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Child Study Report

This document contains a child study report template for a child who is legally free for adoption. The template includes sections for general information about the child such as name, date of birth, sex, religion, and date of admission. It also includes a social data section requesting information about how the child came to the institution and their behavior, intelligence, personality, and development. The social worker certifies the accuracy of the information and prospective adoptive parents must sign agreeing to accept the child. The report is intended to provide essential identifying and background information to support the adoption.

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Shammah Bicua
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Download as PDF, TXT or read online on Scribd
116 views

Child Study Report

This document contains a child study report template for a child who is legally free for adoption. The template includes sections for general information about the child such as name, date of birth, sex, religion, and date of admission. It also includes a social data section requesting information about how the child came to the institution and their behavior, intelligence, personality, and development. The social worker certifies the accuracy of the information and prospective adoptive parents must sign agreeing to accept the child. The report is intended to provide essential identifying and background information to support the adoption.

Uploaded by

Shammah Bicua
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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SCHEDULE II

[See regulations 2(6), 6(15), 7(18), 58(5)(a) and 58(6)(a)]

CHILD STUDY REPORT

Child Adoption Resource Information and Guidance System (CARINGS)


Registration No:
Aadhar Card No:
Name of the Specialised Adoption Agency (SAA)/Child Care Institution
(CCI):

The detailed report on the child shall include identifying information supported
by documents. Child Study Report should be prepared as soon as the child is
declared legally free for adoption by the Child Welfare Committee.

Photograph of
the child

Name and address of the Institution:-

I. GENERAL INFORMATION:

1. Name of the Child. ---------------------- (given by biological mother or


parents or by the Specialised Adoption Agency/Child Care Institution or
Child Welfare Committee)
2. Present age and date of birth:
4. Sex:
5. Place of Birth:
6. Religion (if known):
7. Type of child: Orphan/ abandoned/ surrendered
8. Date of admission of the child to the Specialised Adoption Agency/Child
Care Institution:
9. Date of production before Child Welfare Committee:
10. Date declared as legally free for adoption by the Child Welfare
Committee:

II. SOCIAL DATA:

Please do not give identifying information about the natural parent.

1. How did the child come to your institution?


(a) Admitted directly by parent or any other guardian:
(b) Placed by Child Welfare Committee directly:
(c) Transferred from any other institution, if so name of the
institution:
(d) Any other source:

2. Reasons for seeking protection in the Institution:

3. Attitude of the child towards other children, if applicable

4. Behaviour and relationship of the child towards staff and other adults
including strangers:

5. General intelligence:

6. If the child is enrolled in school, give a detailed report about his or her
standard, attendance, general interest in studies, progress, if any:

7. General personality and description of the child:

8. Play activity and any specific talent: Milestones of the child (for children
below 18 months). Please mark Yes or No (based on age appropriate
responses)
Does the child:-

(a) Smile
(b) Turn on his sides
(c) Lift its head
(d) Grasp objects in its hand
(e) Crawl on its own
(f) Sit with full support or Sit without support
(g) Stand with support or Stand without support
(h) Walk with support or Walk without support

9. Dietary Habits:

Intake of liquid

food: Semi-solid

food: Solid food:

10. Developmental Assessment (language spoken, behaviour, basic play


skills, physical activity and communication and social skills etc.):
11. Social Background: (This should include his social history i.e. brief
background of the birth parents and circumstances necessitating the
child’s surrender or abandonment, etc. Please do not give identifying
information such as name and address of birth parents or relatives.)

12. I ______________ Social Worker hereby certify that the information given in
this form about child _______ is correct.

Signature:
Place: Name:
Date: Designation:

We have read and understood the contents of the Child Study Report and are
willing to accept __________as our adoptive child.

(Signature of the male applicant) (Signature of the female applicant)

(Name of the male applicant) (Name of the female applicant)


Place and Date: Place and Date:
***

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