Shelter Care Application

SHELTER CARE APPLICATION. This is a legal document submitted to a judge in juvenile court to request the temporary placement of a minor (referred to as "the Child") into shelter care, which is a form of protective custody. This form is used when remaining in the current home environment would be contrary to the child's welfare, safety, or health. It outlines the specific facts and legal grounds that support the claim that the child is dependent and in need of state intervention. Dependency may be based on various factors, such as lack of proper parental care or control, abandonment, truancy, habitual disobedience, or previous adjudication as dependent. The application details the circumstances that led to the need for emergency shelter care, including whether any reasonable efforts were made to prevent the child's removal from the home, the absence of less restrictive alternatives, and the agency's family-finding efforts. It also includes information about anticipated placement, safety concerns regarding disclosure of the child's location, and whether the child may qualify as an Indian child under applicable legal definitions, which would trigger special considerations under the Indian Child Welfare Act. The form must be signed and verified by the applicant, who affirms that the information provided is true to the best of their knowledge, and acknowledges that false statements may lead to criminal penalties. If applicable, the attorney representing the applicant also signs the form. www.FormsWorkflow.com