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ORD APPOINTING GUARDIAN (ORAPGD) - Page 1 of 4WPF JU 03.0730 (6/2004) - RCW 13.34.231, .232SUPERIOR COURT OF WASHINGTONCOUNTY OF _______________________JUVENILE COURTDependency of:D.O.B.: NO: HEARING, FINDINGS, CONCLUSIONS AND
ORDER APPOINTING GUARDIAN(ORAPGD) I. HEARING 1.1 A petition was filed requesting the court to establish a guardianship for the above-named minor
child.1.2 A hearing was held on: ________________________________________. (Date) II. FINDINGS The Court FINDS:2.1 Indian status: The child is not Indian as defined in 25 U.S.C. 1903 (4) and the Indian Child Welfare Act
does not apply to these proceedings. The child is an Indian child as defined in 25 U.S.C. § 1903(4) and the Indian Child
Welfare Act does apply to these proceedings. All notice requirements and evidentiary
requirements under the Indian Child Welfare Act have been satisfied. 2.2 The child has been found to be a dependent child under RCW 13.34.030.2.3 A dispositional plan has been entered pursuant to RCW 13.34.130.2.4 The child has been removed or will, at the time of the hearing, have been removed from the
custody of the parent for a period of at least six months pursuant to a finding of dependency
under RCW 13.34.030.2.5 The services ordered under RCW 13.34.130 have been offered or provided and all necessary
services reasonably available, capable of correcting the parental deficiencies within the
foreseeable future, have been offered or provided.
ORD APPOINTING GUARDIAN (ORAPGD) - Page 2 of 4WPF JU 03.0730 (6/2004) - RCW 13.34.231, .2322.6There is little likelihood that conditions will be remedied so the child can be returned to the
parents in the near future.2.7 A guardianship rather than termination of the parent-child relationship or continuation of the
child's current dependent status would be in the best interest of the family. III. CONCLUSIONS 3.1 The mother father legal guardian or custodian received timely and proper notice of this proceeding. 3.2 The court has jurisdiction over the parties and subject matter of this proceeding.3.3 The findings above are supported by a preponderance of the evidence. IV. ORDER IT IS ORDERED that:4.1_______________________________________________________ (Name) is appointed as
guardian for the minor child. This appointment is for the limited purpose of assisting the court in
the supervision of the dependency.4.2 The guardianship will continue until the child reaches 18 years of age, or until further order of the
court.4.3 Visitation will be as follows:4.4 No supervising agency is necessary. _____________________________________________ shall be the supervising agency. (Name) 4.5The guardian shall maintain the physical custody of the child and have the rights and duties listed
in RCW 13.34.232, unless otherwise specified below: . (See text of RCW 13.34.232 on page 3.)
ORD APPOINTING GUARDIAN (ORAPGD) - Page 3 of 4WPF JU 03.0730 (6/2004) - RCW 13.34.231, .2324.6The guardian shall have the authority to consent to health and surgical care and to sign a release
of health care information to appropriate authorities, pursuant to law. The term “health care”
includes, but is not limited to, medical, dental, psychological, and psychiatric care and treatment.4.7 Other:Dated: __________________________________
_______________________________________ JUDGE/COMMISSIONER Presented by: Guardian:Signature SignatureType or Print Name/WSBA No. Type or Print Name FatherMother Text of RCW 13.34.232:(1) If the court has made a finding under RCW 13.34.231, it shall enter an order establishing a
dependency guardianship for the child. The order shall: (a) Appoint a person or agency to serve as dependency guardian for the limited purpose of
assisting the court to supervise the dependency; (b) Specify the dependency guardian's rights and responsibilities concerning the care, custody,
and control of the child. A dependency guardian shall not have the authority to consent to the
child's adoption; (c) Specify the dependency guardian's authority, if any, to receive, invest, and expend funds,
benefits, or property belonging to the child; (d) Specify an appropriate frequency of visitation between the parent and the child; and (e) Specify the need for any continued involvement of the supervising agency and the nature of
that involvement, if any. (2) Unless the court specifies otherwise in the guardianship order, the dependency guardian shall
maintain the physical custody of the child and have the following rights and duties: (a) Protect, discipline, and educate the child; (b) Provide food, clothing, shelter, education as required by law, and routine health care for the
child; (c) Consent to necessary health and surgical care and sign a release of health care information to
appropriate authorities, pursuant to law; (d) Consent to social and school activities of the child; and (e) Provide an annual written accounting to the court regarding receipt by the dependency
guardian of any funds, benefits, or property belonging to the child and expenditures made
therefrom.(3) As used in this section, the term "health care" includes, but is not limited to, medical, dental,
psychological, and psychiatric care and treatment. (4) The child shall remain dependent for the duration of the guardianship. While the guardianship
remains in effect, the dependency guardian shall be a party to any dependency proceedings pertaining
to the child.(5) The guardianship shall remain in effect only until the child is 18 years of age or until the court
ORD APPOINTING GUARDIAN (ORAPGD) - Page 4 of 4WPF JU 03.0730 (6/2004) - RCW 13.34.231, .232terminates the guardianship order, whichever occurs sooner. [1994 c 288 § 7; 1993 c 412 § 4; 1981 c 195 § 3.]
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