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

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Form CPR Part A – Essential Information Support to birth mother Has the birth mother received counselling from an independent person in relation to the plan for adoption? (Give details) Mrs Green was given the information about the independent counselling service on the 18-06-08. She has declined this service. Has the birth mother been given an opportunity to state her views on the adoption plan for the child? If yes, briefly describe the outcome of this. If part F has been completed, note this here. If no, give reasons. Mrs Green has refused to co-operate and provide any information in relation to the adoption process as she disagrees with the Local Authority’s recommendation of adoption for Jane. Social worker has completed part F of this form, views of the birth mother from her conversations with Mrs Green who has verbally stated her reasons for not agreeing to the plan for adoption for her child. Has the birth mother been shown a copy of this CPR? If yes, note date shown and briefly describe the outcome of this. If no, give reasons. If the birth mother has written her own account, is this included with this report? No Tina was offered the opportunity to view the report but she declined this offer. Page 24 © 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 Part A3 – The child’s birth father Surname Green First names Simon Are these the names used at the time of the child’s birth? Yes If no, what were they? Other names (including familiar names) Aka Simon Doe Date of birth 10.02.80 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 he has attended 19 Simon attended mainstream school. Current occupation or profession Unemployed. Brief details of his employment history Simon Green is currently unemployed and has not been able to evidence a sustained period of employment. He reports that he currently ‘helps out’ Tina’s uncle who has a cleaning job. Simon has had a number of jobs including being in the Army, but he has not been able to sustain any occupation for a significant period of time. Brief description of the home and neighbourhood in which he lives Mr Green lives with his wife Tina Green see this description already detailed Part A2 on the birth mother. What was the status of the relationship with the child’s birth mother at the time of the birth of the child (married, cohabiting)? Married. Current status of the relationship (separated, divorced, living apart) – Page 25 © 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 23: 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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