COMMONWEALTH OF KENTUCKY FAYETTE FAMILY COURT DIVISION CASE NUMBER PETITIONER VS. ORDER OF SUPERVISED TIMESHARING / SUPERVISED EXCHANGE RESPONDENT WHEREAS, the Court finds it appropriate and in the best interests ofthe minor child(ren) to have access with the PETITIONER / RESPONDENT (circle one), and the Court finds that: Said timesharing should be supervised and monitored until further notice of the Court. Said exchange for timesharing should be supervised until further notice of the Court. IT IS ORDERED that the PETITIONER / RESPONDENT (circle one) shall have timesharing with the child(ren) accordin-a to the following schedule : o Supervising Person (name, relation, address) Additional Instructions : Level ofSupervised Timesharing Other than Sunflower Kids Visitation Center: Level 1 - Supervising Person in room with family at all times Level 2 - Supervising Person monitoring visually from an adjacent room o Sunflower Kids Visitation Center 2101 Nicholasville Road, Suite 109 859-268-0487 *Visitations to be scheduled after initial intake at Sunflower Kids Visitation Center and the frequency and beginning date for supervised visitation is dependent upon Sunflower Kids Visitation Center's calendar and the availability of openings . Ordered FREQUENCY and DURATION of Timesharing: Number of Visits per week Duration ofVisit Number of Visits per month Duration ofVisit FC-8 Supervised Visitation / Supervised Exchanges Order American LegalNet, Inc. www.USCourtForms.com IT IS FURTHER ORDERED that said Supervised Timesharing Exchanges with PETITIONER / RESPONDENT (circle one) shall take place at / through one ofthe following: o Supervising Person (name, relationship, address): Additional Instructions : o Sunflower Kids Visitation Center 2101 Nicholasville Road, Suite 109 Lexington, KY40503 859-268-0487 Ordered FREQUENCY and DETAIL of Supervised Timesharing Exchanges : IT IS FURTHER ORDERED that the visiting party shall pay all fees incurred for the Supervised Visits or Exchanges conducted by Sunflower Kids Visitation Center. IT IS FURTHER ORDERED that any modification of this Order must be by Agreed Order signed by all parties and the Court, or in the absence of an Agreed Order, by an Order from this Court after a motion is filed by a party requesting modification and noticed for hearing before the Court. If an Agreed Order modifies this Order, the parties are responsible for delivering a copy of the Agreed Order to Sunflower Kids Visitation Center. IT IS FUTHER ORDERED that all parties shall cooperate with the staff of Sunflower Kids Visitation Center and abide by all rules, conditions and requirements established by Sunflower Kids Visitation Center. Failure to do so could result in termination of services. IT IS FUTHER ORDERED that the Cabinet for Health and Family Services is authorized and ordered to provide any and all information concerning these parties and their children to the Safe Havens Domestic Violence Specialist if requested. JUDGE/DATE FC-8 Supervised Visitation / Supervised Exchanges Order American LegalNet, Inc. www.USCourtForms.com