SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO CENTRAL DIVISION, FAMILY COURT, 1555 6TH AVE., SAN DIEGO, CA 92101 (619) 450-7888 NORTH COUNTY DIVISION, 325 S. MELROSE DR., VISTA, CA 92081 (760) 201-8300 NOTICE TO PETITIONERS IN GUARDIANSHIP TERMINATION MATTERS When seeking termination of guardianship of a child(ren) to whom you are related, in order to begin the Family Court Services (FCS) investigation process, copies of the following documents that were filed in the business office of the appropriate courthouse, must be submitted to FCS at the corresponding address listed above, prior to scheduling an investigation date: 1. Petition for Termination of Guardianship of Minor(s) Only (SDSC Form #PR-094) 2. Either an Order Directing or Waiving Investigation signed by Judge of the Superior Court (SDSC Form #PR-063) or a Family Court Services Referral (SDSC Form #FCS-037) request from the Judge of the Superior Court directing FCS to conduct a termination investigation. 3. Family Court Services Guardianship Termination Questionnaire (SDSC Form #FCS-039) (Provided only to Family Court Services). You may mail the information to the San Diego FCS office at 1555 6th Avenue, 2nd Floor, San Diego, California 92101 or to the Vista office at 325 S. Melrose Dr., Vista, California 92081. You may also walk-in and drop your paperwork off from 8:00 a.m. - 12:00 p.m. and 1:00 p.m. – 5:00 p.m. Monday through Friday. Please complete the attached seven page Guardianship Termination Questionnaire in its entirety. We will be seeking information regarding the social history of the petitioner, guardians, parents and children as is required by State Law. Please bring all documentation requested in the questionnaire, including proof of residence and employment, parenting class certificates, treatment programs, etc. Information provided on this questionnaire, in the family interview(s), in other submitted comments and from investigative sources, will be used to prepare a family social history, evaluation and recommendation to the court. This report will then be placed in a sealed court file. Copies will be issued to the petitioner, guardians, parents and their respective attorneys. You may call the Guardianship Clerk at the appropriate number listed above with questions regarding the FCS termination investigation process, or concerns regarding appointments. The petitioner is responsible for notifying the guardians regarding the FCS investigation interview appointment. Any adult living in the home and acting in a parental role should be present for the interview. Please do not bring the child(ren). A subsequent appointment will be scheduled should the investigator need to interview the children. Family Court Services cannot guarantee childcare so a caretaker should also accompany the child(ren). SDSC FCS-039 (New 3/09) GUARDIANSHIP TERMINATION QUESTIONNAIRE (CONFIDENTIAL) American LegalNet, Inc. www.FormsWorkFlow.com SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN DIEGO FAMILY COURT SERVICES GUARDIANSHIP TERMINATION QUESTIONNAIRE THIS FORM IS TO BE COMPLETED AND SUBMITTED TO FAMILY COURT SERVICES BY: Your appointment will not be set until this form has been returned to Family Court Services. COUNSELOR: PROBATE CASE NUMBER: COURT DATE: FCS DATE: I. MINOR CHILD(REN) LISTED ON GUARDIANSHIP TERMINATION PETITION: Full Legal Name Birth Date Social Security Number School and Grade Level Person with whom Residing Attorney for Minor(s): Phone: ( Name: ) Address: Street Apt. City State Zip State Zip II. PETITONER(S) FOR TERMINATION OF GUARDIANSHIP: AKA or Maiden Name: 1. Full Legal Name: Address: Street Phone Numbers: Home ( Apt. ) City Work ( ) Social Security Number: _________________ Birth Date: ____/_____/_____ Place of Birth: Driver License Number: State: _________________ Currently Valid: Relationship to Child(ren) on Petition: Yes Maternal No Paternal AKA or Maiden Name: 2. Full Legal Name: Address: Street Phone Numbers: Home ( Apt. ) City Work ( State Zip ) Social Security Number: _________________ Birth Date: ____/_____/_____ Place of Birth: State: _________________ Currently Valid: Driver License Number: Maternal Relationship to Child(ren) on Petition: Yes No Paternal Attorney for Petitioner(s): Phone: ( Name: ) Address: Street SDSC FCS-039 (New 3/09) Apt. City GUARDIANSHIP TERMINATION QUESTIONNAIRE (CONFIDENTIAL) State Zip Page 1 of 7 American LegalNet, Inc. www.FormsWorkFlow.com III. CURRENT GUARDIAN(S): AKA or Maiden Name: 1. Full Legal Name: Address: Street Phone Numbers: Home ( Apt. ) City Work ( State Zip ) Social Security Number: ____________________ Birth Date: ____/____/____ Place of Birth: ___________________ Driver License Number: ____________________________State: _______________ Currently Valid: Yes Maternal Relationship to Child(ren) on Petition: No Paternal Attorney for Petitioner(s): Phone: ( Name: ) Address: Street Apt. City State Zip State Zip AKA or Maiden Name: 2. Full Legal Name Address: Street Phone Numbers: Home ( Apt. ) City Work ( ) Social Security Number: ____________________Birth Date: ____/____/____Place of Birth: ____________________ Driver License Number: ____________________________State:_______________ Currently Valid: Maternal Relationship to Child(ren) on Petition: Yes No Paternal Attorney for Petitioner(s): Phone: ( Name: ) Address: Street SDSC FCS-039 (New 3/09) Apt. City GUARDIANSHIP TERMINATION QUESTIONNAIRE (CONFIDENTIAL) State Zip Page 2 of 7 American LegalNet, Inc. www.FormsWorkFlow.com IV. PARENTS OF MINORS: (Full legal names) If one of the natural parents has died, please mark “deceased” for that person’s address and add the date of death, if known. AKA or Maiden Name: 1. Full Legal Name: Address: Street Phone Numbers: Home ( Apt. City ) Work ( Birth Date: Social Security Number: / State / Place of Birth: State: Driver License Number: Zip ) Currently Valid: Yes No Relationship to Child(ren) on Petition: Attorney: Name: Phone: ( ) Address: Street Apt. 2. Full Legal Name: City State Zip State Zip AKA or Maiden Name: Address: Street Phone Numbers: Home ( Apt. City ) Work ( Birth Date: Social Security Number: / ) / Place of Birth: State: Driver License Number: Currently Valid: Yes No Relationship to Child(ren) on Petition: Attorney: Name: Phone: ( ) Address: Street Apt. 3. Full Legal Name: City State Zip State Zip AKA or Maiden Name: Address: Street Phone Numbers: Home ( Apt. City ) Work ( Birth Date: Social Security Number: / ) / Place of Birth: State: Driver License Number: Currently Valid: Yes No Relationship to Child(ren) on Petition: Attorney: Name: Phone: ( ) Address: Street Apt. 4. Full Legal Name: City State Zip State Zip AKA or Maiden Name: Address: Street Phone Numbers: Home ( Apt. City ) Work ( Birth Date: Social Security Number: / ) / Place of Birth: State: Driver License Number: Currently Valid: Yes No Relationship to Child(ren) on Petition: Attorney: Name: Phone: ( ) Address: Street SDSC FCS-039 (New 3/09) Apt. City GUARDIANSHIP TERMINATION QUESTIONNAIRE (CONFIDENTIAL) State Zip Page 3 of 7 American LegalNet, Inc. www.FormsWorkFlow.com V. HOUSEHOLD COMPOSITION OF PARTY REQUESTING TO PROVIDE THE CHILD(REN)’S RESIDENCE: A. List other adults 18 or older residing in your home. Indicate if they are acting in a parental role with the child(ren). Any individuals acting in a parental role will be required to attend the investigation interview. AKA or Maiden Name: 1. Full Legal Name: Phone Numbers: Home ( Birth Date: / ) Work ( Birth Place: __________Sex: _________Social Security Number: ________________ / Driver’s License Number: State:____________ Relationship to Applicant: ) / Work ( Yes No AKA or Maiden Name: Phone Numbers: Home ( ) Work ( ) Birth Place: __________Sex: _________Social Security Number: ________________ / Driver’s License Number: State:____________ Relationship to Applicant: Currently Valid: Yes No Relationship to child(ren): AKA or Maiden Name: 4. Full Legal Name: Phone Numbers: Home ( / Currently Valid: Relationship to child(ren): 3. Full Legal Name: Birth Date: ) State:____________ Relationship to Applicant: / No Birth Place: __________Sex: _________Social Security Number: ________________ Driver’s License Number: Birth Date: Yes AKA or Maiden Name: Phone Numbers: Home ( / Currently Valid: Relationship to child(ren): 2. Full Legal Name: Birth Date: ) / ) Work ( ) Birth Place: __________Sex: _________Social Security Number: ________________ Driver’s License Number: State:____________ Relationship to Applicant: Currently Valid: Yes No Relationship to child(ren): B. List other child(ren) under age 18 living in your household: Name SDSC FCS-039 (New 3/09) Birth Date Social Security Number GUARDIANSHIP TERMINATION QUESTIONNAIRE (CONFIDENTIAL) School Page 4 of 7 American LegalNet, Inc. www.FormsWorkFlow.com The remaining sections are to be completed regarding the party requesting to provide the child(ren)’s residence. Relationship: Name: (Please Print) VI. LAW ENFORCEMENT INFORMATION: Have charges ever been filed against you for crimes other than minor traffic citations? Yes No If yes, please explain: Charge City/State Date 1) 2) 3) Are you on parole or probation? Yes No Phone: ( Parole or Probation Officer’s Name: ) Have you or anyone living in your home ever been accused of child abuse or child molestation? Yes No If yes, please explain: VII. EDUCATION: Graduated High School? Highest Grade Completed: Yes No Year: License(s) or Credential(s) Received: College Degree(s) Received: VIII. EMPLOYMENT: Please bring confirmation of employment, including pay stubs to the investigation interview. Employer: Capacity/Job Title: Length of Employment: Salary: Supervisor’s Name, Address and Phone Number: IX. HEALTH: Name of Your Health Insurance Plan: Good Present Health Status: Fair Poor If Your Health is Fair or Poor, Please Explain: Are you taking any medication? Yes No If yes, what kind and for what reason(s)? Special Health Problems: Have you ever had any problem with the following? Alcohol: Yes No Drugs: Yes No Mental/Emotional Problems: Yes No If yes, what is your current condition regarding this problem? (Bring proof of treatment to investigation interview) Professional Practitioners: (Medical doctors, psychotherapists, counselors who may have treated you within the past two years.) Name and Title SDSC FCS-039 (New 3/09) Date of Last Contact Address GUARDIANSHIP TERMINATION QUESTIONNAIRE (CONFIDENTIAL) Phone Number Page 5 of 7 American LegalNet, Inc. www.FormsWorkFlow.com X. FAMILY FINANCES: Residence: Please provide proof of residence, i.e. rental agreement, at investigation interview. The home you live in is: owned rented. Monthly Cost: $ How long have you lived there? Number of Bedrooms: Number of Bathrooms: Value: $ Approximate Size: Income: Please list source(s) of income and amount(s). Income Source sq.ft. Amount 1. 2. 3. Other Assets: Please list other major assets or real property. Asset Value 1. 2. 3. XI. PLANS FOR CHILD CARE: (If necessary) Care Provider(s): Name SDSC FCS-039 (New 3/09) Address Phone Number GUARDIANSHIP TERMINATION QUESTIONNAIRE (CONFIDENTIAL) Hours Relationship to Child Page 6 of 7 American LegalNet, Inc. www.FormsWorkFlow.com XII. SUMMARY OF CIRCUMSTANCES: 1. Briefly summarize the reasons why you are requesting termination of the guardianship. You may attach declarations which are being provided to the court in this regard. 2. What is the guardian’s opinion regarding your request for termination of the guardianship? 3. List any parenting classes or additional programs in which you have participated that you feel enhances your ability to parent. Please provide certificates of completion at the investigation interview. 4. Please describe the contact you have had with the child(ren) since the guardianship has been in effect. I declare under penalty of perjury under the laws of the State of California that all of the information I have submitted in this Guardianship Termination Questionnaire is true and correct. Date: Type or print name SDSC FCS-039 (New 3/09) Signature GUARDIANSHIP TERMINATION QUESTIONNAIRE (CONFIDENTIAL) Page 7 of 7 American LegalNet, Inc. www.FormsWorkFlow.com