Day 1 - Pennsylvania Child Welfare Resource Center
|Identified Child Name: NAME AGE Case/Record Number: |
|Date(s) of Review: _________________ |
|Review Team: Name Phone |
|Name Phone |
|Scheduler: Name Phone |
|Day 1 |Person and Category |Location of Interview & Phone Number |
|Date & Time | | |
|8:00am - 8:30am |Welcome and Overview |ABC County Children and Youth Services |
| | |1234 Main Street |
| | |Anytown, PA 98765 |
| | |Main Conference Room |
|8:30am – 10:00am |Interview Preparation, Review Case File |ABC County Children and Youth Services |
| |(It is important for schedulers to assure that QSR reviewers|1234 Main Street |
| |have time with the case file prior to their first interview)|Anytown, PA 98765 |
| | |Main Conference Room |
|10:00am – 11:00am |Caseworker/Supervisor Interview |ABC County Children and Youth Services |
| |(It is most ideal for QSR reviewers to interview the |1234 Main Street |
| |assigned caseworker/supervisor prior to all other |Anytown, PA 98765 |
| |interviews) |Caseworker’s office – 2nd floor |
|11:15am – 11:45am |Phone Interview with Child’s Attorney |ABC County Children and Youth Services |
| | |1234 Main Street |
| | |Anytown, PA 98765 |
| | |Phone: 999-888-8888 |
| | |Room: Interview Room C |
|12:00pm - 1:00pm |LUNCH |On your own |
|1:15pm - 1:45pm |Interview with Child’s Therapist |ABC County Children and Youth Services |
| | |1234 Main Street |
| | |Anytown, PA 98765 |
| | |Room: Interview Room C |
|1:45pm - 2:15pm |Travel |See packet of information for directions |
|2:15pm - 3:00pm |Interview with Child’s Teacher |ABC Elementary School |
| | |654 Forest Avenue |
| | |Whoville, PA 01234 |
| | |Guidance Counselor’s Office – Rm. 258 |
|3:00pm – 3:15pm |Travel |See packet of information for directions |
|3:30pm – 4:15pm |Interview with Child’s Grandparents |321 Schoolhouse Lane |
| | |Whoville, PA 01234 |
|4:15pm – 5:15pm |Travel |See packet of information for directions |
|5:15pm – 6:45pm |Interview with Child’s Mother and Father |987 River Street |
| | |Smithville, PA 98765 |
| |
| |
|Day 2 |Person and Category |Location of Interview & Phone Number |
|Date & Time | | |
|8:00am – 8:30am |Phone Interview with Mom’s Attorney |ABC County Children and Youth Services |
| | |1234 Main Street |
| | |Anytown, PA 98765 |
| | |Phone: 999-888-8888 |
| | |Room: Interview Room C |
|8:30am – 9:30am |Interview with Provider Worker |ABC County Children and Youth Services |
| | |1234 Main Street |
| | |Anytown, PA 98765 |
| | |Room: Interview Room C |
|9:30am – 11:30am |Scoring |ABC County Children and Youth Services |
| | |1234 Main Street |
| | |Anytown, PA 98765 |
| | |Large/small conference room |
|11:30am-12:30pm |Prepare for Case Specific Debriefing and Feedback Session |ABC County Children and Youth Services |
| | |1234 Main Street |
| | |Anytown, PA 98765 |
| | |Large/small conference room |
|12:30pm – 1:30pm |LUNCH |On your own |
|1:30pm – 2:30pm |Feedback Session with Caseworker/Supervisor |ABC County Children and Youth Services |
| | |1234 Main Street |
| | |Anytown, PA 98765 |
| | |Caseworker’s office – 2nd floor |
|3:00pm - 5:00pm | |ABC County Children and Youth Services |
| |Case Specific Debriefing |1234 Main Street |
| | |Anytown, PA 98765 |
| | |Large/small conference room |
NOTES:
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