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Order Of Dependency JU 03.0400 - Washington
| Order Of Dependency Form. This is a Washington form and can be used in Dependency Juvenile Court Statewide . |
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SUPERIOR COURT OF WASHINGTON COUNTY OF _______________________ JUVENILE COURT No: Dependency of: Order of Dependency (OROD) [ ] Agreed as to [ ] mother [ ] father [ ] other [ ] Contested as to [ ] mother [ ] father [ ] other [ ] Default as to [ ] mother [ ] father [ ] other [ ] Dismissed (ORDYMT) 4.1 [ ] Clerk's Action Required. Paragraphs 4.1, 4. 3, 4.7 D.O.B.: The court will hear [ ] disposition [ ] interim review [ ] dependency review [ ] permanency planning [ ] ________________________ hearing on [date] ______________________ at _________________ a.m./p.m. at: ___________________________________ Court, Room/Department: _________________, located at:_________________________________________________________ ___________________________________________________________________________________ . I. Hearing 1.1 Petition: A petition was filed by [ ] DSHS [ ] Licensed Child Placement Agency ______________ [ ] Other _______________________________________ alleging that the above-named child is dependent, and the court held a hearing on ___________________________________ [Date(s)]. 1.2 Appearance: The following persons appeared at the hearing: [ [ [ [ [ [ [ [ ] ] ] ] ] ] ] ] 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/CASA's Lawyer Agency's Lawyer Current Caregiver Other ___________________________ Or of Dependency (OROD) - Page 1 of 9 WPF JU 03.0400 (07/2011) - JuCR 3.7; RCW 13.34.030, .110, .120, .130, .132 American LegalNet, Inc. www.FormsWorkFlow.com 1.3 Basis: [ ] The court heard testimony [ ] The parties submitted an agreed order. [] The child is 12 years old or older and the court made the inquiry required by RCW 13.34.100(6). II. Findings 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: . [] Based upon the following, the child is an Indian child as defined in Laws of 2011, ch. 309, §4 and federal and Washington State Indian Child Welfare Acts apply to this proceeding: . [ ] 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. 2.2 Facts: [] [] Facts establishing dependency have not been proved. The following facts establishing dependency have been [ ] agreed upon [ ] proved: Or of Dependency (OROD) - Page 2 of 9 WPF JU 03.0400 (07/2011) - JuCR 3.7; RCW 13.34.030, .110, .120, .130, .132 American LegalNet, Inc. www.FormsWorkFlow.com . 2.3 Statutory Basis: [ ] The child is dependent according to RCW 13.34.030, in that the child: [] [] [] (a) has been abandoned, as defined in RCW 13.34.030; (b) is abused or neglected, as defined in Chapter 26.44 RCW, by a person legally responsible for the care of the child; and/or (c) has no parent, guardian or custodian capable of adequately caring for the child, such that the child is in circumstances which constitute a danger of substantial damage to the child's psychological or physical development. 2.4 Placement: [] If the court schedules a separate disposition hearing, the child should remain in the placement and care authority of DSHS/Supervising Agency pending further order of the court. 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; and/or [] the parent or guardian is unwilling to take custody of the child; and/or [] 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 this placement is in the child's best interests. [] 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 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. [] [] [] 2.5 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: Or of Dependency (OROD) - Page 3 of 9 WPF JU 03.0400 (07/2011) - JuCR 3.7; RCW 13.34.030, .110, .120, .130, .132 American LegalNet, Inc. www.FormsWorkFlow.com [] [] The health, safety, and welfare of the chi
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