Form DCF-1248 "Safety Communication System for Deaf and Hard of Hearing Parents and Caregivers" - Connecticut

What Is Form DCF-1248?

This is a legal form that was released by the Connecticut State Department of Children and Families - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2016;
  • The latest edition provided by the Connecticut State Department of Children and Families;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DCF-1248 by clicking the link below or browse more documents and templates provided by the Connecticut State Department of Children and Families.

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Download Form DCF-1248 "Safety Communication System for Deaf and Hard of Hearing Parents and Caregivers" - Connecticut

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Department of Children and Families
SAFETY COMMUNICATION SYSTEM FOR DEAF AND HARD OF HEARING PARENTS AND CAREGIVERS
DCF-1248
3/16 (New)
Page 1 of 1
Child’s Last Name:
Child’s First Name:
Date of evaluation of safety needs:
LINK#:
Last Name of person conducting assessment:
First name of person conducting assessment:
Last Name of person responsible for following up
First Name of person responsible for following up:
Does client have a doorbell light system in place?
Yes
No
Does client have a strobe light fire alarm system?
Yes
No
Does client have TTY, Captel or video phone to make 911 calls?
Yes
No
Does client have a "baby cry" signaling light system or video monitor?
Yes
No
Does client understand how to make a 911call?
Yes
No
Does client have a support person nearby to help in case of emergency?
Yes
No
Does client have an emergency plan if needed?
Yes
No
Is the client registered with Enhanced 911?
Yes
No
The Enhanced 911 form is located on the Department of Emergency Services and Public Protection (DESPP) website:
http://www.ct.gov/dps/lib/dps/office_of_statewide_emergency_telecommunications_files/oset-files/how_to_alert_911.pdf
Please list equipment needs for this client and contact Converse Communication Center at 1-800-743-1219 to obtain needed equipment.
The above check list should be revisited within 14 days to see if corrective action has been taken for a safety need.
Has everything been satisfactorily completed?
Yes
No
Comments:
Date of re-evaluation of safety needs and corrective action:
Department of Children and Families
SAFETY COMMUNICATION SYSTEM FOR DEAF AND HARD OF HEARING PARENTS AND CAREGIVERS
DCF-1248
3/16 (New)
Page 1 of 1
Child’s Last Name:
Child’s First Name:
Date of evaluation of safety needs:
LINK#:
Last Name of person conducting assessment:
First name of person conducting assessment:
Last Name of person responsible for following up
First Name of person responsible for following up:
Does client have a doorbell light system in place?
Yes
No
Does client have a strobe light fire alarm system?
Yes
No
Does client have TTY, Captel or video phone to make 911 calls?
Yes
No
Does client have a "baby cry" signaling light system or video monitor?
Yes
No
Does client understand how to make a 911call?
Yes
No
Does client have a support person nearby to help in case of emergency?
Yes
No
Does client have an emergency plan if needed?
Yes
No
Is the client registered with Enhanced 911?
Yes
No
The Enhanced 911 form is located on the Department of Emergency Services and Public Protection (DESPP) website:
http://www.ct.gov/dps/lib/dps/office_of_statewide_emergency_telecommunications_files/oset-files/how_to_alert_911.pdf
Please list equipment needs for this client and contact Converse Communication Center at 1-800-743-1219 to obtain needed equipment.
The above check list should be revisited within 14 days to see if corrective action has been taken for a safety need.
Has everything been satisfactorily completed?
Yes
No
Comments:
Date of re-evaluation of safety needs and corrective action: