APPENDIX A

APPENDIX B

Ministry of Community and Social Services Ministry of Children and Youth Services South East Region 11 Beechgrove Lane Kingston, ON K7M 9A6 Reception 613-545-0539 Toll Free 1-800-646-3209 Fax 613-536-7272

Ministère des Services sociaux et communautaires Ministère des Services a l'enfance et à la jeunesse Region sud-est 11, ruelle Beechgrove Kingston, ON K7M 9A6 Reception 613-545-0539 Sans Frais 1-800-646-3209 Telecopieur 613-536-7272

December 5, 2011

Mr. William. Sweet Executive Director Children's Aid Society of the County of Prince Edward P.O. Box 1510 16 MacSteven Drive Picton ON K0K 2T0

Dear Mr. Sweet:

Re: 2011 Licensing Report - Foster Care Program

This licensing report is based on the site visits of October 24, 25 and 26, 2011, which were conducted by Pat Tretina and Sandra Lowe, Program Advisors, South Bast Region, Ministry of Children and Youth Services, and the responses received from your agency on November 7th, 2011. The following is the program information, the review data summary and responses.

Program Information

Program:

Foster Care - Transfer Payment Agency

Number of Homes:

32 active homes

Review Data

Checklist:

Utilized Foster Care Licensing Checklist

Interviews:

Management

1 (at initial review)

Staff:

2

Foster Parents:

3

Youth:

2

Files Reviewed:

Foster Parents:

4 1 closed

Children's Files:

3 1 closed

Policies and Procedures

Policies and Procedures were reviewed as part of the initial licensing review in May 2011. Effective August 1, 2011, the operator has developed and implemented policies and procedures compliant with the Ministry of Children and Youth Services new and amended policy requirements for Safe Administration, Storage and Disposal of Medication, and Improved Communication and Transfer of Medication Information

Licensing Issues Identified During the October 2011 Review

1. Foster Care Plan Review (Reg 70, Section 115)
   On one youth's file, Plan of Care appears to be done on time; however it is only signed by the Supervisor. The youth in on Temporary Care Agreement and the Plan of Care does not include the involvement of the parent.

   Directive:

   Ensure that all parties involved in Plans of Care sign the document at completion. Ensure that when a youth's parent is not involved, the reason is provided.

   Response:

   The agency has not provided a response.

   Status:

   Ensure that the Plan of Care is signed by all parties involved and their is a notation of why the child's parent was not involved. This will be a Term and Condition of the License.

   On one youth's Plan of Care, several goals remain in progress for a long period of time.

   Directive:

   Ensure youth's goals identify desired outcomes within specified timeframes.

   Response:

   The agency has not provided a response.

   Status:

   Ensure that the goal identified on this youth's Plan of Care identify outcomes within specified timeframes. This will be a Term and Condition of the License.

   On one youth's file, Plans of Care were not completed at required timeframes, goals appeared to be "in progress" yet were out of date -and Supervisory sign off did not occur for one year.

   Directive:

   Ensure youth's Plans of Care are completed on time and are signed by the supervisor. Ensure that youth's goals identify desired outcomes within specified timeframes.

   Response:

   The Supervisor has reviewed the file with the Child in Care Worker. The first Plan of Care was not completed and created a sequence of problems where the subsequent Plan of Care recordings were all late. The goals on Plans of Care are under review for proper alignment with the youth's development.

   Status:

   Ensure timely completion of Plans of Care and signing of Plans of Care, as well as a review of youth's goals and timeframes. This will be a Term and Condition of the licensing report

2. Social History (Regulation 70, Section 111(7)(8)
   On one youth's file reviewed the Social History was not completed within the required timeframes.

   Directive:

   Ensure that the Social History for a youth is initiated within 60 days of placement and updated annually.

   Response:

   The Supervisor discussed the late completion of the Social History with the Child in Care Staff. The sixty day deadline for completion of the initial Social History has been confirmed.

   Status:

   Compliance of Social History timeframes was a term and condition on the 2008, and.2009 and 2010 license. This will remain a term and condition of the 2011 license.

3. Health Care Responsibilities (Policy Directive 0203-03)
   On one youth's file the intake medical was completed significantly late. There did not appear to be a notation on file for, the delay.

   Directive:

   Ensure that youth have a medical and dental assessment at admission and annually thereafter.

   Response:

   The agency has not provided a response.

   Status:

   Ensure that youth have a medical and dental assessment at admission and annually thereafter. This will be a Term and Condition of the 2011 license.

   On one youth's file, the annual dental check up was 4 months delayed. Reason for delay was not noted. The dentist recommended an Orthodontic consultation. There were no notes on file to indicate this occured Optometrist appointment for this youth in September 2010 recommended a 6 month, follow up. No notes on file to indicat if this occured.

   Directive:

   Ensure that medical and dental reviews are completed annually and that recommendations made during treatment are followed up.

   Response:

   The agency has not provided a response.

   Status:

   Ensure that medical and dental reviews are completed annually and that recommendations made during treatment are followed up. This will be a Term and Condition of the 2011 license.

4. Review of Children's Rights (Policy Directive 0202-09)
   One youth's file does not indicate the youth's Rights and Responsibilities were reviewed at required intervals.

   Directive:

   Youth should be made aware of their Rights and Responsibilities at admission to care again at the Plan of Care that occurs one month, after placement, and minimally, every six months thereafter.

   Response:

   The agency has not provided a response.

   Status:

   Youth should be made aware of their Rights and Responsibilities at admission to care, again at the Plan of Care that occurs one month after placement, and minimally, every six months thereafter. This will be a Term and Condition of the 2011 license.

5. Supervision and Support of Foster Home (Regulation 70, Section 121)

   Directive:

   Ensure that the file contains records of scheduled home visits. Staff should visit the foster home where a child is placed and meet with the youth and the foster parents within 7 days of placement, again within 30 days of placemenet and minimally, every three months thereafter.

   On one Foster Parent file, the supervision visits appear to be 5 months apart.

   Response:

   The Resource Worker visited the home at required intervals but recorded the visits in the general case note section of the file, not in the visit note section.

   On one foster parent file, there was no record of Resource Worker visits between March 1st, 2011 and August 19th, 2011.

   Response:

   The Resource Worker did visit the home in May 2011 for the annual review. The visits were not separately recorded.

   On one youth's file, there was no record of a face to face meeting between, the child and her worker from March 29th, 2011 to June 23rd, 2011 and no indication of a private visit after that date.

   Response:

   The agency has not provided a response.

   Status:

   This will be a Term and Condition of the 2011 license.

6. The Home Study Decision (Policy Directive 0207-05).
   One home was deemed a place of safety and opened in December 2010. The home study was not completed and input electronically until October 2011. This document is still not approved.

   Directive:

   When a home is deemed a place of safety, final documentation should be completed as soon as possible.

   Response:

   The Resource Worker responsible for the home study has limited experience and was unclear on time lines for completion. The Executive Director was acting as an interim Resource Supervisor and the supervisory oversight provided was not adequate. The home study is under review with the expectation of completion by month's end.

   Status:

   Completion of the Home Study and Approval will be a Term and Condition of the 2011 license.

7. Approval of a Foster Home (Regulation 70, Section 118)
   On two Foster Parent files, the initial CPIC clearly states that it does not include Vulnerable Sector Screening.

   Directive:

   As part of the Home Study approval, the file must contain a CPIC report and include Vulnerable Sector Screening.

   Response:

   An error was made when submitting the request for the CPIC of fee foster parents. The second form that includes Vulnerable Sector Screening was not submitted. This is now in process.

   Status:

   CPIC reports with Vulnerable Sector Screening for the two foster parent families will be a Term and Condition of the 2011 license.

   On one foster parent file, the records only included two reference checks. Directive: A single foster parent applicant is required to have three references on file.

   Response:

   The agency has not provided a response.

   Status:

   A single foster parent applicant is required to have three references on file. This will be a Term and Condition of the 2011 license.

   On two foster parent files, the Home Safety Checklist was hot completed in full and all non compliances had not been addressed

   Directive:

   Ensure that the Home Safety Checklist is completed and signed and all areas of non compliance are addressed before a youth is placed in the the home.

   Response:

   A new Home Safety Checklist is to be completed and signed by the foster parents and the workers.

   Status:

   Ensure that the Home Safety Checklist is completed and signed and all areas of non-compliance are addressed before a youth is placed in the the home. This will be a Term, and Condition of me 2011 license.

8. Screening/Reference Checks on all adults in Foster Family Household (Policy Directive 0202-05)

   Directive:

   Legislation requires, in all circumstances, that individuals over the age of 18 provide CPIC reports that include Vulnerable Sector Screening.

   On one foster family file, their █​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█. On one foster family file, there is an █​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█ and previously, an adult son resided in me home for a period of time in 2011. There were no CPIC's or Vulnerable Sector Screening done on any of these adults.

   Response:

   There is some question among Societies on the practice. Resources Staff have been advised by other Societies that the practice is not to request a Criminal Reference Check where a long time resident or family member turns 18 and where the Society is familiar with the person. It would be our preference to follow this practice.

   Status:

   Verification will be required that the adults identified provide a CPIC, with Vulnerable Sector Screening. CPIC reports that include VSS for all individuals in a foster home that are over the age of 18 will be a Term and Condition of the 2011 license.

9. Foster Home Review (Policy Directive 0207-11)

   Directive:

   Foster parent files are to contain an Annual Review signed by the foster parent, the Resource Worker and the Supervisor.

   Two foster home annual reviews completed in 2010 were not approved by the Supervisor until May 12, 2011.

   Response:

   The Resource Worker assigned worked in Resources on an interim basis. Knowledge of timelines of document completion was not satisfactory and supervisory over sight did not capture the delay.

   One foster home review was completed 7 weeks late.

   Response:

   The requirement that Foster Home annual reviews are written, complete and signed by the worker, foster parents and supervisor, due on anniversary dates, has been reviewed with Resources staff.

   Status:

   Timely completion and sign off of annual reviews will be a Term and Condition of the 2011 license.

10. Foster Care Service Agreement (Regulation 70, Section 120)
    On two foster parent files, the Service Agreement was not completed at time of approval and opening of me home. Service Agreements were completed significantly later. On one foster parent file, the Service Agreement completed in July 2010 was not signed by the Supervisor until October 2011

    Directive:

    The Service Agreement is to be signed by the foster parent, the Resource Worker and the Supervisor on approval of the home and reviewed annually.

    Response:

    The agency practice is to review the terms of a service agreement on the opening of a home as part of orientation. This requirement has been reviewed with Resources Staff following the licensing review. The Resources Supervisor will be monitoring completion of Service Agreements on home openings and during each annual review. The expectation that the Service Agreements are provided promptly to the Supervisor has been reviewed with Resources Staff.

    Status:

    Completion of Service Agreements at the opening.of a home, and each, annual review will be a Term and Condition of the 2011 license.

11. Learning about a Placement after a Child Leaves (Policy Directive 0202-07)
    On two youths' files, post placement notes could not be located for each placement a youth had left. On one foster parent file, three youth had been placed in the home, post placement notes were found in two cases. Notes were also found on one foster parent post placement contact addressing concerns they had There was no record of how these concerns were addressed

    Directive:

    Post placement contact is to be made with a youth and the foster parent when a youth leaves a placement in which they have resided for 30 days of more. A process should also be in place to address concerns of the post placement meetings.

    Response:

    Post placement has been addressed with one youth. Staff involved and recording of responses to foster parent concerns is driven by the nature of the complaint Where the concern is with Resource services, the Resource Worker is responsible to report to the Resource Supervisor. Efforts made to resolve the concerns are recorded in the foster family file. - Where a question is beyond. Resources, other staff and supervisors are involved in resolving concerns.

    Status:

    Completion of Post Placement notes when a youth leaves a placement in which they resided for 30 days or more will be a term and condition of the 2011 licenses.

12. Emergency, Fire, Safety and Health Protection (Policy Directive 0205-04).
    A fire safety plan was not posted in one foster parent home. There were some concerns as to whether the youth in the home was familiar with the plan and would exit the home in case of fire.

    Directive:

    Ensure that the fire safety plan has been posted and reviewed with the youth in the home.

    Response:

    The Resource Worker met with, the foster parent to have the fire escape plan posted and discuss what to do in the event of fire.

    Status:

    The Society is to ensure that the fire safety plan has also been reviewed with the youth. This will be a Term and Condition of the 2011 license.

Licensing Issues Identified During the May 2011 Review

1. Foster Plan of Care Review (Reg. 70, Section 115)
   On two youths' files that were reviewed in May 2011, goals on the Plans of Care were virtually unchanged. This still appears to be the same when reviewed in October 2011.

   Directive:

   Ensure youths' goals identify desired outcomes within specified timeframes.

   Response:

   The October 2011 Plans of Care have been completed. The Child in Care Supervisor is reviewing goals in response to question of relevance. Supervisors have been asked to review goal development with all Child in Care Staff to develop goals that are more time sensitive and measurable.

   Status:.

   This will be a Term and Condition of the 2011 license.

2. Supervision and Support of a Foster Home (Reg. 70, Section 121)
   One foster family file reviewed.in May 2011 did not show, any resource visits after April 2011. An annual review was completed in June 2011 in which only the foster mother was present. The licensing review in October 2011 does not indicate follow up.

   Response:

   Resource staff and Child in Care staff are experiencing difficulties in setting up visits with this family. The Child in Care Supervisor is scheduling a meeting with the family to repeat the expectation for regular meetings.

   Status:

   The outcome of this meeting will be a Term and Condition of the 2011 license.

3. Approval of a Foster Home (Regulation 70, Section 118)
   On one foster parent file, it was noted in May 2011 that the foster father did not have a medical assessment on file. This file was reviewed again in October 2011. There does not appear to be a Resource visit since April 19, 2011 and the issue of the medical has not been addressed.

   Directive:

   All foster parents are required to have a medical assessment prior to approval.

   Response:

   The foster family is considering closing their home. If the decision is made to continue, the foster parent will be required to provide a medical assessment.

   Status:

   Follow up of the foster parent medical assessment or closure will be a Term and Condition of the 2011 license.

The agency has failed to address all of the issues raised during the licensing review. A Provisional License will be issued which will expire on May 15, 2012, with the following Terms and Conditions:-

1. Terms and Conditions attached as Schedule "A".
2. The Society is to provide written verification to the Ministry's Program Advisor by December 31, 2011, that the Plan of Care for the youth identified in the licensing review has been signed and reviewed with the youth's parent
3. The Society is to provide written verification to the Ministry's Program Advisor by December 31, 2011, that goals on the youth's Plan of Care identified in the licensing review are addressed and identify outcomes with specified timeframes.
4. The Society is to ensure timely completion and signing of Plans of Care which include review of all youths' goals.
5. The Society is to ensure timely completion of youths' Social Histories.
6. The Society is to provide written verification to the Ministry's Program Advisor by December 31, 2011, that a file notation has been made addressing the late medical intake for the youth identified in the licensing review.
7. The Society is to provide written verification to the Ministry's Program Advisor by December 31, 2011, that a notation is placed on file for the late dental appointment for the youth identified in the licensing review and that Orthodontic and Optical appointments have been addressed.
8. The Society is to provide written verification to the Ministry's Program Advisor by December 31, 2011, that Rights and Responsibilities have been reviewed with the youth identified in the licensing review.
9. The Society is to provide written verification to the Ministry's Program Advisor by December 31, 2011, that private meetings have taken place between the worker and the youth identified in the licensing review.
10. The Society will ensure that when a home is deemed a place of safety, there will be timely completion of the home study and approval process.
11. The Society is to provide written verification to the Ministry's Program Advisor by December 31, 2011, that the two families identified in the licensing report have provided Vulnerable Sector Screening.
12. The Society is to provide written verification to the Ministry's Program Advisor by December 31, 2011; that the foster parent identified in the licensing review has provided a third reference.
13. The Society is to provide written verification to the Ministry's Program Advisor by December 31, 2011, that the home safety checklist has been completed in full for the two foster parents identified in the licensing review.,
14. The Society is to provide written verification to the Ministry's Program Advisor by December 31, 2011, that the adults identified in the licensing review have provided CFTC's with Vulnerable Sector Screening.
15. The Society will ensure that CTIC's with Vulnerable Sector Screening are obtained for all adults in foster homes that are over the age of eighteen (18).
16. The Society will ensure timely completion and sign off of Foster Parent Annual Reviews.
17. The Society will ensure that Service Agreements are completed upon opening of a foster home and updated at each annual review.
18. The Society will ensure that there are post placement meetings with youth and foster parents when a youth leaves a placement in which they have resided for 30 days or more.
19. The Society is to provide written verification to the Ministry's Program Advisor by December 31, 2011, that a fire safety plan has been reviewed with the youth identified in the licensing review.
20. The Society is to provide written verification to the Ministry's Program Advisor by December 31, 2011, that the youth identified in the licensing report in May 2011 has had Plan of Care goals addressed.
21. The Society is to provide written verification to the Ministry's Program Advisor by December 31, 2011, that the foster family identified in the May 2011 licensing review has had regular foster home visits and that expectations for regular meetings have been reviewed.-
22. The Society is to provide written verification to the Ministry's Program Advisor by December 31, 2011, that the foster parent indicated in the May 2011 licensing review has provided a medical assessment or the home has been closed.

The operator of this foster care program is responsible to ensure the requirements of the Child and Family Services Act are met and maintained at all times. If you have any questions or concerns regarding licensing, please contact me at 1-800-646-3209, ext. 7266.

Yours truly,

Sandra Lowe Program Advisor Program & Compliance Review South East Region

c: Anne Moloney, Program Supervisor

APPENDIX C

Crown Ward Review
Agency Report

Society:

The Children's Aid Society of the County of Prince Edward

Review Dates:

April 18-April 20, 2011

Post Review Meeting:

April 21, 2011

Program Supervisor:

Anne Moloney

Manager CWR Unit

Ron Cormier

Reviewers:

Judith Nailer (lead), Nancy Sweete (co-lead), Linda Linklater. Jo-Anne Harington

OVERVIEW

28 Crown wards reviewed  5 Crown wards reviewed for the first time 23 Crown wards previously reviewed 22 Crown wards completed confidential questionnaires  1 Crown wards requested an interview  █ Crown wards of native heritage, of which,  █     Status Indians  █     eligible for review of status

SUMMARY OF FINDINGS SERVICE

The focus of this section of the review is on the provision of service delivery to the children being reviewed. As in previous years, the recommendations (found in Appendix 2) are case related and made for the.Society's consideration.

Child Profile

Table 1 represents a breakdown of the ages of the children reviewed at the time of Grown wardship and at the time of review:

TABLE 1 - Age at Time of Review

As seen in Table 1,19 (67.9%) of the 28 children and youth reviewed were between the ages o 13 and 17 years. The average age at the time of review was 14.5 years. Planning for this group requires services that focus on maintaining youth in stable placements and preparing them for independence. Children had access to recreational, skills building and financial management opportunities to provide them with the life skills needed for successful independence. There was evidence of consideration of the use of the Ontario Child Benefit Equivalent (OCBE) fund In the child's plan of care. Extended care and maintenance for youth who wish to receive ongoing financial support from the society past their 18th birthday was thoroughly documented. Transitional planning for those youth requiring service from the adult developmental sector was also well developed in case planning.

Nine children (32.1 %) were 12 years of age or younger, representing a population which, requires services that focus on permanency and continuity of care. While documentation reflected consideration of children's needs for permanency and enduring relationships, there were cases where permanency planning did not reflect the efforts of the Society to explore adoption and legal custody with long-term caregivers, kin, or others. Two recommendations were made to review children's permanency plans.

TABLE 2a - Primary Diagnosis

As seen in Table 2a, 24 (85.7%) of the 28 children reviewed had a diagnosis of a special need. These children and youth required specific programming and services to address their, identified needs. Eleven children were prescribed psychotropic medication (39.3%), which is lower than the 2009 provincial average of 49%. Fourteen children were involved in treatment (50.0%), which is above the 2009 provincial average of/41%,of children who received therapy, including speech, occupational and physiotherapy as well as counselling services. Specialized treatment needs were addressed in the planning services. Consultation with outside service providers contributed to effective planning for children and youth and recommendations from these professionals were reflected in case planning. In some cases updated assessments may be beneficial to assist in planning and ensure valid and up to date diagnoses and treatment plans for children and youth. Recommendations were made in four cases to consider updated psychological assessments.

TABLE 2b - Behavioural Issues

As noted in Table 2b, 10 children and youth.(35.7%) exhibited behavioural difficulties. There was consistent planning to identify and manage supports to children and their caregivers. The society utilized behaviour support services, including support from child and youth workers. This year, two children or youth (7%) were considered high risk due to behaviours that placed themselves and/or others at risk; Neither of these cases required follow up as the society recognized the needs of high risk youth and had made efforts to keep these children free from, harm. The 2009 provincial average Is 9% of youth designated as high risk.

TABLE 2c - Serious Occurrences

Table 2c indicates that 11 cases required serious occurrence reports over the previous year and all 11 reports were located in children's flies. The requirements for Serious Occurrence reporting were understood and met by the society.

TABLE 2d - Previous History of Verified Abuse

As noted in Table 2d, three children (10.7%) experienced abuse prior to admission to care.

One child reviewed experienced abuse following his/her admission to care. This situation occurred during the current review year. Appropriate steps were taken by the society to ensure the children received the planned treatment or support in response to the abuse he or she experienced. Planning indicated the Society's intent to pursue Criminal Injuries Compensation on the children's behalf.

CLINICAL ISSUES

Appendix II provides a summary of the 25 service recommendations made in 14 cases.

Eleven recommendations were made to improve documentation, which included eight recommendations to enhance plans of care and recording. While significant improvements were noted this year in the development of planning, the documentation required additional work in some cases to address children and youth's strengths and needs with related objectives in each OnLac dimension either with a related objective or Indication of why an objective is not required. Children's plans of care took into account all available information on the child as set out in the Assessment and Action Record (AAR), any existing reports, as well as the child's social history. Social histories clearly documented tie rationale for significant decisions made and the child's significant experiences in care. More Information with regard a child's separation and placement history should be included in the documentation. Three recommendations were made to augment a child's social history.

Five recommendations were made to file pertinent reports, including Crown wardship orders and school reports. Two recommendations pertained to the documentation of the child's progress through progress reports from the therapist.

The society ensured that children and youth had opportunities to participate in age appropriate recreational activities,

SERVICES TO CHILDREN OF NATIVE HERITAGE ████ of the 28 children/youth reviewed ████ were identified as having native heritage. █​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█​█ ​ were provided with opportunities to explore and develop knowledge of their cultural and spiritual heritage and to participate in cultural and spiritual practices.

EDUCATION

Tables 3a and 3b reflect the educational profile of the children reviewed.

TABLE 3a - Educational Placement

As noted in Table 3a, 27 of the 28 children and youth reviewed (96.4%) were enrolled in a school program. Fifteen children (53.6%) had been reviewed by an IPRC Committee. The 2009 provincial average is 52%. Four children experienced suspensions during this review period.

TABLE 3b - Educational Progress

As seen in Table 3b, 26 of the 27 children attending school (96.3%) were making progress towards promotion. Meeting children's educational needs was a consistent focus of the planning and there was evidence of advocacy within the school system to ensure children's educational programming was consistent with their abilities and they received educational supports. Educational placements were preserved whenever possible for children who experienced a placement change and youth were provided with support to make the transit;-to secondary school. There was discussion and planning for youth who were identifying post-secondary educational goals.

PLACEMENTS

TABLE 4 - Placement Type,

As seen in Table 4, of the 28 children and youth reviewed, 16 (57.1%) were placed in society operated resources, representing a decrease in the number of children placed within the society's own resources. Last year 65.5% of the children reviewed were placed in CAS operated settings. The 2009 provincial average is 49%. The society has developed the resources necessary to place and maintain the majority of children within society operated care.

Eleven children (39.3%) were placed in outside paid resources with four children (14%) residing In staffed resources. Placing and maintaining children In family settings and placement with kin continued to be a primary goal for the society. At the time of this year's review, 23 children (82.1%) were living in family based settings. The 2009 provincial average is 76%. Efforts were made to keep siblings together when it was In their best interests to do so.

The permanency plan for 14 of the children reviewed (50.0%) was long-term foster care. For five youth (17.9%), the permanency plan was independence and three children (10.7%) were identified as remaining in long-term residential care. A transition to adult services was planned for one child. The Society was actively seeking adoption for one child (3.6%). The 2009 provincial average is 5% of children reviewed for whom adoption was planned. The society supported the development and maintenance, of positive long term relationships for children and youth with their foster family and/or family of origin. There were four cases where the permanency plan was unclear and the children and youth may benefit from increased clarity with regard to their future permanency goals. Two recommendations were made to review children's permanency plans. In these cases the goals may not have reflected that all permanency options to ensure enduring relationships for children were explored and documented in ongoing case planning.

During an average of 65.0 months of Grown wardship, changes in placement and caseworker assignments Were as follows:

TABLE 5 - Frequency of Placement Change

As noted in Table 5, the average placement length of the children and youth reviewed was 18.2 months which was shorter than the previous year's average of 22.3 months. The 2009 provincial average is a placement change on average every 27 months.

TABLE 6 - Placements Since Grown Wardship

As noted in Table 6, seven children and youth (25.0%) experienced placement continuity since Crown wardship. The children had an average of 3.6 placements since Crown wardship. The 2009 provincial average was 43% of children who had one placement since Crown wardship.

CASEWORKER ASSIGNMENTS

TABLE 7 Frequency of Caseworker Change

As seen in Table 7, the children and youth reviewed experienced a change in caseworker on average every 20.9 months. The average length of caseworker assignment for the society's 2010 review was 22.9 months. Children and youth experienced less caseworker continuity on average over the last year and caseworker continuity was slightly below the provincial average of 21.1 months. The average number of caseworkers since Grown wardship was 3.1.

TABLE 8 - Caseworkers Since Crown Wardship

The average caseworker contact with children was 15.8 times in the past 12 months, which is greater than the 2009 provincial average, of 11.9 visits and consistent with the society's 2010 average of 15.7 visits. The society is to be commended for their accomplishment in. maintaining a high level of caseworker contact with children.

ACCESS

TABLE 9a - Access

TABLE 9b - Access Exercised

As noted In Table 9a, of the 28 children reviewed, access was court ordered for 19 children (67.9%) and eight children (28.6%) had orders of no access. If in the child's best interests, efforts were made to preserve family connections for children. In many cases, children and youth were supported in their relationships with family members both by the society and their foster parents. Children's wishes were addressed and overall, appropriate action was taken by the society to assist the child with any difficulties arising from the access. There were cases where further documentation was required to address updated information about the family's current situation and cases where the children appeared to require additional support during visits. Two recommendations were made to review the access arrangements.

Table 9b notes that access was exercised by mothers in 25% of the cases reviewed. Access was exercised by fathers In 3.6% of the cases reviewed. Both parents exercised access in 28.6% of the cases. Other family members exercised access with children in 35.7% of the cases. Proactive efforts on the part of the society to ensure meaningful and active sibling contact were evident in case documentation. Access between siblings occurred frequently (85.7%). Nineteen of the 28 children reviewed had siblings in care.

RESPONSES FROM CHILDREN

TABLE 10 - Questionnaires and interviews

As seen in Table 10, 22 children and youth completed confidential questionnaires. One child reviewed requested £n interview. Responses from the children and youth indicated that the majority were pleased with their placements, felt cared for, and trusted their caseworkers. The concerns expressed by children and youth included worries about their parents and siblings, being unhappy, getting along with their foster parents and other children in their foster homes, school, health, and what would happen to them when they turned 18 years of age and their wardship terminated.

ADOPTION PROBATION

None of the children and youth reviewed this year were placed on adoption probation.

SUMMARY OF FINDINGS: SYSTEMS

Table 11 indicates comparative figures for the past three years and the 2009 provincial average.

TABLE 11 - Overall Compliance

Seventeen files were in full legislative compliance. Thirty-three directives were issued in 11 cases. Two directives were issued for late minimum three month visits and two directives were issued for missed private visits. Twelve directives were issued for late plans of care, including four directives for a review within 30 days if a child moves, four directives for a late review of the plan of care and four directives for late supervisory endorsements of the plans of care. Five directives were issued for lack of timely AAR completion and five directives were issued for lack of timely update of a social history. Three directives were Issued for late medical and dental examinations. Four directives were issued to develop a plan of care to address a child's specific needs, Please refer to Appendix I for a complete list of directives issued in the current review.

The society's 2011 legislative compliance rate was 60.7%, a decrease over last year's rate of 69.0% and lower than the 2009 provincial average of 66%.

Review Highlights:

• The society provided effective services overall for a high special needs population of children (85.7%)
• The majority of children and youth were placed in society operated care and 82.1 % were. placed in family settings;
• Children were involved in treatment services and medication therapy was reviewed and altered as necessary;
• Academic achievement was a focus of planning with the vast majority of children (96.3%) making progress;
• Youth were provided with support in preparation for independence and services for those youth transitioning to adult services were also well managed, through collaboration with the developmental services working group;
• Caseworker contact with children and youth was above the provincial average;
• Access was well managed overall and sibling contact was maintained for 85.7% of the children reviewed, and
• The society's response to the majority of the directives and recommendations from the 2010 Crown Ward Review was evident in the case files.

Areas Requiring Further Attention:

• Timely completion of planning is required including the social history, AAR, plans of care, including the 30 day plan of care following a move, and supervisor endorsement, In keeping with required time frames;
• Consistent planning is required to develop plans of care that address strengths and needs in each OnLac dimension with the development of detailed, measurable goals and tasks or indication of why an objective is not required, including cases where children and youth were placed in outside paid resources, and
• Continued efforts to address placement continuity.

APPENDIX I

DIRECTIVES

17 Cases in full legislative compliance 33 Directives Issued in 11 cases.  0 Cases not in compliance - no directives Issued.

Summary of Directives

0 7 day visit - 0 30 day visit 2 Minimum three month visits by social worker 2 Private visits 5 Child's family history 2 Annual medical exam 1 Annual dental exam 4 Review of plan of care 4 Review within 30 days if child moves 4 Review of plan by Supervisor 4 POC address specific needs 0 Annual school report 0 Discussion of rights 0 Plan of care residential resources 0 File Serious Occurrence Report 0 Comply Court Order 0 Status review 0 File to be reviewed by Program Supervisor 0 File to be reviewed by senior management 5 Assessment and Action Record

APPENDIX II

RECOMMENDATIONS

14 Cases required no service recommendations 25 Service recommendations were issued in 14 cases, as follows:

Themes

The recommendations are identified in the following themes:

1. 11 (44%) related to enhancing or updating recording for plans of care, social histories and quarterly recordings.
2.  8 (32%) related to Issues regarding planning for children/youth in areas of permanency, access, and referrals for clinical assessments.
3.  6 (24%) related to file documentation such as ensuring Crown ward orders, clinical and educational reports are on file.

A plan to address the above noted themes that emerged during the review can be provided to the Service Review and Compliance Unit as opposed to a response to individual recommendations made at the case level.

Summary of Recommendations

• 2 Review access arrangements
• 2 Review permanency planning
• 1 Counselling
• 2 File documentation to include Crown ward order
• 1 File documentation to include School Report
• 2 File documentation to include Clinical Report
• 7 Enhance /update Plan of Care
• 3 Enhance /update Social history
• 1 Enhance /update Quarterly recordings
• 4 Consider psychological assessment

APPENDIX III

Compliance with Standards

Table 11 previously identified the overall compliance rate for The Children's Aid Society of the County of Prince Edward in 2011 as 60.7%. The overall compliance rate is calculated by determining the number of cases in full compliance. In this case, of the 28 cases reviewed, 17 of the cases were fully compliant.