You are on page 1of 2

DCFS Reporting

Victim Information
1. Name: Joy Martinez
2. Address: 98765 Maple Lane, Village, IL 16789
3. Age: 10
Parent / Caretakers / Siblings
1. Name and address of Parent(s): No names given for parents, 98765 Maple Lane, Village, IL 16789
2. Name and address of Caretaker(s): Mother, 98765 Maple Lane, Village, IL 16789
a. Relationship to victim: Mother
3. Siblings name(s) and address: No names given but she has two sisters, 98765 Maple Lane, Village, IL 16789
Observations
1. Specific incident you witnessed or the child has told you: Child often comes to school hungry, dirty and
without feminine products. She has been soiling her pants. Her siblings and she say strange men visit the
home. She also told me she is often home alone with her five nieces and nephews. She said when she asks her
sister for a pad, her sister said they dont have one. She seems very lethargic in class and seems very
withdrawn from others. She sits alone at lunch. The school and Protective services has been aware of her state
and situation and are concerned.
2. Location: In her body in general, she is dirty and hungry and soils her pants. Abuse seems to happen at home.
3. Severity of injuries: Bad neglect concerning food, bathing and feminine products. Often she has had head lice.
She has soiled her pants a few times. She also seems very socially withdrawn. She sits alone at lunch.

4. Pattern of neglect or abuse: Joy often comes to school very hungry, dirty and without feminine products. She
has soiled herself a few times. Mother says her daughter wants attention but works two jobs and Joy is often
home. The mother doesnt show up for any conferences. The children say strange men visit the home and both
her sisters got pregnant at around age 13 by adult males. She has had head lice a couple times suggesting lack
of hygienic needs available. School helps provide food and clothing. Protective Services, social workers and
counselors are involved in helping her with her neglect.
5. Physical evidence: She is often dirty, hungry and without feminine products. She has soiled herself a couple
times. She sits alone at lunch and is very withdrawn. She has had head lice many times.
6. Any explanation provided by the child (in the childs own words): When Joy was sent to the school nurse for
seeming very lethargic; Joy said she didnt want to go home because her sister would be mad. She also said
that when she asked her sister for a pad, her sister said they had none. Joy also said she is often home alone
with her five nieces and nephews.
7. Any other relevant information that would expedite the investigation such as directions to the victims house
(especially in rural areas) or information about potential risks to the investigator: According to the siblings and
Joy, there are often strange men visiting the home. They may be a threat.