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

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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 © BAAF 2006 All rights reserved. Except as permitted under the Copyright, Designs and Patents Act 1988, this form may not be reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF. Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS
Form CPR Part A – Essential Information A recent good quality photograph should be attached (if appropriate) Date of photograph: (The date should be written on the back of the photograph.) Briefly describe the birth mother’s physical characteristics 17 Tina is 5ft tall and of slim build with thick long dark brown hair which she usually wears tied back away from her face. She has a sallow complexion and deep set large brown eyes. Tina doesn’t wear make-up and is usually observed to be wearing of jeans and a jumper. She wears a stud in the left side of her nose and has pierced ears. Briefly describe the personality and interests of the birth mother 18 Tina’s personality is variable she can swing from being extremely friendly and chatty to being abusive and aggressive. When she becomes agitated she will often shout and swear. This may have something to do with her intellectual abilities. Tina doesn’t have many friends and she appears to struggle in relating to her peers preferring to spend time with Simon and her uncles. She enjoys using the internet and playing computer games and she has talked about enjoying watching programmes about animals on the television. From my observations Tina seems to spend most of her time with her two uncles. She appears to enjoy their company and has spoken about going with them for days out. Tina was unable to talk about any other interests although I have observed her reading magazines. She has a quick temper but soon calms down and from my contact with her it is clear that she is heavily influenced in her thoughts and actions by her husband Simon. Page 17 © BAAF 2006 All rights reserved. Except as permitted under the Copyright, Designs and Patents Act 1988, this form may not be reproduced, stored in a retrieval system, or transmitted in any form or by any means, without the prior written permission of the publishers. A Licence Agreement permitting electronic reproduction of this form can be purchased from BAAF. Published by BAAF, Saffron House, 6–10 Kirby Street, London EC1N 8TS
Page 1 and 2: CHILD’S PERMANENCE REPORT The Ado
Page 3 and 4: Form CPR Part A - Essential Informa
Page 15: Form CPR Part A - Essential Informa
Page 39 and 40: Form CPR Parts B & C - Extended fam
Page 41 and 42: Form CPR Part D - Siblings (full an
Page 47 and 48: Form CPR Part E - Wishes and feelin
Page 49 and 50: Form CPR Part F - Views of the birt
Page 55 and 56: BAAF Form CPR Part G Do you have an

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

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