Intake Form for Visiting Parent

Please click on this link for child friendly information for Supervised Access www.supervisedaccessireland.com/child-safety/child-friendly-information/

By submitting this intake form, I confirm that I have read and understand the program policies and procedures, terms and conditions, fee schedule, and services offered. I also acknowledge that I have provided accurate and complete information on this intake form.

Supervised Access Ireland (SAI) – Policies and Procedures

Supervised Access Ireland (SAI), supervised and supported family access service, is a child focused service. If staff witness abuse or neglect while providing service to a family, we will make a report to the relevant parties.

All referrals are carefully screened for appropriateness to ensure a safe and enjoyable visit for access parent/family member and child/children. SAI reserves the right to decline or end service at any time.

Supervised / Supported Access: Costings are attached for supervision. There is an intake fee (non-refundable) and a security deposit (refundable).

• Both the custodial and access parent/family member are required to engage with the supervisor coordinator (separately) to establish visit guidelines/protocol before a visit can be arranged.
• The ability of SAI to provide this service depends on the cooperation of all parties involved.
• The SAI family access is a private service. The focus of our service is to provide safe and enjoyable visit for children. Custodial parent/family members must understand that they will not be allowed to observe the supervised visit, nor will they give the supervised access worker directions concerning how to conduct/supervise the visit. Custodial parent/family members will not be allowed to stay in the area during a supervised access unless court ordered.
• Once the child/children have entered the SAI program the safety and well-being of the child/children is the responsibility of the visit supervisor. Visit supervisors will not end visits unless the child clearly demonstrates ongoing distress during the visit. The visit supervisor will give the child the time and opportunity to overcome their distress before the visit will end. After the visit guidelines are set, SAI will not allow either the custodial or access parent/family member to make arbitrary changes to the visit guidelines.
• SAI does not allow outside third-party visitors or observers to attend a supervised access unless approved by the SAI Program Coordinator / Manager or court ordered. We require 24 hours notice of any third-party visitors or observers. Failure to give notice may result in access being terminated.
• SAI staff will decline all requests to forward any documents or messages between the access and custodial parent/family member. SAI staff are not mediators or counsellors and do not involve themselves in communication or disputes between parent/family members.

Visit Guidelines:

Visit guidelines are set based on the information submitted by both parent/family members in their Initial Agreement and standard rules set by SAI. These guidelines are set to ensure a safe and enjoyable visit for parent/family member and child/children.

• SAI supervised access workers are proficient to end a visit if the access parent/family member is not following the visit guidelines.
• The role of the visit supervisor is to be understood and respected at all times. Failure to do so may result in access not going ahead or being ended early.
• The custodial parent/family member or indicated person will drop the child/children off at the agreed meeting point at the designated time for the visit and then will leave the vicinity.
• The custodial parent/family member or indicated person will return at the designated time to pick up the child/children at the end of the visit. The custodial parent/family member will remain available to pick the child/children up if a visit needs to end early. The custodial party will be responsible for providing SAI with two telephone numbers and addresses of trusted people who can be contacted in case of emergency if the custodial parent/family member is not immediately available.
• The custodial parent/family member will inform/prepare the child/children about the supervised/supported family visit prior to the visit occurring. Part of these preparations includes reassuring the child/children that a visit supervisor will be with them at all times to ensure their safety and wellbeing. The custodial parent/family member should describe the supervised access in a positive way and encourage child/children to enjoy their time spent with the access parent/family member.
• The access parent/family member will not be under the influence of drugs and/or alcohol during the supervised access.
• No weapons of any kind will be allowed during the supervised access.
• The access parent/family member will not engage in any discussion concerning custody or access with child/children during the supervised access.
• The access parent/family member will not ask children for any information concerning custodial parent/family member during the visit.
• The access parent/family member will not engage in any negative talk with child/children concerning custodial parent/family member during the supervised access.
• The custodial parent/family member will not engage in any negative talk with the child/children concerning the access parent/family member before or after the supervised access.
• The access parent/family member will not bring guests to the supervised visit unless SAI Supervised Access Program Coordinator / Manager approve the visitor.
• The access parent/family member will not ask the child/children to have a phone conversation, zoom call (or similar) an individual unless the SAI Supervised Access Program Coordinator have given prior consent.
• The supervised visit worker will end a visit immediately if the child/children are placed in physical danger during the visit.
• If the child/children appear to be in emotional distress during the visit, the supervised access workers are to make the access parent/family member aware of this distress and to redirect conversation and interactions to help ease this distress. If the access parent/family member does not follow this direction, the access worker will end the visit. Supervised visit workers will encourage parent/family member/child interaction during a visit.
• SAI staff will encourage parent/family members to meet the child's needs during a visit.
• Both parties (custodial and access parent/family member) contract with SAI for our services and because of this visit are not confidential to the access parent/family member. Both parties contracting with SAI will be kept informed about visits.
• All other guides are unique to individual contracts based on information and protocols submitted by both the access and custodial parent/family member.

Arrival and Departure:

• All parties are to arrive at and depart from the meeting point at precisely the prearranged times. At both the beginning and end of the access, the custodial parent/family member or indicated person will not approach or speak to the noncustodial parent/family member or other indicated person and vice verse. Failure to adhere to this may result in access being terminated.

Confidentiality:

• Confidentiality means keeping in strict confidence, all information obtained by SAI about clients. Staff members will keep in strict confidence all private or confidential information about clients. Parent/family members are to respect the confidentiality of all participants in the program.

Aggression/Bullying:

• SAI has zero tolerance for bullying or intimidating behaviour by either the custodial or access parent/family member. We reserve the right to refuse service, at any time, if such behaviour occurs. If the visit supervisor or Program Coordinator believes that bullying or intimidating behaviour has occurred during a visit, the visit will be terminated immediately. If necessary, the access worker will call police/emergency services if the access parent/family member refuses to follow direction concerning ending visits.

Visit Availability:

• The ability of SAI to provide supervised access depends on the availability of our supervised access workers and the availability of our roster. We can not guarantee the same visit supervisor for each access.
• Both the custodial and access parent/family member must email every Monday, of the week in which access is due, to confirm their attendance at the upcoming access. Email admin@supervisedaccessireland.com to confirm.

Languages:

• SAI will attempt to provide a language appropriate visit, but we are limited to the visit supervisors available. SAI reserves the right to limit the language of the visit to English. This is to ensure that there is no manipulation to the child or negative language being used and that the visit supervisor understands what is being said at all times.

Conversations:

• The visit supervisor must hear all conversations. This means that access taking place in some locations will result in the access parent/family member having limited interaction with the child/children e.g., soft play locations, as the supervisor will not follow the child and access parent/family member down slides etc.

Cancellation/no show:

• SAI will charge the full agreed fee for a visit that has been cancelled without 24 hours' notice. Weekend visit must be cancelled by the Friday prior to the visit. SAI does not refund payment if a visit is ended early. SAI requires 24 hours' notice for visit cancellations or the full visit charges will be applied.

Lateness:

• If a party continues to arrive consistently late, the supervised access program may be discontinued

Sick children:

• SAI requests that custodial parent/family members not bring ill children to a supervised access (fever, vomiting, and diarrhoea). SAI will end the visit if the child is ill and in discomfort. A medical certificate maybe be requested.

Right to Terminate:

• SAI staff reserves the rights to terminate a visit at any time and for any reason they see fit. Should a visit be terminated, staff are required to place a note in the file as to the reasoning for the termination. These notes will accompany the observation notes should they be requested.

Observation Notes:

• It is policy for a report to be written by the attending supervisor, following each access. If visit notes/reports have been requested, they will be provided to both the custodial and access parent/family member's legal teams or the courts, if so requested. SAI will not provide visit notes if they have not been requested by the parent/family members' legal team or court ordered. Should observation notes/reports be requested there will be the appropriate fee charged to the requesting party or alternatively to the agreed payment plan. Contact accounts@supervisedaccessireland.com for report fees.

Child Refusal:

• SAI assists in the facilitation of visits but is not an enforcement agency.
• All children will be encouraged to participate in the program and adhere to court orders; however, no child will ever be forced into a visit.
• It is assumed that the custodial parent/family member will provide their full support in encouraging the child to attend the visit.
• The custodial parent/family member must ensure that the child is out of their car and prepared for supervised access on arrival of the access worker.
• If SAI observe that the child's refusal to attend access requires an extra support, we may suggest requesting that a family friend or other family member accompany the child to the meeting point for access, rather than the custodial parent/family member

Picture/Video taking:

• Visiting parties may take photos and videos during the access visit so long as it has been approved by the Supervised Access Program Coordinator and is not otherwise banned by a court order. All pictures and video will be reviewed by the visit supervisor and approved prior to the end of the visit. SAI staff have the right to demand that a photo or video be deleted at their discretion.

Audio recording of access:

• Recording the access via telephone, Dictaphone or any other method is not permitted.

Picture/video taking/audio recording of staff:

• It is not permitted to take any photos, videos and/or audio recording of staff be it covertly or publicly.

Phones and tablets:

• The visiting party can use their mobile phone and/or tablet during the visit; however, SAI staff may ask the visiting party to stop the use of the phone and/or tablet at their discretion if they feel that it is not being used appropriately.

Bathroom Policy:

• If a child requires assistance, the visiting party will assist the child under staff supervision unless otherwise stated in the court order or supervised access protocol.

Toys:

• Parties are expected to provide their own toys and crafts.

Gifts:

• Neither SAI nor its employees are responsible for stopping a visiting parent/family member giving gifts to the child/children attending access.
• If it is not expressed in the court order, it is up to the parent/family members to communicate any issues they have surrounding this to their legal team and ask that the noncustodial parent/family member be updated on same.

Infant Care:

• The custodial party is responsible for supplying clothing, formula, bottles, or whatever else is needed for good care of a baby during a visit. A well-known stuffed toy or blanket can be sent with the child to facilitate their emotional comfort while at the visit. In the summer months a hat and sunscreen are also requested.

Mealtime visits:

• When visits are scheduled over mealtimes, the visiting party is responsible for supplying nutritious meals for the child(ren).

Policy regarding general non-compliance with policies, procedures, and guidelines.

Should a parent/family member/family member fail to comply with the points of this document, the following will occur:

• Parent/family member will be reminded of the program policies, procedures, and guidelines.
• A verbal warning will be given stating that if non-compliance continues the visit or exchange will end.
• If non-compliance continues, the visitation will end immediately. The participant will receive written incident report, as well as a verbal and written report warning that visits/exchanges will be terminated at the next incidence of non-compliance. The other parties and respective legal teams will receive copies of the letter.
• If non-compliance continues, the participant is notified that visits or exchanges are formally suspended or terminated. The other party and respective solicitors will receive notification.

Disclaimer

I understand that SAI staff cannot and will not be involved in any court proceedings due to their involvement with the supervision of SAI clients, unless court ordered or agreed by both legal teams. In addition, I am aware that observation notes are taken regarding the visit and that notes/reports taken during each individual visit can be released to the parties should they be requested by the parties' solicitors or courts.

Supported/Supervised Access Service Terms and Conditions

• Core Caring Ltd t/a Supervised Access Ireland (SAI) the Company, will provide a Supported/Supervised Access Service package as agreed by all participants in the service.
• The Access Workers will provide the services and hours as agreed.
• Any extra duties or hours need to be agreed previously with the management of Supervised Access Ireland.
• The clients will not call or message any Access Worker outside of access hours.
• The clients will not attempt to rearrange access times/days/locations via the Access Worker. These requests must be addressed to the Company Management.
• The clients will adhere to the agreed times/dates/locations and will only request a change in urgent circumstances.
• The clients will give at least a weeks’ notice of any requests. Rosters are done a week in advance and so cannot be changed last minute.
• All payments to the Access Workers are facilitated by SAI.
• Any payment made by the client to the Access Worker directly is not the responsibility of SAI, and does not affect the agreed costing and goes against our policies.
• Any extra expenditure i.e., outside of agreed package must be agreed previously with SAI.
• Any travel expense, change of pick-up address or return address, change of access location, extended access visit times, change of agreed access day and time or any other requirement outside of this costing will incur extra expense and must be agreed by SAI management. If not approved previously by SAI management, these expenses will feature on billing as extra expenses.
• There is a minimum fee of three (3) hours supervised access. Visits of two plus (2+) hours or more will also incur other expenses such as travel expense and travel time.
• Travel and mileage are calculated according to the particular access service.
• Costs for court appearances of the access worker and/or other members of Supervised Access Ireland are a separate charge and are the responsibility of the client. Court appearances are charged as per our costings.

Supported/Supervised Access Service Terms and Conditions cont.

• Access or Court reports are charged separately to the access visits.
• Travel and mileage expenses are charged separately to the access visits.
• All access visits cancelled 24 hours or less before agreed time will incur the full fee.
• Any extra time exceeding the agreed time is charged by the hourly rate or part thereof.
• Receipts for extra expenditure will be available for examination by client at the offices of Supervised Access Ireland.
• Payment for agreed service is due in SAI’s account 5 working days previous to the provision of service. Failure to do so does not guarantee service requested.
• Payment should be made by on line transfer.
• Core Caring Ltd t/a Supervised Access Ireland is not responsible for any incident or accident occurred during the access visit not involved directly in the access package.
• The client will not approach the dedicated SAI access worker / workers to provide services similar or the same as during the contracted service time nor for twelve (12) months following this service termination.

SAI have a Child Safeguarding Statement which can be viewed and downloaded from our webpage. Please follow the link https://supervisedaccessireland.com/child-safety/child-safeguarding-statement/

Fee Summary

Family Access Services

Summary of services offered

The Role of the Visit Coordinator

• Maintains a non-judgmental and supportive attitude.
• Assists with coordination of Family Access Services, parenting skills and facilitates parent/child interactions when required.
• Present at all times to observe and document interactions between parent and child.
• Relates to all cultural, ethnic and socio-economic groups and lifestyles.
• Encourages appropriate conduct and when possible, redirects inappropriate conduct.
• The Visit Supervisor will intervene or terminate the visits if it is in the best interest of the children.

Supervised Access:

This intervention is used for the purpose of ensuring the children's safety while visiting with the noncustodial parent. The visit supervisor ensures that parent-child interactions will be supervised at all times. Every attempt will be made to do so in a discreet manner. The Visit Supervisor will make written observations and share relevant information with custodial parent on an ongoing basis.

Supportive Supervised Access:

This form of access has all of the components of supervised access along with supportive Psychoeducation.

Therapeutic Supervised Access:

A neutral observation of parent/child interactions with the addition of family counselling provided.

Supervised Access Exchanges:

A close supervision of children in transition from one parent to the other. Transportation of children may be included upon request.

Reunification:

A close observation of parent/child interactions in circumstances where the parents and children may not have had contact in a while. Assistance, support and guidance is provided to assist in re-establishing their relationships.

Family Assessment Fees

Please contact our office for a consultation and quote. A consultation is necessary in order to provide an accurate quote, as factors such as travel or specific family circumstances will vary the assessment cost.

Role of Supervisor

Supervised Access:

This intervention is used for the purpose of ensuring the children's safety while visiting with the non-custodial parent. The visit supervisor ensures that parent-child interactions will be supervised at all times. Every attempt will be made to do so in a discreet manner. The role of the access worker is as follows:

• To supervise the access at the location and during the times identified previously by the company and agreed with by all parties involved.
• To be present at all times to observe and document interactions between parent and child.
• Must be able to hear and understand all conversations at all times.
• Maintain a non-judgmental and supportive attitude.
• Ensure the safety of all present with priority being the children.
• Ensure court order is complied with.
• Ensure that children are not alone or unobserved.
• Access worker should accompany children to the bathroom (when indicated).
• Comply with the access protocol agreed and strictly adhere to it.
• Encourages appropriate conduct and when possible, redirects inappropriate conduct.
• The access worker will intervene or terminate the visits if it's in the best interest of the child/children.
• The access worker is not authorised to accept changes to the access time or venue.
• The access worker is not authorised to take calls or messages concerning the access visit outside of the allocated times.
• All queries regarding the access service, outside of the allocated access visit hours should be directed to the manager of the service and not to the supervisor.
• Access workers do not discuss their personal lives with clients.
• Maintain the utmost confidentiality.
• Contact the manger on call for support during the access time, when required.
• Ensure reports are written correctly and submitted within 24 hours of the access.

Reports:

• A report will be prepared by the access worker following each visit.
• All conversation with the access worker during or after the supervised access is documented.
• Matters not pertaining to the actual access visit should not be discussed with the access worker.
• Negative comments made regarding third parties will be documented and will appear on reports.
• Whispering between the visitation parent and children is not allowed and breech of this will appear on the report.

Copies of reports can be requested via your legal team or the court. Reports are not sent to clients. Should reports be issued, they will be sent to the legal teams of both parties. There is a fee for the issuing of reports. An email requesting reports and cost of same should be sent by your legal team or the court to admin@supervisedaccessireland.com and accounts@supervisedaccessireland.com at least ten (10) working days before they are required.

Parent Self-Disclosure Form