Safety indicators are behaviors or conditions that describe a child being in imminent danger of serious harm.
Child vulnerability: these are conditions resulting in child's inability to protect self.
Safety indicators: mark yes for any and all safety indicators present in the family's current situation.
Any Yes: if any Indicators of Immediate Safety are marked Yes, skip the bottom of this page and continue on the next page.
Safety decision: check one line only.
Safety agreement: a safety agreement is used only when there is a specific threat to a child in the immediate or foreseeable future.
| Question | Answer |
|---|---|
| Form Name | DSS-5231 |
| Form Length | 8 pages |
| Fillable? | Yes |
| Fillable fields | 237 |
| Avg. time to fill out | 40 min |
| Edition | 01/2017 |
| Matches the agency's file | Yes, checked October 4, 2026 |
| Other names | DSS-5231, DSS 5231, North Carolina Safety Assessment |
| Official source | DSS-5231 (Rev 01/2017), |
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