Fill and Sign the Juvenile Delinquency Order of Disposition Form

F.C.A.§§ 351.1, 352.1, 352.2, Form 3-31353.1, 353.3,353.5, 353.6 (Juvenile Delinquency-- Order of Disposition Designated Felony; No Restrictive Placement)1 12/2015At a term of the Family Court of the State of New York, held in and for theCounty of ,at , New YorkonP R E S E N THon.Judge.................................................................................In the Matter ofDocket No.A Person Alleged to be aORDER OFJuvenile Delinquent,DISPOSITION(Designated Felony; No Restrictive Placement)Respondent...................................................................................An Order of Fact-finding dated the day of , , having been enteredin  this Court  the Family Court of [specify]: County, adjudging that theRespondent did the following act(s) that would, if committed by an adult, constitute the followingcrime(s) [specify as to each count]: designated felony act(s) pursuant to section 301.2 of the Family Court Act [specify,including section(s) of the Penal Law or other law violated]:  non-designated felony act(s) [specify, including section(s) of the Penal Law or other lawviolated]:And notice having been duly given to Respondent, the Presentment Agency and [checkapplicable box]:  Respondent's parent(s)  the person(s) legally responsible for the Respondent'scare pursuant to section 341.2 of the Family Court Act; And the Respondent having [check applicable box(es)]:  appeared  not appeared, and counsel for Respondent having  appeared  not appeared before this Court to answer thepetition; And the matter having thereafter duly come on for a dispositional hearing pursuant tosection 350.2 of the Family Court Act before the Court; 1 For restrictive placements under F.C.A. §353.5, use Form 3-34. Form 3-31 page 2The Court, after making an examination and inquiry into the facts and circumstances of thecase and after making reports available to counsel in accordance with section 351.1 of the Family CourtAct, finds upon a preponderance of the evidence that: I. Dispositional FindingsA. Respondent requires supervision, treatment, or confinement; andB. The Court, having fully considered the matter of restrictive placement in accordance withsection 353.5 of the Family Court Act, finds that the Respondent does not require restrictive placementfor the following reasons [specify]:; andC. The Court, having fully considered the matter of a particular disposition pursuant tosection 352.2 of the Family Court Act, finds that the Respondent requires the following disposition[specify]: for the following reasons [specify]: II. Required Findings in Cases in Which the Respondent is Placed: 2[The following determinations are required when order is placement; check applicable boxesand provide case-specific reasons]: And the Court has determined that:A. Best Interests Finding: Continuation in, or return to, the Respondent’s home  would  would not be contrary to Respondent’s best interests based upon the following facts andfor the following reasons [specify]: This determination was based upon the following information [check applicable box(es)]: Probation Department report, dated [specify]: Mental health evaluation, dated [specify]: Uniform Case Record, dated [specify]: Risk Assessment Instrument Summary of the Uniform Case Record, dated [specify]: Service Plan, dated [specify]: The report of [specify]: , dated [specify]: Testimony of [specify]:  Other [specify]:B. Reasonable Efforts Findings: 1. Reasonable efforts, where appropriate, to prevent or eliminate the need for removal of thechild from the home [check applicable box (es); state reasons as indicated. If prior finding was made,2 Note: These findings need not be made where the Respondent is placed restrictively pursuant to FamilyCourt Act §353.5. In such cases, use Form 3-34. Form 3-31 page 3so indicate, including date]:  were made as follows [specify]: were not made but the lack of efforts was appropriate [check all applicable boxes]:  because of a prior judicial finding pursuant to F.C.A. §352.2(2)(c) that the authorizedagency was not required to make reasonable efforts to reunify the Respondent with the parent(s)  guardian(s) [specify date of finding]:  because of other reasons [specify other reasons]:  were not made.This determination was based upon the following information [check applicable box(es)]: Probation Department report, dated [specify]: Mental health evaluation, dated [specify]: Uniform Case Record, dated [specify]: Risk Assessment Instrument Summary of the Uniform Case Record, dated [specify]: Service Plan, dated [specify]: The report of [specify]: , dated [specify]: Testimony of [specify]:  Other [specify]:2. Reasonable efforts, where appropriate, to return the Respondent home safely [checkapplicable box and state reasons as indicated]:  were made as follows [specify]:  were not made but the lack of efforts was appropriate [check all applicable boxes]:  because of a prior judicial finding pursuant to F.C.A. §352.2(2)(c) that the authorized agency was not required to make reasonable efforts to reunify the child with the  parent(s)  guardian(s) [specify date of finding]:  because of other reasons [specify]: were not made. This determination was based upon the following information [check applicable box(es)]: Probation Department report, dated [specify]: Mental health evaluation, dated [specify]: Uniform Case Record, dated [specify]: Risk Assessment Instrument Summary of the Uniform Case Record, dated [specify]: Service Plan, dated [specify]: The report of [specify]: , dated [specify]: Testimony of [specify]:  Other [specify]: 3. Reasonable Efforts: Goal Other Than Return Home: [Applicable in cases in which the Form 3-31 page 4Respondent’s permanency plan is adoption, guardianship or permanent living arrangement other thanreunification]: Reasonable efforts to make and finalize the Respondent’s permanency plan of [specify]: have been made as follows [specify]:  were not made based upon the following facts and for the following reasons [specify]: This determination was based upon the following information [check applicable box(es)]: Probation Department report, dated [specify]: Mental health evaluation, dated [specify]: Uniform Case Record, dated [specify]: Risk Assessment Instrument Summary of the Uniform Case Record, dated [specify]: Service Plan, dated [specify]: The report of [specify]: , dated [specify]: Testimony of [specify]:  Other [specify]:C. Findings Regarding Transitional Services and Out-of-State Placements: [Required where Respondent is 14 years of age or older]: The services, if any, neededto assist the Respondent to make the transition from foster care to independent living are [specify]: [Required where the Respondent is placed outside New York State]: Placement outsideNew York State  is  is not appropriate and in the Respondent’s best interests.D. Findings Regarding Pre-dispositional Risk Assessment Instrument:There  is  is not a validated pre-dispositional risk assessment instrument in use in thiscounty that was developed by (or in New York City, approved by) the New York State Office ofChildren and Family Services.[REQUIRED where there is a validated pre-dispositional risk assessment instrument in use]:Respondent has been assessed on the risk assessment instrument as a [check box for level of risk]:[NYC cases only]:  low  medium  high  very high level of risk [NON-NYC cases only]:  low  medium  high level of risk . [REQUIRED where validated pre-dispositional risk assessment instrument is in use andwhere placement is at a higher level of care than the assessed risk level; check box if applicable]: Placement, as directed below, is necessary and no less restrictive alternative is available,both for the protection of the community and to be consistent with the needs and best interests of theRespondent, notwithstanding the assessed risk level, for the following reasons {specify]: NOW, therefore, upon the findings made in the fact-finding and dispositional hearingsand upon all proceedings had herein, it is hereby Form 3-31 page 5ORDERED and ADJUDGED that the above-named Respondent is a juvenile delinquent onthe ground that the Respondent, while under 16 years of age, did an act which if done by an adultwould constitute the crime(s) of [specify each count]:as defined by section(s) of the  Penal Law  Other law [specify]:and on the further ground that Respondent requires supervision, treatment, or confinement; and it isthereforeORDERED that [check applicable box(es)]: Respondent is conditionally discharged for a period of [specify]: months uponthe following terms and conditions [Attach additional sheets, if necessary]:  Respondent is placed on probation under the supervision of the Probation Department ofthe County of for a period of upon the following terms and conditions[Attach additional sheets, if necessary]:[Applicable where Respondent is directly placed with a suitable relative or other person]:  This proceeding is continued and the Respondent is placed for a period of [specify]:  less the period spent in detention pending disposition3 in the custody of [specify suitablerelative or other person]: , subject to the further orders of this Court.[Applicable where Respondent is placed in non-secure or limited-secure level of care]: This proceeding is continued and Respondent is placed in a non-secure level of care for aperiod of [specify period]: less the period spent indetention pending disposition,4 in the custody of the Commissioner of the [check applicable box]: [Non-NYC cases only]:  Department of Social Services of the County of [specify]: [NYC cases only]:  New York City Administration for Children’s Services. This proceeding is continued and Respondent is placed in a limited secure level of care for a period of [specify period]:3 Applicable unless all or part of such credit would not serve the needs and best interests of the Respondentor the need for protection of the community. See F.C.A §353.3(5).4Applicable unless all or part of such credit would not serve the best interests of the Respondent or the needfor protection of the community. See F.C.A. §353.3(5). Note that in all placement cases, the placement period maybe tolled by reason of the Respondent’s absence without leave. Form 3-31 page 6  less the period spent in detention pending disposition,5 in the custody of theCommissioner of the [check applicable box]: [Non-NYC cases only]:  New York State Office of Children and Family Services[NYC cases only]:  New York City Administration for Children’s Services. [NYC cases only]: This proceeding is continued and Respondent is placed in the custody of theNew York City Administration for Children’s Services in a non-secure OR limited secure level of care,the level to be determined by the Commissioner, for a period of [specify period up to 12 months]:  less the period spent in detention pending disposition.6[NON-NYC cases only; applicable where Respondent is placed with Department of SocialServices for non-secure level of care in a specific agency or class of agency]: The position of the Commissioner of Social Services of the County of [specify]: having been considered by the Court, this proceeding is continued and Respondent is placed for aperiod of [specify period]:  less the period spent in detention pending disposition,7 in the custody of theCommissioner of Social Services of the County of [specify]: , for non-secureplacement with [specify agency or class of agency; note: if the Respondent has been found to besexually exploited, as defined in Social Services Law §447-a, so indicate if Respondent should beplaced in an available long-term safe house]: , subject to thefurther orders of this Court. In the event that the Commissioner of Social Services is unable to so place the child, theCommissioner [check applicable box]:  shall  need not apply to the Court for an order to stay, modify, set aside or vacate the order pursuant to Family Court Act §355.1.  shall  need not return Respondent to this Court for a new dispositional hearing. [NYC cases only; applicable where Respondent is placed with the NYC Administration forChildren’s Services for non-secure or limited-secure level of care where specific services areneeded; check box if applicable]:  The Commissioner of the New York City Administration for Children’s Services isdirected to provide the following services, authorized or required to be made available in the approvedplan for the “Close to Home” program, to meet the needs of the Respondent [specify services; note: if5Applicable unless all or part of such credit would not serve the best interests of the Respondent or the needfor protection of the community. See F.C.A. §353.3(5). Note that in all placement cases, the placement period maybe tolled by reason of the Respondent’s absence without leave.6Applicable unless all or part of such credit would not serve the best interests of the Respondent or the needfor protection of the community. See F.C.A. §353.3(5). Note that in all placement cases, the placement period maybe tolled by reason of the Respondent’s absence without leave.7Applicable unless all or part of such credit would not serve the best interests of the Respondent or the needfor protection of the community. See F.C.A. §353.3(5) Form 3-31 page 7the Respondent has been found to be sexually exploited, as defined in Social Services Law §447-a, soindicate if Respondent needs the services afforded by an available long-term safe house]: [The following three paragraphs are applicable where Respondent is placed with the New YorkState Office of Children and Family Services; note: in New York City cases, these paragraphsare applicable only to secure level of care]:  This proceeding is continued and the Respondent is placed for a period of [specify]:  less the period spent in detention pending disposition,8 in the custody of the New York State Officeof Children and Family Services, which is authorized to place the Respondent in a [specify]:  secure facility at any time or from time to time during the first 60 days of residency;9  limited secure facility [non-NYC cases only]  non-secure facility [non-NYC cases only] subject to further orders of this Court. [Applicable to non-NYC cases only]:  The position of the New York State Office of Children andFamily Services having been considered by the Court, this proceeding is continued and the Respondentis placed for a period of [specify]:  less the period spent in detention pendingdisposition,10 in the custody of the New York State Office of Children and Family Services forplacement with [specify agency or class of agency; note: if the Respondent has been found to besexually exploited, as defined in Social Services Law §447-a, so indicate if Respondent should beplaced in an available long-term safe house ]: , subject to furtherorders of this Court. In the event that the New York State Office of Children and Family Services isunable to place the Respondent in accordance with the direction hereof, or discontinues the placementwith the authorized agency, the Respondent shall be deemed to have been placed with the New YorkState Office of Children and Family Services pursuant to paragraph (b) or (c) of subdivision three ofsection 353.3 of the Family Court Act. In such cases, the New York State Office of Children andFamily Services shall notify the court, Presentment Agency, counsel for the Respondent and parent orother person responsible for the Respondent’s care, of the reason for discontinuing the placement withthe authorized agency and the level and location of the youth’s placement.[Optional where Respondent is placed with the New York State Office of Children and FamilyServices; check box if applicable]: The New York State Office of Children and Family Services shall photograph theRespondent pursuant to Executive Law § 507-a(3). [Optional where Respondent is 14 years of age and is placed with the New York State Office ofChildren and Family Services, the New York City Administration for Children’s Services orCommissioner of Social Services; check box if applicable ]:8 Applicable unless all or part of such credit would not serve the needs and best interests of the Respondentor the need for protection of the community. See F.C.A. §353.3(5).9 See F.C.A. §353.3(3)(a).10 Applicable unless all or part of such credit would not serve the needs and best interests of the Respondentor the need for protection of the community. See F.C.A. §353.3(5). Form 3-31 page 8 The placement agency is directed to provide the following services determined above tobe needed to assist the child to make the transition from foster care to independent living [specify]: [Optional where Respondent, upon adjudication for an act that would constitute a felony ifcommitted by an adult, is placed with the New York State Office of Children and FamilyServices or the New York City Administration for Children’s Services pursuant toF.C.A.§353.3(9); check box if applicable]:  Respondent shall be confined in a residential facility for a minimum period of [specifyminimum period not to exceed six months]: [Required where Respondent is placed with the New York City Administration for Children’sServices; optional for all other placement cases; check box if applicable]:  The placement agency is directed to provide prior notice to the Respondent, attorney forthe Respondent and Respondent’s parent or guardian in the event that Respondent is transferred fromone facility to another, unless an immediate change of placement is necessary, in which case the noticeshall be transmitted on the next business day.[Required where Respondent is placed with the New York State Office of Children and FamilyServices, the New York City Administration for Children’s Services or a local social servicesdistrict; check applicable boxes]:  Respondent’s parent or legal guardian was present in Court and consented to theprovision of routine medical, dental and mental health services and treatment to the Respondent by the:  New York State Office of Children and Family Services  New York City Administration forChildren’s Services  Department of Social Services, County of [specify]: ;OR  Consent has not been obtained from Respondent’s parent or legal guardian, but thisOrder shall be deemed to grant consent for the :  New York State Office of Children and FamilyServices  New York City Administration for Children’s Services  Department of Social Services,County of [specify]: to provide routine medical, dental and mental health services andtreatment to the Respondent.[Required where Respondent is placed non-securely with the Commissioner of a CountyDepartment of Social Services, the New York City Administration for Children’s Services or theNew York State Office of Children and Family Services, pursuant to F.C.A.§353.3 or §353.4;check box if applicable]:  ORDERED that if the Respondent remains in foster care, the [check box]:  New York State Office of Children and Family Services;  Commissioner of Social Services of [specify county]: New York City Administration for Children’s Services shall file a petition for the next permanency hearing NO LATER THAN [specify date not lessthan 60 days before permanency hearing must be completed]: and the permanency hearingshall be completed by [specify date]: And it is further ORDERED that: Date: , . ENTER Form 3-31 page 9 Judge of the Family CourtPURSUANT TO SECTION 1113 OF THE FAMILY COURT ACT, AN APPEAL FROM THISORDER MUST BE TAKEN WITHIN 30 DAYS OF RECEIPT OF THE ORDER BYAPPELLANT IN COURT, 35 DAYS FROM THE DATE OF MAILING OF THE ORDER TOAPPELLANT BY THE CLERK OF COURT, OR 30 DAYS AFTER SERVICE BY A PARTYOR THE ATTORNEY FOR THE CHILD UPON THE APPELLANT, WHICHEVER ISEARLIEST.Check applicable box:Order mailed on [specify date(s) and to whom mailed]: Order received in court on [specify date(s) and to whom given]: