Health, Social, Emotional, and Genetic History Report (HSEGH)
Also known as the Adoption Readiness Assessment (ARS)
Overview:
The HSEGH is required by the Texas Family Code and RCCL Minimum Standards in
Texas before placing a child for adoption with anyone other than the child's stepparent,
grandparent, aunt, or uncle by birth, marriage, or prior adoption. It is:
1.
Given to the potentional adoptive family prior to adoptive placement; and
2.
Filed by the family’s attorney with the Petition to Adopt and therefore becomes a
legal document that is reviewed by the judge for adoptions.
Purpose of the report:
The purposes of the HSEGH report are

To fully document DFPS's assessment of the child's readiness for adoption, and

To inform prospective adoptive parents about the child's history and needs.
Process:
1.
Review the file as soon as possible. Determine what documents are still needed
and which ones are missing. The following items should be contained in the case
record for the HSEGH completion:

Hospital Birth Records

Copy of Birth Certificate

Social Security Card

Intake Reports (for all referrals to CPS)

Common Application

Affidavit of Removal

Termination Decree

Medical/Mental Assessment Log (this is a Medical Log printed from
IMPACT and gives the appointment date, reason for appointment,
findings, professionals name/address, comments for each entry)

Current Dental Exam Report (within the last year for children 1 year of
age and older)

Current Medical Exam Report (within the last year)

Current Psychological or Developmental Assessment (Based upon
child’s age, history, and special needs of the child. Assessments must
be current within 30 days of adoptive placement if the child is age 0-18
months; Three (3) months of placement if the child is age 18 months-5
years; and Six (6) months of placement if the child is age 5 or older).
Most foster children should have one or the other within the last year.

Immunization records

CPS Case Notes/Contact Log/Monthly Summary (removal to present
date)

Current Plan of Service from CPS or private agency (within the last six
months)

Current CPS Family Plan of Service
CK HSEGH Guide
Revised 07.24.2013

2.
3.
4.
5.
6.
Adoption preparation documentation (from therapist, case worker,
and/or adoption prep group)

School Records, including current report card

Child’s Placement History
Contact the child’s CPS worker and request the documents/missing information.

Send an email to the worker requesting the information.

Indicate a due date by which information must be received in order to
allow you time to complete the HSEGH within the time frame given on
the Routing and Approval form.

If the worker asks you to contact another person (CASA, foster family,
or biological parent), document within the HSEGH report.
Determine which documents from the case records in addition to the items listed
in #1 above pertain to the child's history and are needed for completion of the
report, including sibling/parent records that pertain to the child's history or are
significant to his health and development. Additional documentation relevant to
the HSEGH, depending upon the specific case may include:

Mediated agreement (if termination was due to Mediated Agreement)

CASA reports (if child had CASA worker assigned)

Child’s most recent ARD report (if child is in special education)

Therapy notes (if child is therapeutic LOC)

Current LOC Authorization (if child is therapeutic LOC); this will give
you information as to what their LOC is and will have a short
explanation of how this LOC was determined by Youth for Tomorrow
(YFT).

Any relevant notes regarding child/family from : Permanency
Conferences, Family Based Services, Circle of Support Meetings , and
Family Team meetings

ECI Progress Reports

Incident Reports

Restraint Reports

Child’s Juvenile Detention/Probation Records

Foster Parent Progress Notes

Private Agency Progress Notes

Psychiatric Medical Reports

Hospital Discharge Records

Parent Psychological (much of Part II can come from the psychological
of the parent)

Parent Drug Testing Results

Parent Criminal History Reports

Relative Home Studies
Flag (put sticky notes on items in #1 and #3) for quick reference when writing the
report. Do NOT write in the file.
Use information flagged to complete report in relevant sections as identified on
form.
Family Assessment Specialist:
CK HSEGH Guide
Revised 07.24.2013


Submit HSEGH and signature page to Family Assessment Supervisor
Return Case Record to Office Manager when HSEGH is completed,
approved and submitted to CPS.

Submit Contact Log to filing.
7. Family Assessment Supervisor:

Submit HSEGH, along with Routing and Approval form to CPS.

Enter Routing and Approval Information into ACCESS.

Submit Original HSEGH and signature form to filing.
8. Return the case file to designated support staff for return to CPS once the HSEGH is
approved by Supervisor and CPS.
REMEMBER:
 There can be several different places where you may find the information to
complete the form.
 Email CPS for important information that you don’t have, such as legal status/date.
 There should be no blanks on the form. If the information is applicable, but not
provided, you should indicate “information not provided” or “unknown.” If the
information is not applicable to the case, such as date of death, you should indicate
“N/A.” You can also qualify it, such as “no military history reported.”
 As much as possible, note the source of the information (“Foster Parent Progress
Notes for 10/09 state that…”).
 For psychological assessments, note date of report, psychologist/psychiatrist name,
recommendations, and diagnosis for each evaluation reported.
 Legal Status options, generally, since you are completing HSEGH parental rights
have been terminated, therefore in most cases the legal status will be “PMC with
termination.” This means that parental rights were terminated and CPS was granted
Permanent Managing Conservatorship at the time of the termination hearing. This
can be found in the termination decree or the most recent court documentation,
and/or service plan.
CK HSEGH Guide
Revised 07.24.2013