Chapter 501 of the Laws of 2012 (“Protection of People with Special Needs Act”) - Immediate Protections Safety Assessment
September 2013
SPECIAL EDUCATION FIELD ADVISORY
TO:
Executive Directors of Approved Private Residential Schools
Superintendents, Special Act School Districts
Superintendents, State-Operated Schools
Superintendents, State-Supported Schools with a Residential Component
Out-of-State Residential Schools
FROM:
James P. DeLorenzo
SUBJECT:
Chapter 501 of the Laws of 2012 (“Protection of People with Special Needs Act”) - Immediate Protections Safety Assessment - PDF 
(60 KB)
In July 2013, I notified you of requirements for completion of an “Immediate Protections Safety Assessment” when a report has been made to the Justice Center of alleged abuse, neglect or reportable significant incidents in a residential school. We have a seen a high level of cooperation and compliance with this requirement by residential schools.
Since July, and upon consideration of recommendations from residential school providers, the State Education Department has revised the “Immediate Protections Safety Assessment” form that must be used to ensure that proper actions have been taken to assure the health and safety of students who may be the subject of reports of abuse/neglect or significant incidents that occurred at the school or off hour school activities and were reported to the New York State Justice Center’s Vulnerable Persons Central Registry pursuant to Chapter 501 of the Laws of 2012 (“Protection of People with Special Needs Act”). A copy of the revised form with revised directions for submittal is attached to this memorandum and may be found at http://www.p12.nysed.gov/specialed/justicecenter/home.html.
If you have any questions regarding this matter, please contact the Regional Associate assigned to your residential school.
Attachment
IMMEDIATE PROTECTIONS SAFETY ASSESSMENT- Word 
(48 KB)
ACTIONS TAKEN
Name of Residential School:
Vulnerable Persons Central Registry (VPCR) Identification Number (if known):
Date Alleged Incident Reported:
Describe Alleged Incident:
Location where the Alleged Incident Occurred:
Parent/Guardian Contact
Were the parent(s)/guardians contacted? Yes No
If yes, by whom?
If no, why not?
Actions to Protect the Health and Safety of the Student(s)
Did the student[s] incur any injuries? __ Yes __ No
Did he/she receive medical evaluation and/or treatment? __ Yes __ No
Does the student require follow-up medical care? __ Yes __ No
Check and specify the other actions the agency took to assure the health and safety of the student(s) involved in the report and any other students similarly situated in the facility or program.
__ The staff named in the incident was removed or transferred so as not to have contact with the student(s). Describe:
__ The supervision of the staff named in the incident has been increased. Describe:
__ The student(s) were temporarily removed or transferred. Describe:
__ The student(s) were provided with emotional support (e.g., immediate counseling). Describe:
__ All students related to the incident have been removed from harm’s way. Describe:
__ Other actions taken. Describe:
Immediate Actions Related to the Investigation of Abuse/Neglect/Criminal Reports
Was the area where the alleged incident of abuse occurred secured?
__ Yes __ No __ Not applicable
Was potential evidence preserved and secured?
__ Yes __ No __ Not applicable
If the student incurred injuries, were photos of the student taken?
__ Yes __ No __ Not applicable
Was law enforcement contacted?
__ Yes __ No __ Not applicable
Printed Name of Individual Completing the Form: ___________________
Contact Telephone Number: _______________________________
Signature of Chief School Administrator or Designee: ________________
Date: _________________
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Please complete this form wihtin 24 hours of notificaiton of the alleged incident and fax it during regular business hours to:
P-12: OFFICE OF SPECIAL EDUCATION
NEW YORK STATE EDUCATION DEPARTMENT
89 WASHINGTON AVENUE, RM 301M EB
ALBANY, NY 12203
FAX NUMBER: (518) 402-3534
ATTN: RESIDENTIAL SCHOOL IMMEDIATE PROTECTIONS SAFETY ASSESSMENT