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Permanency Hearing Order PH-5 - New York
| Permanency Hearing Order Form. This is a New York form and can be used in Permanency Hearing Family Court Statewide . |
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F.C.A.§§1089, 1089-A Form PH-5 (12/2009) New York State Family Court County of ______________ Hearing Date: ____________ PRESENT: Hon. Judge ........................................................................... In the Matter of Docket No. PERMANENCY HEARING ORDER CIN # A Child or Children Under 21 Years of Age Alleged to be Abused Neglected Voluntarily Placed by Respondent(s) ........................................................................... NOTICE: IF YOUR CHILD IS PLACED IN FOSTER CARE, YOU MAY LOSE YOUR RIGHTS TO YOUR CHILD AND YOUR CHILD MAY BE ADOPTED WITHOUT YOUR CONSENT. IF YOUR CHILD STAYS IN FOSTER CARE FOR 15 OF THE MOST RECENT 22 MONTHS, THE AGENCY MAY BE REQUIRED BY LAW TO FILE A PETITION TO TERMINATE YOUR PARENTAL RIGHTS AND MAY FILE BEFORE THE END OF THE 15-MONTH PERIOD. THE NEXT COURT DATE IS [date/time]: ____________________ THE NEXT PERMANENCY HEARING SHALL BE HELD ON [date/time]:________________ An order having been issued directing that the child(ren) be placed or removed from the parent or person legally responsible for the child(ren) ; and This hearing having been consolidated with the custody guardianship petition, Docket #: __________________________ ; And the position and information provided by the NYS Office of Children and Family Services or local department of social services, as well as that of the child and others appearing before the Court, having been considered by the Court; Reasonable Efforts Determination The Court makes the following findings regarding reasonable efforts to implement the permanency hearing goal in place at the commencement of this hearing: Reasonable efforts to make and finalize the permanency planning goal of [return to parent, adoption, guardianship, permanent placement with a fit and willing relative, or placement in another planned permanent living arrangement][specify]:_____________________________________ American LegalNet, Inc. www.FormsWorkFlow.com PH-5 Page 2 were made as follows [specify reasonable efforts, including consideration of out-of-State resources:] ____________________________________________________________________ ______________________________________________________________________________ were not made [specify]: _______________________________________________________ _____________________________________________________________________________ The permanency goal is reunification and reasonable efforts were not made, but the lack of efforts was appropriate because of a prior judicial finding that the authorized agency was not required to make reasonable efforts to reunify the child(ren) with the parent(s). This determination is based upon the following information [check applicable box(es)]: Permanency report, sworn to on [specify date]: __________________________________________ Case record, dated [specify]: ________________________________________________________ Service plan, dated [specify]: ________________________________________________________ Probation Department report, dated [specify]: ___________________________________________ Mental health evaluation, dated [specify]: ______________________________________________ The report of [specify]: ____________________________ , dated: _____________________________ Testimony of [specify]: ____________________________, (on _______________________________) Other [specify]: ______________________________________________________________ Findings and Orders THE COURT ORDERS that: PLACEMENT OR TEMPORARY REMOVAL IS TERMINATED: And the child(ren) (is) (are) discharged to the custody of the respondent(s) ______________________ Immediately or on [specify date]: ______________________________ without supervision with supervision of a child protective agency, social services official, or duly authorized agency until:________________ upon the following terms and conditions: ________________________________________ ______________________________________________________________________________ THE CHILD(REN) IS/ARE PLACED OR CONTINUE(S) TO BE PLACED in the custody of the Commissioner of Social Services until the completion of the next permanency hearing or pending further orders of this court. And the child(ren) shall reside with [specify authorized agency, facility, relative or other suitable person ]1: ____________________________________ And during the period of such placement, respondent(s)[specify]: _________________________ shall remain under the supervision of a child protective agency, social services official, or duly authorized agency upon the following terms and conditions:____________________________________ ________________________________________________________________________ 1 The relative or suitable person must be approved or certified as a foster parent. American LegalNet, Inc. www.FormsWorkFlow.com PH-5 Page 3 The Court finds that continued placement or temporary removal of the child is required due to best interests and safety needs of the child and that the child would be at risk of further abuse or neglect if returned to the parent/respondent. THE CHILD(REN) IS/ARE DIRECTLY PLACED OR CONTINUE(S) TO BE DIRECTLY PLACED pursuant to Family Court Act §1055(a)(ii), in the custody of_____________________, who has consented to the jurisdiction of this Court, until the completion of the next permanency hearing or further orders of this court. During the pendency of the placement, the local Commissioner of Social Services shall supervise the placement : under the following terms and conditions: ______________________________________________________________________________ ______________________________________________________________________________ The Court finds that continued placement or temporary removal of the child is required due to best interests and safety needs of the child and that the child would be at risk of further abuse or neglect if returned to the parent/respondent. CONSOLIDATED HEARINGS: The Court having adjudged that custody guardianship of:________________ by [specify relative(s) or suitable person(s)] :____________________________will provide a safe and permanent home for the child(ren); AND 1. all parties, including the attorney for the child(ren) and any foster parent who has had custody of the child(ren) in excess of one year, have consented to such custody or guardianship; OR the following parties [specify]: have not consented, but this Court has found custody or guardianship to be in the child(ren)'s b
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