Approved, SCAO JIS CODE: OFE ORDER FOLLOWING CASE NO. EMERGENCY REMOVAL HEARING PETITION NO. JUDICIAL CIRCUIT - FAMILY DIVISION COUNTY (CHILD PROTECTIVE PROCEEDINGS), PAGE 1 ORDER _____ OF _____ STATE OF MICHIGAN Court address Court telephone no. 1. In the matter of name(s), alias(es), DOB 2. Date of hearing: Judge/Referee: Bar no. THE COURT FINDS: 3. The court ordered the protective custody of the child(ren) on (form JC 05b). Date 4. This emergency removal hearing is held pursuant to MCR 3.974(B)(3). 5. The parents, guardian, or legal custodian were present and/or attempts were made to secure the presence of each parent, guardian, or legal custodian. 6. The lawyer-guardian ad litem for the child(ren) was present. 7. The child(ren) is/are Indian as defined in MCR 3.002(5). The petitioner has has not given notice of the preliminary hearing as required by MCR 3.920(C)(1). The preliminary hearing must be adjourned pending conclusion of a removal hearing required by MCR 3.967. The removal hearing required by MCR 3.967 was conducted in conjunction with this hearing (see required findings in item 10). A qualified expert, , testified as required by law. Name 8. a. Taking the child(ren) into protective custody was necessary to protect the health, safety, or welfare of the child(ren), and it is is not necessary that removal continue pending the dispositional review hearing. Contrary to the welfare findings were made in the order authorizing the emergency removal (form JC 05b). b. There are reasonable grounds for this court to remove the child(ren) from the parent(s), guardian, or legal custodian in compliance with MCL 712A.2(b) and MCR 3.974(B)(1) because conditions or surroundings of the child(ren) are such as to endanger the health, safety, or welfare of the child(ren), and it is contrary to the welfare of the child(ren) to remain in the home because: (Attach separate sheets as necessary.) c. Taking the child(ren) into protective custody is not necessary. 9. The parent(s), guardian, or legal custodian from whom the child(ren) was/were removed has/have received a written statement of the reasons for the removal and has/have been advised of his/her/their rights in compliance with MCR 3.974(B). 10. a. Reasonable efforts to prevent removal of the child(ren) from the home were made as determined in the order authorizing the emergency removal (form JC 05b). b. Reasonable efforts were made to prevent removal of the child(ren) from the home. The efforts include: (Specify on page 2.) c. The child(ren) is/are Indian, and the court finds by clear and convincing evidence and the testimony of an expert witness who has knowledge about the child-rearing practices of the Indian child's tribe, active efforts have have not been made to provide remedial services and rehabilitative programs designed to prevent the breakup of the Indian family. These efforts have proved unsuccessful, successful, the continued custody of the child(ren) by the parent or Indian custodian is is not likely to result in serious emotional or physical damage to the child(ren), and the child(ren) should should not be removed from the home. (Specify on page 2.) d. Reasonable efforts to prevent removal of the child(ren) from the home were not made. (SEE SECOND PAGE) Do not write below this line - For court use only MCL 712A.13a, MCR 3.920(C)(2)(a), MCR 3.965(C), MCR 3.974(B), MCR 3.979(F)(2) JC 75 (9/10) ORDER FOLLOWING EMERGENCY REMOVAL HEARING (CHILD PROTECTIVE PROCEEDINGS), PAGE 1 American LegalNet, Inc. www.FormsWorkFlow.com Approved, SCAO JIS CODE: OFE CASE NO. ORDER FOLLOWING PETITION NO. EMERGENCY REMOVAL HEARING JUDICIAL CIRCUIT - FAMILY DIVISION (CHILD PROTECTIVE PROCEEDINGS), PAGE 2 COUNTY ORDER _____ OF _____ STATE OF MICHIGAN Court address Court telephone no. In the matter of 10. (continued from page 1) The efforts for 10.b. and 10.c. are follows: (Specify the efforts from 10.b. and 10.c. here. If the child is an Indian child, both 10.b. and 10.c. apply and both the reasonable efforts and active efforts must be specified here.) 11. a. Reasonable efforts are not required to prevent the child(ren)'s removal from the home due to the mother father subjecting the child(ren) to the aggravated circumstance(s) of as provided in section MCL 722.638(1) and (2), and as evidenced by . the mother's father's conviction for murder of another child of the parent. the mother's father's conviction for voluntary manslaughter of another child of the parent. the mother's father's conviction for aiding or abetting in the murder or manslaughter of another child of the parent, attempting to murder the child(ren) or another child of the parent, or conspiring or soliciting to commit the murder of the child(ren) or another child of the parent. the mother's father's conviction for felony assault that resulted in serious bodily injury to the child(ren) or another child of the parent. the mother's father's involuntary termination of parental rights to a sibling of the child(ren). b. Reasonable efforts to preserve and reunify the family to make it possible for the child(ren) to safely return home are not required because the parent subjected the child or another child of the parent to one of the circumstances stated above. OR still recommended because: (When item 11 is checked, either complete item 13 below or schedule a permanency planning hearing within 30 days of this determination.) 12. a. Reasonable efforts shall be made to preserve and reunify the family to make it possible for the child(ren) to safely return home. b. Reasonable efforts shall not be made to preserve and reunify the family because it would be detrimental to the child(ren)'s health and safety. 13. Because reasonable efforts to prevent removal or to reunite the child(ren) and family are not required, a permanency planning hearing was conducted. (Use and attach form JC 19, Order Following Dispositional Review/Permanency Planning Hearing.) 14. Conditions of custody in the home and with the individual with whom the child(ren) reside(s) a. are adequate to safeguard the child(ren) from the risk of harm to the child(ren)'s life, physical health, and mental well-being. b. are not adequate to safeguard the child(ren) from the risk of harm to the child(ren)'s life, physical health, and mental wellbeing. No provision of service or other arrangement except removal of the child(ren) is reasonably available to adequately safeguard the child(ren) from the risk of harm to the child(ren)'s life, physical health, and mental well-being. Conditions of custody at the placement away from the home and with the individual with whom the child(ren) is/are placed are adequate to safeguard the child(ren)'s life, physical health, and mental well-being. 15. Parenting time with , even if supervised, may be harmful to the child(ren). (SEE THIRD PAGE) JC 75 (9/10) ORDER FOLLOWING EMERGENCY REMOVAL HEARING (CHILD PROTECTIVE PROCEEDINGS), PAGE 2 American LegalNet, Inc. www.FormsWorkFlow.com Approved, SCAO JIS CODE: OFE ORDER FOLLOWING CASE NO. EMERGENCY REMOVAL HEARING PETITION NO. JUDICIAL CIRCUIT - FAMILY DIVISION (CHILD PROTECTIVE PROCEEDINGS), PAGE 3 COUNTY ORDER _____ OF _____ STATE OF MICHIGAN Court address Court telephone no. In the matter of IT IS ORDERED: 16. The child(ren) is/are a. placed with the Department of Human Services for care and supervision, and i. the parent(s), guardian, or legal custodian shall execute all documents necessary to release confidential information regarding the child(ren) including medical, mental, and educational reports, and shall also, within 7 days, provide the Department of Human Services with the name(s) and address(es) of the medical provider(s) for the child(ren). Any medical provider for the child(ren) shall release the medical records of the child(ren) to the department. ii. if the child(ren) is/are placed in the home of a relative, a home study shall be performed by the Department of Human Services and a copy of the home study submitted to the court not more than 30 days after the placement. iii. upon request, the Department of Human Services shall release to the foster parent the information concerning the child(ren) in accordance with MCL 712A.13a(13). b. released to Name(s) of parent(s), guardian, or legal custodian of Human Services. under the supervision of the Department The following terms and conditions apply to the parent(s), guardian, or legal custodian: 17. Each child shall have a psychological evaluation counseling to determine appropriateness and conditions of parenting time. 18. Parenting time of is supervised by the Department of Human Services and/or its designee. unsupervised at the discretion of the Department of Human Services. suspended while psychological evaluation or counseling is conducted, or until further order of the court. 19. Parenting time of is supervised by the Department of Human Services and/or its designee. unsupervised at the discretion of the Department of Human Services. suspended while psychological evaluation or counseling is conducted, or until further order of the court. 20. Parenting time of is supervised by the Department of Human Services and/or its designee. unsupervised at the discretion of the Department of Human Services. suspended while psychological evaluation or counseling is conducted, or until further order of the court. 21. This matter is set for a dispositional review hearing before on Date and time 22. This matter is set for a removal hearing on . Name (Must be within 14 days of removal pursuant to MCR 3.974[C].) pursuant to MCR 3.967. The petitioner Date and time shall give notice of these proceedings as required by MCR 3.920(C)(2) (use form JC 48). 23. Other: Recommended by: Date JC 75 (9/10) Referee signature Judge ORDER FOLLOWING EMERGENCY REMOVAL HEARING (CHILD PROTECTIVE PROCEEDINGS), PAGE 3 American LegalNet, Inc. www.FormsWorkFlow.com