IN THE STATE OF MARYLAND ____________________________________, MARYLAND CITY or COUNTY In the Matter of: ________________________________ RESPONDENT'S FULL NAME ________________________________________________ RESPONDENT’S DOB Sitting as a Juvenile Court ) ) ) ) ) Case Number: ______________________ ) ) ) ADJUDICATION/ DISPOSITION ORDER Upon consideration of the CINA Petition and written stipulation proffer evidence submitted by the __________________________________________________, and with the following persons present: [PARTIES] Child Child’s Attorney Case/Social Worker DSS Attorney Mother Advised of right to counsel Self Represented Father Advised of right to counsel Self Represented Guardian Advised of right to counsel Self Represented Custodian CASA Other_________________ Mother’s Attorney Father’s Attorney Guardian’s Attorney Other________________ The ______________ attorney amended the Petition in the following manner: ___________________________ [ DSS or COUNTY] and having heard this matter on the issue________________, by the Court for ____________________, on this [CITY or COUNTY] ____ day of ____________, 20_____, [MONTH] THE COURT FINDS BY PREPONDERANCE OF THE EVIDENCE: (if not previously found at shelter)-At the time of removal, the child/respondent was in the physical custody of ___________________________________________________, with whom the child began [ INDIVIDUAL NAME, RELATIONSHIP TO THE CHILD] living on _____________ and [DATE] in the legal custody of __________________________________, with whom the child last lived on ________. [INDIVIDUAL NAME, RELATIONSHIP TO THE CHILD] [DATE] Or Information not available because ________________________________ [e.g. abandonment, runaway, etc.] In accordance with Rule 11-114 and the Courts and Judicial Proceedings Article of the Annotated Code of Maryland §3-817, that the allegations in the CINA petition have been proven by a preponderance of the evidence, and that the following facts as alleged in the petition CC-JO22 (Revised 12/2009) 1 American LegalNet, Inc. www.FormsWorkFlow.com were sustained: ___________________________________________________________________. were not sustained: ________________________________________________________________. The following additional facts were found: ______________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ That the evidence presented sustained the finding that continuation of the aforesaid child in the child’s home is not contrary to the child’s welfare and that it is now possible to return the child to that home because the following circumstances exist: ______________________________________________________ __________________________________________________________________________________________ ______________________________________________; and there is no further likelihood of abuse or neglect is contrary to the child’s welfare and that it is not possible to return the child to that home because the following circumstances exist: ______________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ It is further found that the evidence presented sustained that reasonable efforts to prevent or eliminate the need for removal of the child: were made because of the following ________________________________________________ ____________________________________________________________________________________ _________________________________________________________________________________; or were not made because the following emergent circumstances existed _____________________ ____________________________________________________________________________________ _________________________________________________________________________________; or were not made. The efforts or absence of reasonable efforts were not reasonable for the following reasons _____________________________________________________________________ ____________________________________________________________________________________ _________________________________________________________________________________; or The court has found by clear and convincing evidence that the local department is not required to provide reunification services because this case involves a case of chronic abuse; chronic and life threatening neglect; sexual abuse; torture; crimes of violence; or a prior involuntary termination of parental rights in accordance with Courts and Judicial Proceedings Article of the Annotated Code of Maryland §3-812. ________ __________________________________________________________________________________________ __________________________________________________________________________________________ The CINA petition is DISMISSED before DISPOSITION CC-JO22 (Revised 12/2009) 2 American LegalNet, Inc. www.FormsWorkFlow.com DISPOSITION DISPOSITION #1 In light of the above findings on this _____ of ________ 20___, it is therefore [MONTH] ORDERED, in accordance with the Courts and Judicial Proceedings Article of the Annotated Code of Maryland, Section 3-819 and the Maryland Rules of Procedure, Rule 11-115, that the child is found to be a Child in Need of Assistance for the following reasons ______________________________________________ __________________________________________________________________________________________ _________________________________________________________________________________________: [Describe reasons found as a result of the sustained facts and other dispositional information] and, it is further ORDERED, that the Respondent Child, __________________________________, be placed/ continued [NAME OF THE RESPONDENT CHILD] in the custody of __________________________________________: and/or [NAME OF PARENT(S)/ RELATIVE/ OTHER] under the protective supervision of the ______________ or [LOCAL DSS] committed to the custody of the __________ pending further dispositional review before this Court; [LOCAL DSS] and it is further, _____________________________ [continue with other orders] Or Formatted DISPOSITION #2 In light of the above findings on this _____ of ________ 20___, it is therefore [MONTH] ORDERED, in accordance with the Courts and Judicial Proceedings Article of the Annotated Code of Maryland, Section 3-819, and the Maryland Rules of Procedure, Rule 11-115, that the child IS NOT found to be a Child in Need of Assistance for the following reasons: ____________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ [Describe reasons or circumstance changes that go into making this finding] the allegations as sustained above do not constitute sufficient evidence of abuse or neglect to warrant continued jurisdiction of this Court. Or since the allegations were sustained sufficient remedial efforts _________________________________ have [changes in circumstances] CC-JO22 (Revised 12/2009) 3 American LegalNet, Inc. www.FormsWorkFlow.com occurred causing the child to no longer be in danger of further abuse or neglect arising from the sustained facts of this case, ORDERED, that the COURTS JURISDICTION IS TERMINATED Or Formatted DISPOSITION #3 In light of the above findings on this _____ of ________ 20___, it is therefore [MONTH] ORDERED, in accordance with the Courts and Judicial Proceedings Article of the Annotated Code of Maryland, Section 3-819 (e), and the Maryland Rules of Procedure, Rule 11-115, that the child IS NOT found to be a Child in Need of Assistance for the following reasons: that having sustained allegations against one parent only and finding that the other parent is available and is able and willing to care for the child, custody is awarded to ______________________________, with the right [NAME of CUSTODIAL PARENT] to reasonable visitation under such supervision and conditions as follows: ORDERED, in accordance with the Family Law Article of the Annotated Code of Maryland, Section 9-101 that There is no further likelihood that abuse or neglect would occur with visitation rights granted as follows: Or The following supervised visitation arrangement assures the safety and the physiological, emotional, and psychological well being of the child: and it is further, ORDERED; that this CASE is DISMISSED and JURISDICTION TERMINATED. ORDERED, THAT ALL PARTIES ARE TO RETURN TO THIS COURT FOR THE _______________ HEARING TYPE HEARING ON THE _______DAY OF________________, 20_____ AT ____A.M./P.M THAT ALL PARTIES PRESENT HAVE A CONTINUING OBLIGATION TO ASSIST THE COURT IN IDENTIFYING AND LOCATING EACH PARENT OF EACH CHILD. THAT ALL PARENTS PRESENT SHALL CONTINUALLY KEEP THE CLERK OF THE COURT AND THE DEPARTMENT OF SOCIAL SERVICES APPRISED OF THEIR CURRENT ADDRESS(ES). EXCEPTIONS SHALL BE IN WRITING AND SHALL BE FILED WITH THE CLERK’S OFFICE. IF ANY PARTY TAKES EXCEPTIONS, THEY MUST FILE WITHIN FIVE DAYS OF THE DATE OF SERVICE. THE FILING SHALL SPECIFY THOSE ITEMS TO WHICH EXCEPTIONS ARE TAKEN. COPIES OF EXCEPTIONS MUST BE SERVED ON ALL OTHER PARTIES INVOLVED IN THE CASE. CC-JO22 (Revised 12/2009) 4 American LegalNet, Inc. www.FormsWorkFlow.com ALL PARTIES LISTED ABOVE A PRESENT RECEIVED NOTICE OF THE FINDINGS ON THE RECORD AND UPON COMPLETION A COPY OF THIS ORDER WAS HANDED TO THEM SENT BY FIRST CLASS MAIL. A COPY OF THIS ORDER WILL BE MAILED TO THOSE PARTIES NOT PRESENT, SERVICE TO BE ACCOMPLISHED BY: FIRST CLASS MAIL SHERIFF’S SERVICE ON: __________________ CERTIFIED MAIL, RETURN RECEIPT REQUESTED ON: __________________ APPROPRIATE MEANS WHEN AN ADDRESS IS SUPPLIED TO THE COURT Recommended by: ____________________________ Master ________________________ Date ____________________________ JUDGE ________________________ DATE CC-JO22 (Revised 12/2009) 5 American LegalNet, Inc. www.FormsWorkFlow.com