FL-341(D) PETITIONER: RESPONDENT: OTHER PARENT/PARTY: CASE NUMBER: ADDITIONAL PROVISIONS--PHYSICAL CUSTODY ATTACHMENT TO Petition Response Responsive Declaration to Request for Order Request for Order Stipulation and Order for Custody and/or Visitation of Children Findings and Order After Hearing or Judgment Custody Order--Juvenile--Final Judgment Other (specify): Petitioner Respondent Respondent Other Parent/Party The additional provisions to physical custody apply to (specify parties): 1. Notification of parties' current address. must notify all parties within (specify number): Petitioner Other Parent/Party days of any change in his or her a. address for residence mailing work e-mail b. telephone/message number at home cell phone work the children's schools The parties may not use such information for the purpose of harassing, annoying, or disturbing the peace of the other or invading the other's privacy. No residence or work address is needed if a party has an address with the State of California's Safe at Home confidential address program. 2. Notification of proposed move of child. Each party must notify the other (specify number): days before any planned change in residence of the children. The notification must state, to the extent known, the planned address of the children, including the county and state of the new residence. The notification must be sent by certified mail, return receipt requested. Child care. a. The children must not be left alone without age-appropriate supervision. b. The parties must let each other know the name, address, and phone number of the children's regular child-care providers. Right of first option of child care. In the event any party requires child care for (specify number): hours or more while the children are in his or her custody, the other party or parties must be given first opportunity, with as much prior notice as possible, to care for the children before other arrangements are made. Unless specifically agreed or ordered by the court, this order does not include regular child care needed when a party is working. Canceled visitation (parenting time). a. If the noncustodial party fails to arrive at the appointed time and fails to notify the custodial party that he or she will be late, then the custodial party need wait for only (specify number): minutes before considering the visitation (parenting time) canceled. b. If the noncustodial party is unable to exercise visitation (parenting time) on a given occasion, he or she must notify the custodial party (specify): at the earliest possible opportunity. Other (specify): c. If the children are ill and unable to participate in the scheduled visitation (parenting time), the custodial party must give the noncustodial party (specify): as much notice as possible. A doctor's excuse. Other (specify): 6. Phone contact between parties and children. a. b. The children may have telephone access to the parties children at reasonable times, for reasonable durations. and the parties may have telephone access to the 3. 4. 5. The custodial parent must make the child available for the following scheduled telephone contact (specify child's telephone contact with each party): c. No party or any other third party may listen to, monitor, or interfere with the calls. Page 1 of 2 Form Approved for Optional Use Judicial Council of California FL-341(D) [Rev. July 1, 2016] ADDITIONAL PROVISIONS--PHYSICAL CUSTODY ATTACHMENT Family Code, §§ 3003, 3024, 3083 www.courts.ca.gov American LegalNet, Inc. www.FormsWorkFlow.com FL-341(D) PETITIONER: RESPONDENT: OTHER PARENT/PARTY: 7. 8. CASE NUMBER: No negative comments. The parties will not make or allow others to make negative comments about each other or about their past or present relationships, family, or friends within hearing distance of the children. Discussion of court proceedings with children. Other than age-appropriate discussion of the parenting plan and the children's role in mediation or other court proceedings, the parties will not discuss with the children any court proceedings relating to custody or visitation (parenting time). No use of children as messengers. The parties will communicate directly with each other on matters concerning the children and may not use the children as messengers between them. Alcohol or substance abuse. The petitioner respondent other parent/party may not consume alcoholic beverages, narcotics, or restricted dangerous drugs (except by prescription) within (specify number): hours and may not permit any third party to do so in the presence of the before or during periods of time with the children children. No exposure to cigarette or medical marijuana smoke. The parties will not expose the children to secondhand cigarette or medical marijuana smoke. No interference with schedule of any party without that party's consent. The parties will not schedule activities for the children during the other party's scheduled visitation (parenting time) without the other party's prior agreement. Third-party contact. a. b. The children will have no contact with (specify name): The children must not be left alone in the presence of (specify name): 9. 10. 11. 12. 13. 14. Children's clothing and belongings. a. b. Each party will maintain clothing for the children so that the children do not have to make the exchanges with additional clothing. The children will be returned to the other party with the clothing and other belongings they had when they arrived. 15. Log book. The parties will maintain a "log book" and make sure that the book is sent with the children between their homes. Using businesslike notes (no personal comments), parties will record information related to the health, education, and welfare issues that arise during the time the children are with them. Terms and conditions of order may be changed. The terms and conditions of this order may be added to or changed as the needs of the children and parties change. Such changes will be in writing, dated and signed by the parties; each party will retain a copy. If the parties want a change to be a court order, it must be filed with the court in the form of a court document. Other (specify): 16. 17. FL-341(D) [Rev. July 1, 2016] ADDITIONAL PROVISIONS--PHYSICAL CUSTODY ATTACHMENT Page 2 of 2 American LegalNet, Inc. www.FormsWorkFlow.com