Preview
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023
Exhibit C
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
4
NYSCEF DOC. NO. 18 w Office of Children RECEIVED NYSCEF: 04/27/2023
RK
~TE and Family Services
ANDREW M. CUOMO SHEILA J. POOLE
Governor Commissioner
6/14/2021
CERTIFIED MAIL
Jody Agostinelli, Esq.
Bureau of Special Hearings
Office of Children and Family Services
333 E. Washington Street
Syracuse, NY 13202
Dear Jody Agostinelli, Esq. :
Enclosed please find a copy of the State Central Register (SCR) record concerning the below-
referenced case as well as our certification of the record . We request that, pursuant to 18NY CRR
Section 434'. 9 (c) , this record be admitted into evidence at the hearing requested by the appellant.
This admission Irita evidence is solely for the purpose of showing that the attached forms and
documents are those presently maintained in the SCR in relation to the case at issue; these forms
and documents should be admitted without regard to the truth or falsity of any of the contents of
such forms and documents , and no implication may be made by the hearing officer as to the truth
or falsity of any of the contents·of any of the forms or documents solely on the basis of such forms
and documents having been admitted into evidence.
The SCR will not be appearing at the hearing in as much as the SCR record will be made part of
the hearing record pursuant to 18 NYCRR Section 434 .9 (c) of Social Service Law.
Sincerely,
KRYSTLE PRENTICE
Request ID: 30798426
Subject Name: KEVIN BASKERVI LLE
Case ID: 27142961 , 27026143
Intake Stage ID: 32274053, 32030223, 32079323, 32052066
Enclosures
cc: Appellant: KEVIN BASKERVILLE
County Liaison/County Attorney: NYC STI P
Mary Anne Szabo
Authorized Appellant Attorney: N/A
S tale Central Register I P.O. Box 4480 Albany, NY I 2204 I ocfs.ny.gov # 338 • Page 1 / 1
BASKERVILLE AR 1
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023
BASKERVILLE AR 2
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023
~6:'K Office of Children
~ A T E and Family Services
ANDREW M. CUOMO SHEILA J. POOLE
Governor Acting Commissioner
June 14, 2021
In the Matter of the Request of
KEVIN BASKERVILLE
That the records of the New York State Central Register of Child Abuse and Maltreatment be.
amended or expunged.
Pursuant to the 18 NYCRR Section 434.9 (c), I, KRYSTLE PRENTICE,
Office Asssistant-3, hereby certify that the attached forms and documents are true and accurate
copies of the originals maintained at the State Central Register cif Child Abuse and Maltreatment
(SCR), that the attached forms and documents constitute the record of the case maintained at the
SCR concerning the appellant; that the SCR is required by law to receive reports of alleged child
abuse and maltreatment; and that portions of the record have been redacted as required by Section
1
422 of the Social Services Law to protect the confidentiality of the source or other persons who
cooperated in the investigation: I am designated by the director of the SCR to make this certification
on behalf of the SCR.
Slate Centrnl Register j P.O. Box ,1480 Albany, NY 12204 I ocfs.ny.gov
BASKERVILLE AR 3
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023
BASKERVILLE AR 4
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023
FORM EXPLANATION
DSS-2221 (paper) Oral Report Transmission (ORT) & Investigative Summary/Call Narrative:
database
Allegations of child abuse or maltreatment & family composition as repotied to the SCR on a specific date
DSS-2221 A (paper) Submitted by mandated repotiers to confirm their repotis to the SCR
DSS-2221 B (paper) To amend identifying or demographic information on a case
DSS-2222 (paper) Submitted by local/agency investigators to the SCR regarding the first
DSS-2222I (paper) seven days of the investigation and documents the initial assessment of
Preliminary Report (PR!) & the safety of the children
NYC Check List (database)
DSS-2223 (paper) Submitted by local/agency investigators regarding the determination of
DSS-2223I (paper) the report(s); Submitted post investigation progress reports (known as
Continuing Service Report (CSR) in direct data entry database)
Sequence Determination Submitted directly onto the database by local/agency investigators
Report (SOR) regarding the determination of a repoti
CPS Investigative Summary/ (Converted data from previous database will be displayed in this
CPS Investigative Narrative section in the CONNECTIONS system) Submitted directly onto the
. database by local/agency investigators regarding the deterrriination of a
report
Report Record Transmittal (RRT) Cumulative record submitted directly to the database prior to 6/21/97
Case Record Transmittal (CRT) Cumulative data in case submitted prior to 6/21/97
CPS Investigative Summary (Converted data from previous database will be displayed in this
CPS Investigative Narrative section in the CONNECTIONS system) Submitted directly onto the
database by local/agency investigators regarding the determination of a
repoti
Memo to File (paper) Documents the decision of the SCR Administrative Review or decision
Administrative Review & of the Fair Hearing
Fair Hearing Narratives ( coded pre-conversion)
DSS-2224 (paper)/CNN. Internal means used to communicate information on case within the
SCR
The State Central Register (SCR) does not do the actual investigation of the report made to the SCR. If you
want further information concerning the investigation, please contact the local county child protective
services or State Agency. Prior to November of 1992, the text of all forms were retained on paper and the
SCR database reflected family composition, allegations and investigative follow-up with determinations in
code. By March of 1993, all paper forms could be directly entered into the database by local CPS. On
June 21, 1997, the SCR converted all data into a computer environment called "CONNECTIONS". The
CONNECTIONS system maintains all "convetied" data regarding a repoti and case in the "Summary of
Investigations" section. Data may reflect former alpha/numeric codes from previous computer system
Tracking by specific report dates, function and individual or by SCR# and CASE ID# and subdivisions of
Data referred to as stages with their designated numerical identifications. "Principals" are those named in
The report. Converted data may reflect inaccurate information. Please read the text of the narrative. As of
January 8, 1998, the Department of Social Services became the Office of Children and Family Services.
State Central Register I P.O. Box 4480 Albany, NY 12204 I ocfs.ny.govc # 339 - Page 1 i 1
BASKERVILLE AR 5
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023
BASKERVILLE AR 6
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023
•••••WARNING•..••
CONNECTIONS
STAGE SUMMARY CONFlDl;NTlAL INFOR MA TION
AUTHORIZED PERSONNEL ONLY
STAGE: Investigation
CASE ID: 27026143 STAGE ID: 32030317
CASE NAME: S ,ld STAGE NAME: S ,ld
CD: R01 REPORT DATE: 6/13/2018
CASE SUMMARY
STAGE ID S TAGE NAME STAGE TYPE DT OPEN DT CLOSE QEL STAT. REASO N STAGE CLASS. SUB-
CLOSED CLASS
33328967 Baskerville.Kevin ARI 11/12/2020 · CPS - Familial
32126621 Baskerville.Kevin INV INI 8/23/2018 8/24/2018 IND APRV Case open-CPS r_equired CPS • Familial
32079323 Baskerville.Kevin INT INI · 7/18/2018 8/23/2018 CPS - Familial
33328948 Baskerville.Kevin ARI 1'1/12/2020 CPS-Familial
32127713 S ,ld FSS cws 8/23/2018 10/15/2018
32126821 S ,ld · FSI cws 8/23/2018 8/23/2018
32126620 St ,ld INV · INI 8/23/2018 8/24/2018 IND APRV Case open-CPS required CPS -Familial
32052066 St ,ld INT INI 6/27/2018 8/23/2018 CPS • Familial
33328946 Baskerville.Kevin ARI · 11/12/2020 11/12/2020 Retain (Untimely Request) CPS - Familial
32092093 St ,ld INV DUP 7/27/2018 8/1/2018 SUS APRV Closed as Duplicate CPS - Familial
32092052 St ,ld INT SUB 7/27/2018 7/27/2018 CPS·- Familial
32047114 St ,ld INV DUP· 6/25/2018 6/27/2018 SUS APRV Closed as Duplicate CPS - Familial
32047109 St ,ld INT SUB 6/25/2018 6/25/2018 CPS - Familial
32047086 St .Id INT DUP 6/25/2018 6/27/2Q18 Closed - Duplicate Report CPS • Familial
32047066 St ,la INV DUP 6/25/2018 6/27/2018 SUS APRV Closed as Duplicate CPS - Familial
32047056 St ,ld INT SUB 6/25/2018 6/25/20,1 8 CPS - Familial .
32033451 St ,ld INV DUP 6/15/2018 6/19/2018 SUS APRV Closed as Duplicate . CPS • Familial
32033344 St , ld INT SUB 6/15/2018 6/15/2018 CPS - Familial
32032719 St ,ld INV DUP 6/1 4/2018 6/19/2018 SUS APRV Closed as Duplicate CPS • Familial
32032673 St ,ld INT SUB 6/1 4/2018 6/14/2018 CPS· Familial
32030317 St ,ld INV INI 6/13/2018 8/1 0/2018 IND APRV Closed-Referred to CPS - Familial
Communi_ty Based Services
Only
32030223 S ,ld INT INI 6/1 3/2018 6/13/2018 CPS· Familial
STAGE ID WORKER NAME ROLE TELEPtJQt:jE DISTRICT OR REGIONAL OFFICE
33328967 Ari,A-B Primary No Phone Available Nys Office Children & Families
STAGE ID WORKER NAME ROLE TELEPHONE DIS!RICT OR REGIONAL OFFICE
32126621 Tirado.Alexandr R Histor. Staten lslalld Field Office
Primary
32126621 Akinduro,Anthony Historic.al Family Court Legal Services
Secondary
STAGE ID WOBKER NAME ROLE TELEPHONE DISTRICT OR REGIONAL OFFICE
32079323 nrado,Alexandr R Histor. Staten Island Field Office
Primary
32079323 Aklnduro,Anthony Historical Family Court Legal Services
Secondary
STAGE ID WORKER t:!AME ROLE TELEPHONE DISTRICT OR R EGIONAL OFFICE
33328948 Arl ,A-B Primary No Phone Available Nys Office Children & Families
Date Printed: 12/3/2020 12:56:33 PM Page:
BASKERVILLE AR 7
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023
CONNECTIONS .....WARNING..*'"'
STAGE SUMMARY CONFIDENTIAL INFORMATION
AUTHORIZED PERSONNEL ONLY
STAGE: Investigation
CASE ID: 27026143 STAGE ID: 32030317
CASE NAME: S ,ld STAGE NAME: St ,ld
c·D: R01 REPORT DATE: 6/13/2018
S.TAGE ID WORKER NAME ROLE TELEPHONE DISTRICT OR REGIONAL OFFICE
32127713 Velonis,Stephani Histor. No Phone Ava ilable
Manager
STAGE ID WORKER NAME ROLE 'FELEPHONE DISTRICT OR REGIONAL OFFICE ·
32126821 Tirado.Alexandr R Hlstor. Case Staten Island Field Office
Worker
STAGE ID WORKER NAME ROLE TELEPHO~E DISTRICT OR BEGIONAL OFFICE
32126620 Tirado.Alexandr R . Histor. Staten Island Field Office
Primary
STAGE ID WORKER NAME ROLE TELEPHONE DISTRICT OR REQIONAL OFFICE
32052066 Tirado.Alexandr R Histor. Staten Island Field Office
Primary
STAGE ID WORKER NAME ROLE TELEPl:iQNE DISTRICT OR REGIONAL OFFICE
33328946 Pierre.Rhonda Histor. · No Phone Available Nys Office Children-& Families
Primary
ST AGE ID WORKER NAME ROLE TELEPHONE DISTRICT-OR REGfONAL OFFICE
32092093 Tirado.Alexandr R Histor. S.talen Island Field Office
Prima·ry
32092093 Aklnduro,Anthony Historical Family Court Legal SeNices
Secondary
32092093 'Audain.Felisha Historical Staten Island Field Office
Secondary
32092093 Battle Jr,Alexande Historical Acs Emergency Children's SeNi
Secondary
32092093 Witherspoon,lyesha Historical Brooklyn East Field Office
Secondary
STAGE ID WORKER NAME ROLE TELEPHONE DISTRICT OR REGIONAL OFFICE
32092052 Adekoya,Hakeem Hlstor. Brooklyn West Field Office
Primary
ST AGE ID WORKER NAME ROLE 'TELEPHONE DISTRICT OR REGIONAL OFE!~E
32047114 Tirado.Alexandr R Histor. Staten Island Field Office
Primary
320471 14 Aklnduro,Anthony Historical Family _Court Legal SeNices
Secondary
32047114 Ferguson, Christia Historical Brooklyn West Field Office
Secondary
32047114 Flavigny,Alicia Historical Placement Administration
Secondary
STAGE ID WORKER NAME ROLE TELEPHONE DISTRICT OR REGIONAL OFFICE
Date Printed: 12/3/2020 12:56:33 PM Page: 2
BASKERVILLE AR 8
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023
*"'..WARNING"''*'
CONNECTIONS
STAGE SUMMARY CONFIDENTIAL INFORMATION
A~THOR~EDPERSONNELONLY
· STAGE: Investigation
CASE ID: 27026143 STAGE ID: 32030317
CASE NAME: St ,ld STAGE NAME: · St ,ld
CD: R01 REPORT DATE: 6/13/2018
32047109 Jones.Ayana Histor. Brooklyn West Field Office
Primary
STAGE ID WORKER NAME BQ!J; TEbEPHONE Dl~TRIC! OR REGIONAL OFFICE
32047086 Tirado.Alexandr R Histor. Staten Island Field Office
Primary
32047086 Akinduro,Anthony Historical Family Court Leg,,!I Services
Secondary
32047086 Ferguson.Christia Historical Brooklyn West Field Office
Secondary
32047086 Flavigny,Alicia Historical Placement Administration
Secondary
STAGE ID WORKER NAME RObE TELEPHONE DISTRICT OR REGIONAL OFFICE
32047066 Tlrado,Alexandr R Histor. Staten Island Field Office
· Primary
· 32047066 Akinduro,Anth ony Historical Family Court Legal Services
Secondary
32047066 Ferguson.Christia Historical Brooklyn West Field Office
Secondary
32047066 Flavigny,Alicia Historical Placement Administration
Secondary
STAGE ID WORKER NAME ROLE · TELEPHQt:!E Dl§TRICT QR RE~IONAL OFFICE
32047056 Jones.Ayana Histor. Brooklyn West Field Office
Primary
STAGE ID WORKER NAME ROLE TELEPt!ONE DISTRICT OR REGIONAL OFFICE
32033451 Tirado.Alexandr R Hlstor. Staten Island Field Office
Primary
32033451 Akindur'o,Anthony Historical Family Court Legal Services
Secondary
32033451 Audain.Felisha Historical Staten Island Field Office
Secondary
STAGE ID WOR.KER NAME ROLE . TEbEPHONE DISTRICT OR REGIONAL, QEFICE
32033344 Nowell,Bernadin Histor. No Phone Available
Primary
STAGE ID WORKER NAME ROLE TELEeHQNE Dl§TRICT QB R E~IONAb OFFICE
32032719 Tirado,Alexa ndr R Histor. Staten Island Field Office
Primary
32032719 Akinduro,Anthony Historical Family Court Legal Services
Secondary
32032719 Audain.Felisha Historical Staten Island Field Office
Secondary
STAGE ID WORKER NAME ROLE TELEPHONE DISTRICT OR R EGIONAL OFFICE
32032673 Adekoya,Hakeem Histor. Brooklyn West Field Office
Primary
Date Printed: 12/3/2020 12:56:33 PM Page: 3
BASKERVILLE AR 9
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023
CONNECTIONS ""**'WARNING•••••
STAGE SUMMA RY CONFIDENTIAL INFORMATI ON
AUTHORIZED PERSONNEL ONLY
STAGE: Investigation
CASE ID: 27026143 STAGE ID: 32030317
CASE NAME: St ,ld STAGE NAME: St ,ld
CD: R01 REPORT DATE: 6/13/2018
ST AGE ID WORKER NAME ROLE TELEPHONE DISTRICT OR REGIONAL OFFICE
32030317 Tirado,Alexandr R Histor. Staten Island Field Office
Primary·
32030317 Akinduro,Anthony Historical Family Court Legal Services
Secondary
32030317 Audain,Felisha Historical Staten Island Field Office
Secondary
32030317 Bonsu,Janice Historical
Secondary
STAGE ID WORKER .NAME .B.Q!.£ TELEPHONE DISTRICT OR REGIONAL QFFICE
32030223 Nowell,Bernadin Histor. No Phone Available
Primary
Date Printed: 12/3/2020 12:56:33 PM Page: 4
BASKERVILLE AR 10
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
NYSCEF DOC. NO. 18 CONNECTIONS
RECEIVED NYSCEF: 04/27/2023
""***WARNING•....
STAGE SUMMARY CONFIDENTIAL INFORMATION
AUTHORIZED PERSONNEL ONLY
STAGE: lnvesligation
CASE ID: 27026143 STAGE ID: 32030317
CASE NAM E: S ,ld STAGE NAME: St ,ld
CD: R01 REPORT DATE: 6/13/2018
PERSON LIST
ID NAME PERSON ID REU INT D.O.B. SEX ROLE ETH. RACE LAN G SSN REL
2 S ,ld 44262435 Mother . 1981 F Non- NH White English Unknown
Confirmed
Subject
3 Baskerville.Brenda 44915152 Grandparent - 1947 F No Role NH B1/Af- English Unknown
Amer
3 Baskerville,Kevin 44262431 Bio. Father - 1969 M Confirmed NH B1/Af- English Unknown
Subject Amer
Unknown.C 45582435 Parent Sub . 1983 M Non- NH Unknown English
Confirmed
Subject
4
• 44262432 Child . ,2011 F Confirmed
Abused
NH Multiple English Unknown
ID
1
2
3
4.
ADDRESS
VE
-
CITY STATE ZIP
•
•
•
•
-
CNTY
073
073
074
074
£g
01
01
01
01
PHONE
NIA
Date Printed: 12/3/2020 12:56:33 PM Page: 5
BASKERVILLE AR 11
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023
CONNECTIONS •uuwARNING**·• ••
STAGE SUMMARY CONFIDENTIAL INFORMATiON
AUTHORIZED PERSONNEL ONLY
STAGE: Investigation
CASE ID: 27026143 STAGE.ID: 32030317
CASE NAME: St ,ld STAGE NAME: S ,ld
CD: R01 REPORT DATE: 6/13/2018
ALLEGATIONS
MA/AB CHILD:
ALLEGED SUBJECT: Baskerville,Kevin
.. CHILO ID:
SUBJECT ID:
44262432
44262431
..
ALLEGATION : lnadequat~ Guardianship UNSUB/SUB: SUB
MA/AB CHILD; CHILD ID: 44262432
ALLEGED SUBJECT: Baskerville.Kevin SUBJECT ID: 44262431
..
ALLEGATION: Other UNSUB/SUB: UNS
MA/AB CHILD: CHILD ID: 44262432
ALLEGED SUBJECT: Baskerville.Kevin SUBJECT ID: 44262431
..
ALLEGATION: Sexual Abuse UNSUB/SUB: UNS .
MA/AB CHILD: CHILD ID: 44262432
ALLEGED SUBJECT: S ,l SUBJECT ID: 44262435
ALLEGATION: Other UNSUB/SUB: UNS
MAJAB CHILD:
ALLEGED SUBJECT:
ALLEGATION:
St
Sexual Abuse
,l
·- CHILD ID:
SUBJECT ID:
UNSUB/SUB :
44262432
44262435
UNS
MA/AB CHILD:
ALLEGED SUBJECT:
ALLEGATION:
S ,l
·-
Excessive Corporal Punishment
CHILD ID:
SUBJECT ID:
UNSUB/SUB:
44262432
44262435
UNS
MA/AB CHILD:
ALLEGED SUBJECT:
ALLEGATION:
S ,l
·-
Inadequate Guardianship
CHILD ID:
SUBJECT ID:
UNSUB/SUB:
' 44262432
44262435
UNS
MA/AB CHILD: CHILD ID: 44262432
ALLEGED SUBJECT: S c,l SUBJECT ID: · 44262435
ALLEGATION:
MA/AB CHILD:
ALLEGED SUBJECT: Unknown.C
..
Lacerations, Bruises, Wells UNSUB/SUB:
CHILD ID:
SUBJECT ID:
UNS
44262432
45582435
...
ALLEGATION: Sexual Abuse UNSUB/SUB: UNS
MA/AB CHILD: CHILD ID: 44262432
ALLEGED SUBJECT: Unknown.C SUBJECT ID: 45582435
Date Printed: 121312020 12:56:33 PM Page: 6
BASKERVILLE AR 12
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023
CONNECTIONS •••••WARNING* 0 **
STAGE SUMMARY CONFIDENTIAL INFORMATION
AUTHORIZED PERSONNEL ONLY
STAGE: Investigation
CASE ID: 27026143 STAGE ID: 32030317
CASE NAME: S ,ld STAGE NAME: S ,ld
CD: R01 REPORT DATE: 6/13/2018
ALLEGATION: Inadequate Guardianship UNSUB/SUB: UNS
MA/AB CHILD:
ALLEGED SUBJECT:
ALLEGATION:
Unknown.C
·-
Excessive Corporal Punishment
CHILD ID:
·suBJECT ID:
UNSUB/SUB:
44262432
45582435
UNS
MA/AB CHILD: ,'1111 CHILD ID: 44262432
ALLEGED SUBJECT: Unknown.C SUBJECT ID: 45582435
ALLEGATION: Lacerations, Bruises, Welts UNSUB/SUB: UNS
Date Printed: 12/3/2020 12:56:33 PM Page: 7
BASKERVILLE AR 13
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023
CONNECTIONS •••..WARNING•"*••
STAGE SUMMARY CONFIDENTIAL INFORMATION
\
AUTHORIZED PERSONNEL ONLY
STAGE:· Investigation
CASE ID: 27026143 STAGE ID: 32030317
CASE NAME: S ,ld STAGE NAME: St ,ld
CD: R01 REPORT DATE: 6/13/2018
INTAKE NARRATIVE
Call Narrative
Narrative: Parent substitute C has kissed 6 year old KIii
in a sexually inappropriate
manner by inserting his tongue into her mouth. C also put his fingers in ~ •s mouth.
Mother Id was made aware and she told~ that it Was okay. Father has no role.
Miscellaneous Information: The parents are involved in a custody battle.
Locating Information: The child was transported to Staten Island University North.
Date Printed: 12/3/2020 12:56:33 PM . Page: 8
BASKERVILLE AR 14
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023
NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023
CONNECTIONS •••••WARNING•••••
STAGE SUMMARY CONFIDENTIAL INFORMATION
A UTHORIZED PERSONNEL ONLY
STAGE: Investigation
CASE ID: 27026143 STAGE ID: 32030317
CASE NAME: St ,ld STAGE NAME: St ,ld
CD: R01 REPORT DA TE: 6/13/2018
SAFETY ASSESSMENT
Assessment Date: 08/03/2018 Event Status: APRV
Type: Case Close Event Date: 08103/2018
Decision: 2. Safety Factors exist, but do not rise to the level of immediate or impending danger of serious harm, No Safety
Plan/Controlling Interventions are necessary at this time. However, Identified Safety Factors have been/will be
addressed with the Parent(s)/Caretaker(s) and reassessed .
Selected Safety Factors :
• Based on your present assessment and review of prior history of abuse or maltreatment, the Parent(s)/Caretaker(s) is unable or
unwilling to protect the child(ren),
Comment:
The Family Is known to ACS a pattern of INGD due to the parents unable to co-parenting
• Child(ren) has experienced or Is likely to experience physical or psychological harm as a result of domestic violence In the
household.
Comment:
There is ongoing parental Issues with a past of DV. There Is a current OOP and the parents are unable to communicate further than
speaking about pick up and drops. There is concern the lack of co-paren ting Is affecting the child.
• Chlld(ren) has been or Is suspected of being sexually abused or exploited and the Parent(s)/Caretaker(s) Is unable or unwllling to
provide adequate protection of the child{ren).
Comm ent:
There is concern that after visitation with the biological mother, the subject child makes discourses of sexual and physical abuse
Safety Factors that place the chlld(ren) In Immediate danger of serious harm:
, None
Comment:
Mitigating Strengths and Resources:
The mother denied the reported allegations and maintained that she is not currently in a relationship with anyone and
she denied having a boyfriend named C . The child was seen and assessed at the CAC and the child will remain in
the ~re of the father. CPS will continue to assess the family fo r services at this time
The biological father has begun taking the subject child, l9 lo therapy at the Jewish Board
Intervent ions:
Comments:
SAFETY ASSESSMENT
Assessment Date: 06/20/2018 Event Status: APRV
Type: CPS 7 day Event Date: 06/20/2018
Decision: 2. Safety Factors exist, but do not rise to the level of immediate or imp~nding danger of serious harm. No Safety
Plan/Controlling Interventions are necessary at this lime. However, Identified Safety Factors have been/Will be
Dale Printed : 12/3/2020 12:56:33 PM Page· 9
Preview
FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023 Exhibit C FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 4 NYSCEF DOC. NO. 18 w Office of Children RECEIVED NYSCEF: 04/27/2023 RK ~TE and Family Services ANDREW M. CUOMO SHEILA J. POOLE Governor Commissioner 6/14/2021 CERTIFIED MAIL Jody Agostinelli, Esq. Bureau of Special Hearings Office of Children and Family Services 333 E. Washington Street Syracuse, NY 13202 Dear Jody Agostinelli, Esq. : Enclosed please find a copy of the State Central Register (SCR) record concerning the below- referenced case as well as our certification of the record . We request that, pursuant to 18NY CRR Section 434'. 9 (c) , this record be admitted into evidence at the hearing requested by the appellant. This admission Irita evidence is solely for the purpose of showing that the attached forms and documents are those presently maintained in the SCR in relation to the case at issue; these forms and documents should be admitted without regard to the truth or falsity of any of the contents of such forms and documents , and no implication may be made by the hearing officer as to the truth or falsity of any of the contents·of any of the forms or documents solely on the basis of such forms and documents having been admitted into evidence. The SCR will not be appearing at the hearing in as much as the SCR record will be made part of the hearing record pursuant to 18 NYCRR Section 434 .9 (c) of Social Service Law. Sincerely, KRYSTLE PRENTICE Request ID: 30798426 Subject Name: KEVIN BASKERVI LLE Case ID: 27142961 , 27026143 Intake Stage ID: 32274053, 32030223, 32079323, 32052066 Enclosures cc: Appellant: KEVIN BASKERVILLE County Liaison/County Attorney: NYC STI P Mary Anne Szabo Authorized Appellant Attorney: N/A S tale Central Register I P.O. Box 4480 Albany, NY I 2204 I ocfs.ny.gov # 338 • Page 1 / 1 BASKERVILLE AR 1 FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023 BASKERVILLE AR 2 FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023 ~6:'K Office of Children ~ A T E and Family Services ANDREW M. CUOMO SHEILA J. POOLE Governor Acting Commissioner June 14, 2021 In the Matter of the Request of KEVIN BASKERVILLE That the records of the New York State Central Register of Child Abuse and Maltreatment be. amended or expunged. Pursuant to the 18 NYCRR Section 434.9 (c), I, KRYSTLE PRENTICE, Office Asssistant-3, hereby certify that the attached forms and documents are true and accurate copies of the originals maintained at the State Central Register cif Child Abuse and Maltreatment (SCR), that the attached forms and documents constitute the record of the case maintained at the SCR concerning the appellant; that the SCR is required by law to receive reports of alleged child abuse and maltreatment; and that portions of the record have been redacted as required by Section 1 422 of the Social Services Law to protect the confidentiality of the source or other persons who cooperated in the investigation: I am designated by the director of the SCR to make this certification on behalf of the SCR. Slate Centrnl Register j P.O. Box ,1480 Albany, NY 12204 I ocfs.ny.gov BASKERVILLE AR 3 FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023 BASKERVILLE AR 4 FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023 FORM EXPLANATION DSS-2221 (paper) Oral Report Transmission (ORT) & Investigative Summary/Call Narrative: database Allegations of child abuse or maltreatment & family composition as repotied to the SCR on a specific date DSS-2221 A (paper) Submitted by mandated repotiers to confirm their repotis to the SCR DSS-2221 B (paper) To amend identifying or demographic information on a case DSS-2222 (paper) Submitted by local/agency investigators to the SCR regarding the first DSS-2222I (paper) seven days of the investigation and documents the initial assessment of Preliminary Report (PR!) & the safety of the children NYC Check List (database) DSS-2223 (paper) Submitted by local/agency investigators regarding the determination of DSS-2223I (paper) the report(s); Submitted post investigation progress reports (known as Continuing Service Report (CSR) in direct data entry database) Sequence Determination Submitted directly onto the database by local/agency investigators Report (SOR) regarding the determination of a repoti CPS Investigative Summary/ (Converted data from previous database will be displayed in this CPS Investigative Narrative section in the CONNECTIONS system) Submitted directly onto the . database by local/agency investigators regarding the deterrriination of a report Report Record Transmittal (RRT) Cumulative record submitted directly to the database prior to 6/21/97 Case Record Transmittal (CRT) Cumulative data in case submitted prior to 6/21/97 CPS Investigative Summary (Converted data from previous database will be displayed in this CPS Investigative Narrative section in the CONNECTIONS system) Submitted directly onto the database by local/agency investigators regarding the determination of a repoti Memo to File (paper) Documents the decision of the SCR Administrative Review or decision Administrative Review & of the Fair Hearing Fair Hearing Narratives ( coded pre-conversion) DSS-2224 (paper)/CNN. Internal means used to communicate information on case within the SCR The State Central Register (SCR) does not do the actual investigation of the report made to the SCR. If you want further information concerning the investigation, please contact the local county child protective services or State Agency. Prior to November of 1992, the text of all forms were retained on paper and the SCR database reflected family composition, allegations and investigative follow-up with determinations in code. By March of 1993, all paper forms could be directly entered into the database by local CPS. On June 21, 1997, the SCR converted all data into a computer environment called "CONNECTIONS". The CONNECTIONS system maintains all "convetied" data regarding a repoti and case in the "Summary of Investigations" section. Data may reflect former alpha/numeric codes from previous computer system Tracking by specific report dates, function and individual or by SCR# and CASE ID# and subdivisions of Data referred to as stages with their designated numerical identifications. "Principals" are those named in The report. Converted data may reflect inaccurate information. Please read the text of the narrative. As of January 8, 1998, the Department of Social Services became the Office of Children and Family Services. State Central Register I P.O. Box 4480 Albany, NY 12204 I ocfs.ny.govc # 339 - Page 1 i 1 BASKERVILLE AR 5 FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023 BASKERVILLE AR 6 FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023 •••••WARNING•..•• CONNECTIONS STAGE SUMMARY CONFlDl;NTlAL INFOR MA TION AUTHORIZED PERSONNEL ONLY STAGE: Investigation CASE ID: 27026143 STAGE ID: 32030317 CASE NAME: S ,ld STAGE NAME: S ,ld CD: R01 REPORT DATE: 6/13/2018 CASE SUMMARY STAGE ID S TAGE NAME STAGE TYPE DT OPEN DT CLOSE QEL STAT. REASO N STAGE CLASS. SUB- CLOSED CLASS 33328967 Baskerville.Kevin ARI 11/12/2020 · CPS - Familial 32126621 Baskerville.Kevin INV INI 8/23/2018 8/24/2018 IND APRV Case open-CPS r_equired CPS • Familial 32079323 Baskerville.Kevin INT INI · 7/18/2018 8/23/2018 CPS - Familial 33328948 Baskerville.Kevin ARI 1'1/12/2020 CPS-Familial 32127713 S ,ld FSS cws 8/23/2018 10/15/2018 32126821 S ,ld · FSI cws 8/23/2018 8/23/2018 32126620 St ,ld INV · INI 8/23/2018 8/24/2018 IND APRV Case open-CPS required CPS -Familial 32052066 St ,ld INT INI 6/27/2018 8/23/2018 CPS • Familial 33328946 Baskerville.Kevin ARI · 11/12/2020 11/12/2020 Retain (Untimely Request) CPS - Familial 32092093 St ,ld INV DUP 7/27/2018 8/1/2018 SUS APRV Closed as Duplicate CPS - Familial 32092052 St ,ld INT SUB 7/27/2018 7/27/2018 CPS·- Familial 32047114 St ,ld INV DUP· 6/25/2018 6/27/2018 SUS APRV Closed as Duplicate CPS - Familial 32047109 St ,ld INT SUB 6/25/2018 6/25/2018 CPS - Familial 32047086 St .Id INT DUP 6/25/2018 6/27/2Q18 Closed - Duplicate Report CPS • Familial 32047066 St ,la INV DUP 6/25/2018 6/27/2018 SUS APRV Closed as Duplicate CPS - Familial 32047056 St ,ld INT SUB 6/25/2018 6/25/20,1 8 CPS - Familial . 32033451 St ,ld INV DUP 6/15/2018 6/19/2018 SUS APRV Closed as Duplicate . CPS • Familial 32033344 St , ld INT SUB 6/15/2018 6/15/2018 CPS - Familial 32032719 St ,ld INV DUP 6/1 4/2018 6/19/2018 SUS APRV Closed as Duplicate CPS • Familial 32032673 St ,ld INT SUB 6/1 4/2018 6/14/2018 CPS· Familial 32030317 St ,ld INV INI 6/13/2018 8/1 0/2018 IND APRV Closed-Referred to CPS - Familial Communi_ty Based Services Only 32030223 S ,ld INT INI 6/1 3/2018 6/13/2018 CPS· Familial STAGE ID WORKER NAME ROLE TELEPtJQt:jE DISTRICT OR REGIONAL OFFICE 33328967 Ari,A-B Primary No Phone Available Nys Office Children & Families STAGE ID WORKER NAME ROLE TELEPHONE DIS!RICT OR REGIONAL OFFICE 32126621 Tirado.Alexandr R Histor. Staten lslalld Field Office Primary 32126621 Akinduro,Anthony Historic.al Family Court Legal Services Secondary STAGE ID WOBKER NAME ROLE TELEPHONE DISTRICT OR REGIONAL OFFICE 32079323 nrado,Alexandr R Histor. Staten Island Field Office Primary 32079323 Aklnduro,Anthony Historical Family Court Legal Services Secondary STAGE ID WORKER t:!AME ROLE TELEPHONE DISTRICT OR R EGIONAL OFFICE 33328948 Arl ,A-B Primary No Phone Available Nys Office Children & Families Date Printed: 12/3/2020 12:56:33 PM Page: BASKERVILLE AR 7 FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023 CONNECTIONS .....WARNING..*'"' STAGE SUMMARY CONFIDENTIAL INFORMATION AUTHORIZED PERSONNEL ONLY STAGE: Investigation CASE ID: 27026143 STAGE ID: 32030317 CASE NAME: S ,ld STAGE NAME: St ,ld c·D: R01 REPORT DATE: 6/13/2018 S.TAGE ID WORKER NAME ROLE TELEPHONE DISTRICT OR REGIONAL OFFICE 32127713 Velonis,Stephani Histor. No Phone Ava ilable Manager STAGE ID WORKER NAME ROLE 'FELEPHONE DISTRICT OR REGIONAL OFFICE · 32126821 Tirado.Alexandr R Hlstor. Case Staten Island Field Office Worker STAGE ID WORKER NAME ROLE TELEPHO~E DISTRICT OR BEGIONAL OFFICE 32126620 Tirado.Alexandr R . Histor. Staten Island Field Office Primary STAGE ID WORKER NAME ROLE TELEPHONE DISTRICT OR REQIONAL OFFICE 32052066 Tirado.Alexandr R Histor. Staten Island Field Office Primary STAGE ID WORKER NAME ROLE TELEPl:iQNE DISTRICT OR REGIONAL OFFICE 33328946 Pierre.Rhonda Histor. · No Phone Available Nys Office Children-& Families Primary ST AGE ID WORKER NAME ROLE TELEPHONE DISTRICT-OR REGfONAL OFFICE 32092093 Tirado.Alexandr R Histor. S.talen Island Field Office Prima·ry 32092093 Aklnduro,Anthony Historical Family Court Legal SeNices Secondary 32092093 'Audain.Felisha Historical Staten Island Field Office Secondary 32092093 Battle Jr,Alexande Historical Acs Emergency Children's SeNi Secondary 32092093 Witherspoon,lyesha Historical Brooklyn East Field Office Secondary STAGE ID WORKER NAME ROLE TELEPHONE DISTRICT OR REGIONAL OFFICE 32092052 Adekoya,Hakeem Hlstor. Brooklyn West Field Office Primary ST AGE ID WORKER NAME ROLE 'TELEPHONE DISTRICT OR REGIONAL OFE!~E 32047114 Tirado.Alexandr R Histor. Staten Island Field Office Primary 320471 14 Aklnduro,Anthony Historical Family _Court Legal SeNices Secondary 32047114 Ferguson, Christia Historical Brooklyn West Field Office Secondary 32047114 Flavigny,Alicia Historical Placement Administration Secondary STAGE ID WORKER NAME ROLE TELEPHONE DISTRICT OR REGIONAL OFFICE Date Printed: 12/3/2020 12:56:33 PM Page: 2 BASKERVILLE AR 8 FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023 *"'..WARNING"''*' CONNECTIONS STAGE SUMMARY CONFIDENTIAL INFORMATION A~THOR~EDPERSONNELONLY · STAGE: Investigation CASE ID: 27026143 STAGE ID: 32030317 CASE NAME: St ,ld STAGE NAME: · St ,ld CD: R01 REPORT DATE: 6/13/2018 32047109 Jones.Ayana Histor. Brooklyn West Field Office Primary STAGE ID WORKER NAME BQ!J; TEbEPHONE Dl~TRIC! OR REGIONAL OFFICE 32047086 Tirado.Alexandr R Histor. Staten Island Field Office Primary 32047086 Akinduro,Anthony Historical Family Court Leg,,!I Services Secondary 32047086 Ferguson.Christia Historical Brooklyn West Field Office Secondary 32047086 Flavigny,Alicia Historical Placement Administration Secondary STAGE ID WORKER NAME RObE TELEPHONE DISTRICT OR REGIONAL OFFICE 32047066 Tlrado,Alexandr R Histor. Staten Island Field Office · Primary · 32047066 Akinduro,Anth ony Historical Family Court Legal Services Secondary 32047066 Ferguson.Christia Historical Brooklyn West Field Office Secondary 32047066 Flavigny,Alicia Historical Placement Administration Secondary STAGE ID WORKER NAME ROLE · TELEPHQt:!E Dl§TRICT QR RE~IONAL OFFICE 32047056 Jones.Ayana Histor. Brooklyn West Field Office Primary STAGE ID WORKER NAME ROLE TELEPt!ONE DISTRICT OR REGIONAL OFFICE 32033451 Tirado.Alexandr R Hlstor. Staten Island Field Office Primary 32033451 Akindur'o,Anthony Historical Family Court Legal Services Secondary 32033451 Audain.Felisha Historical Staten Island Field Office Secondary STAGE ID WOR.KER NAME ROLE . TEbEPHONE DISTRICT OR REGIONAL, QEFICE 32033344 Nowell,Bernadin Histor. No Phone Available Primary STAGE ID WORKER NAME ROLE TELEeHQNE Dl§TRICT QB R E~IONAb OFFICE 32032719 Tirado,Alexa ndr R Histor. Staten Island Field Office Primary 32032719 Akinduro,Anthony Historical Family Court Legal Services Secondary 32032719 Audain.Felisha Historical Staten Island Field Office Secondary STAGE ID WORKER NAME ROLE TELEPHONE DISTRICT OR R EGIONAL OFFICE 32032673 Adekoya,Hakeem Histor. Brooklyn West Field Office Primary Date Printed: 12/3/2020 12:56:33 PM Page: 3 BASKERVILLE AR 9 FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023 CONNECTIONS ""**'WARNING••••• STAGE SUMMA RY CONFIDENTIAL INFORMATI ON AUTHORIZED PERSONNEL ONLY STAGE: Investigation CASE ID: 27026143 STAGE ID: 32030317 CASE NAME: St ,ld STAGE NAME: St ,ld CD: R01 REPORT DATE: 6/13/2018 ST AGE ID WORKER NAME ROLE TELEPHONE DISTRICT OR REGIONAL OFFICE 32030317 Tirado,Alexandr R Histor. Staten Island Field Office Primary· 32030317 Akinduro,Anthony Historical Family Court Legal Services Secondary 32030317 Audain,Felisha Historical Staten Island Field Office Secondary 32030317 Bonsu,Janice Historical Secondary STAGE ID WORKER .NAME .B.Q!.£ TELEPHONE DISTRICT OR REGIONAL QFFICE 32030223 Nowell,Bernadin Histor. No Phone Available Primary Date Printed: 12/3/2020 12:56:33 PM Page: 4 BASKERVILLE AR 10 FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 NYSCEF DOC. NO. 18 CONNECTIONS RECEIVED NYSCEF: 04/27/2023 ""***WARNING•.... STAGE SUMMARY CONFIDENTIAL INFORMATION AUTHORIZED PERSONNEL ONLY STAGE: lnvesligation CASE ID: 27026143 STAGE ID: 32030317 CASE NAM E: S ,ld STAGE NAME: St ,ld CD: R01 REPORT DATE: 6/13/2018 PERSON LIST ID NAME PERSON ID REU INT D.O.B. SEX ROLE ETH. RACE LAN G SSN REL 2 S ,ld 44262435 Mother . 1981 F Non- NH White English Unknown Confirmed Subject 3 Baskerville.Brenda 44915152 Grandparent - 1947 F No Role NH B1/Af- English Unknown Amer 3 Baskerville,Kevin 44262431 Bio. Father - 1969 M Confirmed NH B1/Af- English Unknown Subject Amer Unknown.C 45582435 Parent Sub . 1983 M Non- NH Unknown English Confirmed Subject 4 • 44262432 Child . ,2011 F Confirmed Abused NH Multiple English Unknown ID 1 2 3 4. ADDRESS VE - CITY STATE ZIP • • • • - CNTY 073 073 074 074 £g 01 01 01 01 PHONE NIA Date Printed: 12/3/2020 12:56:33 PM Page: 5 BASKERVILLE AR 11 FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023 CONNECTIONS •uuwARNING**·• •• STAGE SUMMARY CONFIDENTIAL INFORMATiON AUTHORIZED PERSONNEL ONLY STAGE: Investigation CASE ID: 27026143 STAGE.ID: 32030317 CASE NAME: St ,ld STAGE NAME: S ,ld CD: R01 REPORT DATE: 6/13/2018 ALLEGATIONS MA/AB CHILD: ALLEGED SUBJECT: Baskerville,Kevin .. CHILO ID: SUBJECT ID: 44262432 44262431 .. ALLEGATION : lnadequat~ Guardianship UNSUB/SUB: SUB MA/AB CHILD; CHILD ID: 44262432 ALLEGED SUBJECT: Baskerville.Kevin SUBJECT ID: 44262431 .. ALLEGATION: Other UNSUB/SUB: UNS MA/AB CHILD: CHILD ID: 44262432 ALLEGED SUBJECT: Baskerville.Kevin SUBJECT ID: 44262431 .. ALLEGATION: Sexual Abuse UNSUB/SUB: UNS . MA/AB CHILD: CHILD ID: 44262432 ALLEGED SUBJECT: S ,l SUBJECT ID: 44262435 ALLEGATION: Other UNSUB/SUB: UNS MAJAB CHILD: ALLEGED SUBJECT: ALLEGATION: St Sexual Abuse ,l ·- CHILD ID: SUBJECT ID: UNSUB/SUB : 44262432 44262435 UNS MA/AB CHILD: ALLEGED SUBJECT: ALLEGATION: S ,l ·- Excessive Corporal Punishment CHILD ID: SUBJECT ID: UNSUB/SUB: 44262432 44262435 UNS MA/AB CHILD: ALLEGED SUBJECT: ALLEGATION: S ,l ·- Inadequate Guardianship CHILD ID: SUBJECT ID: UNSUB/SUB: ' 44262432 44262435 UNS MA/AB CHILD: CHILD ID: 44262432 ALLEGED SUBJECT: S c,l SUBJECT ID: · 44262435 ALLEGATION: MA/AB CHILD: ALLEGED SUBJECT: Unknown.C .. Lacerations, Bruises, Wells UNSUB/SUB: CHILD ID: SUBJECT ID: UNS 44262432 45582435 ... ALLEGATION: Sexual Abuse UNSUB/SUB: UNS MA/AB CHILD: CHILD ID: 44262432 ALLEGED SUBJECT: Unknown.C SUBJECT ID: 45582435 Date Printed: 121312020 12:56:33 PM Page: 6 BASKERVILLE AR 12 FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023 CONNECTIONS •••••WARNING* 0 ** STAGE SUMMARY CONFIDENTIAL INFORMATION AUTHORIZED PERSONNEL ONLY STAGE: Investigation CASE ID: 27026143 STAGE ID: 32030317 CASE NAME: S ,ld STAGE NAME: S ,ld CD: R01 REPORT DATE: 6/13/2018 ALLEGATION: Inadequate Guardianship UNSUB/SUB: UNS MA/AB CHILD: ALLEGED SUBJECT: ALLEGATION: Unknown.C ·- Excessive Corporal Punishment CHILD ID: ·suBJECT ID: UNSUB/SUB: 44262432 45582435 UNS MA/AB CHILD: ,'1111 CHILD ID: 44262432 ALLEGED SUBJECT: Unknown.C SUBJECT ID: 45582435 ALLEGATION: Lacerations, Bruises, Welts UNSUB/SUB: UNS Date Printed: 12/3/2020 12:56:33 PM Page: 7 BASKERVILLE AR 13 FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023 CONNECTIONS •••..WARNING•"*•• STAGE SUMMARY CONFIDENTIAL INFORMATION \ AUTHORIZED PERSONNEL ONLY STAGE:· Investigation CASE ID: 27026143 STAGE ID: 32030317 CASE NAME: S ,ld STAGE NAME: St ,ld CD: R01 REPORT DATE: 6/13/2018 INTAKE NARRATIVE Call Narrative Narrative: Parent substitute C has kissed 6 year old KIii in a sexually inappropriate manner by inserting his tongue into her mouth. C also put his fingers in ~ •s mouth. Mother Id was made aware and she told~ that it Was okay. Father has no role. Miscellaneous Information: The parents are involved in a custody battle. Locating Information: The child was transported to Staten Island University North. Date Printed: 12/3/2020 12:56:33 PM . Page: 8 BASKERVILLE AR 14 FILED: NEW YORK COUNTY CLERK 04/27/2023 05:26 PM INDEX NO. 151739/2023 NYSCEF DOC. NO. 18 RECEIVED NYSCEF: 04/27/2023 CONNECTIONS •••••WARNING••••• STAGE SUMMARY CONFIDENTIAL INFORMATION A UTHORIZED PERSONNEL ONLY STAGE: Investigation CASE ID: 27026143 STAGE ID: 32030317 CASE NAME: St ,ld STAGE NAME: St ,ld CD: R01 REPORT DA TE: 6/13/2018 SAFETY ASSESSMENT Assessment Date: 08/03/2018 Event Status: APRV Type: Case Close Event Date: 08103/2018 Decision: 2. Safety Factors exist, but do not rise to the level of immediate or impending danger of serious harm, No Safety Plan/Controlling Interventions are necessary at this time. However, Identified Safety Factors have been/will be addressed with the Parent(s)/Caretaker(s) and reassessed . Selected Safety Factors : • Based on your present assessment and review of prior history of abuse or maltreatment, the Parent(s)/Caretaker(s) is unable or unwilling to protect the child(ren), Comment: The Family Is known to ACS a pattern of INGD due to the parents unable to co-parenting • Child(ren) has experienced or Is likely to experience physical or psychological harm as a result of domestic violence In the household. Comment: There is ongoing parental Issues with a past of DV. There Is a current OOP and the parents are unable to communicate further than speaking about pick up and drops. There is concern the lack of co-paren ting Is affecting the child. • Chlld(ren) has been or Is suspected of being sexually abused or exploited and the Parent(s)/Caretaker(s) Is unable or unwllling to provide adequate protection of the child{ren). Comm ent: There is concern that after visitation with the biological mother, the subject child makes discourses of sexual and physical abuse Safety Factors that place the chlld(ren) In Immediate danger of serious harm: , None Comment: Mitigating Strengths and Resources: The mother denied the reported allegations and maintained that she is not currently in a relationship with anyone and she denied having a boyfriend named C . The child was seen and assessed at the CAC and the child will remain in the ~re of the father. CPS will continue to assess the family fo r services at this time The biological father has begun taking the subject child, l9 lo therapy at the Jewish Board Intervent ions: Comments: SAFETY ASSESSMENT Assessment Date: 06/20/2018 Event Status: APRV Type: CPS 7 day Event Date: 06/20/2018 Decision: 2. Safety Factors exist, but do not rise to the level of immediate or imp~nding danger of serious harm. No Safety Plan/Controlling Interventions are necessary at this lime. However, Identified Safety Factors have been/Will be Dale Printed : 12/3/2020 12:56:33 PM Page· 9