Fill and Sign the Intake Workersocial Worker Form

JD-1709, 02/18 Minutes - Juvenile This form shall not be modified. It may be supplemented with additional mater ial. Page 1 of 2 STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Name Minutes - Juvenile Date of Birth Case No. Clerk Date Reporter Activity Time Court Official APPEARANCES: Prosecuting attorney Intake Worker/Social worker Juvenile/child Defense attorney Parent 1 [Name] Attorney Parent 2 [Name] Attorney Other: Guardian ad litem Ct. Description Statute No. Sev. Plea Amended to Adjudication RIGHTS: Juvenile/child Parent 1 Parent 2 Substitution of judge requested Notice to victim(s) given Victim(s) wishes to make statement to the Court: Yes No TEMPORARY PHYSICAL CUSTODY: Placement in: Secure Custody Nonsecure Custody Location: PLEA: Juvenile/Child Admit Deny No contest Parent 1 Admit Deny No contest Parent 2 Admit Deny No contest GAL Admit Deny No contest JURY DEMANDED BY: FACT FINDING: Court Jury 6-person Jury 12-person COURT FINDINGS: Capias issued Summons ordered Capias cancelled Plea questionnaire filed Adjudication: delinquent JIPS CHIPS Found in default: Parent 1 Parent 2 Other: Out-of-home placement: Contrary to the welfare Reasonable efforts to prevent removal Reasonable efforts to achieve permanency goal of the perma nency plan Reasonable efforts to place sibling group together were: made not required Asked to provide the names of three adult relatives/individuals: Parent 1 Parent 2 Court report dated filed with the court Parties waive time period between adjudication and dispositi on Good cause found to schedule beyond time limits Other: NEXT ACTIVITY: Date: Time: Minutes - Juvenile Page 2 of 2 Case No. JD-1709, 02/18 Minutes - Juvenile This form shall not be modified. It may be supplemented with additional mater ial. Page 2 of 2 ICWA FINDINGS: Active efforts to prevent breakup of the Indian family Continued custody would result in serious damage to child: qualified expert witness testimony Placement preferences: followed good cause to depart from order of preference Consent to TPR or voluntary placement agreement is: filed with the court judge certifies informed and voluntary COURT ORDERS: Petition dismissed: Dismiss count(s) of petition Count(s) dismissed and read in TPR granted: Parent 1 Pa rent 2 other possible parent(s) Motion for Granted Denied Consent Decree for Waived into adult court Supervision by _____________________ with placement at: Expiration of order: Court report recommendations followed except Ordered to Juvenile Correctional Facility Stayed Restitution/Forfeiture of $ , to be paid solely by juvenile joint and severally with parent(s) Mandatory victim-witness fee of $20.00 ordered to be paid by Order for recoupment of juvenile legal fees assessed and distri buted to parties Driver’s license suspension revocation for years months Psychological psychiatric drug/alcohol evaluation competency NGI evaluation or testing ordered on: juvenile/child Parent 1 Parent 2 Order to lift stay for juvenile correction placement Sanctions ordered: Request to change placement: Granted Denied Request to revise dispositional order: Granted Denied Request to extend supervision: Granted Denied Permanency Plan: approved not approved TPR warnings issued orally to: Parent 1 Parent 2 TPR warnings provided in writing to: Parent 1 Parent 2 Notice of Right to Seek Post-disposition Relief provided to: Parent 1 Parent 2 Other: Sanctions warning given Department/agency shall conduct diligent search to locate and prov ide notice to adult relatives Reasonable efforts to provide sibling visitation/interaction: required not required Other: