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Complaint ID
First Name
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Last Name
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Address Line 2
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Zip Code
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CS Message
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Date Complaint Received
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Source of Complaint
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Child/Youth in Care
Community Member
Court Personnel
Current/Former DHR Staff
Educator/School Personnel
Elected Official
Foster/Adoptive Parent
GAL/Attorney
Governor's Office
Law Enforcement
Medical Professional
Out-of-State Agency
Parent/Legal Guardian
Relative/Kinship Caregiver
Service Provider
Complaint Program Area
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Adult Services
Child & Family Services
Child Care Services
Child Support
Community Services
Food Assistance
JOBS
Other State Agency
Quality Assurance
Resource Management
STC Education
TANF
Involves Specific Case
*
Yes
No
Family/Children Name
*
Investigation Status
Closed
Open
Pending Closure
Under Review
CS Status
Completed
Pending
Submitted for Supervisor Review
Flagged for Pattern
Yes
No
Nature of Complaint
Nature of Complaint
*
Administrative/Procedural Issues
Case Specific Concerns
Legal/Appeals Issues
Personnel/Professional Conduct
Placement/Licensing Concerns
Administrative/Procedural Issues
Confidentiality Breaches
Delays
Failure to Communicate
Inconsistent Information
Case Specific Concerns
CA/N mishandling
Child Safety
Delayed Services
ISP
Placement Disruption
Safety Plan Issues
Visitation
Legal/Appeals Issues
Due Process
GAL Issues
Parental Rights
TPR Disputes
Personnel/Professional Conduct
Bias
Ethics
Mishandling of Case
Misconduct
Non-Responsive
Retaliation
Rudeness
Visitation
Placement/Licensing Concerns
Abuse in Placement
Cultural Insensitivity
Custody
Licensing Violation
Placement Disruption
Retaliation
Runaway
Visitation
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