long Term Care;
    5. When the facility is the reporting source the worker is to contact the Risk Manager/Investigator for assistance in arranging access to the alleged victim, alleged perpetrator, witnesses and records;
    6. When family members, visitors, off duty employees or other individuals are the reporting source, the worker is to proceed to the facility to conduct the investigation. The worker is to inform the administrator or designee as to the worker’s presence and then proceed with the investigation.

After the investigation has been completed and approved an exit interview is to be conducted with the administrator or designee to discuss results of the investigation and recommendations.

Following the exit interview, the worker shall forward a "Results of the Investigation" letter to the facility administrator. This step applies ONLY to State Operated Facilities. (See Forms Chapter)

The worker provides verbal information to the alleged victim as to the results of the investigation and action(s) the Department will take, if any, to remedy the abusive, neglectful and/or exploitative situation.

Reports in Assisted Living Facilities, Registered Boarding Homes, and Supports for Community Living

When the worker receives a report on an individual residing in Assisted Living, a Registered Boarding Home or in a Supports for Community Living placement, the worker shall review the allegations to see if the information meets the acceptance criteria. These types of facilities are not licensed by the OIG Division of Long Term Care. Therefore, a DCBS-284 is not sent to them, unless the report indicates the facility may be operating as an illegal health care facility. (Refer to the Standards of Practice for Acceptance Criteria in Chapter 2)

Assisted Living Facilities 
The Office of Aging certifies Assisted Living Facilities. The Office of Aging may request a written report of the investigation of an individual living in Assisted Living. Prior to giving the Office of Aging a copy of the requested investigation, the worker shall determine, on a case by case basis, that the Office of Aging has a legitimate interest in the investigation.
Registered Boarding Homes 
The Department of Public Health, Food Safety Branch registers Boarding Homes. The Department of Public Health, Food Safety Branch may request a written report of an investigation in a registered Boarding Home. Prior to giving them a copy of the requested investigation, the worker shall determine, on a case by case basis, that The Department of Public Health, Food Safety Branch has a legitimate interest in the investigation.
Supports for Community Living (SCL) 
The Department of Mental Retardation (DMR) certifies Supports for Community Living. The Department of Mental Retardation may request a written report of an investigation in an SCL. Prior to giving them a copy of the requested investigation, the worker shall determine, on a case by case basis, that DMR has a legitimate interest in the investigation.

Entering the name of the perpetrator and the facility’s name into TWIST

The worker shall have a finding of substantiation or some indication against an individual who is identifiable as a perpetrator of abuse, neglect or exploitation in a facility.

The worker may have a finding of substantiation or some indication against the facility, if there is a systemic pattern of abuse, neglect or exploitation.

Factors or conditions which may show that there is a systemic pattern include, but are not limited to, conditions which show that there is a lack of supervision or training by management or staffing problems over a period of time which creates a risk of harm to the adults in their care.

If the worker has questions as to whether there is a systemic problem, the worker may contact regional or Quality Central specialists and an attorney with the Office of the General Counsel.

For tracking purposes, all alternate care cases shall be entered into TWIST under the name of the facility. The worker shall cross reference in the adult’s case, if appropriate.

Entering the facility’s name into TWIST:

If the facility is a hospital, enter hospital as the last name and the name of the hospital as the first name, for example, Last Name: Hospital; First Name: Central Baptist.

If the facility is an alternate care facility, enter facility as the last name and the name of the alternate care facility as the first name, for example, Last Name: Facility; First Name: Pine Meadows.

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SOP 168: Death of an Adult - Adult Protective Services

When investigating reports of alleged adult abuse or neglect resulting in death, or when a client dies during the course of an investigation the worker shall:

Notify appropriate supervisory staff ;

Consult with law enforcement, and appropriate regulatory agencies regarding assistance in completing the investigation;

Determine within the household or facility if there are other potential victims of abuse neglect or exploitation and report any allegations in compliance with KRS 209.030 and KRS 620.030;

Examine the coroner's or doctor's report when available; and

 Obtain a copy of the death certificate.

SOP 170: Assessment and Documentation on the Adult Continuous Quality Assessment (CQA) - Adult Protective Services (Effective Date 5/24/02)

The SSW shall complete the investigation and assessment of risk on the Adult CQA. The SSW is to submit to the supervisor or designee for approval and signature within thirty (30) working days after the investigation was initiated. The FSOS may grant an extension for completing the investigation upon justification by the SSW. All extensions are to be documented in TWIST. Completion of the Adult CQA is not necessary in situations where the SSW after repeated, diligent efforts is unable to locate an alleged victim. Completion of the Adult CQA is not necessary in situations were the SSW is unable to have a personal face to face or telephone interview with an alleged victim after following all the steps listed in SOP 154, Spouse or Partner Investigations and a "No Findings" determination is made for the referral. The SSW documents their effort in the "Investigation Results" section in TWIST.

Ratings

The SSW is to assign a numerical rating or anchor for all the appropriate sections of the Adult CQA. The SSW reviews the anchors in descending order to determine the appropriate rating to select. Each rating is based on the highest risk. In cases where the adult refuses to be interviewed the SSW uses the highest rating for each of the sections.

The rating is only to be used to discuss with clients our concerns for their safety. All adult services are voluntary except when court ordered.

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SOP 172: Determining the Findings of an Investigation for Adult Abuse/Neglect/or Exploitation (Excluding Spouse/Partner and Alternate Care)-Adult Protective Services

Following the completion of a thorough investigation and assessment of risk, including interviews with all pertinent collaterals and gathering of all supportive facts or written documentation, the worker is to make a determination of the findings of the report. This is a social work not a legal determination. The findings should be entered in TWIST for each type of abuse, neglect or exploitation. (

Definitions of the findings of the investigations are as follows:

Substantiated

A finding of "Substantiated" should be used when there is a personal interview with the alleged victim except in cases of death of the alleged victim and:

There is an adjudication resulting from the abuse, neglect or exploitation; or

The SSW has conducted an interview with the alleged perpetrator in which the alleged perpetrator was advised that the interview was part of an adult protective services investigation and the alleged perpetrator has made an admission of the abuse, neglect or exploitation; or

There is strong evidentiary or supportive facts, but lacking an admission or adjudication. Examples of strong evidentiary or supportive facts include: witnesses to the incident, medical facts, and/or observation of injuries resulting from the incident. These examples should be combined with other strong collaborating facts, which are clearly documented in the Adult CQA.

In cases of death, a finding of "substantiated" should be used when there is:

An admission of abuse, neglect, exploitation or spouse abuse by the person(s) responsible; or

An adjudication resulting from the allegation of abuse, neglect, and exploitation or spouse abuse; or

Strong evidentiary or supportive facts, but lacking an admission or adjudication. Examples of strong evidentiary or supportive facts include: witnesses to the incident, medical facts, and/or observation of injuries resulting from the incident. These examples should be combined with other strong collaborating facts, which are clearly documented in the Adult CQA.

Found and Substantiated

A code of "found and substantiated" should be used when there is a personal interview with the alleged victim except in cases of death of the alleged victim and in the following circumstances:

Adult abuse, neglect, exploitation or spouse abuse was not reported but was discovered and substantiated by the worker during the course of an investigation; or

In instances where a worker is making a routine service contact and discovers abuse, neglect, exploitation, a report and an investigation is completed.

The worker should use the same standards for a finding of "Found and Substantiated" as for a "Substantiated" finding.

Some Indication

A finding of "some indication" should be used when the adult does not confirm that abuse, neglect or exploitation occurred but circumstantial or other supportive facts of abuse exists.

In cases of death, a finding of "some indication" should be used when there is circumstantial or other supportive indication, but lacking an admission or adjudication.

Unsubstantiated

A finding of "unsubstantiated" should be used when:

A personal interview or contact with the alleged victim has occurred and there is no evidence, fact(s), indicator(s) or justification for suspicion of abuse, neglect, exploitation; or

The location of the adult is known and attempts at personal interview or contact with the alleged victim have been unsuccessful, and there is lack of supportive indication of abuse, neglect, or exploitation.

In cases of death, a finding of "unsubstantiated" should be used when there is no evidence, facts indicators or justification for suspicion of abuse, neglect, and exploitation or spouse abuse.

Unable to Locate

A code of "unable to locate" should be used when:

The worker has been unable to locate an alleged victim, after repeated, diligent efforts.

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SOP 172.1- Determining the Findings of an Investigation - Adult Protective Services in Alternate Care

Following the completion of a thorough investigation and assessment of risk, including interviews with all pertinent collaterals and gathering of all supportive facts or written documentation, the worker is to make a determination of the findings of the report. This is a social work determination, not a legal determination. The findings shall be entered in TWIST for each type of abuse, neglect or exploitation. (SOP 152 - Initial Investigation--Adult Protective Services and SOP 160 Investigations in Alternate Care Facilities-- Adult Protective Services.)

Definitions of the findings in investigations in Alternate Care Facilities are as follows:

Substantiated

The worker should use a finding of "Substantiated" when there is a personal interview with the alleged victim except in cases of death of the alleged victim and:

There is an adjudication resulting from the abuse, neglect or exploitation; or

The SSW has conducted an interview with the alleged perpetrator in which the alleged perpetrator was advised that the interview was part of an adult protective services investigation and the alleged perpetrator has made an admission of the abuse, neglect or exploitation.

There is strong circumstantial or other supportive indication, but lacking an admission or adjudication. Examples of strong evidentiary or supportive facts include: witnesses to the incident, medical facts, and/or observation of injuries resulting from the incident. These examples should be combined with other strong collaborating facts, which are clearly documented in the Adult CQA.

A systemic pattern exists.

Only in cases of death of the alleged victim could a finding of substantiated be made without a personal interview of the alleged victim.

Found and Substantiated

A code of "found and substantiated" should be used when there is a personal interview with the alleged victim except in cases of death of the alleged victim and in the following circumstances:

Adult abuse, neglect, exploitation or spouse abuse was not reported but was discovered and substantiated by the worker during the course of an investigation; or

In instances where a worker is making a routine service contact and discovers abuse, neglect, exploitation, a report and an investigation is completed.

The worker should use the same standards for a finding of "Found and Substantiated" as for a "Substantiated" finding.

Some Indication

A finding of "some indication" should be used when there is a personal interview with the alleged victim and the adult does not confirm that abuse, neglect, exploitation occurred but circumstantial or other supportive indication of abuse, neglect or exploitation exists.

In cases of death, a finding of "some indication" should be used when there is circumstantial or other supportive indication, but lacking an admission or adjudication.

Unsubstantiated

A finding of "unsubstantiated" should be used when there is:

A personal interview or contact with the alleged victim has occurred and there is no evidence, fact(s), indicator(s) or justification for suspicion of abuse, neglect, exploitation; or

The location of the adult is known and attempts at personal interview or contact with the alleged victim have been unsuccessful, and there is lack of supportive indication of abuse, neglect, or exploitation.

In cases of death, a finding of "unsubstantiated" should be used when there is no evidence, fact(s), indicators or justification for suspicion of abuse, neglect, and exploitation or spouse abuse.

Unable to Locate

A code of "unable to locate" should be used when:

The worker has been unable to locate an alleged victim, after repeated, diligent efforts.

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SOP 172.2 - Determining the Findings of a Spouse or Partner Abuse Investigation - Adult Protective Services

Following the completion of a thorough investigation and assessment of risk, including interviews with all pertinent collaterals and gathering of all supportive facts or written documentation, the worker is to make a determination of the findings of the report. This is a social work not a legal determination. The findings should be entered in TWIST for each type of abuse, neglect or exploitation. (SOP 152 -Initial Investigation--Adult Protective Services and

Definitions of the findings of the investigations are as follows:

Substantiated

A finding of "Substantiated" should be used when there is a personal interview with the alleged victim, except in cases of death of the alleged victim, and:

There is an adjudication resulting from the abuse, neglect or exploitation, i.e. DVO or criminal adjudication (does not include EPO); or

The SSW has conducted an interview with the alleged perpetrator in which the alleged perpetrator was advised that the interview was part of an adult protective services investigation and the alleged perpetrator has made an admission of the abuse, neglect or exploitation; or

There is strong evidentiary or supportive facts, but lacking an admission or adjudication. Examples of strong evidentiary or supportive facts include: witnesses to the incident, medical facts, observation of injuries resulting from the domestic violence incident, and/or JC-3's. These examples should be combined with other strong collaborating facts, which are clearly documented in the Adult CQA.

In cases of death, a finding of "substantiated" should be used when there is:

An admission of abuse, neglect, exploitation or spouse abuse by the person(s) responsible; or

An adjudication resulting from the allegation of abuse, neglect, and exploitation or spouse abuse; or

Strong evidentiary or supportive facts, but lacking an admission or adjudication, i.e. witnesses to the incident, medical facts, observation of injuries resulting from the domestic violence incident, JC-3's combined with other strong collaborating facts. These examples should be combined with other strong collaborating facts, which are clearly documented in the Adult CQA.

Found and Substantiated

A code of "found and substantiated" should be used when there is a personal interview with the alleged victim except in cases of death of the alleged victim and in the following circumstances:

Adult abuse, neglect, exploitation or spouse abuse was not reported but was discovered and substantiated by the worker during the course of an investigation; or

In instances where a worker is making a routine service contact and discovers abuse, neglect, exploitation, a report and an investigation is completed.

The worker should use the same standards for a finding of "Found and Substantiated" as a "Substantiated" finding.

Some Indication

A finding of "some indication" should be used when there is a personal interview with the alleged victim and the adult does not confirm that abuse, neglect, or exploitation occurred but circumstantial or other supportive facts exists.

In cases of death, a finding of "some indication" should be used when there is circumstantial or other supportive facts.

Unsubstantiated

A finding of "unsubstantiated" should be used when:

A personal interview or contact with the alleged victim has occurred and there is no evidence, fact(s), indicator(s) or justification for suspicion of abuse, neglect, exploitation; or

In cases of death, a finding of "unsubstantiated" should be used when there is no evidence, facts, indicators or justification for suspicion of abuse, neglect, and exploitation or spouse abuse.

No Findings

A code of "No Finding" should be used only for Spouse/Partner abuse reports when the location of the victim is known and:

All measures and steps for initiating contact with the victim of spouse/partner abuse has been considered and/or attempted and documented, and

The worker was unable to make contact with the alleged victim.

Unable to Locate

A code of "unable to locate" should be used when:

The worker has been unable to locate an alleged victim, after repeated, diligent efforts.

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