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FORMAT OF HOMESTUDY REPORT (HSR) FOR PROSPAECTIVE ADOPTIVE PARENTS (PAP’s)
IN INDIA
CARINGS RESIGTRATION NO. – ABKPD9595N (PrMa42420187) DATE OF REGISTRATION - 07.12.2015
AADHAR CARD - 675309054604 NAME OF THE SOCIAL WORKER – Sr. Fatima Lopes
DATE OF HOME VISIT - 10.02.2016
PART – I SELF ASSESMENT
A. Identifying information about the PAP’s and their family background :
Particulars of information Male Applicant Female Applicant
Full Name Anil Barthol D’mello Neelima Anil D’mello
Date of Birth & age 09-12-1970 (45 Years) 09-04-1972 (43 Years)
Place of Birth Vasai Vasai Complete Address with E-mail ID
( Present & Permanent Address)
Anil D’mello
PokharniWadiTamtalao Near Liberty Hotel, Vasai
(W) – 401201, Dist. Palghar Maharashtra
Neelima Anil D’mello
PokharniWadiTamtalao Near Liberty Hotel, Vasai
(W) – 401201, Dist. Palghar Maharashtra
[email protected] Country of Origin India India
Country of Citizenship India India
Passport Number G0405207 Not Applicable Religion Roman Catholic Roman Catholic
Language(s) Marathi, English, Hindi Marathi, Hindi Date of Marriage 10-01-1999 10-01-1999
Date of Earlier Marriage ( if any) Not Applicable Not Applicable
Date of Divorce ( if any ) Not Applicable Not Applicable
Present Educational Qualification Bachelor of Commerce Bachelor of Arts
Employment/ Occupation Business House Wife Name & Address of Present
Employer / Business concern
Glomed Healthcare P. Ltd.
B.P. Patel Estate Nr. NavdurgaMandir
Dashrath, Vadodara-391740, Gujarat
Not Applicable
Annual Income Rs.6,50,000.00 Not Applicable
Health Status Normal Normal
-2-
B. Family Background Information :
Details about Parents of Applicants
Male Applicants Female Applicants
Father Mother Father Mother Name in full Barthol
D’mello
Mary
D’mello
Anthony
Machado
Josphine
Machado
Age 75 Years 80 Years 85 Years 82 Years Nationality/ Citizenship Indian Indian Indian Indian
Occupation Retired House wife
Retired House Wife
Previous occupation Business House
wife
Farmer House wife
Presently residing with Me Me Their Son Their Son
(2) Adopted / Biological Children:
Name of the child Sex Date of Birth Education Status
Not Applicable Not Applicable Not Applicable Not Applicable
(3) Please describe how you believe the prospective adoption of a child will affect the lives of
your exiting children. ---------Not Applicable-----------
(4) Please indicate whether there are any other family members residing in the family home.
(b) No
(5) If yes, please complete the following table including the age, gender, occupation and
nature of the familial relationship of the other residing family members
Name Nature of the Relationship Age Gender Occupation
Not Applicable Not Applicable
-3-
(6) Please describe how you believe the prospective adoption would affect these family
members. – It will not affect any one’s life but my parents will be more than happy
(7) Please indicate whether there are any other non-related adults/ children in the home
(b) No
(8) Please describe how you think the prospective adoption will affect non-related adults /
children residing in the familial home. --------- Not Applicable ------------
C. Professional/ Employment Details (Professional details for last 5 years : Please
complete the following details relating to your professional career.
Male Applicant
Organization Employer Details (Name & Address )
Job Title From - To
Glomed Healthcare P. Ltd.
Glomed Healthcare P. Ltd.
B.P. Patel Estate Nr.
NavdurgaMandir Dashrath, Vadodara-391740, Gujarat
Director 01.01.2014
Prime Medica
Promotion P. Ltd.
Prime Medica
Promotion P. Ltd. E/96, GIDC – Manjusar, Savli Road, Vadodara – 391 775, Gujarat
Senior Manager
Accounts
12.04.2004 to
31.12.2013
Female Applicant
Organization Employer Details (Name & Address )
Job Title From - To
Not Applicable Not Applicable Not Applicable Not Applicable
D. Financial Position ( Give a short description of your income from all sources , saving
investments ,expenditure and liabilities)
- Getting monthly salary of Rs.53000.00
- 30% Share Holding in Glomed Healthcare P. Ltd.
- Have Fixed Deposit of more than 5 Lacs & Investment in LIC/PPF
- Don’t have any Loan Liability
(1) Please provide your most recent tax invoices, bank statements etc. and the taxable
income of you and your partner.
(2) Do you have any outstanding debts, mortgages etc.
(a) No
E. Description of Home and Neighborhood: (Describe the accommodation details and
neighborhood relationship)
I have my own house (RCC) of app. 1200 sq. ft...House has Hall, Kitchen, Store
Room, 2 rooms & 2 toilet bathroom. We have good relation with neighbors
(1) How many rooms do you have in your home and describe the play area available
for the child.
We have 2 rooms. Our hall and kitchen area is big in size hence don’t find any
problem for child’s play area.
(2) Please describe the neighborhood in which you reside, including any aspects that
you believe makes it child friendly.
We don’t find any problem for child in neighborhood.
-4-
F. Current marital relationship and quality of marital relationship (if applicable) (Give
details about the marriage, legal separation , if any, reasons for such separation,
present marital life and decision making procedures)
We are happily married for 17 years
(1) Please circle the term the best describes your marital status
(a) Married
(2) Please describe the procedures you and your partner use to reach a decision.
Not Applicable
G. Attitude and Motivation of PAP’s for adoption
(1) Please circle the term which best describe the reason why you wish to adopt,
you may circle more than one option, if applicable:
a) Infertility
b)
2. Please circle the statement which describe how you think the adoption will improve the
lives of your other children, you may circle more than one, if applicable:
a) Not applicable as I have no other children H .Attitude of grandparents /extended family members, other relatives and significant others towards the resent adoption: (Give a short description about the opinion of other important persons towards adoption who would have impact in the child rearing process when the child arrives in the receiving country. Our parents are happy about our decision of adoption
-5-
I Anticipated plans of the PAPs for adopted child and rearing in the family: 1) Please describe how you will manage caring for the adopted child and other life Commitments such as work. We have seen our parent’s life. Hence don’t find any problem while managing things. 2) Who will be responsible for caring for the child when you are at work, or absent from the Familial home (Domestic help, grandparents, spouse) We both are responsible but wife will take maximum responsibility 3) Please describe your disciplinary approach to parenting. We are mentally & physically ready for parenting. We have not decided any disciplinary
approach to parenting. 4) In case the adopted child demonstrates adjustment difficulties, please describe the steps that you plan to take to ease his/her transition into the family. We will try to give maximum time to the child. 5) Would you be prepared to utilize additional family counseling if the adopted child continues to have difficulties adjusting?
a) Yes
J Preparation and training for adoption: (Give details about the counseling sessions the
PAPs have Undergone on adoption, child care, handling of the needs of the children, etc. and their capacity, PAPs training and /or experiences in parenting children with their special need if any. K Possible rehabilitation plan for the child in case of any eventuality with PAPs:( Give a short description about your plan for the security of the child in case you face any short or long term eventuality. In case you are a single PAP, please give a short description about the close relative who would be giving undertaking for the security of the child)
1 Does your work require you to travel? – No. 2 Who would care for the child in your absence? Please provide a brief description
including his/ her age, gender, occupation and relationship. – Not Applicable
3 In the event of unforeseen misfortune do you have someone who would take legal guardianship of child? If so, details thereof: - My elder brother
4 In case relationship does not work out would you part with custody of this child/ren to someone else, send back to homes, consult a counselor. – Not applicable
L Plans for disclosure of facts of adoption of the child: We plan to disclose to the child about the adoption in a very friendly way or in a story form as an when the child is able to understand.
M Health status (Emotional and physical) (Give details of the state of emotional and
physical health status of the applicant (s), if any. If a family member suffers from a
particular disease, condition or syndrome, describe how the family copes with it and
how this might affect any proposed adoption.
We both are 100% fit with don’t have any health issues.
PART - II ASSESSMENT REPORT OF THE SOCIAL WORKER
1. Factual Assessment
(i) Have you verified the contents of the facts mentioned in Part I of the template
Yes
(ii) Are you satisfied about the facts mentioned in the documents vies-a-visa
observation Yes
2. Psychological Assessment :
Mr. Anil is 45 years old. He is of tall, thin and of fair complexion. Anil finished his
initial studies up to Std. XIIth at St. Thomas Baptista High School, Papdi, Vasai and
completed his B. Com from Gonsalo Gracia College, Vasai. After his B. Com he did
a year’s NIT course in computers. Anil is specialized in accounts. After his
education he worked in various firms and held a good post. At present he has his
own factory at Varodara, Gujarat. His father Mr. Barthol is 75years old. His father
had his own business in Air Conditioning. Now because of age and ill health he
does not continue with this business. His Mother Mrs. Mary is 81 years old. She
has been a house wife. Anil has a brother 50 years old; married has one daughter
and runs a business in Air Conditioning. He has two sisters; both are married and
well settled. His sister Sunita has a joint business in Interior Decoration at Sharja.
The other sister Anita is a house wife. Anil shared that since they stayed in a joint
family he has a good and happy memory of his childhood. He also shared that as a
youth belonged to a youth group and took a very active part in the church
activities etc. His mother he said very loving person, his father was a very
disciplinary man. Who would insist on inculcating good values and studies.
Mrs. Neelima is 43 years old. She is tall, and has fair complexion. Did her initial
years of studies from St. Thomas high School, Vasai and completed her B.A. from
Gonsalo Garcia College, Vasai. She has also dome one Basic course in Computers.
Soon after her education Neelima worked for more than 10 years, due to added
responsibilities Neelima was unable to continue working and decided to quit her
join, at present she is a house wife. Her Father Mr. Anthony is 85 years old. Her
mother Mrs. Josephine is 82 years old and is a house wife. They both live with
their son in Vasai. Neelima shared that she too had a very happy childhood.
2
2.1 Interaction with PAP’s
(i) Have you interacted with PAP’s individually and /or jointly?
Yes, the social worker has interacted with the PAPs individually and jointly during the
interviews and home visit.
(ii) Are the PAP’s well prepared for adoption? In case of single PAP, please
mention about family support system.
The PAPs have been married for last 17years. At the initial stage they tried
having their own biological child, since this was not happening they consulted
a doctor. According to the doctor there is nothing medically wrong. The couple
has been very patiently waiting for the gift of a child. They both shared, they
gone through almost two years of discernment while deciding about the
adoption. Once they were convinced about their decision they communicated
the same to their close family members. They couple and their family
members are prepared and are very much convinced about the decision they
have taken about the adoption.
Do you think that PAP’s have expressed their genuine feeling for parenting
Yes / No
2.2 Home Visit findings
(i) When did you visit the home of the PAP’s / Who were there the members
present during the visit ?
The social worker went for the home visit on the 10th February 2016. During the
home visit the PAPs, Anil’s parents and his sister in law was present.
(ii) Whom did you interact during the visit?
The social worker interacted with the PAPs, Anil’s parents, and his sister in law.
(iii) Have you met any neighbour / relative? Give a detailed about the interaction.
The PAPs reside in a village setting, hence where the houses are situated very
close to each other. The neighbours are very friendly, helpful in any situation.
They have very good relationship with their neighbours.
3
(iv) Whether the home environment is conducive for the child? If no, what steps
can be taken to improve the situation? Have you advised the PAP’s?
The PAPs have their own big (RCC) bungalow; app. 1200 sq. Ft. With enough
open space around the house. The house has a big Hall, kitchen, Store Room, 2
rooms & 2 toilet bathrooms. Since the house is situated in the village setting
there is ample open space, play ground for play etc. The PAPs reside at the
heart of the village; they are very close to the market, school and medical
facilities. The PAPs have their own car.
(v) Are the PAP’s well prepared for adoption?
The social worker has met PAPs at various times at one to one level and jointly. She
has discussed with them on various topics regarding adoption. She spoke to them in
detail about their decision to adopt a child. During the home visit the PAPs shared
that they have discussed the issue of adoption with each other among the family
members, relatives and friends and have a very positive attitude towards adoption.
The worker strongly feels the PAPs are well aware and are prepared to take this step
in their life and complete the family.
(vi) Do you think that the PAP’s have expressed their genuineness during the
interaction?
Yes, during the number of interviews and home visit the worker observed that the
PAPs were very open, frank and co-operative. The PAPs shared that at the initial stage
it was a difficult to make a decision. Presently they are very clear about the decision
they have taken. The PAPs have also discussed this matter with the couples who have
already adopted a child.
(vii) Did the PAP’s have any doubts about parenting issues or any other issues?
Have you cleared their doubts?
During the interviews and Home Visits the PAPs were open in asking their doubts
about parenting and the adoption procedure. The Social Worker was able to clarify
their doubts and explain to them the adoption procedure.
4
Interaction with the family members
(i) Have you interacted with the family members of the PAP’s? What is their
opinion about the proposed adoption? Are they positive about the adoption?
The Social Worker was happy to interact with Anil’s parents and his sister in law. They
are all very positive about the decision they have taken to adopt a baby. They are all
looking forward to the arrival of the baby.
(ii) Are there any other family members (s) whom you could not interact but they
might have a large role in the proposed adoption? If so, how did you interact?
Would you plan to take their views?
No.
(iii) Have you interacted with older child/children present in the home of the PAP’s
If yes, please give details.
No.
(iv) Have you noticed any adverse remark from the family members? If so, how far
those remarks may have an impact on the adoption process?
No
(i) Financial Position ( Give a short description of your income from all sources ,
saving investments
Mr. Anils owns Glomed Healthcare Pvt. Ltd. factory at Vadodara, Gujarat. His
annual income is RS. 650000/- The have fixed investments, a car, gold and a big
specious RCC bungalow. The financial situation of the PAPs is stable. They are
in position to take care of the educational, physical and medical needs of the
adopted child.
(ii) Have you observed any financial situation which is hidden in the template?
No. The PAPs have very openly shared about their financial situation during the
Home Visit & interviews.
5
2.5. Physical and emotional capacity
(i) Are the PAP(s) in a good physical and emotional state to take care of a child?
The Social Worker did not observe any physical or psychological issues with
the PAPs nor did the PAPS share anything with regard to this during the
Interview or home visit. They are very happy married couple for last 17years.
Both shared that so far they have never had a heated argument with each
other. There is much understanding among them. Anil’s parents suffer from
diabetes, they under medication, it is under control.
(ii) Have you observed any physical or psychological issues with the PAPs or any
other family members that is going to affect the life of the upcoming child? If
so, give details.
The PAPs do not suffer from any serious illness. They both keep good health.
They are able to make important decisions and abide by them. They are
healthy and mature people.
(iii) Are the PAPs emotionally equipped enough to take care of a child?
The Social Worker did not observe any physical or psychological issues with
the PAPs nor did the PAPS share anything with regard to this during the
Interview or home visit.
Recommendation for adoption:
3.1 Do you recommend the PAPs for adoption? Put your views and rational for
recommending the PAPs for adoption including parents suitability.
Anil and Neelima have a very stable married life for last 17 years. There is very healthy
marital relationship among them. There seems to be loving, trusting and caring marital
relationship between them. They are matured couple who can take responsibility and are
able to make decision. They both are physically; mentally fit to adopt a child. Their