JV-215, Page 1 of 2Judicial Council of California, www.courts.ca.gov New September 1, 2018, Mandatory Form Welfare and Institutions Code, 247 14717.1 Order After Hearing on Waiver of Presumptive Transfer Order After Hearing on Waiver of Presumptive Transfer JV-215 The social worker / probation officer provided a report no later than two days after a hearing was granted. The report included the information as required by rule 5.647(d) of the California Rules of Court.The child or nonminor:a. Is being placed in a county outside the county of original jurisdiction on (date):. The court has read and considered the report.a. Hearing date: Time: Dept.: Room:b. Judicial officer:c.The Court Finds and Orders b. Was placed in a county outside the county of original jurisdiction on (date):. Party (name):(1) Child: Present Attorney: (2) Mother: Attorney: (3) Father-presumed: Attorney: (4) Father-biological: Attorney: (5) Father-alleged: Attorney: (6) Legal guardian: Attorney: (7) Indian custodian: Attorney: (8) De facto parent: Attorney: (9) County agency social worker: Attorney: (10) Tribal representative: Attorney: (11) Other (specify): Attorney: A request for a waiver to presumptive transfer was made to the placing agency by:. Clerk stamps date here when form is filed. Fill in court name and street address: Superior Court of California, County of Court fills in case number when form is filed.Case Number: Fill in child's name and date of birth:Child's/Nonminor's Name:Date of Birth: 5 4 3 2 1 American LegalNet, Inc. a.(1) The transfer would disrupt continuity of care or delay access to services provided to the child or nonminor.(2) The transfer would interfere with family reunification efforts documented in the individual case plan. The placing agency has determined an exception to the presumptive transfer of the responsibility to provide for and arrange for the child222s or nonminor222s specialty mental health services:b.(3) The child222s or nonminor222s placement in a county other than the county of original jurisdiction is expected to last less than six months.(4) The child222s or nonminor222s residence is within 30 minutes of travel time to his or her established specialty mental health care provider in the county of original jurisdiction. The placing agency has determined that no exception applies to the presumptive transfer. The placing agency consulted the child and family team and others who serve the child or nonminor as appropriate regarding the waiver determination. a. Notice of the placing agency222s determination on the request to waive presumptive transfer of specialty mental health services was provided to the individual who requested waiver of presumptive transfer, and to all parties to the case. 9 After having considered the basis for the request for a hearing, the report provided for the hearing, and any other evidence presented at the hearing, the court finds that is in the child222s or nonminor222s best interests. waiver of presumptive transfer presumptive transfer Date:Judge (or Judicial Officer) If waiver applies, the mental health plan in the county of original jurisdiction has an existing contract with a specialty mental health care provider, or has demonstrated the ability to enter into a contract within 30 days of the waiver decision and to deliver timely specialty mental health services directly to the child or nonminor.a. The placing agency222s decision on the request for waiver of presumptive transfer was communicated by the placing agency to the child and family team on (date): .b. b. Case Number: Child's/Nonminor's Name: 8 7 6 JV-215, Page 2 of 2 New September 1, 2018, Mandatory Form Order After Hearing on Waiver of Presumptive Transfer American LegalNet, Inc.