Fill and Sign the Shelter Hearing Form

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 1 of 10 WPF JU 02.0200 (10/2017) - JuCR 2.1, 2.3, 2.4; RCW 13.34.062, .065 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 2 of 10 WPF JU 02.0200 (10/2017) - JuCR 2.1, 2.3, 2.4; RCW 13.34.062, .065 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 petitioner establishes reasonable cause for the continued out-of-home placement of the child pending the fact finding hearing; and/or Specific services offered or provided to the parent(s) have been unable to remedy the unsafe conditions in the home and make it possible for the 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: ________________________________________________________________ ________________________________________________________________. Shelter Care Hearing Order (SCOR) - Page 3 of 10 WPF JU 02.0200 (10/2017) - JuCR 2.1, 2.3, 2.4; RCW 13.34.062, .065 2.7 Shelter 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 in or return home. The child is in need of shelter care because there is reasonable cause to believe: 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. The Department recommends the following examinations, evaluations, or immediate services for the child: ______________________________________________________________________ ______________________________________________________________________. Shelter Care Hearing Order (SCOR) - Page 4 of 10 WPF JU 02.0200 (10/2017) - JuCR 2.1, 2.3, 2.4; RCW 13.34.062, .065 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. T he 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 student’s educational information. The child meets the criteria for appointment of an educational 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 liaison 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: ___________________________________________________ ___________________________________________________ Subject to the following conditions: Shelter Care Hearing Order (SCOR) - Page 5 of 10 WPF JU 02.0200 (10/2017) - JuCR 2.1, 2.3, 2.4; RCW 13.34.062, .065 . 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 : DSHS/Supervising Agency shall offer or provide and the parent/guardian/custodian shall participate in the following agreed upon examinations, evaluations, or immediate services: Shelter Care Hearing Order (SCOR) - Page 6 of 10 WPF JU 02.0200 (10/2017) - JuCR 2.1, 2.3, 2.4; RCW 13.34.062, .065 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 within seven school days timely enroll the child in school and request transfer of records. DSHS/Supervising Agency or its designee shall provide the child’s school with a certified copy of the Order and Authorization Re Health Care and Education. (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 Agency. 3.6 Parental Cooperation : 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:_____________________________________________________________________. Shelter Care Hearing Order (SCOR) - Page 7 of 10 WPF JU 02.0200 (10/2017) - JuCR 2.1, 2.3, 2.4; RCW 13.34.062, .065 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 : 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. Shelter Care Hearing Order (SCOR) - Page 8 of 10 WPF JU 02.0200 (10/2017) - JuCR 2.1, 2.3, 2.4; RCW 13.34.062, .065 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. 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. Shelter Care Hearing Order (SCOR) - Page 9 of 10 WPF JU 02.0200 (10/2017) - JuCR 2.1, 2.3, 2.4; RCW 13.34.062, .065 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 _______________________ Shelter Care Hearing Order (SCOR) - Page 10 of 10 WPF JU 02.0200 (10/2017) - JuCR 2.1, 2.3, 2.4; RCW 13.34.062, .065