Shelter Care Hearing Order (SCOR) - Page 1 of 10
WPF JU 02.0200 (10/2017) - JuCR 2.1, 2.3, 2.4; RCW 13.34.062, .065
SUPERIOR COURT OF WASHINGTON
COUNTY OF _______________________
JUVENILE COURT
Dependency of:
D.O.B.: No:
Shelter Care Hearing Order
Agreed as to mother father other
Contested as to mother father other
Default as to mother father other
(SCOR)
Clerk’s Action Required. Para. 3.5 (EDL), 3.10
The parties shall:
Hold a case conference/__________________________________________:
On: (Date) ________________________________ at ______________ a.m./p.m.
At: _____________________________________________________________.
Address: __________________________________________________
__________________________________________________
Not hold a case conference at this time because the parent did not appear at shelter
care
did not want to participate.
The court shall:
Conduct a ___________________________________________________ hearing:
On: (Date) ____________________________ at __________________ a.m./p.m.
At: ____________________________ Court, Room/Department: ______________.
Address: _____________________________________________________ _____________________________________________________
I. Hearing
1.1 Petition : A dependency petition was filed in this matter on ___________________ [Date] by
DSHS Licensed Child Placement Agency ____________________________
Other __________________________. The child was removed from the parents’ care on
_______________________ (Date) by
court order protective custody hospital/doctor
hold
voluntary placement agreement. The court held a shelter care hearing on this date or on
___________________________________ (Date).
Shelter Care Hearing Order (SCOR) - Page 2 of 10
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1.2 Appearance : The following persons appeared at the hearing:
Child Child's Lawyer
Mother Mother's Lawyer
Father Father's Lawyer
Alleged Father _________________ Alleged Father ____________________
Guardian or Legal Custodian Guardian's or Legal Custodian's Lawyer
Child's GAL/CASA GAL's Lawyer
DSHS/Supervising Agency Worker Agency’s Lawyer
Tribal Representative Current Caregiver
Interpreter for mother father Other ___________________________
other ___________________
1.3 Basis: The court considered the dependency petition, declarations, testimony, if any, and the
relevant court records.
The child is 12 years old or older and the court made the inquiry required by RCW
13.34.100(6).
II. Findings
2.1 Notice: The petitioner gave adequate notice as required under RCW 13.34.062 to the
mother
father child if age 12 or older guardian legal custodian other:
________________.
The petitioner
has has not made reasonable efforts to provide notice to the mother
father child guardian legal custodian other:_____________________ and to
inform them of their rights.
2.2 Child’s Indian Status : The court asked each participant on the record whether the participant
knows or has reason to know that the child is an Indian child.
The petitioner
has has not made a good faith effort to determine whether the child is an
Indian Child.
Based upon the following, there is not a reason to know the child is an Indian child as
defined in RCW 13.38.040 and 25 U.S.C. § 1903(4), and the Federal and Washington
State Indian Child Welfare Acts do not apply to this proceeding:
.
Based upon the following information currently available to the court, there is reason to
know the child is an Indian child as defined in RCW 13.38.040 and 25 U.S.C. § 1903(4),
and the Federal and Washington State Indian Child Welfare Acts do apply to this
proceeding, unless and until it is determined on the record that the child does not meet
the definition of an Indian child:
.
Based upon the following, the child is an Indian child as defined in RCW 13.38.040 and
25 U.S.C. § 1903(4), and the Federal and Washington State Indian Child Welfare Acts do
apply to this proceeding:
.
Shelter Care Hearing Order (SCOR) - Page 3 of 10
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The petitioner has has not made preliminary efforts to notify all tribes to which the
petitioner or court knows or has reason to know the child may be a member or eligible for
membership of this proceeding.
2.3 Rights: The parties present at the hearing were informed of their rights pursuant to
RCW 13.34.065 and 13.34.090.
2.4 Waiver of Shelter Care Hearing : The
mother father guardian legal custodian
requested a waiver of the shelter care hearing. The court determined that the parent, guardian,
or legal custodian
was was not represented by an attorney and the waiver of the shelter
care hearing was knowing and voluntary.
2.5 Shelter Care Factors :
The court considered the following factors:
(a) What services DSHS/Supervising Agency provided to the family to prevent or eliminate the need for removal of the child from the child’s home.
If lack of suitable housing was a significant factor in removal of the child, whether
DSHS/Supervising Agency provided housing assistance to the family.
(b) Whether the child can be safely returned to the home pending the dependency fact- finding hearing.
(c) Whether restraining orders or orders excluding an allegedly abusive household member from the house of a nonabusive parent, guardian, or legal custodian, will allow the child to
safely remain in the home.
(d) What efforts DSHS/Supervising Agency made to place the child with a relative or other suitable person known to the child and with whom the child has a relationship. The court
inquired whether DSHS/Supervising Agency has discussed this issue with the parents.
(e) Whether the placement proposed by DSHS/Supervising Agency is the least disruptive and most family-like setting that meets the needs of the child.
(f) Appointment of an attorney or guardian ad litem for the child’s parent, guardian, or legal
custodian, or for the child.
(g) The terms and conditions for parental, sibling, and family visits.
2.6 Reasonable Efforts :
Petitioner made reasonable efforts to prevent or eliminate the need for removal of the child
from the child’s home. For the reasons set forth in the dependency petition, supporting
declarations and affidavits, and/or the testimony presented to the court:
The risk of imminent harm to the child as assessed by petitione r establishes
reasonable cause for the continued out-of-home placement of th e child pending the
fact finding hearing; and/or
Specific services offered or provided to the parent(s) have been u nable to remedy
the unsafe conditions in the home and make it possible for t he child to return home;
and/ or
Returning the child to the home would seriously endanger the child’s health, safety,
and welfare.
Additional reasonable efforts findings: ________________________________________________________________
________________________________________________________________.
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2.7Shelter Care :
The court does not find reasonable cause to believe that shelter care is needed.
It is currently contrary to the welfare of the child to remain i n or return home. The child is in
need of shelter care because there is reasonable cause to belie ve:
The child has no parent, guardian, or legal custodian to provide supervision or care for
such child; and/or
The release of the child would present a serious threat of substantial harm to the child;
and/or
The parent , guardian or custodian to whom the child could be released is alleged to
have violated RCW 9A.40.060 or 9A.40.070.
2.8 Placement :
A relative or suitable person is available or willing to care for the child and to meet
any special needs of the child or to facilitate the child’s visitation with siblings.
Placement with the relative or other suitable person is in the child’s best
interests.
DSHS/Supervising Agency needs to further investigate the character and
suitability of the proposed relative or other suitable person to determine if the
placement is in the child’s best interests.
Placement with the relative or other suitable person is not in the child’s best
interests as there is reasonable cause to believe that placement of the child with
the relative or suitable person would
jeopardize the health, safety or welfare
of the child
hinder efforts to reunite the parent and child.
A relative or suitable person is not available or willing to care for the child and to
meet any special needs of the child or to facilitate the child’s visitation with siblings.
DSHS/Supervising Agency made the following efforts toward placement with a relative or
other suitable person: _______________________________________________________________________ _______________________________________________________________________
.
2.9 Restraining Order :
The court finds reasonable cause to believe that an incident of sexual or physical abuse
has occurred and that a restraining order is necessary pursuant to RCW 26.44.063(2).
A restraining order has been shall be entered pursuant RCW 26.44.063 and shall
be incorporated by reference into this order. Placement of the child with
___________________________ [name] shall be contingent on continued compliance
with the terms of the restraining order.
2.10 Services :
The court inquired into whether the child, the parent or parent(s), or the legal guardian requires
examinations, evaluations, or immediate services. The court also inquired into whether the
parent(s) agree(s) to any recommended services, and the parent(s) agree(s) to participate in the
services listed in the Order.
Shelter Care Hearing Order (SCOR) - Page 5 of 10
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The Department recommends the following examinations, evaluations, or immediate
services for the child: ______________________________________________________________________
______________________________________________________________________.
The child is 12 or older and agrees to the services was notified of the services
was notified that he/she may request an attorney.
2.11 Education status :
The child is not of school age.
The court considered whether it is in the best interest of the child to remain enrolled in the
_______________________________________ [name of school, developmental
program, or child care] the child was in prior to placement and what efforts have been
made to maintain the child in the school, program, or child care if it would be in the best
interest of the child to remain in the same school, program, or child care.
The child should not remain enrolled in the child’s present school, developmental program,
or child care and the reasons for the transfer to a new school, developmental program, or
child care are:
______________________________________________________________________
______________________________________________________________________.
DSHS/Supervising Agency should enroll the child in school, developmental program, or
child care immediately and within seven school days and request transfer of records.
DSHS/Supervising Agency is responsible for coordinating the stud ent’s educational
information.
The child meets the criteria for appointment of an education al liaison. DSHS/Supervising
Agency recommends that the court appoint (name) _______________ ______ as the child’s
educational liaison.
The parents are not able to serve as the educational liai son because:
.
2.12 Other:
______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
______________________________________________________________________.
III. Order
3.1 Placement :
The child is released to the child’s parent, guardian or legal custodian:
Name(s): ___________________________________________________
Address: ___________________________________________________
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___________________________________________________
Subject to the following conditions:
.
The child is placed in or shall remain in shelter care, in the temporary custody and under
the supervision of DSHS/Supervising Agency, which shall have the authority to place the
child in:
Licensed foster care.
Relative placement with ___________________________ [name].
Placement with a suitable person: [name].
Placement with the relative or suitable person is contingent upon the caregiver’s
cooperation with the DSHS/Supervising Agency case plan and compliance with this, and
all subsequent court orders related to the care and supervision of the child, including but
not limited to parent-child contact, sibling contacts, and any other conditions imposed by
the court.
Placement conditions:
.
DSHS/Supervising Agency shall continue to make reasonable efforts to locate and
investigate an appropriate relative or other suitable person who is available and willing to
care for the child, and is authorized to share information with potential relative or other
suitable person placement resources as necessary to determine their suitability and
willingness as a placement for the child.
DSHS/Supervising Agency shall have authority to place the child with an appropriate
relative with prior reasonable notice to the parties, subject to review by the court.
3.2 Visitation : DSHS/Supervising Agency shall provide visits between the child and parent, guardian,
or legal custodian as follows:
Per visitation attachment.
As follows:
.
If siblings are not placed together, DSHS/Supervising Agency shall provide sibling visits or
contact as follows: ____________________________________________________________________
_____________________________________________________________________________.
Visitation may be expanded upon agreement of the parties.
3.3 Attorney/GAL Appointments : Attorney and guardian ad litem appointments are as follows:
attorney guardian ad litem for ______________________________________ [Name].
attorney guardian ad litem for ______________________________________ [Name].
attorney guardian ad litem for ______________________________________ [Name].
attorney guardian ad litem for ______________________________________ [Name].
3.4 Services :
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DSHS/Supervising Agency shall offer or provide and the parent/guardian/custodian shall
participate in the following agreed upon examinations, evaluations, or immediate services:
The mother shall participate in the following:
_______________________________________________________________________ ________________________________________________________________________
_.
The father shall participate in the following:
_____________________________________________________________________________ _
_____________________________________________________________________________.
The alleged father ______________________ (name) shall participate in the following:
_____________________________________________________________________________ _
_____________________________________________________________________________.
The guardian/legal custodian shall participate in the following:
_____________________________________________________________________________ _
_____________________________________________________________________________.
DSHS/Supervising Agency shall provide and the child shall participate in the following examinations, evaluations, or immediate services:
_____________________________________________________________________________ _
_____________________________________________________________________________.
Per attached service plan.
Other:
.
3.5 Education :
DSHS/Supervising Agency or its designee shall immediately and w ithin seven school days
timely enroll the child in school and request transfer of records.
DSHS/Supervising Agency or its designee shall provide the chil d’s school with a certified
copy of the Order and Authorization Re Health Care and Ed ucation.
(Name) ________________________ is appointed as the child ’s educational liaison to carry
out the responsibilities described in Laws of 2013, ch. 182, §5 . The educational liaison
must complete criminal background checks required by DSHS/Supervising A gency.
3.6 Parental Cooperation :
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The parents shall cooperate with DSHS/Supervising Agency and provide a current address and
phone number to the social worker at all times. Within two weeks of the entry of this order, the
parents shall provide additional information necessary for placement and notice purposes
including:
(a) The names, addresses, and phone number of any relatives or other suitable persons who
may be placement resources for the child.
(b) The names, addresses, phone numbers and other identifying information of any alleged parent(s) of the child.
(c) Any known information regarding possible membership in or descent from an Indian tribe.
(d) Information necessary to determine financial eligibility for services or foster care.(e) Other:_____________________________________________________________________
.
The parents shall sign and maintain current releases of information during the course of these
proceedings for exchange of information between all evaluators and service providers,
DSHS/Supervising Agency, CASA/GAL, Juvenile Court, AAG, and the parents’ attorneys.
3.7 Paternity :
The alleged father(s) ________________________________ shall cooperate in the
establishment of paternity and shall complete all interviews, paperwork, and genetic
testing within _______ days of the entry of this order.
The mother shall cooperate in the establishment of paternity and shall complete all
interviews, paperwork, and genetic testing within _______ days of the entry of this order.
The child shall be made available for genetic testing.
If paternity has not been established regarding the child, the court authorizes the
__________________________County Prosecutor’s Office to proceed in the
______________________ County Superior Court, Family Law Division, on the issue of
paternity, current and past child support, and costs.
3.8 Release of Information :
All court-ordered service providers shall make all records and all reports available to DSHS,
attorney for DSHS, parent’s attorney, the guardian ad litem and attorney for the child. Parents
shall sign releases of information and allow all court-ordered service providers to make all records
available to DSHS and the guardian ad litem or attorney for the child. Such information shall be
provided immediately upon request. All information, reports, records, etc., relating to the
provision of, participation in, or parties’ interaction with services ordered by the court or offered by
DSHS may be subject to disclosure in open court unless specifically prohibited by state or federal
law or regulation.
3.9 General :
DSHS/Supervising Agency shall have the right to access, inspect, and copy all records pertaining
to the above-named child, including but not limited to health, medical, mental health and
educational records.
DSHS/Supervising Agency may authorize evaluations of the child’s physical or emotional
condition, routine medical and dental examination and care, and all necessary emergency care.
DSHS/Supervising Agency shall make reasonable efforts to advise the child’s
mother
father
legal guardian or custodian of the status of this case, including the date and time of the
hearing(s) scheduled below and their rights under RCW 13.34.090.
3.10 Restraining Order :
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The court signed a separate restraining order on this date.
The restraining order entered pursuant to RCW 26.44.063 is incorporated into this order.
Placement of the child with _________________________ is contingent on continued
compliance with the terms of this restraining order. Failure to comply with any and all terms of
this order may result in removal of the child.
The person having physical custody of the child has an affirmative duty to assist in the
enforcement of this restraining order and to notify law enforcement, DSHS/ Supervising Agency,
and the court as necessary to request assistance and/or report violations of the order.
3.11 Child’s Indian Status:
Any party who subsequently receives information that provides a reason to know the child is an
Indian child under 25 C.F.R. § 23.107 shall inform the court.
3.12 All parties shall appear at the next scheduled hearing (see page one).
3.13 Other:
___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________
__________________________________________________________________________.
Dated: ____________________________________
Judge/Commissioner
Presented by:
Signature
Print Name/Title WSBA No.
Copy Received. Approved for entry, notice of presentation waived.
Signature of Child Signature of Child’s Lawyer
Print Name WSBA No.
Signature of Mother Signature of Mother’s Lawyer
Pro Se, Advised of Right to Counsel
Print Name WSBA No.
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Signature of Father Signature of Father’s Lawyer
Pro Se, Advised of Right to Counsel
Print Name WSBA No.
Signature of Guardian or Legal Custodian Signature of Guardian or Legal Custodian’s Lawyer
Pro Se, Advised of Right to Counsel
Print Name WSBA No.
Signature of Child’s GAL Signature of Lawyer for the Child’s GAL
Print Name Print Name WSBA No.
Signature of Agency Representative Signature of Agency Representative’s Lawyer
Print Name Print Name WSBA No.
Signature of Tribal Representative Signature
Print Name Print Name WSBA No.
Lawyer for _______________________