Orosanmälan För allvarliga missförhållande i omsorgen kring ett placerat barn eller ungdom. Familjehem/Vårdhem.______________________________________________ Barnet/Ungdomens namn. ______________________________________ Barnets Personnummer._____________________________________________ Beskrivning av ett missförhållande kring barnet/Ungdomen. Datum. _______________________Tidpunkt._______________________ Plats._____________________________________ Beskrivning/händelseförlopp._________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ ………………………………………………………………………………………………………………………….. Datum. Underskrift. Utredning och anmälan (Lex Sarah). Godman/Anhörig underrättad Vem är underrättad________________________________________________ Tidpunkt._________________ Underättad av.___________________________ Home 4You Familjehemsvård AB dokumentation på åtgärdsinsats som förhindrar upprepning. _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ Klart datum._________________ Underskrift.___________________________ Anmälan till Socialstyrelsen. Datum._____________________ Underskrift.___________________________ Eventuell Polisanmälan. Datum._____________________ Underskrift.___________________________