The CP report being screened-out even though it met screening guidelines was influenced by the agency's perception that the report was not credible and that the worker felt safe with the screening decision. Agency staff reported that there is considerable complexity in screening guidelines surrounding medical neglect and neglect – failure to provide adequate care. There is a general expectation that all information needs to be in the report to make a screening decision, and the perception of not enough evidence included in the report to screen-in influenced the decision to screen the report out. In addition to this, the agency had a history of receiving these types of reports (diabetes related), which are difficult to screen due to the complexity of the disease process and the child's condition (they often lend themselves to alternative explanations) so external consultation occurs often with law enforcement (LE) in these cases. The LE agency was aware of the situation and never made a CP report or signed a hold for the children after their involvement (there is reliance on LE for initial safety assessment when they are involved) further dampening the credibility of the report. In this case, the report was made by the child's father against his estranged girlfriend which additionally led the screener to question the credibility of the report. 
DHS also had issued guidance around the utilization of a screening team when making screening decisions. After the group consultation, that included consideration of their history of receiving these types of reports and the absence of documented LE or hospital concerns or reports, staff believed that the report did not meet the screen in criteria.