Tag: violence

 Worth 30%

Please study the case study below and conduct arisk assessment as per the Adult Screening Tool found on Moodle under Assessment 3.

All professionals working with victim survivors should use the Screening and Identification Tool, either applied routinely when this is a part of your professional role or service, or when indicators of family violence are identified.

Screening is not an activity that occurs only once by a single professional or within a service. In service settings where a person has multiple contacts, it is necessary to screen over time and at each contact to ensure any changes in the relationship or use of violence is identified.

Adult Screening Tool

In addition to the screening tool, students are required to submit an accompanying Word document (with an Assessment Cover Sheet), responding to the following questions about the case study. Responses should be 750 words in total. (Please use references correctly when answering the questions below)

Questions:

1.       What forms of domestic/family violence has David used against Celina?

2.       How has having no financial control affected Celina?

3.       What might a community service worker in the domestic/family violence area want to consider when working with Celina to ensure that Celina and also her mother are provided with safe, sensitive and effective support?

CASE STUDY

Celina and David grew up in the same country of origin, however, at the time they met through an online dating website, David had been living in Australia for 7 years, and Celina was still living in her home country with her mother. Both Celina and David have been married previously, are professionally qualified and aged in their thirties. David has a primary-school age child who lives with his former wife and spends regular weekend and holiday time with David. After Celina and David married overseas, David promptly returned to Australia and Celina applied to Australian Immigration for a joint visa with David as the sponsor. When the visa was granted, Celina resigned from her professional employment and travelled to Australia to live with David.

Celina speaks fondly of her early days living with David. She described him as gentlemanly, respectful, loving and enthusiastic about showing her the sights of the exciting city she had moved to. Celina had experienced stigma in her own culture due to being a divorced woman and felt that her marriage to David restored her dreams for a good life and a family. She was committed to supporting David in caring for his child, and believes she made a genuine effort to build a relationship. When the child was staying with Celina and David, Celina would take care of the child’s needs, prepare meals and do the housekeeping while David went to work. This was not a lifestyle Celina was accustomed to having been employed and independent for many years. Celina was unable to get employment while on a temporary visa and was therefore entirely financially dependent on David.

One evening, around a month after Celina arrived in Australia, David’s behaviour towards her changed abruptly. It was the child’s birthday and they had planned to collect the child from the mother’s house and go out for dinner. Celina had prepared and wrapped presents. David refused to allow Celina to travel in the car on the basis that it would upset the child’s mother. Instead, she was dropped somewhere close to a big junction on the way and was pushed out of the car by force. In the middle of an unfamiliar area, she walked down the street and stopped at a supermarket and decided to wait there as it was getting dark and she didn’t know where else to go being still new to Australia. She was left for several hours until David eventually collected her. Celina found herself highly distressed, at night in unfamiliar surrounds, and confused and hurt by David’s inconsiderate treatment. Not knowing what to do, she rang his parents and her own mother (all living overseas) seeking their advice and comfort. She pleaded with David’s father to contact David and ask him to collect her. David’s mother told her that David had a bad temper, but he couldn’t afford to have another marriage fail. Celina’s mother advised that she must try hard to make the marriage work. When David collected Celina later that evening, he shouted abuse at her, claiming that she was trouble and had ruined the child’s birthday, and that he didn’t want a woman who wouldn’t obey him. Once home, David left Celina in the car crying for half an hour then returned and grabbed and shook her violently. Considerably smaller than David, Celina felt scared and weak and asked him to stop; he then dragged her out of the car and pushed her away. Celina fell and hit her head on the concrete driveway resulting in a painful bump to her head and wounded right foot. David dragged her into the house where she laid crying and shaking on the floor while he had a meal. Seemingly to revive her, David began slapping Celina repeatedly on both cheeks, and then tossed a bucket of water over her face. Some hours later, Celina managed to get to her feet and make her way to their bed. In the days following, David apologised to Celina, but remained angry about her contacting the parents and sharing details of their marriage, which he believed should remain private.

Over time, David demanded that Celina take on more and more of the household duties and child caring responsibilities. David began scolding and verbally abusing Celina in the presence of the child. Celina was not allowed a phone of her own; instead, David would give her his personal mobile while he was at work and he would use his office mobile to call her incessantly through the day, principally to tell her what he wanted done and to get details of the meals and snacks she was preparing for the child. When David returned home, he would check the activity and search history on his personal mobile and inspect the food in the fridge and cupboards. So demeaned by this suspicious conduct, Celina decided to document meals and activities through the day by taking digital photographs and loading them on David’s Dropbox so he could inspect and verify them. David only ever gave Celina small amounts of cash to cover public transport costs to and from the child’s school; otherwise, she had no access to any funds. He also accused her of secreting spare coins for her own use. They argued daily about David’s demands and Celina’s resistance to comply. David would often skype his parents and complain to them about Celina being a bad wife, aware that Celina was listening.

Not long after the incident on the child’s birthday, David argued with Celina and, in full view of the child, tried to strangle her. Celina called the police but upon their arrival minimised what had occurred, not telling the police what had actually taken place.

Celina’s mother decided to visit her daughter in Australia and travelled to Australia with David after he had been on a brief visit to their home country. They were to live together in the same house, and Celina’s mother was to share the child’s bedroom. David however insisted that the child sleep between him and Celina while the mother stayed in the other room. Celina tried to talk with David about alternative and more comfortable sleeping arrangements, but he wasn’t amenable. One night, Celina was left with so little room in the bed that she fell out and injured herself. David handed her over to her mother and went back to sleep. Celina and her mother were forced to sleep together in a very small bed. Thereafter, they spent most nights on the couches in the living room. The marital relationship soured, and sexual relations ceased, yet Celina continued to make an effort to look after David’s child and keep the household going despite suffering diarrhoea, headaches, muscle and back pain, and feelings of stress and depression.

Another evening (in the presence of Celina and her mother), David skyped his parents, again complaining about Celina. During the conversation, Celina tried to correct David’s claims and explain her experience of his behaviour. David called her (in their first language) a prostitute and accused her of having sex with her mother because they slept together. He then wielded a coffee cup as if to throw it at her when Celina’s mother physically intervened. Later, as he became increasingly intoxicated, he told them both to leave the house before he turned into an animal; he said he would refuse them food and drinks and get rid of them if they caused trouble. He threatened to separate them and send Celina’s mother back to her home country. When David was asleep, Celina went to a neighbour as she was scared, the neighbour urged Celina to contact the police, however, Celine resisted. Upon returning to the home, David woke and destroyed the wedding photographs hung on the wall by smashing them in front of Celina. Celina and her mother were left totally helpless. At this point, Celina & her mother both went to the neighbour & the neighbour called the police.

The police initiated a protection order application on Celine’s behalf and, at the first mention date, secured a temporary protection order. The police referred Celina to a family violence service provider so as her risk could be assessed & for further assistance such as legal & financial advice after having removed David from the home.

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Criteria for essay/case study	Weight 100%	Areas to be covered	HD	D	C	P	F
Academic writing	40%	§ Questions answered & considered& answered within the parametres outlined§ Citations use as required accurately
Accurate & complete completion of the Adult Risk Assessment & Screening tool	60%	§ Persuasive and sound§ All areas completed with considered responses§ Risk category & factors reflected in Risk Assessment Tool

Criteria for Essay	High Distinction80% – 100 %	Distinction70%- 79%	Credit60-69%	Pass50-59%	Fail<50%
Academic Writing	Demonstrates very clear and good understanding of the subject, very well effective use of outside sources, clear and concise in text citations and referencing.	Demonstrates clear and good understanding of the subject, effective use of outside sources, clear and concise in text citations and referencing.	Demonstrates well understanding of the subject, effective use of outside sources, clear and concise in text citations and referencing.	Demonstrates adequate understanding of the subject, use of outside sources, and in text citations and referencing.	Demonstrates poorly the understanding of the subject, effective use of outside sources, unclear and omitting in text citations and referencing.
Accurate & complete completion of the Adult Risk Assessment & Screening tool	Completely accurate & adequate completion of Adult Risk & Assessment & Screening considering all areas in the Tool	Mostly accurate & adequate completion of Adult Risk & Assessment & Screening considering most areas in the Tool	Mostly accurate completion of Adult Risk & Assessment & Screening considering many areas in the Tool	Adequate completion of Adult Risk & Assessment & Screening with some consideration of areas in the Tool	Poor completion of Adult Risk & Assessment & Screening with little to no consideration of areas in the Tool

RISK ASSESSMENT TOOL

Victim Survivor Details
Full Name:	Alias:
Date of Birth:	Also known as:
Gender:☐Woman/Girl ☐ Man/Boy ☐ Self-described (please specify)☐Client preferred not to say ☐ Unknown	Intersex:☐ Yes☐ No ☐Client preferred not to say☐ Unknown
Transgender:☐ Yes☐ No ☐ Client preferred not to say☐ Unknown	Sexuality:☐ Same sex/gender attracted☐ Heterosexual/other gender attracted☐Multi-gender attracted ☐ Asexual ☐ None of the above☐ Client preferred not to say ☐ Unknown
Primary address:	Current Location:
Contact number:	Comments:
Aboriginal and/or Torres Strait Islander☐Aboriginal ☐Torres Strait Islander☐Both Aboriginal and Torres Strait Islander ☐Client preferred not to say ☐Neither ☐Not known	CALD☐ Yes ☐ No ☐ Not known  LGBTIQ☐ Yes☐ No ☐ Not known  People with disabilities☐ Yes ☐ No ☐ Not known  Rural☐ Yes ☐ No ☐ Not known
Was an interpreter used during this assessment?	☐Yes ☐No (If yes, what language):
Country of birth:	Year of arrival in Australia:
Bridging or Temporary Visa?	☐Yes ☐No (If yes, what type):
Language mainly spoken at home:	Service provider client ID:
Emergency contact:Relationship to victim survivor:	Name:                                                        Contact Number:

Perpetrator Details
Full Name:	Alias:
Date of Birth:	Also known as:
Gender:☐Woman/Girl ☐ Man/Boy ☐ Self-described (please specify)☐Client preferred not to say ☐ Unknown	Intersex:☐ Yes☐ No ☐Client preferred not to say☐ Unknown
Transgender:☐ Yes☐ No ☐ Client preferred not to say☐ Unknown	Sexuality:☐ Same sex/gender attracted☐ Heterosexual/other gender attracted☐Multi-gender attracted ☐ Asexual ☐ None of the above☐ Client preferred not to say ☐ Unknown
Primary address:	Current Location:
Relationship to victim survivor:	Service provider client ID:
Aboriginal and/or Torres Strait Islander☐Aboriginal ☐Torres Strait Islander☐Both Aboriginal and Torres Strait Islander ☐Client preferred not to say ☐Neither ☐Not known	CALD☐ Yes ☐ No ☐ Not known  LGBTIQ☐ Yes☐ No ☐ Not known  People with disabilities☐ Yes ☐ No ☐ Not known  Rural☐ Yes ☐ No ☐ Not known
Further details
PLEASE COMPLETE FURTHER DETAILS HERE

Child 1 Details#
Full Name:	Alias:
Date of Birth:	Also known as:
Gender:☐Woman/Girl ☐ Man/Boy ☐ Self-described (please specify)☐Client preferred not to say ☐ Unknown	Intersex:☐ Yes☐ No ☐Client preferred not to say☐ Unknown
Transgender:☐ Yes☐ No ☐ Client preferred not to say☐ Unknown	Sexuality:☐ Same sex/gender attracted☐ Heterosexual/other gender attracted☐Multi-gender attracted ☐ Asexual ☐ None of the above☐ Client preferred not to say ☐ Unknown
Primary address:	Current Location:
Contact number:	Comments:
Relationship to victim survivor:	Relationship to perpetrator:
Aboriginal and/or Torres Strait Islander☐Aboriginal ☐Torres Strait Islander☐Both Aboriginal and Torres Strait Islander ☐Client preferred not to say ☐Neither ☐Not known	CALD☐ Yes ☐ No ☐ Not known  LGBTIQ☐ Yes☐ No ☐ Not known  People with disabilities☐ Yes ☐ No ☐ Not known  Rural☐ Yes ☐ No ☐ Not known
Child 2 Details#
Full Name:	Alias:
Date of Birth:	Also known as:
Gender:☐Woman/Girl ☐ Man/Boy ☐ Self-described (please specify)☐Client preferred not to say ☐ Unknown	Intersex:☐ Yes☐ No ☐Client preferred not to say☐ Unknown
Transgender:☐ Yes☐ No ☐ Client preferred not to say☐ Unknown	Sexuality:☐ Same sex/gender attracted☐ Heterosexual/other gender attracted☐Multi-gender attracted ☐ Asexual ☐ None of the above☐ Client preferred not to say ☐ Unknown
Primary address:	Current Location:
Contact number:	Comments:
Relationship to victim survivor:	Relationship to perpetrator:
Aboriginal and/or Torres Strait Islander☐Aboriginal ☐Torres Strait Islander☐Both Aboriginal and Torres Strait Islander ☐Client preferred not to say ☐Neither ☐Not known	CALD☐ Yes ☐ No ☐ Not known  LGBTIQ☐ Yes☐ No ☐ Not known  People with disabilities☐ Yes ☐ No ☐ Not known  Rural☐ Yes ☐ No ☐ Not known
Child 3 Details#
Full Name:	Alias:
Date of Birth:	Also known as:
Gender:☐Woman/Girl ☐ Man/Boy ☐ Self-described (please specify)☐Client preferred not to say ☐ Unknown	Intersex:☐ Yes☐ No ☐Client preferred not to say☐ Unknown
Transgender:☐ Yes☐ No ☐ Client preferred not to say☐ Unknown	Sexuality:☐ Same sex/gender attracted☐ Heterosexual/other gender attracted☐Multi-gender attracted ☐ Asexual ☐ None of the above☐ Client preferred not to say ☐ Unknown
Primary address:	Current Location:
Contact number:	Comments:
Relationship to victim survivor:	Relationship to perpetrator:
Aboriginal and/or Torres Strait Islander☐Aboriginal ☐Torres Strait Islander☐Both Aboriginal and Torres Strait Islander ☐Client preferred not to say ☐Neither ☐Not known	CALD☐ Yes ☐ No ☐ Not known  LGBTIQ☐ Yes☐ No ☐ Not known  People with disabilities☐ Yes ☐ No ☐ Not known  Rural☐ Yes ☐ No ☐ Not known

Question	Yes	No	Comments (or not known)
Has anyone in your family done something that made you or your children feel unsafe or afraid?
Is there more than one person in your family that is making you or your children feel unsafe or afraid? (Are there multiple perpetrators)
The following risk related questions refer to the perpetrator:
PERPETRATOR ACTIONS	Have they…
	controlled your day-to-day activities (e.g. who you see, where you go) or put you down?*
	threatened to hurt you in any way?
	physically hurt you in any way (hit, slapped, kicked or otherwise physically hurt you)?
SELF-ASSESSMENT	Do you have any immediate concerns about the safety of your children or someone else in your family?
Do you feel safe when you leave here today?
Would you engage with a trusted person or police if you felt unsafe or in danger?(Note: if lack of trust in police is identified risk management must address this)
Further details
NEEDS AND SAFETY
Needs assessment (Please complete)

https://www.vic.gov.au/maram-practice-guides-and-resources

Worth 30%

Please study the case study below and conduct a risk assessment as per the Adult Screening Tool found on Moodle under Assessment 3.

All professionals working with victim survivors should use the Screening and Identification Tool, either applied routinely when this is a part of your professional role or service, or when indicators of family violence are identified.

Screening is not an activity that occurs only once by a single professional or within a service. In service settings where a person has multiple contacts, it is necessary to screen over time and at each contact to ensure any changes in the relationship or use of violence is identified.

Adult Screening Tool

In addition to the screening tool, students are required to submit an accompanying Word document (with an Assessment Cover Sheet), responding to the following questions about the case study. Responses should be 750 words in total. (Please use references correctly when answering the questions below)

Questions:

1. What forms of domestic/family violence has David used against Celina?
2. How has having no financial control affected Celina?
3. What might a community service worker in the domestic/family violence area want to consider when working with Celina to ensure that Celina and also her mother are provided with safe, sensitive and effective support?

CASE STUDY

Celina and David grew up in the same country of origin, however, at the time they met through an online dating website, David had been living in Australia for 7 years, and Celina was still living in her home country with her mother. Both Celina and David have been married previously, are professionally qualified and aged in their thirties. David has a primary-school age child who lives with his former wife and spends regular weekend and holiday time with David. After Celina and David married overseas, David promptly returned to Australia and Celina applied to Australian Immigration for a joint visa with David as the sponsor. When the visa was granted, Celina resigned from her professional employment and travelled to Australia to live with David.

Celina speaks fondly of her early days living with David. She described him as gentlemanly, respectful, loving and enthusiastic about showing her the sights of the exciting city she had moved to. Celina had experienced stigma in her own culture due to being a divorced woman and felt that her marriage to David restored her dreams for a good life and a family. She was committed to supporting David in caring for his child, and believes she made a genuine effort to build a relationship. When the child was staying with Celina and David, Celina would take care of the child’s needs, prepare meals and do the housekeeping while David went to work. This was not a lifestyle Celina was accustomed to having been employed and independent for many years. Celina was unable to get employment while on a temporary visa and was therefore entirely financially dependent on David.

One evening, around a month after Celina arrived in Australia, David’s behaviour towards her changed abruptly. It was the child’s birthday and they had planned to collect the child from the mother’s house and go out for dinner. Celina had prepared and wrapped presents. David refused to allow Celina to travel in the car on the basis that it would upset the child’s mother. Instead, she was dropped somewhere close to a big junction on the way and was pushed out of the car by force. In the middle of an unfamiliar area, she walked down the street and stopped at a supermarket and decided to wait there as it was getting dark and she didn’t know where else to go being still new to Australia. She was left for several hours until David eventually collected her. Celina found herself highly distressed, at night in unfamiliar surrounds, and confused and hurt by David’s inconsiderate treatment. Not knowing what to do, she rang his parents and her own mother (all living overseas) seeking their advice and comfort. She pleaded with David’s father to contact David and ask him to collect her. David’s mother told her that David had a bad temper, but he couldn’t afford to have another marriage fail. Celina’s mother advised that she must try hard to make the marriage work. When David collected Celina later that evening, he shouted abuse at her, claiming that she was trouble and had ruined the child’s birthday, and that he didn’t want a woman who wouldn’t obey him. Once home, David left Celina in the car crying for half an hour then returned and grabbed and shook her violently. Considerably smaller than David, Celina felt scared and weak and asked him to stop; he then dragged her out of the car and pushed her away. Celina fell and hit her head on the concrete driveway resulting in a painful bump to her head and wounded right foot. David dragged her into the house where she laid crying and shaking on the floor while he had a meal. Seemingly to revive her, David began slapping Celina repeatedly on both cheeks, and then tossed a bucket of water over her face. Some hours later, Celina managed to get to her feet and make her way to their bed. In the days following, David apologised to Celina, but remained angry about her contacting the parents and sharing details of their marriage, which he believed should remain private.

Over time, David demanded that Celina take on more and more of the household duties and child caring responsibilities. David began scolding and verbally abusing Celina in the presence of the child. Celina was not allowed a phone of her own; instead, David would give her his personal mobile while he was at work and he would use his office mobile to call her incessantly through the day, principally to tell her what he wanted done and to get details of the meals and snacks she was preparing for the child. When David returned home, he would check the activity and search history on his personal mobile and inspect the food in the fridge and cupboards. So demeaned by this suspicious conduct, Celina decided to document meals and activities through the day by taking digital photographs and loading them on David’s Dropbox so he could inspect and verify them. David only ever gave Celina small amounts of cash to cover public transport costs to and from the child’s school; otherwise, she had no access to any funds. He also accused her of secreting spare coins for her own use. They argued daily about David’s demands and Celina’s resistance to comply. David would often skype his parents and complain to them about Celina being a bad wife, aware that Celina was listening.

Not long after the incident on the child’s birthday, David argued with Celina and, in full view of the child, tried to strangle her. Celina called the police but upon their arrival minimised what had occurred, not telling the police what had actually taken place.

Celina’s mother decided to visit her daughter in Australia and travelled to Australia with David after he had been on a brief visit to their home country. They were to live together in the same house, and Celina’s mother was to share the child’s bedroom. David however insisted that the child sleep between him and Celina while the mother stayed in the other room. Celina tried to talk with David about alternative and more comfortable sleeping arrangements, but he wasn’t amenable. One night, Celina was left with so little room in the bed that she fell out and injured herself. David handed her over to her mother and went back to sleep. Celina and her mother were forced to sleep together in a very small bed. Thereafter, they spent most nights on the couches in the living room. The marital relationship soured, and sexual relations ceased, yet Celina continued to make an effort to look after David’s child and keep the household going despite suffering diarrhoea, headaches, muscle and back pain, and feelings of stress and depression.

Another evening (in the presence of Celina and her mother), David skyped his parents, again complaining about Celina. During the conversation, Celina tried to correct David’s claims and explain her experience of his behaviour. David called her (in their first language) a prostitute and accused her of having sex with her mother because they slept together. He then wielded a coffee cup as if to throw it at her when Celina’s mother physically intervened. Later, as he became increasingly intoxicated, he told them both to leave the house before he turned into an animal; he said he would refuse them food and drinks and get rid of them if they caused trouble. He threatened to separate them and send Celina’s mother back to her home country. When David was asleep, Celina went to a neighbour as she was scared, the neighbour urged Celina to contact the police, however, Celine resisted. Upon returning to the home, David woke and destroyed the wedding photographs hung on the wall by smashing them in front of Celina. Celina and her mother were left totally helpless. At this point, Celina & her mother both went to the neighbour & the neighbour called the police.

The police initiated a protection order application on Celine’s behalf and, at the first mention date, secured a temporary protection order. The police referred Celina to a family violence service provider so as her risk could be assessed & for further assistance such as legal & financial advice after having removed David from the home.

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CLICK HERE TO MAKE YOUR ORDER

TO BE RE-WRITTEN FROM THE SCRATCH

NO PLAGIARISM

• Original and non-plagiarized custom papers- Our writers develop their writing from scratch unless you request them to rewrite, edit or proofread your paper.
• Timely Delivery– primewritersbay.com believes in beating the deadlines that our customers have imposed because we understand how important it is.
• Customer satisfaction- Customer satisfaction. We have an outstanding customer care team that is always ready and willing to listen to you, collect your instructions and make sure that your custom writing needs are satisfied
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Criteria for essay/case study	Weight 100%	Areas to be covered	HD	D	C	P	F
Academic writing	40%	Questions answered & considered& answered within the parametres outlinedCitations use as required accurately
Accurate & complete completion of the Adult Risk Assessment & Screening tool	60%	Persuasive and sound All areas completed with considered responsesRisk category & factors reflected in Risk Assessment Tool

Criteria for Essay	High Distinction 80% – 100 %	Distinction 70%- 79%	Credit 60-69%	Pass 50-59%	Fail <50%
Academic Writing	Demonstrates very clear and good understanding of the subject, very well effective use of outside sources, clear and concise in text citations and referencing.	Demonstrates clear and good understanding of the subject, effective use of outside sources, clear and concise in text citations and referencing.	Demonstrates well understanding of the subject, effective use of outside sources, clear and concise in text citations and referencing.	Demonstrates adequate understanding of the subject, use of outside sources, and in text citations and referencing.	Demonstrates poorly the understanding of the subject, effective use of outside sources, unclear and omitting in text citations and referencing.
Accurate & complete completion of the Adult Risk Assessment & Screening tool	Completely accurate & adequate completion of Adult Risk & Assessment & Screening considering all areas in the Tool	Mostly accurate & adequate completion of Adult Risk & Assessment & Screening considering most areas in the Tool	Mostly accurate completion of Adult Risk & Assessment & Screening considering many areas in the Tool	Adequate completion of Adult Risk & Assessment & Screening with some consideration of areas in the Tool	Poor completion of Adult Risk & Assessment & Screening with little to no consideration of areas in the Tool

RISK ASSESSMENT TOOL

Victim Survivor Details
Full Name:	Alias:
Date of Birth:	Also known as:
Gender: ☐Woman/Girl ☐ Man/Boy ☐ Self-described (please specify) ☐Client preferred not to say ☐ Unknown	Intersex: ☐ Yes☐ No ☐Client preferred not to say ☐ Unknown
Transgender: ☐ Yes☐ No ☐ Client preferred not to say ☐ Unknown	Sexuality: ☐ Same sex/gender attracted ☐ Heterosexual/other gender attracted ☐Multi-gender attracted ☐ Asexual ☐ None of the above ☐ Client preferred not to say ☐ Unknown
Primary address:	Current Location:
Contact number:	Comments:
Aboriginal and/or Torres Strait Islander ☐Aboriginal ☐Torres Strait Islander ☐Both Aboriginal and Torres Strait Islander ☐Client preferred not to say ☐Neither ☐Not known	CALD☐ Yes ☐ No ☐ Not known   LGBTIQ☐ Yes☐ No ☐ Not known   People with disabilities☐ Yes ☐ No ☐ Not known   Rural☐ Yes ☐ No ☐ Not known
Was an interpreter used during this assessment?	☐Yes ☐No (If yes, what language):
Country of birth:	Year of arrival in Australia:
Bridging or Temporary Visa?	☐Yes ☐No (If yes, what type):
Language mainly spoken at home:	Service provider client ID:
Emergency contact: Relationship to victim survivor:	Name:                                                         Contact Number:

Perpetrator Details
Full Name:	Alias:
Date of Birth:	Also known as:
Gender: ☐Woman/Girl ☐ Man/Boy ☐ Self-described (please specify) ☐Client preferred not to say ☐ Unknown	Intersex: ☐ Yes☐ No ☐Client preferred not to say ☐ Unknown
Transgender: ☐ Yes☐ No ☐ Client preferred not to say ☐ Unknown	Sexuality: ☐ Same sex/gender attracted ☐ Heterosexual/other gender attracted ☐Multi-gender attracted ☐ Asexual ☐ None of the above ☐ Client preferred not to say ☐ Unknown
Primary address:	Current Location:
Relationship to victim survivor:	Service provider client ID:
Aboriginal and/or Torres Strait Islander ☐Aboriginal ☐Torres Strait Islander ☐Both Aboriginal and Torres Strait Islander ☐Client preferred not to say ☐Neither ☐Not known	CALD☐ Yes ☐ No ☐ Not known   LGBTIQ☐ Yes☐ No ☐ Not known   People with disabilities☐ Yes ☐ No ☐ Not known   Rural☐ Yes ☐ No ☐ Not known
Further details
PLEASE COMPLETE FURTHER DETAILS HERE

Child 1 Details#
Full Name:	Alias:
Date of Birth:	Also known as:
Gender: ☐Woman/Girl ☐ Man/Boy ☐ Self-described (please specify) ☐Client preferred not to say ☐ Unknown	Intersex: ☐ Yes☐ No ☐Client preferred not to say ☐ Unknown
Transgender: ☐ Yes☐ No ☐ Client preferred not to say ☐ Unknown	Sexuality: ☐ Same sex/gender attracted ☐ Heterosexual/other gender attracted ☐Multi-gender attracted ☐ Asexual ☐ None of the above ☐ Client preferred not to say ☐ Unknown
Primary address:	Current Location:
Contact number:	Comments:
Relationship to victim survivor:	Relationship to perpetrator:
Aboriginal and/or Torres Strait Islander ☐Aboriginal ☐Torres Strait Islander ☐Both Aboriginal and Torres Strait Islander ☐Client preferred not to say ☐Neither ☐Not known	CALD☐ Yes ☐ No ☐ Not known   LGBTIQ☐ Yes☐ No ☐ Not known   People with disabilities☐ Yes ☐ No ☐ Not known   Rural☐ Yes ☐ No ☐ Not known
Child 2 Details#
Full Name:	Alias:
Date of Birth:	Also known as:
Gender: ☐Woman/Girl ☐ Man/Boy ☐ Self-described (please specify) ☐Client preferred not to say ☐ Unknown	Intersex: ☐ Yes☐ No ☐Client preferred not to say ☐ Unknown
Transgender: ☐ Yes☐ No ☐ Client preferred not to say ☐ Unknown	Sexuality: ☐ Same sex/gender attracted ☐ Heterosexual/other gender attracted ☐Multi-gender attracted ☐ Asexual ☐ None of the above ☐ Client preferred not to say ☐ Unknown
Primary address:	Current Location:
Contact number:	Comments:
Relationship to victim survivor:	Relationship to perpetrator:
Aboriginal and/or Torres Strait Islander ☐Aboriginal ☐Torres Strait Islander ☐Both Aboriginal and Torres Strait Islander ☐Client preferred not to say ☐Neither ☐Not known	CALD☐ Yes ☐ No ☐ Not known   LGBTIQ☐ Yes☐ No ☐ Not known   People with disabilities☐ Yes ☐ No ☐ Not known   Rural☐ Yes ☐ No ☐ Not known
Child 3 Details#
Full Name:	Alias:
Date of Birth:	Also known as:
Gender: ☐Woman/Girl ☐ Man/Boy ☐ Self-described (please specify) ☐Client preferred not to say ☐ Unknown	Intersex: ☐ Yes☐ No ☐Client preferred not to say ☐ Unknown
Transgender: ☐ Yes☐ No ☐ Client preferred not to say ☐ Unknown	Sexuality: ☐ Same sex/gender attracted ☐ Heterosexual/other gender attracted ☐Multi-gender attracted ☐ Asexual ☐ None of the above ☐ Client preferred not to say ☐ Unknown
Primary address:	Current Location:
Contact number:	Comments:
Relationship to victim survivor:	Relationship to perpetrator:
Aboriginal and/or Torres Strait Islander ☐Aboriginal ☐Torres Strait Islander ☐Both Aboriginal and Torres Strait Islander ☐Client preferred not to say ☐Neither ☐Not known	CALD☐ Yes ☐ No ☐ Not known   LGBTIQ☐ Yes☐ No ☐ Not known   People with disabilities☐ Yes ☐ No ☐ Not known   Rural☐ Yes ☐ No ☐ Not known

Question	Yes	No	Comments (or not known)
Has anyone in your family done something that made you or your children feel unsafe or afraid?
Is there more than one person in your family that is making you or your children feel unsafe or afraid? (Are there multiple perpetrators)
The following risk related questions refer to the perpetrator:
Perpetrator actions	Have they…
	controlled your day-to-day activities (e.g. who you see, where you go) or put you down?*
	threatened to hurt you in any way?
	physically hurt you in any way (hit, slapped, kicked or otherwise physically hurt you)?
SELF-ASSESSMENT	Do you have any immediate concerns about the safety of your children or someone else in your family?
Do you feel safe when you leave here today?
Would you engage with a trusted person or police if you felt unsafe or in danger? (Note: if lack of trust in police is identified risk management must address this)
Further details
NEEDS AND SAFETY
Needs assessment (Please complete)

https://www.vic.gov.au/maram-practice-guides-and-resources