FAMILY AND ADULT SUPPORT TOOL (FAST) SINGAPORE

Date: D D M M Y Y

Family name: Assessor (Print Name):

Legend:
Father (F) ______________ Mother (M) ______________ Child (C1) ______________ Child (C2) _____________Child (C3) ____________

Individual (I) ____________Spouse (S) ___________ Elderly Adult (E1) __________ Elderly Adult (E2) __________ Other (O) ___________

SAFETY CONCERNS
0 = No need for action 2 = Need for action Person Other(s) Remarks
1 Need for monitoring 3 = Need for immediate/ intensive with with
action highest similar
needs concerns
1 *Child Abuse 0 1 2 3 N.A. E
2 *Spousal abuse 0 1 2 3 N.A. E
3 *Elder abuse 0 1 2 3 N.A. E
4 *Other Types of Family 0 1 2 3 E
Violence
5 Exploitation 0 1 2 3 E
6 Home Environment Safety 0 1 2 3 E
* To rate the Safety Concerns Supplementary Items if the rating is 2 or 3

SAFETY CONCERNS SUPPLEMENTARY ITEMS (Child Abuse)

0 = No need for action 2 = Need for action Person Other(s) Remarks
1 Need for monitoring 3 = Need for immediate/ intensive with with
action highest similar
needs concerns
1A Sexual Abuse 0 1 2 3 E
1B Physical Abuse 0 1 2 3 E
1C Psychological / Emotional 0 1 2 3 E
Abuse
1D Neglect / Abandonment 0 1 2 3 E

SAFETY CONCERNS SUPPLEMENTARY ITEMS (Spousal Abuse)

0 = No need for action 2 = Need for action Person Other(s) Remarks
1 Need for monitoring 3 = Need for immediate/ intensive with with
action highest similar
needs concerns
2A Sexual Abuse 0 1 2 3 E
2B Physical Abuse 0 1 2 3 E
2C Psychological / Emotional 0 1 2 3 E
Abuse
2D Neglect / Abandonment 0 1 2 3 E
2E Financial Exploitation 0 1 2 3 E

SAFETY CONCERNS SUPPLEMENTARY ITEMS (Elder Abuse)

0 = No need for action 2 = Need for action Person Other(s) Remarks
1 Need for monitoring 3 = Need for immediate/ intensive with with
action highest similar
needs concerns
3A Sexual Abuse 0 1 2 3 E
3B Physical Abuse 0 1 2 3 E
3C Psychological / Emotional 0 1 2 3 E
Abuse
3D Neglect / Abandonment 0 1 2 3 E
3E Financial Exploitation 0 1 2 3 E

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 FAMILY AND ADULT SUPPORT TOOL (FAST) SINGAPORE

SAFETY CONCERNS SUPPLEMENTARY ITEMS (Other Types of Family Violence)

0 = No need for action 2 = Need for action Person Other(s) Remarks
1 Need for monitoring 3 = Need for immediate/ intensive with with
action highest similar
needs concerns
4A Sexual Abuse 0 1 2 3 E
4B Physical Abuse 0 1 2 3 E
4C Psychological / Emotional 0 1 2 3 E
Abuse
4D Neglect / Abandonment 0 1 2 3 E
4E Financial Exploitation 0 1 2 3 E

RISK BEHAVIOURS
0 = No need for action 2 = Need for action Person Other(s) Remarks
1 Need for monitoring 3 = Need for immediate/ intensive with with
action highest similar
needs concerns
7 Suicide Risk 0 1 2 3 E
8 Self Harm Risk 0 1 2 3 E
9 Danger to Others 0 1 2 3 E
10 Sexual Aggression 0 1 2 3 E
11 Criminal Behaviours 0 1 2 3 E
12 Other Risk Taking 0 1 2 3 E
Behaviours

CHILD/YOUTH/ADULT FUNCTIONING
0 = No need for action 2 = Need for action Person Other(s) Remarks
1 Need for monitoring 3 = Need for immediate/ intensive with with
action highest similar
needs concerns
13 Physical/ Medical 0 1 2 3 E
14 Employment Functioning 0 1 2 3 N.A. E
15 Educational Functioning 0 1 2 3 N.A. E
16 Behavioural Functioning 0 1 2 3 E
17 Social Functioning 0 1 2 3 E
18 Intellectual / 0 1 2 3 E
Developmental
19 Daily Functioning Skills 0 1 2 3 E
20 Medication Compliance 0 1 2 3 E
21 Mental Health Status 0 1 2 3 E
22 Addiction Problems 0 1 2 3 E

FAMILY FUNCTIONING
0 = No need for action 2 = Need for action Person Other(s) Remarks
1 Need for monitoring 3 = Need for immediate/ intensive with with
action highest similar
needs concerns
23 Family Conflict 0 1 2 3 N.A. E
24 Family Communication 0 1 2 3 N.A. E
25 Family Role 0 1 2 3 N.A. E
Appropriateness
26 Financial Resources 0 1 2 3 E
27 Social Resources 0 1 2 3 E
28 Housing Stability 0 1 2 3 E
29 Supply of nutrition 0 1 2 3 E
30 Familys involvement in 0 1 2 3 E
Criminal and Protective
systems
31 *Familys Interaction with 0 1 2 3 E
Systems
* To rate the Systems Supplementary Items if the rating is 2 or 3

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 FAMILY AND ADULT SUPPORT TOOL (FAST) SINGAPORE

SYSTEMS SUPPLEMENTARY ITEMS

0 = No need for action 2 = Need for action Person Other(s) Remarks
1 Need for monitoring 3 = Need for immediate/ intensive with with
action highest similar
needs concerns
31A Interaction With Medical 0 1 2 3 N.A. E
Agencies
31B Interaction With Housing 0 1 2 3 N.A. E
Agencies
31C Interaction With 0 1 2 3 N.A. E
Financial Agencies
31D Interaction With 0 1 2 3 N.A. E
Education Agencies
31E Interaction With 0 1 2 3 N.A. E
Employment Agencies
31F Interaction With Social 0 1 2 3 N.A. E
Service Agencies
31G Interaction With Care 0 1 2 3 N.A. E
Agencies
31H Interaction With 0 1 2 3 N.A. E
Protective Systems
31I Interaction With Criminal 0 1 2 3 N.A. E
Systems
31J Interaction With 0 1 2 3 N.A. E
Immigrations Systems
31K Interactions With Legal 0 1 2 3 N.A. E
Systems

PARENT/CAREGIVER STATUS
0 = No need for action 2 = Need for action Person Other(s) Remarks
1 Need for monitoring 3 = Need for immediate/ intensive with with
action highest similar
needs concerns
32 Parent/Caregivers 0 1 2 3 N.A. E
Physical/ Behavioral Health
33 Parent/Caregivers 0 1 2 3 N.A. E
Employment Functioning
34 Parent/Caregivers 0 1 2 3 N.A. E
Involvement With
Caregiving Functions
35 Parent/Caregivers 0 1 2 3 N.A. E
Supervision and Discipline
36 Parent/Caregivers 0 1 2 3 N.A. E
Knowledge
37 Parent/Caregivers Stress 0 1 2 3 N.A. E
38 Parent/Caregivers 0 1 2 3 N.A. E
Organisation Skills

FAMILY STRENGTHS
0 = Significant strength 2 = Potential strength Person Other(s) Remarks
1 = Moderate strength 3 = No strength identified with with
greatest similar
strengths strengths
39 Family Relationship 0 1 2 3 E
40 Familys Resiliency 0 1 2 3 E
41 Familys Resourcefulness 0 1 2 3 E
42 Familys Adaptation in 0 1 2 3 E
Adversity
43 Familys Willingness to 0 1 2 3 E
Work for Positive Change
44 Familys Willingness to 0 1 2 3 E
Work on Action Plan

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