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Supervised visitation observation checklist

1 Parent/ Supportive Adult Visitation Record and Observation Form ... 2025

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The document is a 'Parent/Supportive Adult Visitation Record and Observation Form' used by Child Protective Services (CPS) to document supervised visits between parents/adults and children. It includes instructions for completing the form, details about the visit such as participants, behaviors observed, and emotional interactions. The form aims to assess the quality of the visit, including how well the parent/adult meets the child's physical and emotional needs, and concludes with sections for both observer and parent signatures.

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Click ‘Get Form’ to open the Parent/Supportive Adult Visitation Record and Observation Form in the editor.
Begin by filling in the case-specific information, including the Case Name, Date of Visit, and Visit Location. This sets the context for your observations.
List all participants in the visit under 'List Children and Adults Participating in the Visit.' Include names and ages for children, as well as relationships to the child.
In the Visitation/Observation Details section, carefully assess behaviors observed during the visit. For each question, check 'Yes' or 'No' and provide a brief description to support your choice.
After completing all sections, ensure that both the observer and parent(s) sign at the end of the form. If parents wish to answer questions separately, provide them with a copy of page 3.
Finally, save your completed form and share it with relevant parties while filing it appropriately in your case records.

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How to explain supervised visits to a child?

Explaining the Purpose of Supervised Visits to Your Child Depending on the childs age, you may want to reassure them that their visitation schedule with the non-custodial parent is only temporary. Reassure them that having a supervisor around is a preventative measure taken to ensure the safety of everyone.

How do you document supervised visitation?

Checklist of the Minimum Requirements for Recording a Visit Client identifier or case number Who brought the child to the visit Who supervised the visit Any additional authorized observers Date, time, and duration of visit Who participated in the visit A detailed description of any Critical Incidents that occurred.

What is an example of supervised visitation?

For example, it can be ordered when: There are safety issues, like allegations of domestic violence, child abuse, or child abduction. A parent wants to spend time with a child that theyve never had a relationship with or theyve been apart from.

What not to do during supervised visitation?

Engage in negativity: Gossip or criticism of the other parent in front of your child harms their relationship with both parents and may violate a court order. Use drugs or alcohol before or during a visit: Never show up for visits under the influence of drugs or alcohol.

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