Sample CPR - the Leicester City, Leicestershire and Rutland ...

Form CPR
Part A – Essential Information
Part A2 – The child’s birth mother
Surname
Green
First names
Tina
Are these the names used at the time of the child’s birth?
Yes
If no, what were they?
Other names (including familiar names)
Jakes maiden name
Date of birth
06.01.82
Place of birth
Leicester
Nationality
British
First language
English
Current address
480 Falcon Crescent, Braunstone, Leicester
Local authority area
Leicester City Council
Identify the last known type of educational provision that she has
attended 16
Tina Green attended mainstream school but received support from the Student
Support Services. Tina was made subject to an Educational Statement of
Special Needs.
Current occupation or profession
Unemployed.
Brief details of her employment history
Tina doesn’t have an established employment history. She has never been able
to sustain any work undertaken and for the most part she has been unemployed.
Brief description of the home and neighbourhood where she lives
Tina lives in a one-bed council flat, which is on a large estate a couple of miles
outside of the City centre. The house is sparsely furnished with dog hair
everywhere. Piles of cigarette ash and beer cans litter the main living area.
Overall the house is grubby with ingrained dirt on the floors and work surfaces.
Piles of dirty pots and pans have been observed in the kitchen and decaying
items of food.
Page 16
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