Orange County California Forms

Confidential Guardianship Status Report

GC-251

Superior Court of California, County of:

Street Address:

Mailing Address:

City and Zip Code:

Branch Name:

Guardianship of the:

Minor

Case Number:

Notice to Guardian

You must complete, sign, and return to the court on or before:

Separate copy of this form for each child for whom you are guardian of the person or estate under the above case number. If you are the guardian of the child's estate only, you must complete at least items 1-2, 6d, and 7-8. All other guardians must complete the entire form.

Failure to complete, sign, and return this form will result in further court action, possibly including your removal as guardian. A guardian who willfully submits any material information required by this form that he or she knows to be false is guilty of a misdemeanor.

1. Guardian

a. Name:

b. Present address (street address, including apartment number, city, state, and zip code):

c. Years at this address:

Telephone (home):

Telephone (work):

d. Do you have any significant health problems that would interfere with your ability to continue as guardian in the next year?

If yes, explain:

e. Since your appointment or your last report, have you, or has any adult living in the home where the child is living, been arrested for, charged with, or convicted of any felony or misdemeanor, or any other offense involving alcohol, illegal drugs, or sexual misconduct?

If yes, explain:

f. Are you a court-appointed guardian or conservator for any other child or adult under a different case number or court?

If yes, identify each other child or adult, by name, court, and case number:

2. Personal Information on Child Under Guardianship

a. Name:

b. Birthdate:

c. The child is:

d. If the child lived in your home but has left, state when and why the child left. If the child has never lived in your home, please explain:

e. If the child is not now living in your home, state the complete name, relationship to child, address, and telephone number of the person the child is living with:

3. Child's Education

a. Name and address of child's school:

b. Child's grade:

c. Describe the child's current progress in school, including grades, attendance, behavior problems, tutoring programs, etc.:

4. Child's Physical and Emotional Health

a. Is the child having any current medical or dental problems?

If yes, explain:

b. The child is:

If not current, explain:

c. Name, address, and telephone number of each physician, dentist, or other health care provider now seeing or treating the child:

d. Is the child having any emotional or behavioral problems that cause you concern?

If yes, explain:

e. Has the child experienced any traumatic event, major disruption or significant change during the past year, such as the death of a parent, abuse, or a major illness?

If yes, explain:

f. Name, address, and telephone number of any therapist the child has been seeing for any of the problems described above:

g. Describe the child's social activities/services, including recreational, educational, church, social, occupational, or cultural activities:

h. Describe your goals for the child for the next year:

5. Other Persons in the Child's Home

a. Name, age, and relationship to the child and to you of each person now living in the child's home:

b. Name of each person identified above who moved into the child's home after the guardianship was established:

6. Child's Natural Parents

a. (1) Name, address, and telephone number of child's mother:

(2) Name, address, and telephone number of child's father:

b. Visits of child's mother:

Frequency:

Average length:

(1) Visits are:

(2) Name and telephone number of person who is present during visits:

(3) Overnight visits:

Address of overnight visits:

(4) Are there any problems during the visits?

If yes, explain:

c. Visits of child's father:

Frequency:

Average length:

(1) Visits are:

(2) Name and telephone number of person who is present during visits:

(3) Overnight visits:

Address of overnight visits:

(4) Are there any problems during the visits?

If yes, explain:

d. Financial contribution of either or both natural parents:

Average monthly amount: $

7. Need for Guardianship

The guardianship is:

State reasons:

8. Continuation as Guardian

I am:

If not able to continue, state reasons:

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

Date: