DCYF Form 15-258SM "Safety Assessment/Safety Plan" - Washington (Somali)

DCYF Form 15-258SM is a Washington State Department of Children, Youth, and Families form also known as the "Safety Assessment / Safety Plan". The latest edition of the form was released in February 1, 2019 and is available for digital filing.

Download an up-to-date DCYF Form 15-258SM in PDF-format down below or look it up on the Washington State Department of Children, Youth, and Families Forms website.

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Download DCYF Form 15-258SM "Safety Assessment/Safety Plan" - Washington (Somali)

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DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES (DCYF)
Qiimeynta Badbaadada / Qorshaha Badbaadada
Safety Assessment / Safety Plan
Qiimeynta Badbaadada waxaa lagu isticmaalaa guud ahaan nolosha kiiska si loo aqoonsado in uu cunugu yahay uu
bedqabo iyo inkale. Waxaa ay ku saleysan tahay macluumaad dhammeystiran oo ku saabsan qoyska oo la helo karo
wakhtiga dhammeyntiisa. Buuxi Qorshaha Badbaadada/Qiimeynta Badbaadada iyada oo la raacayo siyaasadda
DCYF.
MAGACA / AQOONSIGA KIISKA
AQOONSIGA AQBALAADDA
GO'AANKA BADBAADADA
(AQOONSIGA) KA-QAYBGALAYAASHA
TAARIIKHDA DHALASHADA
QORSHAHA BADBAADADA
TAARIIKHDA QIIMEYNTA
KHABIIRKA ADEEGA BULSHADA
LAMBARKA TELEEFOONKA
NOOCA QIIMEYNTA
Information Required for Assessing Child Safety – For Information Gathering Purposes Only.
Shaded area needs to be entered into the Case Assessment.
Shaded area is not translated.
Describe the nature and extent of the maltreatment:
Describe the circumstances that accompany the maltreatment:
Describe how the child or children function on a daily basis:
Describe how the parent / caregiver(s) disciplines the child:
SAFETY ASSESSMENT/SAFETY PLAN - SOMALI
DCYF 15-258SM (02/2019) INT/EXT
Bogga 1
DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES (DCYF)
Qiimeynta Badbaadada / Qorshaha Badbaadada
Safety Assessment / Safety Plan
Qiimeynta Badbaadada waxaa lagu isticmaalaa guud ahaan nolosha kiiska si loo aqoonsado in uu cunugu yahay uu
bedqabo iyo inkale. Waxaa ay ku saleysan tahay macluumaad dhammeystiran oo ku saabsan qoyska oo la helo karo
wakhtiga dhammeyntiisa. Buuxi Qorshaha Badbaadada/Qiimeynta Badbaadada iyada oo la raacayo siyaasadda
DCYF.
MAGACA / AQOONSIGA KIISKA
AQOONSIGA AQBALAADDA
GO'AANKA BADBAADADA
(AQOONSIGA) KA-QAYBGALAYAASHA
TAARIIKHDA DHALASHADA
QORSHAHA BADBAADADA
TAARIIKHDA QIIMEYNTA
KHABIIRKA ADEEGA BULSHADA
LAMBARKA TELEEFOONKA
NOOCA QIIMEYNTA
Information Required for Assessing Child Safety – For Information Gathering Purposes Only.
Shaded area needs to be entered into the Case Assessment.
Shaded area is not translated.
Describe the nature and extent of the maltreatment:
Describe the circumstances that accompany the maltreatment:
Describe how the child or children function on a daily basis:
Describe how the parent / caregiver(s) disciplines the child:
SAFETY ASSESSMENT/SAFETY PLAN - SOMALI
DCYF 15-258SM (02/2019) INT/EXT
Bogga 1
Describe the overall parenting / child care practices:
Describe how the parent / caregiver(s) manages his / her own life on a daily basis (this focuses on how the parent
functions in an adult role outside of his / her parenting role:
Bilowga Badbaadada
Bixi macluumaad ku saabsan halista(halisaha) badbaadada la aqoonsaday si ay uga mid noqoto 1 – 5 hoose, balse aan ku
xaddidnayn macluumaadkan:
Sidee halista badbaadada ay ugu yeelatay ama ugu yeelan doontaa saameyn daran cunuga?
Sidee halista badbaadada ay u tahay mid degdeg ah ama dhici karta mustaqbalka dhow?
Nuglaanta cunuga ee la xiriirta halisaha Badbaadada.
Sababta uusaan u jirin waalid/daryeele ama qof weyn oo jooga guriga kaas oo ka hortagi kara halista.
Dabeecadaha gaarka ah ah, xaaladaha, iwm., kuwaas oo la ogaadey ee ka dhiga in halista si cad loo fahma oo la
arki karo.
Halisaha Badbaadada
HAA
MAYA
1.
Xaalada qoyska / xarunta waxaa ay keenaysaa in dad waaweyn joogin guriga / xarunta fulinaysa
waajibaadyada iyo mas'uuliyadaha waaliinimo / daryeelka cunuga ee hubinaya badbaadada cunuga.
Sharrax:
2.
Xaaladda qoyska / xarunta waa kuwo qabanqaabada nolosha / daryeelka cunuga ay si xun halis u
gelinaya caafimaadka jireed ee cunuga
Sharrax:
3.
Daryeelaha(yaasha) ayaa la soo baxay dabeecad (u dhaqmaya) qaab rabsho leh ama si khatar leh
dabeecadahana waxaa ay saameeyaan badbaadada cunuga.
4.
Waxaa jirta dhacdo rabsho guri taas oo saameynaysa badbaadada cunuga.
Haddii ay tahay “Haa” buuxi su'aalaha hoos ku qoran:
a.
Qofka geystay rabshada guriga wuxuu sababey waxyeello daran ama halis dhibaateyn ka dhan ah
dhibbanaha qaangaarka ah / daryeelaha cunuga.
b.
Dambiilaha geystay rabshada guriga wuxuu si halis ah u dhaawacay ama ugu hanjabay in uu
waxyeello halis ah u geysan doono cunuga.
c.
Heerka rabshada iyo/ ama hanjabaadaha ku aadan midkood dhibanaha qofka weyn ama cunuga waa
mid sii kordheysa sidaas daraadeed
waxyeello halis ah ayaa dhici karta.
d.
Waxaa jira calaamado kale oo tusinaya khatarta sii kordheysa taas oo ka timaada dambiilaha geystay
rabshada guriga sida hanjabaado isdilid ama isku dayid ah, ama isticmaal daroogo ama hanjabaado
hub ah.
Sharrax:
5.
Daryeelaha(yaasha) ma xakameyn doonaan ama ma xakameyn karaan dabeecadooda iyada oo
dabeecadooda ay saameyso badbaadada cunuga.
Sharrax:
6.
Daryeelaha(yaasha) waxaa ay u arkaan cunuga in uu ku jiro xaalado aad u xun.
Sharrax:
7.
Daryeelaha(yaasha) ma haystaan ama ma isticmaalaan ilaha lagama maarmaanka u ah in ay daboolaan
baahiyada aasaasiga ah ee cunuga kuwaas oo u soo bandhiga cunuga hanjabaad waxyeelo halis ah oo
degdeg ah.
Sharrax:
SAFETY ASSESSMENT/SAFETY PLAN - SOMALI
DCYF 15-258SM (02/2019) INT/EXT
Bogga 2
8.
Dabeecadaha, dareenka iyo hab-dhaqanka daryeelaka waxaa ay hanjabaad waxyeello daran u
geysanayaan cunuga, ama daryeelaha(yaasha) waxaa ay ka cabsi qabaan in ay si xun ula dhaqmi
doonaan cunuga waxayna codsanayaan meelayn.
Sharrax:
9.
Daryeelaha(yaasha) waxaa ay ugu tallo galeen in ay si halis ah dhaawac ugu geystaan cunuga
Sharrax:
10. Daryeelaha(yaasha) ma laha aqoonta, xirfadaha, ama dhiirrigelinta daruuriga u ah xaqiijinta badbaadada
cunuga.
Sharrax:
11. Daryeelaha(yaasha) waxaa ay si cad u diidayaan soo dhexgalka DCYF, waxaa ay diidayaan in cunuga loo
gudbo, ama waxaa jira tilmaamaha qaar oo muujinaya in daryeelaha(yaasha) ay carari doonaan
12. Daryeelaha(yaasha) ma buuxinayaan, ma buuxin karaan ama ma buuxin doonaan baahiyada jireed,
dareen, daaweyn, ama dabeeceed ee cunuga.
Sharrax:
13. Daryeelaha(yaasha) ma awoodaan ama ma sharxi doonaan dhaawacyada cunuga ama xaaladaha arxad-
darrada ama sharraxaadda ma ahan mid waafaqsan xaqiiqooyinka
Sharrax:
14. Cunuga wuxuu qabaa dhaawacyo jireed oo halis ah ama xaalado jirka ah oo halis ah kuwaas oo ka
dhashey arxan-darrada loola dhaqmey.
Sharrax:
15. Cunuga wuxuu muujinayaa calaamado dareen oo halis ah, dabeecad nafta-burburisa iyo/ama la'aanta
xakameyn dabeecadeed taas oo dhalisa ka careysiin ficil celis halis ah oo ku aadan daryeelayaasha.
Sharrax:
16. Cunuga wuxuu si aad ah uga cabsanayaa xaaladda guriga / xarunta ama dadka guriga / xarunta jooga.
Sharrax:
17. Xadgudubka galmo ee cunuga ayaa laga shakisan yahay, wey dhacdey, ama duruufaha ayaa soo
jeedinaya xadgudub galmo in laga yaabo in uu dhaco.
Sharrax:
Falanqeynta Qorshaha Badbaadada
HAA
MAYA
Guriga waxaa jooga waalid/daryeele ama qof weyn.
Gurigu waa mid degan si uu ugu ogolaado kuwa bixiya badbaadada in ay kas haqeeyaan guriga.
Dadka waaweyn ee guriga jooga waxaa ay oggolaadeen in ay la shaqeeyaan una oggolaadaan
sameynta Qorshaha Badbaadada-Gudaha Guriga ah.
Khayraad ku filan, munaasab ah, oo la isku halayn karo ayaa la helayaa waxaa ayna diyaar u
yihiin in ay bixiyaan adeegyo badbaado / hawlo.
Haddii “Haa” loo xushey dhammaan afarta jumlo ee kor ku xusan Qorshaha Badbaadada-Gudaha Guriga (DCYF 15-
259) waa in la sameeyo.
Haddii “Maya” loo xushey mid ka mid ah afarta jumlo ee kor ku xusan, Qorshaha Badbaadada Guriga-Dibadiisa waa in
la sameeyo.
OGGOLAANSHAHA HORJOOGAHA
TAARIIKHDA
SAFETY ASSESSMENT/SAFETY PLAN - SOMALI
DCYF 15-258SM (02/2019) INT/EXT
Bogga 3
Orshaha Badbaadada Gudaha-Guriga
DEPARTMENT OF CHILDREN, YOUTH, AND FAMILIES (DCYF)
Qorshaha Badbaadada Dibada-Guriga
Qorshaha Badbaadada
Looma baahna Qorshaha Badbaadad
Safety Plan
Qorshaha Badbaadada waa mid ay u baahan yihiin dhammaan caruurta halka ay ka jirto hanjabaado badbaado oo lagu arkey
Qiimeynta Badbaadada. Qorshaha Badbaadada waa qorshe qoraal ah oo u dhaxeeya qoys iyo DCYF oo tilmaamaya sida
halisaha badbaadada ee cunuga degdeg loogu xakameyn lahaa oo loo maareyn lahaa. Ogow: Marka la samaynayo Qorshaha
Badbaadada Gudaha-Guriga shuruudahan Falanqeynta Qorshaha Badbaadada ee soo socda waa in ay jiraan.
Waxaa guriga jooga ugu yaraan hal waalid/daryeele ama qof weyn.
Gurigu waa mid degan si uu ugu ogolaado kuwa bixiya badbaadada in ay kas haqeeyaan guriga.
Dadka waaweyn ee guriga jooga waxaa ay oggolaadeen in ay la shaqeeyaan una oggolaadaan sameynta Qorshaha
Badbaadada-Gudaha Guriga ah.
Khayraad ku filan, munaasab ah, oo la isku halayn karo ayaa la helayaa waxaa ayna diyaar u yihiin in ay bixiyaan
adeegyo badbaado / hawlo.
MAGACA KIISKA
LAMBARKA KIISKA
MAGACA SHAQAALAHA KIISKA
LAMBARKA TELEEFOONKA
Falanqeynta Qorshaha Badbaadada
Taariikhda Dhalashada
Waxqabadyada / Hawlaha Badbaadada
Hanjabaadaha Badbaadada la Aqoonsadey:
TAARIIKHDA BILOWGA
TAARIIKHDA DHAMMAADKA HADAFKA
Waxqabadyada / Hawlaha:
Maxaa la sameyn doonaa (sharrax waxqanadyada / hawlaha kuwaas oo la samayn doono si loo maareeyo badbaadada
cunuga, sida uu qorshuhu u shaqeyn doono, iwm.):
Qofka ay Ka Timid:
Soo noq-noqodka (saacadahee, maalmahee todobaadka, iwm.; ku dar dhammaan waqtiyada laga yaabo in ay
hanjabaadu dhacdo):
Hanjabaadaha Badbaadada la Aqoonsadey:
TAARIIKHDA BILOWGA
TAARIIKHDA DHAMMAADKA HADAFKA
Waxqabadyada / Hawlaha:
SAFETY ASSESSMENT/SAFETY PLAN - SOMALI
DCYF 15-258SM (02/2019) INT/EXT
Bogga 4
Maxaa la sameyn doonaa (sharrax waxqanadyada / hawlaha kuwaas oo la samayn doono si loo maareeyo badbaadada
cunuga, sida uu qorshuhu u shaqeyn doono, iwm.):
Qofka ay Ka Timid:
Soo noq-noqodka (saacadahee, maalmahee todobaadka, iwm.; ku dar dhammaan waqtiyada laga yaabo in ay
hanjabaadu dhacdo):
Hanjabaadaha Badbaadada la Aqoonsadey:
TAARIIKHDA BILOWGA
TAARIIKHDA DHAMMAADKA HADAFKA
Waxqabadyada / Hawlaha:
Maxaa la sameyn doonaa (sharrax waxqanadyada / hawlaha kuwaas oo la samayn doono si loo maareeyo badbaadada
cunuga, sida uu qorshuhu u shaqeyn doono, iwm.):
Qofka ay Ka Timid:
Soo noq-noqodka (saacadahee, maalmahee todobaadka, iwm.; ku dar dhammaan waqtiyada laga yaabo in ay
hanjabaadu dhacdo):
Hanjabaadaha Badbaadada la Aqoonsadey:
TAARIIKHDA BILOWGA
TAARIIKHDA DHAMMAADKA HADAFKA
Waxqabadyada / Hawlaha:
Maxaa la sameyn doonaa (sharrax waxqanadyada / hawlaha kuwaas oo la samayn doono si loo maareeyo badbaadada
cunuga, sida uu qorshuhu u shaqeyn doono, iwm.):
Qofka ay Ka Timid:
Soo noq-noqodka (saacadahee, maalmahee todobaadka, iwm.; ku dar dhammaan waqtiyada laga yaabo in ay
hanjabaadu dhacdo):
FAALOOYINKA
Dokumentiga ku lug leh macluumaada la xiriirta badbaadada ee ku saabsan: Xaaladaha loogu talo galay Ku-noqoshada
(
Guriga, Tijaabda Ku-noqodka Guriga, la midoobida waalidka aan-ahayn midka haya, iwm.
SAFETY ASSESSMENT/SAFETY PLAN - SOMALI
DCYF 15-258SM (02/2019) INT/EXT
Bogga 5
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