District Court Denver Juvenile Court __________________________________________County, Colorado Court Address: THE PEOPLE OF THE STATE OF COLORADO In the interest of: _________________________________________ Child(ren) and Concerning _________________________________________ Parent(s)/Guardians(s) Attorney or Party Without Attorney (Name and Address): COURT USE ONLY Case Number: Phone Number: FAX Number: Division JUVENILE DELINQUENCY PLACEMENT ORDER E-mail: Atty. Reg.#: Courtroom This matter came before the Court on the ________________ day of _______________________, 20 _______. The Court having reviewed the file and evidence in this matter and being otherwise sufficiently advised in the premises, FINDS: _______________ There is reason to believe that the juvenile has committed a delinquent act, violated probation, runaway, failed to appear, or violated the conditions of bond. _______________ _______________ The juvenile is a danger or threat to (himself) (herself) or the community. Placement out of the home is necessary and is in the best interests of the juvenile and the community AND _______________ a) Reasonable efforts were made to prevent or eliminate the placement of the juvenile OR _______________ b) An emergency existed such that the lack of efforts to prevent removal from the home was reasonable. _______________ The juvenile has been placed in the least restrictive placement available which can effectively meet (his) (her) needs and is closest to the home. _______________ Procedural safeguards to preserve parental rights have been applied in connection with the removal of the juvenile from the home. THEREFORE, IT IS HEREBY ORDERED, ADJUDGED AND DECREED: _______________ Temporary legal custody of the juvenile is granted to the _________________ County Department of Social Services for out of home placement. _______________ The ______________County Department of Social Services shall make reasonable to safely return said juvenile to (his) (her) home. _______________ The parent(s)/guardian shall immediately provide the Court and the need for ___________________ County Department of Social Services the names and addresses of and/or means of locating any parent(s) not present in court and of other relatives of the JDF 554 5/01 Juvenile Delinquency Placement Order Page 1 of 2 2001 © American LegalNet, Inc. juvenile or other individuals who may be able to provide placement for the juvenile if (he) (she) remains in out of home placement. Good cause exists and the ____________________County Department of Social Services is authorized to contact identified relatives and/or individuals and share information, including otherwise confidential information, regarding the juvenile, the parent(s), and this proceeding to complete an appropriate placement study of such relatives or individuals. _______________ _______________ This matter is set for __________ on ______________, 20____, at ________ (am) (pm), at which time all parties must be present. Six (6) month Periodic reviews and/or Permanency Hearings shall be conducted by the Colorado Department of Human Services as Administrative Reviews, unless a party to the action requests a court hearing, or unless the Court deems it necessary to require a hearing. Dated: ______________________________ BY THE COURT _________________________________ JUDGE MAGISTRATE JDF 554 5/01 Juvenile Delinquency Placement Order Page 2 of 2 2001 © American LegalNet, Inc.