Domestic Violence Safety Assessment Tool (DVSAT)

The Domestic Violence Safety Assessment Tool (DVSAT) is a risk identification checklist designed for use in intimate partner violence situations. It helps service providers to identify the risk of violence towards the client, relationship between client and partner, background of partner, children, and sexual assault. The tool also includes a professional judgement section to assess the client's fear of their partner, concerns expressed, and action taken. The threat level is determined based on the results of Part A and/or Part B. The DVSAT does not change or replace existing child protection obligations and procedures.

Domestic Violence
Safety Assessment
Tool

DOMESTIC VIOLENCE SAFETY ASSESSMENT TOOL NSW GOVERNMENT
1
Domestic Violence Safety Assessment Tool (DVSAT)
For use by non-government service providers and government agencies other than NSW Police
Force.
The DVSAT has primarily been designed for use in intimate partner violence situations. Service
providers who decide to use the DVSAT in other situations should be mindful that some of
the questions in Part A might not be relevant. Service providers should use their professional
judgement about the appropriateness of individual questions.
The DVSAT does not change or replace existing child protection obligations and procedures.
Client’s name:
Client’s date of birth:
Completed by:
Signature:
Date:
PART A: Risk identification checklist
Violence toward client
Risk indicator Yes No Unknown
Refused
to
answer
Source of
information
if not client
(e.g. Police)
1. Has your partner ever
threatened to harm or kill you?
2. Has your partner ever used
physical violence against you?
3. Has your partner ever choked,
strangled or suffocated you or
attempted to do any of these
things?
4. Has your partner ever
threatened or assaulted you
with any weapon (including
knives and/or other objects)?
5. Has your partner ever harmed
or killed a family pet or
threatened to do so?
6. Has your partner ever been
charged with breaching
an apprehended domestic
violence order?
Mara Clara
1989
Ravida Jey
5/8/19
police

DOMESTIC VIOLENCE SAFETY ASSESSMENT TOOL NSW GOVERNMENT
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Relationship between client and partner
Risk indicator Yes No Unknown
Refused
to
answer
Source of
information
if not client
(e.g. Police)
7. Is your partner jealous towards
you or controlling of you?
8. Is the violence or controlling
behaviour becoming worse or
more frequent?
9. Has your partner stalked,
constantly harassed or texted/
emailed you?
10. Does your partner control your
access to money?
11. Has there been a recent
separation (in the last 12
months) or is one imminent?
Background of partner
12. Does your partner or the
relationship have financial
difficulties?
13. Is your partner unemployed?
14. Does your partner have mental
health problems (including
undiagnosed conditions) and/or
depression?
15. Does your partner have a
problem with substance abuse
such as alcohol or other drugs?
16. Has your partner ever
threatened or attempted
suicide?
17. Is your partner currently on bail
or parole, or has served a time
of imprisonment or has recently
been released from custody in
relation to offences of violence?
18. Does your partner have access

DOMESTIC VIOLENCE SAFETY ASSESSMENT TOOL NSW GOVERNMENT
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Children
Risk indicator Yes No Unknown
Refused
to
answer
Source of
information
if not client
(e.g. Police)
19. Are you pregnant and/or do you
have children who are less than
12 months apart in age?
20. Has your partner ever
threatened or used physical
violence toward you while you
were pregnant?
21. Has your partner ever harmed
or threatened to harm your
children?
22. Is there any conflict between
you and your partner regarding
child contact or residency
issues and/or current Family
Court proceedings?
23. Are there children from a
previous relationship present in
the household?
Sexual assault
24. Has your partner ever done
things to you, of a sexual
nature, that made you feel bad
or physically hurt you?
25. Has your partner ever been

DOMESTIC VIOLENCE SAFETY ASSESSMENT TOOL NSW GOVERNMENT
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PART B: Professional judgement
How fearful is the client of
their partner? (Select one) Not afraid Afraid Terrified
Unable/
unwilling
to answer
What concerns did the client
express? What did the client
think the partner might do and
to whom?
Do you believe any children
in the household are at risk of
harm?
If yes, what action have you
taken? Confirm that you have
met your mandatory reporting
obligations.
Are you aware of any
other additional factors,
circumstances or details
which make you believe
overall there is a threat or
serious threat to the safety of
the client and/or children?
Consider issues such as the
client’s situation in relation to
disability, substance misuse,
mental health issues, cultural/
language barriers; whether
they are willing to engage with
a support service; whether
the perpetrator’s occupation
or interests has given them
unique access to weapons,
or if there is involvement with
Community Services (FACS).
Threat Level Select appropriate level based on Part A result and/or Part B
result
At threat At serious threat
Action Required ■■ Make referrals and provide support as required.

JUNE 2015