Dss 5282-2025

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The document is a notification form for Child Protective Services (CPS) involvement related to mental health and child care facilities in North Carolina. It outlines the requirements for reporting CPS assessments, including details about the facility, involved parties, and incident specifics. The form ensures confidentiality while facilitating communication between various regulatory divisions regarding child welfare.

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Click ‘Get Form’ to open the dss 5282 in the editor.
Begin by filling in the 'Name of Facility/Home' and 'Location of Facility/Home' fields. Ensure that the physical address is accurate for proper identification.
Next, indicate whether this is an 'Initial Notification' or a 'Case Decision Notification'. This selection is crucial for processing your form correctly.
Complete the sections regarding the perpetrator's name and date of birth, as well as the county conducting the investigative assessment. If applicable, specify the responsible county.
Provide details about the investigating social worker and their supervisor, including phone numbers for easy communication.
In the 'Information Needed' section, describe what happened in detail. Include all relevant information to avoid re-interviewing alleged victim children.
Finally, review all entries for accuracy before saving or submitting your completed form through our platform.

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