Fill and Sign the Fillable Online Fca 661 Scpa 708 1726 Form 6 2 Guardianship

PERMANENCY HEARING REPORT PERMANE NCY HE ARING DAT E CE RTAI N: / / Judge / Referee Court Part IN THE MATTER OF : Child’s Name Date of Birth Sex Person ID (PID) Docket Nu mber / / / / DATE OF REPORT PREPARATION: / / All information must b e current and represent an update of events an d circumstances since removal or the previou s Permanen cy Hearing Case Name: Law Guardi an(s): CONNECTIONS Case ID: Attorney for Parent(s) or Person(s) L egally Responsible: Local Case #: Attorney for DSS/ACS: Case Manager & Phone: Casework er & Phone: Agency with Planning Responsibility: Child Protective Worker/Mo nitor & Phone: PARENTS AND PERSONS L EGAL LY RE SPONSI BLE Name Relationship Associated C hild(ren) Date Printed 11/10/2005 4:48 PM Page 1 of 17 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT SECTION I. PERMANENCY P LAN S UMMARY Child’s Name Current P ermanency Planning Goal (PPG) PPG/Date Established Anticipated PPG Return to parent(s) Placement f or adoption Referral for legal guardianshi p Permanent placement w ith fit and willin g relative Placement i n another planned permanent living arrangement with significant connection to an adult / / Return to parent(s) Placement f or adoption Referral for legal guardianshi p Permanent placement w ith fit and willin g relative Placement i n another planned permanent living arrangement with significant connection to an adult Return to parent(s) Placement f or adoption Referral for legal guardianshi p Permanent placement w ith fit and willin g relative Placement i n another planned permanent living arrangement with significant connection to an adult / / Return to parent(s) Placement f or adoption Referral for legal guardianshi p Permanent placement w ith fit and willin g relative Placement i n another planned permanent living arrangement with significant connection to an adult Date by which it is expected that the cu rrent or anticipated PPG will be accomplished: Child’s Name PPG Comple tion Date / / / / Date Printed 11/10/2005 4:48 PM Page 2 of 17 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT SECTION II. PERM ANE NCY PLANNING 1. If there is a plan for continuing placement for any of the children, specify t he child and describ e the reason placement contin ues to be nec essary and in a ccordance with the be st intere sts a nd safety of the child, including whether t he child would be at risk of abuse or neglect if retu rned to the parent or other person legally responsible . 2. If there is a plan for continuing placement for any of the children, describ e the efforts made since rem oval or the last permanency hearing, if an y, to locate any a bsent parent or relative(s) of the children and to notif y each of them of the children’s place ment in foste r care. 3. State whethe r the absent parent or rel ative express ed an interes t in obtaining custody of or planning for any of the children, or whether any rel ative is int erested in beco ming a foster parent for any of the children. If interes t has been expre sse d, what has been done to further any of these outc omes? 4. Desc ribe the concurrent p lan or any other per mane ncy discharge resour ce b eing considered for each child, in the event that any of the children are unlikely to be able to return home. 5. If there is a plan for trial discharge in the next six months, spec ify the child, the anticipated date and explain why such dischar ge is safe and appropriate. 6. If there is a plan for final discharge in the next six months, specify the chil d, the anticipated date and explain why such dischar ge is safe and appropriate. Date Printed 11/10/2005 4:48 PM Page 3 of 17 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT 7. If the per manency plan includes trial or final disch arge from f oster care, d escrib e the D ischarge Plan for the children. Desc ribe Ty pe of Living Arrangemen t : Educational/ Vocational P lan: Health Coverage: Follow-up Health/Mental Health Trea tment Plan: Other: Date Printed 11/10/2005 4:48 PM Page 4 of 17 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT SECTION III. REASONABLE E FFORTS TO FINAL IZ E PERMANENCY 8. Has ther e be en a court determination that reasonabl e efforts to reunify the children wit h their pare nt(s) are not required? Yes No If Yes, for b oth parents, skip Questio n 9. If No , for one or both parents, answer Que stion 9. 9. For each parent for whom the answe r to Questio n 8 is “No” and who has not had his or her parental rights termi nated or surrendered, describe th e reasonab le efforts that have been made since removal or the last per manency he aring to enable the children to return home safely. The question must be answered regardless of the children’s permanen cy planning goal(s). 10. If the per manency planning goal is Adoption and the children are not compl etely legally free: a. Describe t he reasonable efforts to fr ee the child ren, which sh all include, but are not limited to, information regarding the potential for a surrende r, whether a ny surrende r is complet e and, if so, whether it in cludes any terms or condi tions; wheth er a Ter mination of Parental Rights proceeding has been filed and if so, when; whether an y diligent search has been completed o n an absent parent, including the methods a nd outcome. b. Are the c hildren placed in a pre-adoptive home? Yes No If no, descri be efforts made to identify an adoptive resourc e. c. What ser vices are anticipated in the next six months? 11. If the perma nency goal is Guardianship or Placement with a Fit and Willin g Relative: a. Describe reasonable efforts made and services provi ded to finaliz e this p lan. Specify the name and relationship of the guardi an or fit and willing relative. b. What services are anticipated in the next six months? Date Printed 11/10/2005 4:48 PM Page 5 of 17 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT 12. If the perm anency goal is Another Planned Perm anent Living Arrangement: a. Provide t he compellin g reason for determining that it would not be in the best interests of the children to be returned home, placed for adopti on, placed with a legal gu ardian, or pl aced with a fit and willin g relative. b. Describ e how this arrangement pr ovides the children with a significant connection to an adult who is willing to be a permanency resource fo r the children. Specify the arrangement and the name of the adult, and describ e reaso nable efforts made and services provided to finaliz e this plan. If no adult has as yet been ide ntified, descr ibe efforts ma de to identify a permanency resour ce. c. What ser vices are anticipated in the next six months? 13. Is any child AWOL? Yes No If yes, identify the child(ren) and desc ribe efforts t o locate the child(ren). Date Printed 11/10/2005 4:48 PM Page 6 of 17 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT SECTION IV. CHILDRE N’S P LACEMENT(S) 14. Child’s Name Physical Rem oval Date # of Changes in Placem ent Since Rem oval or Previous Permanen cy Hearing Child Curre ntly Placed / / Foster Boarding Home Non-relative Relative Congregate Care Facility Relative (Direct Place ment) Other / / Foster Boarding Home Non-relative Relative Congregate Care Facility Relative (Direct Place ment) Other Date Printed 11/10/2005 4:48 PM Page 7 of 17 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT 15. Provide curr ent informat ion regarding the placement of each child including: the name of the person(s) with whom each child is placed, if ap plicable; chan ges in the placement sett ing; protecting factors in the current ho me/facility that support the children’s sa fety; and how this setti ng supports the least restri ctive, most appropriate placement that address es the n eeds of the ch ildren. 16. Is any child placed out of state? Yes No If Yes, expla in why it is appropriate, neces sary and in the best interest s of the child? Date Printed 11/10/2005 4:48 PM Page 8 of 17 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT SECTION V. PARENT STAT US AND SERVICES PRO VIDE D 17. For parent(s ) or legally r esponsible p erson(s): a. Describe services offered and/or provided to each parent/person legally responsible since removal or the last per manency he aring. b. Describe the efforts made by ea ch parent/perso n legally responsibl e to engage in the services, the progress made towards r eunification, and any oth er efforts made by each parent/person legally responsible to achieve the per manenc y plan. c. De scrib e any barriers to service pr ovision. d. Describe any additional services a nticipated in the next six months. Date Printed 11/10/2005 4:48 PM Page 9 of 17 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT SECTION VI. VISITI NG 18. Desc ribe the current visiti ng plan, including whom each child is visiting (including parents, siblings, grandparents, permanen cy resources, etc.), and the frequen cy, duration and quality of visits. Desc ribe any anticipated modifications to the visiti ng plan in th e next six months, and the reasons therefor e. Date Printed 11/10/2005 4:48 PM Page 10 of 1 7 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT SECTION VII. SERVICES PRO VIDE D TO CHILDRE N 19. Desc ribe all service s offe red and/or provided to each child since rem oval or the last perm anency hearing and the outcomes or pro gress each c hild has mad e. Child’s Name Desc ribe any additional services for each child ant icipated in the next six months. Child’s Name 20. If any child i s age 14 or older, describe the Indepen dent Living Skills Services provided to each child since removal or the last permanency hearing and the skills attained. Child’s Name Desc ribe any additional Independe nt Living Skills Services a nticipated for each child in the next six months. Child’s Name Date Printed 11/10/2005 4:48 PM Page 11 of 1 7 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT SECTION VIII. CHILDREN’S HEALTH AND WELL- BEING 21. If applicab le, note the follow ing for each child : Significant Chronic Conditions: None Child’s Name Significant Developmen tal Delay: None Child’s Name Mental Health Diagnoses: None Child’s Name Serious Inju ries/ Hospitaliz ation: None Child’s Name Current M edication: None Child’s Name Date Printed 11/10/2005 4:48 PM Page 12 of 1 7 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT 22. Desc ribe any other significant information ab out the children’s current h ealth and well-being not included above. Child’s Name Date of Last Physical Date of Last Mental Health Appointmen t, if applicable Date of Last Dental Appointmen t Date of Last Vision Screening Date of Last Hearing Screening Immuni zations Up-To-Date / / / / / / / / / / Yes No / / / / / / / / / / Yes No 23. Desc ribe any follow-up treatment or r ecommendat ion s for any of the children, as a result of the above appointments/scr eenings. Date Printed 11/10/2005 4:48 PM Page 13 of 1 7 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT SECTION IX. CHILDRE N’S E DUCATION 24. Provide info rm ation on each child’s current grade level or progr am, academic progre ss and achievement s, and any other rel evant educational information. Child’s Name 25. Describe the steps the agency will take during th e next six months to enable prompt delivery of appropriate educational and/or vocational services to each child in their current place ment or in any proposed placement, if applicable or while on trial or at final di scharge. Child’s Name Date Printed 11/10/2005 4:48 PM Page 14 of 1 7 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT 26. Complete t he sections a ppropriate to the age-level and educational status of the child. a. If any child is under age 3, identify the child a nd check which, if any, of the following criteria the child meet s: Child’s Name involved in an indicated case of child abuse or maltreatment suspected to have a disab ility has been found eligible for Early Interv ention Services (EI) pri or to or during foster care If one or more crit eria are met, ch eck the appropriate boxes. Child’s Name Refe rred for EI Refe rral Date Receiving Services Not Eligible / / / / Desc ribe the steps taken t o refer the c hild to Early Interventio n Services, t he status of the refe rral and any services the child is receiving. If any child listed above has not yet been ref err ed, explain why. Child’s Name b. If any child is eligible for Pre-Kind erg arten (turns age 4 before Dece mb er 1 st), check the appropriate boxes. Child’s Name Pre-K Not Available Pre-K Available Not Enrolled Enrolled If Pre-kinde rgarten is available and the child is NOT enrolled, describe ste ps taken to enroll the child. Child’s Name Date Printed 11/10/2005 4:48 PM Page 15 of 1 7 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT c. If any child is age three or older and is suspecte d of having a disability or has been found eligible for Special Education prior to or during foster car e, describ e the status of the refe rral, the Individualized Education Program (IEP) related recommendations and services provided by the school. Child’s Name d. If any child i s school age (ages 6-16/1 7, depending on locality) or elects to participate in a program leading to a high school diploma, describ e the steps ta ken to enroll the child in a program or continue in a program leading to a hig h school dipl om a. Child’s Name e. If any child i s over age 16 /17 (depending on lo cality), and the c hild has elected not to par ticipate in a high school diploma program, describe th e ste ps taken to assist the chil d to become employed and/or to be com e enrolled in an appr opriate vocat ional progra m. Child’s Name Date Printed 11/10/2005 4:48 PM Page 16 of 1 7 PH-2 Multiple Childr en (FINAL 10/25/05) PERMANENCY HEARING REPORT VERIF ICATION STATE OF NEW Y ORK, COUNT Y OF , BEING DUL Y S W OR N, DE POSES AN D SAYS: that I a m employ ed at , as a cas ew orker; that I have (written read) the foregoing perm an ency report and know the contents thereof; that the infor mation is true and com plet e to m y own knowledge, or believed to be true based upon inform ation derived from official recor ds and/or reports kept in the re gular course of business by this social services distr ict or voluntary authorized agency directly in volved in assess ment and/or service provi sion to the individuals that are the subject(s) of this report; that this repor t is a true and com plet e co py of t he report that was mailed to the parties 14 day s prior to the date certain of the per manency hearing. Na me: Title: Sworn to bef ore me this da y of Notary Public Co mm issioner of Deeds Date Printed 11/10/2005 4:48 PM Page 17 of 1 7 PH-2 Multiple Childr en (FINAL 10/25/05)