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Supervised Visitation Supervised Exchange Order 306 - California
| Supervised Visitation Supervised Exchange Order Form. This is a California form and can be used in Family Solano Local County . |
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306 Superior Court of California, County of Solano 600 Union Avenue 321 Tuolumne Street PO Caller 5000 Vallejo, CA 94590 Fairfield, CA 94533 Petitioner: Respondent: Claimant: ORDER FOR SUPERVISED VISITATION SUPERVISED EXCHANGE Case Number: 1. Pursuant to Family Code sections 3100 and 3200, the court finds that the best interest of the child(ren) requires that visitations and/or exchanges be supervised pending further hearing or trial, or until further order of the court, for the following reason(s): Father Mother a. Evidence has been presented in support of a request that the contact of Other with the child(ren) should be supervised based upon allegations of Sexual Abuse Physical Abuse Emotional Abuse Other: THE COURT ORDERS: 2. CHILD(REN) TO BE SUPERVISED Name: Birthdate: Age: Sex: Drug/Alcohol Abuse Neglect Risk of Abduction Domestic violence Mental Illness Failure to Comply with Custody Orders 3. TYPE OF SUPERVISION Visitation Exchange Therapeutic Visitation 4. SUPERVISED VISITATION PROVIDER Professional Supervision Facility or Supervisor Triad Family Services 733 Webster Street, Fairfield, CA 94533 (707) 396-6010 Visitation Care Center: 1201 Marshall Road, Vacaville, CA 95688 (707) 365-1636 Stipulated Non-Professional Supervisor: (name) Address: Phone Number: Safe Harbor: Other: Address: Phone Number: SUPERVISED VISITATION ORDER Adopted for Mandatory Use SCLF # 0306 Rev. 01/12 Page 1 of 2 American LegalNet, Inc. www.FormsWorkFlow.com IN RE: vs. CASE NUMBER: 5. DURATION AND FREQUENCY Father Mother Other child(ren) on the following schedule: shall have supervised visitation/exchange with the above named According to the availability of the Professional Facility and the schedules of the parties. According to the availability of the Non-Professional Supervisor and the schedules of the parties. The court reserves jurisdiction to modify and/or set days and times in the event the parties are unable to agree. 6. PAYMENT RESPONSIBILITY Petitioner Respondent Claimant Entire cost Entire cost Entire cost 50% of cost 50% of cost 50% of cost Other: Other: Other: Access to Visitation Grant Safe Haven Grant The court reserves jurisdiction to reallocate or reapportion any costs. 7. FURTHER ORDERS: a. The court and litigants shall be provided with a report of attendance, compliance with facility procedures, and/or assessment of supervised visitation/exchange by the Professional Supervisor or Supervised Visitation Facility. b. Failure to comply with the policies and procedures of the Supervisor or Supervised Visitation Facility is a basis for the Supervisor or Facility to suspend or terminate visitation or exchange services pending further court hearing. c. Intake: Each party shall contact the Supervisor or Supervised Visitation Facility within days of notice of this Order to initiate intake. calendar d. Failure to initiate intake with the Supervisor or Supervised Visitation Facility within 30 calendar days of notice of this Order shall cause this Order to be suspended pending further court hearing. Failure by the supervised party to maintain contact or utilize supervised visitation or exchange for a period greater than 60 calendar days shall cause this Order to become suspended pending further hearing. Other: e. f. 8. Next court date: Date: Judicial Officer SUPERVISED VISITATION ORDER Adopted for Mandatory Use SCLF # 0306 Rev. 01/12 Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com
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