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Personal Reference Questionnaire - California
| Personal Reference Questionnaire Form. This is a California form and can be used in Civil Kings Local County . |
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(local form) In the Superior Court of the State of California FOR COURT USE ONLY (RECEIVED ON): In and for the County of Kings PERSONAL REFERENCE QUESTIONNAIRE Guardianship Guardianship Termination Step-Parent Adoption CASE NUMBER: Name and telephone number of the individual for whom you are completing the questionnaire: Petitioner's Name: Instructions on completing this form: In order to begin the investigation ordered by the Court, please complete this questionnaire for the petitioner who is requesting the guardianship. The petitioner will submit this form, along with the investigation packet to: KINGS COUNTY SUPERIOR COURT 449 "C" Street Lemoore, CA 93245 Attention: Civil Investigator As you answer each question below, please keep in mind that it is the responsibility of the Court to safeguard the welfare and future development of the children in this family. You can help the Court in meeting this responsibility by being objective and confining your statements to observations which you have personally made. Answer each question as completely as possible using additional paper if needed. The investigator may contact you personally to discuss your statement with you. Your Name: Address: Home Telephone: ( ) (City, State and Zip Code) Work Telephone: ( ) ext. What is your relationship to the person (petitioner) named above (relative, friend, coworker, etc.)? How long have you known this person? How often do you have contact with them? Date you last had contact with them: How long have you known the child(ren) in this case? How often do you have contact with them? Do you know the natural parent? No Date you last had contact with them: Yes, if yes, how long have you known them? Personal Reference Questionnaire.doc Last revised on: 04-15-11 Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com PHYSICAL ENVIRONMENT Have you been in the home of the Petitioner? If so, describe the general cleanliness and order of the home. CARE OF THE CHILDREN Describe how the Petitioner treats, or cares for, the children. Describe the relationship between the individual and the children from your observation? Have you ever witnessed any questionable treatment of the children by the Petitioner? (If so, please explain) CHILDREN State your personal observations of each child, including any physical or emotional issues known to you. Have the children expressed their feelings about this matter to you? Personal Reference Questionnaire.doc Last revised on: 04-15-11 Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com PARENTS Do you know if the Petitioner has a history of: Drugs: Alcohol: Criminal activities: Prescribed (for them) Occasional No Illegal Frequent Yes If you have answered "Yes" to any of the above, please explain. FOR GUARDIANSHIP TERMINATIONS ONLY: Do you feel the Petitioner is a more appropriate caretaker than the current Guardian? ADDITIONAL COMMENTS DATE: / / _______________________________ (Signature) Personal Reference Questionnaire Last revised on: 04-15-11 Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com
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