Source: https://forms.justia.com/washington/statewide/juvenile-court/dependency/order-of-disposition-on-dependency-11877.html
Timestamp: 2019-04-20 01:27:28+00:00

Document:
Order Of Disposition On Dependency Form. This is a Washington form and can be use in Juvenile Court Statewide.
SUPERIOR COURT OF WASHINGTON COUNTY OF _______________________ JUVENILE COURT No: Dependency of: Order of Disposition on Dependency (ORDD) [ [ [ [ D.O.B.: ] Agreed as to [ ] mother [ ] father [ ] other ] Contested as to [ ] mother [ ] father [ ] other ] Default as to [ ] mother [ ] father [ ] other ] Clerk’s Action Required. Paragraphs 3.4, 3.9 The court will hear [ ] interim review [ ] dependency review [ ] permanency planning [ ] ________________________ [type of hearing] on [date] ______________________ at _________________ a.m./p.m. at: ________________________________________________ Court, Room/Department: _________________, located at:________________________________________ ___________________________________________________________________________________ . I. Hearing 1.1 Dependency: The court found the above-named child to be dependent on _______________________ [date]. 1.2 Hearing: The court held a disposition hearing on _______________________________ [date]. 1.3 Appearance: The following persons appeared at the hearing: [ [ [ [ [ [ [ [ 1.4 ] ] ] ] ] ] ] ] Child Mother Father Guardian or Legal Custodian Child's GAL/CASA DSHS/Supervising Agency Worker Tribal Representative Interpreter for [ ] mother [ ] father [ ] other ___________________ [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] Child's Lawyer Mother's Lawyer Father's Lawyer Guardian's or Legal Custodian's Lawyer GAL's Lawyer Agency’s Lawyer Current Caregiver Other ___________________________ Basis: [ ] The court heard testimony [ ] The parties submitted an Agreed Order Or of Disposition on Dependency (ORDD) - Page 1 of 8 WPF JU 03.0410 (03/2012) - JuCR 3.8; RCW 13.34.110, .130, .132 American LegalNet, Inc. www.FormsWorkFlow.com [ ] The child is 12 years old or older and the court made the inquiry required by RCW 13.34.100(6). Or of Disposition on Dependency (ORDD) - Page 2 of 8 WPF JU 03.0410 (03/2012) - JuCR 3.8; RCW 13.34.110, .130, .132 American LegalNet, Inc. www.FormsWorkFlow.com II. Findings and Conclusions Except where otherwise indicated, the following facts have been established by a preponderance of evidence: 2.1 Child’s Indian status: The petitioner [ ] has [ ] has not made a good faith effort to determine whether the child is an Indian Child. [ ] Based upon the following, the child is not an Indian child as defined in Laws of 2011, ch. 309, § 4, and the federal and Washington State Indian Child Welfare Acts do not apply to these proceedings: . [ ] The child is an Indian child as defined in Laws of 2011, ch. 309, § 4, and the federal and Washington State Indian Child Welfare Acts do apply to these proceedings: . [ ] [ ] [ ] 2.2 The facts establish by clear, cogent and convincing evidence, including the testimony of a qualified expert witness, that continued custody of the child by the [ ] mother [ ] father [ ] Indian custodian is likely to result in serious emotional or physical damage to the child. DSHS/Supervising Agency made active efforts by actively working with the parent, parents, or Indian Custodian to engage them in remedial services and rehabilitative programs to prevent the breakup of the Indian family beyond simply providing referrals to such services, but those efforts have been unsuccessful. The petitioner [ ] has [ ] has not provided notice of these proceedings as required by Laws of 2011, ch. 309, §7 and the federal Indian Child Welfare Act to all tribes to which the petitioner or court knows or has reason to know the child may be a member or eligible for membership. Placement: [ ] The child should be placed or remain in the home of the [ ] mother [ ] father [ ] legal custodian [ ] guardian. [ ] It is currently contrary to the child’s welfare to return home. The child should be placed or remain in the custody, control and care of DSHS/Supervising Agency for the following reasons: [ ] [ ] [ ] [ ] there is no parent or guardian available to care for the child; the parent or guardian is unwilling to take custody of the child; the court finds by clear, cogent and convincing evidence that a manifest danger exists that the child will suffer serious abuse or neglect if the child is not removed from the home, and an order under RCW 26.44.063 will not protect the child from danger. The child should be placed or remain in: [ ] [ ] relative placement. placement with a suitable person and such placement is in the child’s best interests. [ ] placement with an adoptive parent or other person with whom the child’s siblings or half-siblings live. [ ] licensed care: Or of Disposition on Dependency (ORDD) - Page 3 of 8 WPF JU 03.0410 (03/2012) - JuCR 3.8; RCW 13.34.110, .130, .132 [ ] 2.3 [ ] pending completion of DSHS/Supervising Agency investigation of relative placement options. [ ] because there is no relative, or other suitable person who is willing, appropriate, and available to care for the child, with whom the child has a relationship and is comfortable. [ ] because there is reasonable cause to believe that relative placement would jeopardize the safety or welfare of the child; and/or hinder efforts to reunite the parent(s) and child. The child is an Indian child as defined in Laws of 2011, ch. 309, §4 and this placement complies with the placement priorities in Laws of 2011, ch. 309, §18, and 25 U.S.C. §1915. Reasonable Efforts: [ ] DSHS/Supervising Agency made reasonable efforts to prevent or eliminate the need for removal of the child from the child's home; but those efforts were unsuccessful because: [ ] [ ] The health, safety, and welfare of the child cannot be adequately protected in the home. Specific services have been offered or provided to the parent(s), guardian or legal custodian and have failed to prevent the need for out-of-home placement and make it possible for the child to return home. The following services have been offered or provided to the child and the child's parent(s), guardian or legal custodian: [ ] as listed in the social study (ISSP); and/or [ ] _______________________________________________________ _______________________________________________________ ______________________________________________________. [ ] housing assistance, if applicable. [ ] [ ] [ ] The whereabouts of the [ ] mother [ ] father [ ] alleged father [ ] guardian or [ ] legal custodian are unknown. Other: ________________________________________________________ ________________________________________________________. Reasonable efforts are not required at this time to attempt to reunify the child with his/her parent(s), guardian or legal custodian because: [ ] [ ] [ ] The child has been abandoned. The existence of aggravated circumstances makes it unlikely that services will effectuate the return of the child to the parent in the near future. In determining whether aggravated circumstances exist, the court considered and found: [ ] that the following factor(s) listed in RCW 13.34.132, exist: _____________________________________________________________ _____________________________________________________________ _____________________________________________________________. [ ] other:______________________________________________________. The court ordered the child removed from the home pursuant to RCW 13.34.130(1)(b), and DSHS/Supervising Agency has recommended that a petition be filed seeking termination of the parent-child relationship between the child's [ ] mother [ ] father and the child. Because of [ ] abandonment of the child and/or [ ] the existence of aggravated circumstances as set forth above, filing of a termination petition is in the child's best interest and DSHS/Supervising Agency is not required to make reasonable efforts to reunify the family. Or of Disposition on Dependency (ORDD) - Page 4 of 8 WPF JU 03.0410 (03/2012) - JuCR 3.8; RCW 13.34.110, .130, .132 2.4 Sibling contact: [ ] The court ordered the child removed from the home and it [ ] is [ ] is not in the child’s best interest to be placed with or to have contact or visits with these siblings (which could include step-siblings if there is a pre-existing relationship and the child is comfortable with the step-siblings): and, a) the court has jurisdiction over the child(ren) listed above or the parents of the child(ren) for whom there is no jurisdiction are willing to agree; and b) there is no reasonable cause to believe that the health, safety, or welfare of any child would be jeopardized or that efforts to reunite the parent and child would be hindered by placement, contact or visitation. 2.5 Child’s school: [ ] The court ordered the child removed from the home pursuant to RCW 13.34.130(1)(b) and placed into nonparental or nonrelative care. A placement that allows the child to remain in the same school he or she attended prior to the start of the dependency proceeding [ ] is [ ] is not practical and in the child’s best interests. 2.6 Other: 3.1 Placement: III. Order [ ] The child shall be placed or remain in the home of the [ ] mother [ ] father [ ] legal custodian [ ] guardian. [ ] The child is placed in the custody, control and care of DSHS which shall have the authority to place and maintain the child in: [ ] Relative placement with ______________________________________ [name]. [ ] Placement with a suitable person: ______________________________ [name]. [ ] The home of an adoptive parent or other person with whom the child’s siblings or half-siblings live. [ ] Licensed care: [ ] pending completion of DSHS/Supervising Agency investigation of relative placement options. [ ] because there is no relative or other suitable person with whom the child has a relationship and who is willing, appropriate and available to care for the child. [ ] because there is reasonable cause to believe that relative placement would jeopardize the safety or welfare of the child; and/or hinder efforts to reunite the parent(s) and child. [ ] DSHS/Supervising Agency is authorized to place the child with a relative or other suitable person who is willing, appropriate and available, with prior reasonable notice to the parties, subject to review by the court. Or of Disposition on Dependency (ORDD) - Page 5 of 8 WPF JU 03.0410 (03/2012) - JuCR 3.8; RCW 13.34.110, .130, .132 [ ] Continuation of the ordered placement is subject to the following placement conditions: . 3.2 Services: [ ] Services for the parents/guardians/legal custodians ordered pursuant to RCW 13.34.130 [any evaluation must comply with RCW 13.34.370]: [ ] [ ] [ ] see attached service plan. as follows: DSHS/Supervising Agency shall provide and the child shall participate in the following examinations, evaluations, or services [any evaluation must comply with RCW 13.34.370]: . [ ] [ ] 3.3 SAY evaluation, and the child was notified that he/she may request an attorney. 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. Visitation: [ ] The specific visitation plan between the child(ren) and mother shall be: [ ] as set forth in the visitation attachment. [ ] as follows: . [ ] The specific visitation plan between the child(ren) and father shall be: [ ] as set forth in the visitation attachment. [ ] as follows: . [ ] Visitation between the parent/custodian _________________ [name] and the child may be expanded upon agreement of the parties. [ ] The specific plan for visitation or contact between the child and child’s siblings shall be: [ ] as set forth in the visitation attachment. [ ] as follows: Or of Disposition on Dependency (ORDD) - Page 6 of 8 WPF JU 03.0410 (03/2012) - JuCR 3.8; RCW 13.34.110, .130, .132 . 3.4 Restraining Order: [ ] The court has entered a separate restraining order pursuant to RCW 26.44.063. 3.5 Parental Cooperation: [ ] The parents shall cooperate with reasonable requests by DSHS/ Supervising Agency and provide DSHS/Supervising Agency with income and asset information necessary to establish and maintain the child’s eligibility for medical care, evaluations, counseling and other remedial services, foster care reimbursement, and other related services and benefits. 3.6 Health Care: DSHS/Supervising Agency with custody of the child shall have full power to authorize and provide all necessary, routine and emergency medical, dental, or psychological care as recommended by the child's treating doctor or psychologist, subject to review by the court, as needed. 3.7 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. 3.8 Reports: DSHS/Supervising Agency shall submit a report for the next review hearing to the court and to the parties in a timely manner. 3.9 Termination Petition: [ ] Due to the [ ] abandonment of the child and/or [ ] the existence of aggravated circumstances as found by this court, filing of a termination petition is in the child's best interests and DSHS/Supervising Agency is not required to make reasonable efforts to reunify the family. DSHS/ Supervising Agency shall file within _________ days a petition to terminate the parent-child relationship between the child's [ ] mother [ ] father and the child. A permanency planning review hearing shall be held within thirty (30) days. 3.10 All parties shall appear at the next scheduled hearing (see page one). 3.11 [ ] Other: . Dated: Judge/Commissioner Presented by: Signature Print Name/Title WSBA No. Or of Disposition on Dependency (ORDD) - Page 7 of 8 WPF JU 03.0410 (03/2012) - JuCR 3.8; RCW 13.34.110, .130, .132 Notice: A petition for permanent termination of the parent-child relationship may be filed if the child is placed out-of-home under an order of dependency. (RCW 13.34.180.) Copy Received; Approved for Entry; Notice of Presentation Waived: Signature of Child [ ] Signature of Child’s Lawyer Print Name [ ] Signature of Mother [ ] Pro Se, Advised of Right to Counsel [ ] Signature of Mother’s Lawyer Print Name [ ] Signature of Father [ ] Pro Se, Advised of Right to Counsel WSBA No. [ ] Signature of Father’s Lawyer Print Name [ ] Signature of Guardian or Legal Custodian [ ] Pro Se, Advised of Right to Counsel WSBA No. WSBA No. [ ] Signature of Guardian or Legal Custodian’s Lawyer Print Name WSBA No. [ ] Signature of Child’s GAL [ ] Signature of Lawyer for the Child’s GAL Print Name Print Name Signature of Agency Representative Signature of Agency Representative’s Lawyer Print Name Print Name [ ] Signature of Tribal Representative [ ] Signature Print Name Print Name Lawyer for Or of Disposition on Dependency (ORDD) - Page 8 of 8 WPF JU 03.0410 (03/2012) - JuCR 3.8; RCW 13.34.110, .130, .132 WSBA No. WSBA No. WSBA No.

References: § 4
 § 4
 §7
 §4
 §18
 §1915