DECLARATION IN SUPPORT OF REQUEST TO INSPECT AND/OR COPY JUVENILE COURT RECORDS WITHOUT A COURT ORDER L - 0673 ( 0 1/19 ) Welfare and Institutions Code 247 247 103, 362.5, & 827 Form Adopted for Mandatory Use Cal. Rules of Court 5.552 Page 1 Miscellaneous Orders 543.2, 528. 7, M - 2013 - 1 - 2013 De c l a r at i on s ub m i tted b y : Na m e: S t r eet A dd r e ss : C i t y , S tate , Zip : T e l ephone Nu m be r : FO R C O UR T U SE O NLY S U PE RI O R C O URT O F C A L I FO RNI A , C O UN T Y O F O R A N G E La m o r eaux J u s t i c e Center J u v en il e Cou r t 341 T he C i ty D r iv e South, Ste. 207 Or ange, CA 92868 N A ME O F CHILD: D A T E O F B IR T H: D E CL A R A TION IN S U PP ORT OF R E QU ES T TO IN SPE CT A ND/OR CO P Y J U VE NILE COURT R E CORDS W ITHOUT A COURT ORD E R ( We l f a re a nd In s t i t u t ions Code 247 827) C ASE NU MBE R : CONFIDENTIALITY REQUIREMENTS / WARNING: No person or entity may copy or inspect confidential psychological, medical or educational information absent an order from the Presiding Judge of the Juvenile Court. For records you are provided today, all records, reports or information obtained from Juvenile Court shall not be further released or disseminated to persons or agencies not otherwise entitled pursuant to Welf. & Inst. C ode 247247 827 or 362.5. Said informatio n shall not be attached to any document without prior approval of the Presiding Judge of the Juvenile Court, unless they are used in connection with adult criminal or juvenile court proceedings to declare a minor a dependent or ward of the court. Pursuant to the amendment of Labor Code s ection 432.7, an employer , whether a public agency or private individual or corporation, may not DECLARATIO N REGARDING YOUR ROLE: (Sections 1 and 2 below) ( 1 ) I a m o r r ep r esen t on e o f t h e f o ll o w i n g i nd i v i dua ls an d en t i t i e s t ha t m a y i nspec t , r ece i v e , an d cop y t h e j u v en ile cas e f ile w i t hou t a n o r de r o f t h e j u v en ile cou r t pu r suan t t o W e l f . & I ns t . Cod e 247 82 7 , Welf & Inst. Code 247 362.5, Orange County Superior Court Local Rule 903 , and Administrative O r de r 12/003 - 903 of t h e O r ang e Coun t y Ju v en ile Cou rt : The district attorney, a city attorney, or a city prosecutor authorized to prosecute criminal or juvenile cases under the law; The child or non - minor dependent who is the s ubject of the proceeding; parental rights have not been terminated. If the subject is older than 17 years and 6 months of age, I am currently receiving reunification services from the social services agency; An attorney for a party, including any trial court or appellate attorney representing a pa rty in the juvenile proceeding or related appellate proceeding; A judge, referee, other hearing officer, probation officer, and law enforcement officer who is actively participat ing in criminal or juvenile proceedings involving the child or non - minor dependent, including the district attorney if the non - minor is also a ward of the Juvenile Court; T he coun t y counsel, ci t y a tt o r ne y , or any o t her a tt o r ney r ep r esen t ing t he petitioning agency in a dependency action; A m ember of a child protective agency as defined in P enal Code 24711165.9 ; A n a ssigned Social Worker or Probation Officer charged with review of court records for purpose of making a written recommendation to the court in a social study report pursuant to Welf. & Inst. Code 247 241.1 for determination of dual status suitability of a current dependent or ward of the court; American LegalNet, Inc. www.FormsWorkFlow.com DECLARATION IN SUPPORT OF REQUEST TO INSPECT AND/OR COPY JUVENILE COURT RECORDS WITHOUT A COURT ORDER L - 0673 ( 0 1/19 ) Welfare and Institutions Code 247 247 103, 362.5, & 827 Form Adopted for Mandatory Use Cal. Rules of Court 5.552 Page 2 Miscellaneous Orders 543.2, 528. 7, M - 2013 - 1 - 2013 A Court Appointed Special Advocate, or CASA Administrative Personnel; The California Depart m en t o f Soc i a l Se rv i ce s in o r de r t o ca rr y ou t i t s du t y t o o v e r se e an d m on i t o r c oun t y ch ild w e l f a r e agenc i es , ch il d r e n in f os t e r ca r e o r r ece i v i n g f os t er - ca r e ass i s t ance , an d ou t - o f - s t a te p l ace m en t s, or authorized legal staff or special investigators who are peace officers employed by, or who are authorized representatives of the State Department of Social Services, as necessary for the performance of their duties to inspect, license, and investigate community care facilities, to ensure that the standards of care and services provided in those facilities are adequate and appropriate, and to ascertain compliance with the rules and regulation to which the facil ities are subjec t; The Juvenile Justice Commission; A judge, commissioner or other hearing officer assigned to a family law or probate case involving the minor, or the following person, if actively participating in the family law or probate case: A court - appointed mediator or evaluator conducting a court - connected child custody evaluation, investigation or assessment pursuant to Family C ode 247 247 311 1 o r 3118 , and counsel appointed for the minor in the family law case pursuant to Family Code 247 3150 . Counsel for the minor on related matters is required to provide a A n I nd i a n c h il d tr i be , if t h e tr i b e ha s i n t e rv ene d in t h e ch il d case; A n individual other than a person described in Welfare and Institutions Code, section 827, subparagraphs (A) to (P) who files a notice of appeal or petition for writ challenging a juvenile court o rder, or who is a respondent in that appeal or real party in interest in that writ proceeding who was previously granted access by the juvenile court pursuant to subparagraph (Q) of paragraph (1) . NOTE: A Request for Release of Juvenile Case File (JV - 570) m us t b e submitted to the Presiding Judge of the Juvenile Court for review if cop i e s o f sealed r eco r d s a r e being r eques t e d unde r nu m be r one ( 1 ) abo v e. ( 2 ) I understand I am not authorized to receive copies of Juvenile Court record without a prior court order. I a m o r r ep r esen t on e o f t h e f o ll o w i n g i nd i v i dua ls an d en t i t i e s t ha t m a y i nspec t Juvenile Court records. A m e m be r o f t h e ch il d m u l t i d i sc i p li na r y t ea m s , pe r so n o r agenc y p r o v i d i n g tr ea tm en t o r supe rv i s i o n of t h e ch il d ; A cou r t - appo i n t e d i n v es t i ga t o r w h o is ac t i v e ly pa rt i c i pa t i n g in a gua r d i ansh i p cas e i n v o l v i n g a ch ild pu r suan t t o Section 7663, 7851, or 9001 of the Family Code or Part 2 (commencing with Section 1500) of Division 4 of the P r oba t e Code , an d ac t i n g w i t h in t h e scop e o f h i s / he r du t i e s in t ha t case; A l oca l ch ild suppo r t agenc y f o r t h e pu r pose s o f es t ab li sh i n g pa t e r n i t y an d es t ab li sh i n g an d en f o r c i ng ch ild suppo r t o r de r s ; A child welfare agency of a county responsible for the supervision and placement of a minor or nonminor dependent for the purpose of determining an appropriate placement or service that has been o rdered for the minor or nonminor dependent by the court; NOTE: A Request for Release of Juvenile Case File (JV - 570) m us t b e f il e d if cop i e s o f r eco r d s a r e r eques t e d unde r nu m be r t w o ( 2 ) abo v e. A u t ho ri za ti o n m a y b e o r de r e d on l y b y t h e P r es i d i ng Judg e o f t h e Ju v en il e Cou rt . (3) I have read and agree to the following terms for inspection: The inspector shall not disclose or disseminate any information contained in the records to any person, unless otherwise ordered by the court. The inspector may receive the documents in an electronic forma t for inspection on site at Juvenile Court. The inspector shall not alter, del e te, transmit, copy, or photograph, by any means, anything contained in the case file (the inspector may take notes regarding the contents of the documents). If these, or any oth er document(s) placed in a confidential or sealed