Fill and Sign the Community Assessment Guide Book Nc State Center for Form

STATE OF NORTH CAROLINA File No. On or about [date(s)] On or about (date) f. e. c. a. b. d. Other Findings: refusing to allow DSS to observe and/or interview the j uvenile in private. refusing to allow DSS to arrange for an evaluation of the juvenile by a physician or other expert. engaging in other conduct making it impossible for DSS t o carry out its duty to investigate. received a report of suspected abuse, neglect, or dependen cy of the juvenile named above, or a report that the juvenile had died as a result of suspected maltreatment, which report required DSS to conduct an investigation pursuant to G.S. 7B-302. More specifically: Respondent(s) has/have not established a lawful excuse for the obstruction or interference described above. 4. More specifically: refusing to disclose to DSS the whereabouts of the juvenile. 1., the Department of Social Services (DSS) of the county n amed above 2. , the respondent(s) named above obstructed or interfered with DSS's investigation of the report b y: refusing to allow DSS personal access to the juvenile. refusing to allow DSS access to confidential information/ records after a proper request. 3. (See ADDITIONAL FINDINGS on Reverse) ORDER TO CEASE OBSTRUCTION OF OR INTERFERENCE WITH JUVENILE INVESTIGATION In The General Court Of Justice District Court Division County IN THE MATTER OF: G.S. 7B-303 Name And Address Of Juvenile AOC-J-123, New 7/99 © 1999 Administrative Office of the Courts Name And Address Of Respondent 2 Date Of Birth Age Name Of Petitioner Name And Address Of Respondent 1 This case having been heard before the undersigned judge, the Court finds that the matter is properly before the Court and that the Court has jurisdiction over the subject matt er and the parties. The following persons were present at the hearing: FINDINGS Based on the evidence presented, the Court finds the fol lowing facts by clear, cogent, and convincing evidence: allow representatives of the DSS access to the following information/records: Other: That this matter be dismissed. 1.do disclose the whereabouts of the juvenile. a. The respondent(s) named above: allow representatives of the DSS personal access to the juve nile. b. allow representatives of the DSS to observe and interview the juvenile in private. c. It is hereby ORDERED AND DECREED that: d. That grounds do not exist for the issuance of an order under G.S. 7B-303 directing respondent(s) to cease obstructing and/or interfering with an investigation by DSS of suspected abuse, neglect, or dependency, or death by suspected maltreatment, of the above-named child . allow DSS to arrange for an evaluation of the juvenil e by a physician or other expert. e. f. 2. Other: 3. ORDER CONCLUSIONS OF LAW ADDITIONAL FINDINGS AOC-J-123, Side Two, New 7/99 © 1999 Administrative Office of the Courts Based on the foregoing Findings of Fact, the Court concl udes as a matter of law: Signature Of District Court Judge Date Name Of District Court Judge (Type Or Print) . .