NORTH CAROLINA
FAMILY ASSESSMENT OF STRENGTHS AND NEEDS
INSTRUCTIONS
DSS-5229 Instructions Revised 11/18 Page 2 of 6
Family Support and Child Welfare Services
S4. Housing/Environment/Basic Physical Needs
a. Adequate basic needs.
Family has adequate housing, clothing, and food.
b. Some Problems. but correctable.
Family has correctable housing, clothing and food problems that affect health and safety needs
and family is willing to correct.
c. Serious problems, not corrected.
Numerous and/or serious housing, clothing and food problems that have not been corrected or are not
easily correctable and family is not willing to correct.
d. Chronic basic needs deficiency.
House has been condemned or is uninhabitable, or family is chronically homeless and without
clothing and/or food.
S5. Family Relationships
a. Supportive relationship.
A supportive relationship exists between household members.
b. Occasional problematic relationship(s). Relationship(s) is occasionally strained but not disruptive.
c. Domestic discord.
Current relationship or domestic discord, including, frequent arguments, degradation, or blaming. Open
disagreement on how to handle child problems/discipline. Frequent and/or multiple transient household
members. Violent acts that cause minor or no injury to any household member and are not assessed as
“domestic violence”.
d. Serious domestic discord/domestic violence.
A pattern of relationship discord or domestic violence. Physical, emotional, or sexual abuse, economic
oppression, isolation, threats, intimidation, and maltreatment of the children to control the non-offending
parent/adult victim. Repeated history of leaving and returning to abusive partner(s). Repeated history of
violating court orders by the perpetrator of domestic violence. Repeated history of violating safety plans.
Involvement of law enforcement and/or restraining orders. Serious or repeated injuries to any household
member.
S6. Child Characteristics
For children under the age of three, any identification of need on this item requires that a referral to Early
Intervention be made using the DSS-5238. For assistance in determining whether or not a developmental
need is present you may access the North Carolina Infant Toddler Program eligibility conditions of:
“Established Conditions” or "Developmental Delay" (definitions can be found at: http://www.ncei.org).
Additional information on developmental milestones can be found at: http://www.pedstest.com/). This site
shows a developmental screening that may be used by families or any staff working with the child. At any
time that a Social Worker or a parent expresses some concern about how a child is developing, contact your
local CDSA for consultation or to make a referral. If a DSS agency needs technical assistance on eligibility
for the early intervention program or how to make a referral, please contact the early intervention program
state office or your local CDSA (http://www.ncei.org).
a. Age-appropriate, no problems.
Child(ren) appears to be age appropriate, no problems.
b. Minor problems.
Child(ren) has minor physical, emotional, medical, educational, or intellectual difficulties addressed with
minimal or routine intervention.
c. One child has severe/chronic problems.
One child has severe physical, emotional, medical, educational, or intellectual problems resulting in
substantial dysfunction in school, home, or community which strain family finances and/or relations.
d. Children have severe/chronic problem.
More than one child has severe physical, emotional, medical, or intellectual problems resulting
in substantial dysfunction in school, home, or community which strain family finances
relationships.
