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Dispositional Order Protection Or Services Chapter 48 JC-1611 - Wisconsin
| Dispositional Order Protection Or Services Chapter 48 Form. This is a Wisconsin form and can be used in Juvenile Circuit Court Statewide . |
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For Official Use STATE OF WISCONSIN, CIRCUIT COURT, IN THE INTEREST OF COUNTY Dispositional Order Protection or Services (Chapter 48) Name Case No. Date of Birth A petition was filed with the court. This dispositional hearing was held on [Date] , which is the effective date of this order. THE COURT FINDS: 1. The child is in need of protection or services because: Ct Description Wisconsin Statutes Plea Date of Petition 2. The provisions of the Indian Child Welfare Act do not apply. (For an Indian child who is placed out-of-home, use the Indian Child Welfare Act version [IW-1611] of this order.) 3. The child is placed out-of-home. a. Placement in the home at this time is is not contrary to the child's welfare. b. Reasonable efforts to prevent removal were [Complete one of the following] made by the department or agency responsible for providing services. made by the department or agency responsible for providing services, although an emergency situation resulted in immediate removal of the child from the home. not required under §48.355(2d). required, but the department or agency responsible for providing services failed to make reasonable efforts. c. Reasonable efforts to place the child in a placement that enables the sibling group to remain together were made. not required because the child does not have siblings in out-of-home care. not required because it would be contrary to the safety or well being of the child or any of the siblings. JC-1611, 03/12 Dispositional Order - Protection or Services (Chapter 48) Page 1 of 4 §§48.345, 48.355, 48.356, Wisconsin Statutes American LegalNet, Inc. www.FormsWorkFlow.com This form shall not be modified. It may be supplemented with additional material. Dispositional Order - Protection or Services (Chapter 48) Page 2 of 4 Case No. d. Permanency plan was not filed. was filed and reasonable efforts to achieve the goal(s) of the permanency plan, including through an out-of-state placement if appropriate, were [Complete one of the following only if a permanency plan was filed] made by the department or agency responsible for providing services. not made by the department or agency responsible for providing services. e. The parent(s) who appeared in court have been orally advised of the applicable grounds for termination of parental rights (TPR) and the conditions that are necessary for a safe return to the home or a restoration of visitation rights. Written TPR Warnings are attached. f. The mother father was present and was asked to provide the names and other identifying information of three adult relatives of the child or other adult individuals whose home the parent requests the court to consider as placements for the child, unless that information was previously provided. 4. As to the department or agency recommendation a. The placement location recommended by the department or agency is adopted. OR b. After giving bona fide consideration to the recommendations of the department or agency and all parties, the placement location recommended is not adopted. 5. The Statement of Guardian ad Litem was filed. 6. Other: THE COURT ORDERS: 1. The child is placed under court jurisdiction. 2. Placement a. In-home at Expiration date of this order [Not to exceed 1 year] . b. Out-of-home at and into the placement and care responsibility of the county department, which has primary responsibility for providing services. Department of Children and Families, which has primary responsibility for providing services. Bureau of Milwaukee Child Welfare, which has primary responsibility for providing services. Expiration date of this order shall be the later of One year from the date of this order; or th The date the child reaches his or her 18 birthday; or th The date the child reaches his or her 19 birthday if the child is enrolled fulltime in a secondary school or vocational or technical equivalent and reasonably expected to complete the program prior to age 19. OR Expiration date of this order [Date] . JC-1611, 03/12 Dispositional Order - Protection or Services (Chapter 48) Page 2 of 4 §§48.345, 48.355, 48.356, Wisconsin Statutes American LegalNet, Inc. www.FormsWorkFlow.com This form shall not be modified. It may be supplemented with additional material. Dispositional Order - Protection or Services (Chapter 48) Page 3 of 4 Case No. 3. This is an out-of-home placement. The child has one or more siblings in out-of-home care and the child is not placed with all those siblings. The department or agency shall make reasonable efforts to provide frequent visitation or other ongoing interaction between the child and any siblings. The department or agency is not required to provide for frequent visitation or other ongoing interaction because it would be contrary to the safety or well being of the child or any siblings. 4. This is an out-of-home placement and the department or agency shall conduct a diligent search in order to locate and provide notice as required by §48.355(2)(cm), Wis. Stats., to all adult relatives of the child, including the three adult relatives provided by the parents under §48.335(6),Wis. Stats., no later than 30 days from the date of the child's removal from the home, unless the search was previously conducted and notice provided. 5. This is an out-of-home placement. If a permanency plan has been prepared, filed and is consistent with this order, this order contains the plan. Otherwise, a permanency plan consistent with the court's order shall be filed no later than 60 days from the date of the child's removal from the home and shall be made part of this order. 6. Conditions of supervision and/or return See attached 7. Specific services to be provided to child and family See attached 8. Legal custody transferred to County Department of Human/Social Services Wisconsin Department of Children and Families Bureau of Milwaukee Child Welfare Other: 9. Special treatment or care 10. If the child is placed outside of the home, the parent(s) shall provide a statement of income, assets, debts, and living expenses to the county department or agency. a. The parent(s)/guardian shall contribute toward the expenses of custody/services in the amount of $ . to be determined by [Agency] b. The amount of support to be paid by the parent(s), guardian or trustee for the out-of-home placement is $ or % of gross income payable by wage assessment. to be set by the child support agency. The support obligation begins on the date of placement. 11. For an out-of-home p
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