The Adoption Agencies (Wales) Regulations 2005

SCHEDULE 4

Regulation 26(2)

PART 1 INFORMATION ABOUT PROSPECTIVE ADOPTER

Information about the prospective adopter

1.  Name, gender, date and place of birth and address including the local authority area.

2.  A photograph and physical description.

3.  Whether the prospective adopter is domiciled or habitually resident in a part of the British Islands and if habitually resident for how long he or she has been habitually resident.

4.  Racial origin and cultural and linguistic background.

5.  Religious persuasion, if any.

6.  Relationship (if any) to the child.

7.  An assessment of the prospective adopter’s personality and interests.

8.  If the prospective adopter is married or in a civil partnership and is applying alone, an assessment of the prospective adopter’s suitability to adopt and the reasons for this.

9.  Details of any previous family court proceedings in which the prospective adopter has been involved.

10.  Names and addresses of three referees who will give personal references on the prospective adopter, not more than one of whom may be a relative.

11.  Name and address of the prospective adopter’s registered medical practitioner, if any.

12.  If the prospective adopter is—

(a) married, the date and place of marriage;

(b) has formed a civil partnership, the date and place of registration of that partnership; or

(c) has a partner, details of that relationship.

13.  Details of any previous marriage, civil partnership or relationship.

14.  A family tree with details of the prospective adopter, their children and any siblings, with their ages (or ages at death).

15.  A chronology of the prospective adopter from birth.

16.  The observations of the prospective adopter about their own experience of being parented and how this has been an influence.

17.  Details of any experience the prospective adopter has had of caring for children (including as a parent, step-parent, foster parent, child-minder or prospective adopter) and an assessment of their ability in this respect.

18.  Any other information which indicates how the prospective adopter and anybody else living in their household is likely to relate to a child placed for adoption with the prospective adopter.

Wider family

19.  A description of the wider family of the prospective adopter and their role and importance to the prospective adopter and their likely role and importance to a child placed for adoption with the prospective adopter.

Information about the home of the prospective adopter etc.

20.  An assessment of the prospective adopter’s home and the neighbourhood of their home.

21.  Details of other members of the prospective adopter’s household (including any children of the prospective adopter whether or not resident in the household).

22.  The local community of the prospective adopter, including the degree of the family’s integration, its peer groups, friendships and social networks.

Education and employment

23.  Details of the prospective adopter’s educational history and attainments and the observations of the prospective adopter about how this has been an influence.

24.  Details of the prospective adopter’s employment history and the observations of the prospective adopter about how this has been an influence.

25.  The current employment of the prospective adopter and their views about achieving a balance between employment and child care.

Income

26.  Details of the prospective adopter’s income and expenditure.

Other information

27.  The prospective adopter’s capacity to —

(a) share the child’s birth history and associated emotional issues;

(b) understand and support the child through possible feelings of loss and trauma.

28.  The prospective adopter’s —

(a) reasons for wishing to adopt a child;

(b) views and feelings about adoption and its significance;

(c) views about their parenting capacity;

(d) views about their parental responsibility and what it means;

(e) views about a suitable home environment for a child;

(f) views about the importance and value of education;

(g) views and feelings about the importance of a child’s religious and cultural upbringing;

(h) views and feelings about contact.

29.  The views of other members of the prospective adopter’s household and wider family in relation to adoption.

30.  Any other relevant information which might assist the adoption panel or the adoption agency.

Regulation 26(3)(a)

PART 2 INFORMATION ABOUT THE HEALTH OF THE PROSPECTIVE ADOPTER

1.  Name, date of birth, gender, weight and height.

2.  A family health history of the parents, the brothers and sisters (if any) and the children (if any) of the prospective adopter, with details of any serious physical or mental illness and inherited and congenital disease.

3.  Infertility or reasons for deciding not to have children (if applicable).

4.  Past health history, including details of any serious physical or mental illness, disability, accident, hospital admission or attendance at an out-patient department, and in each case any treatment given.

5.  Obstetric history (if applicable).

6.  Details of any present illness, including treatment and prognosis.

7.  A full medical examination.

8.  Details of any consumption of alcohol that may give cause for concern or whether the prospective adopter smokes or uses habit-forming drugs.

9.  Any other relevant information which the agency considers may assist the panel.

10.  The signature, name, address and qualifications of the registered medical practitioner who prepared the report, the date of the report and of the examinations carried out together with the name and address of any other doctor who may be able to provide further information about any of the above matters.