Enclosure (8) to COMDTINST 1754.12
WORK-LIFE SUPERVISORS' CHECKLIST
WHAT TO LOOK FOR IN A FAMILY ADVOCACY CASE RECORD
1.
Copy of Child/Spouse Abuse Incident Report(s), Form 5488, updated whenever there is a change in
case status, new allegation transfer or closure.
2.
Standardized Family Advocacy documentation format completed correctly. Initial risk assessment has
been properly recorded. There is an updated risk assessment every 30 to 60 days.
3.
On-going specific documentation in case notes identifying all contacts (family, member and
civilian/military agencies) by telephone, face-to-face or written. Frequency of documentation necessary
will vary as to status of case, i.e., serious may be daily until services are in place and/or determination is
made progressing to several times a week, moderate may be several times a month, etc.
4.
Each entry in the case must be dated and signed by the FPA.
5.
Case documentation must include non-judgmental written assessments and statements which denote
only factual events without personal opinions, thoughts and/or feelings.
6.
Other documentation which should be included in a Family Advocacy case record may include: CRC
recommendations to the FPA; psychological evaluations; medical information; letters from local Child
Protective Services; investigative reports; letters from commands; or anything else relevant to the case.
7.
When cases are closed or transferred, the standardized Family Advocacy Closing or Transfer Summary
Sheet must be filled out with the proper information, dated and signed by the FPA and initialed by the
Work-Life Supervisor.
8.
No case record documentation may be copied and released locally. The case record must stay in the
possession of the FPA at all times. If CGI or a command has need to review the record, it must be done
in the presence of the FPA. If CGI needs a copy of anything in the family advocacy case record, they
must request the information in writing and that part may be copied and given to them.
WHAT TO LOOK FOR IN A SPECIAL NEEDS CASE RECORD
1.
Copy of Coast Guard Special Needs Enrollment and Assessment Form(s) (updated every two years or
sooner if warranted). There should be one Completed form for every family member with special
needs.
2.
For every enrollment form in the record, there must be supportive documentation, i.e., medical,
educational and/or psychological. This information shall also be updated at least every 2 years, or
whenever there has been a significant change in the special needs condition. (Note: Repeated attempts
to acquire documentation are noted in the file if documentation is absent.)
3.
Standardized Special Needs documentation format completed correctly.
4.
On-going specific documentation in case notes identifying all contacts (family, member and
civilian/military agencies) by telephone, face-to-face or written. Frequency of documentation necessary
will vary as to status of case, i.e., serious may be daily until services are in place or problem has become
manageable progressing then to several times a week, moderate may be several times a month, and
maintenance may be once or twice per year. At a minimum, there should be case note
documentation and contact with the member or family recorded in each special needs case once a
year.
5.
Each Special Needs case shall be assigned a level in accordance with appropriate risk factors and
criteria by agreement of both the DRC and FPA and that level recorded in the case documentation.
Whenever the level increases or decreases, a notation must be made in the record. All cases with an
assigned level of 4 or 5 shall be case managed exclusively by the FPA. Level 3 may be managed by the
DRC in conjunction with the FPA.
6.
Each entry in the case must be dated and signed by the DRC, whenever the assigned level is 1, 2 or 3, in
accordance with criteria of the level assigned. Level 3 cases may be signed by the DRC if done in
conjunction with the FPA.
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