POSITIVE DBS DISCLOSURE RISK ASSESSMENT (HR-F033) Updates POSITIVE DBS DISCLOSURE RISK ASSESSMENT Positive DBS Disclosure Risk Assessment (HR-F033)SECTION 1: APPLICANT, DBS CERTIFICATE DETAILS & DETAILS OF THE DISCLOSURETitle- Select -MrMrsMissMsMxOtherStaff Member NameStaff_IDJob TitleCare Worker / Support WorkerComplex Care WorkerSenior Care Worker / MentorField SupervisorCare Coordinator / Rota SchedulerClinical LeadQuality Assurance / Compliance OfficerHR / Recruitment AdministratorImplementation ResearcherDeputy Care ManagerRegistered Care ManagerOperating Local Authority- Select -HaringeyIslingtonBarnetWaltham ForestCamdenHackneyBrentHarrowRedbridgeNewhamCity of LondonWestminsterTower HamletsBarking and DagenhamHaveringKensington and ChelseaHammersmith and FulhamEalingHillingdonHounslowSouthwarkLambethLewishamGreenwichWandsworthRichmond upon ThamesMertonKingston upon ThamesSuttonBexleyBromleyCroydonOtherLevel of DBS Check- Select -Enhanced with Adult Barred List checkEnhanced with Adult & Children's Barred List checkEnhanced without Barred List checkStandardDBS Certificate NumberDBS Issue DateIs the individual currently on the Adult Barred List?- Select -YesNoN/AIs the individual currently on the Children's Barred List?YesNoNot CheckedBarred List, immediate hard stop. Employment in regulated activity is a criminal offence- Select -Report to Police/DBS/Local Authority LADO triggeredFiltering Rules VerificationI explicitly confirm this disclosure is not a 'protected' caution or conviction under the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2020), and can be legally considered.Total Number of Offences / Cautions ListedAge of Applicant at the Time of Most Recent OffenceNature of Disclosure(s)Violence / Assault (e.g., ABH, GBH, Affray)Domestic Abuse / Coercive Control (System LogicTheft / Fraud / Financial / DeceptionDrug-related (Possession)Drug-related (Supply / Intent to supply)Sexual offences (System LogicMotoring / Driving offences (e.g., DUI, Dangerous Driving)Public Order / Anti-social behaviourRegulatory/Licensing OffenceDate of Most Recent OffenceDisposal / Sentence Given- Select -Police Caution / Reprimand / WarningAbsolute or Conditional DischargeFine / Compensation OrderCommunity Service / Unpaid Work OrderSuspended Custodial SentenceCustodial Sentence (Prison)Driving DisqualificationNext Review Date:SECTION 2: DOMICILIARY CARE RISK MATRIXFinancial Risk (Safe QS1): Does the role involve access to service users' homes, property, or finances?- Select -YesNoN/AIf the offence is Theft/Fraud, does this pose an unacceptable risk to vulnerable adults?- Select -Unacceptable RiskManageable RiskLow/No RiskPhysical/Emotional Risk (Safe QS3): Does the offence indicate a history of violence, poor temper control, or coercive behaviour?- Select -YesNoN/ADriving Risk (Safe QS2): Is driving a requirement of the role? [Drop-down: Yes / No] If the offence is a DUI/Dangerous Driving, are they transporting service users or driving company vehicles?- Select -Unacceptable RiskManageable RiskLow/No RiskPattern of Behaviour: Was this an isolated incident or part of a repeated pattern of offending?- Select -Isolated incident (Historic - Over 5 years ago)Isolated incident (Recent - Within last 5 years)Repeated pattern (Historic - Over 5 years ago)Repeated pattern (Recent - Within last 5 years)SECTION 3: SAFEGUARDING CONTROLS, MITIGATION, FINAL DECISION & STATUTORY REPORTINGProposed Safeguarding Controls (Select all that apply)No involvement in service user finances, banking, or shopping tasks.Do not deploy to service users with complex challenging behaviours/aggression.Do not deploy to households where children are present.Increased frequency of unannounced Spot Checks (Field Competency) for the first 6 months.Increased frequency of 1-to-1 supervision (Monthly instead of Quarterly).Cannot transport service users in their personal vehicle.No mitigation required (Offence is minor, historic, and entirely irrelevant to care).Primary Mitigation Strategy- Select -System blocks applied to prevent deployment to high-risk calls; intense supervision schedule locked into the rota.Explicit financial/driving bans communicated to Care Coordination team.Standard probationary monitoring deemed sufficient; offence carries negligible risk to current role.Assessor's Risk Grading- Select -Low RiskMedium RiskHigh / Critical RiskFinal Employment Decision- Select -Approve for Hire / Continue Employment (With standard induction).Approve for Hire / Continue Employment (With strict mitigations applied to Care Worker profile).Withdraw Offer / Terminate Employment (Unacceptable Safeguarding/Integrity Risk).Statutory Referral Required?- Select -No referral required.Yes - Referral to Disclosure and Barring Service (DBS) required (Attempted entry to workforce by barred individual or critical safeguarding risk).Yes - Referral to Local Authority Safeguarding / LADO required.Date of DecisionSUBMIT FORM