F.C.A. §§355.3, 355.5 Form 3-39 (Juvenile DelinquencyExtension of Placement and Permanency Hearing Order) 12/2015 At a term for the Family Court of the State of New York, held in and for the County of at New York on , . PRESENT Hon. Judge In the Matter of Docket No. A Person Alleged to be a Juvenile Delinquent, Respondent. EXTENSION OF PLACEMENT AND PERMANENCY HEARING ORDER1 DEADLINE: IF THE RESPONDENT REMAINS IN A NON-SECURE LEVEL OF CARE, A PETITION FOR THE NEXT PERMANENCY HEARING MUST BE FILED NOT LATER THAN [SPECIFY]:2 ________________________________ . The above-named Respondent having been adjudicated by this Court to be a juvenile NOTE: Delete "Permanency Hearing" if this is solely an extension of placement order. Utilize General Form GF-35, instead of this form, if this is solely a permanency hearing order. Family Court Act §355.5(2) requires the permanency and extension of placement hearings to be combined. However, a permanency hearing may be required in advance of (and thus separately from) an extension of placement if a finding is made that reasonable efforts are not required (requiring a permanency hearing within 30 days) or if the Respondent was placed on a felony pursuant to F.C.A. §353.3 for 18 months (requiring a permanency hearing annually). Further, if the Respondent is placed in a facility not requiring a permanency hearing, an extension of placement hearing without a permanency hearing may be held. Although all juveniles placed pursuant to Family Court Act §§353.3 and 353.5 are subject to extensions of placement, F.C.A. §355.5 requires a permanency hearing only with respect to juveniles who, during the period of placement, are or may be placed in a non-secure level of care, that is, in facilities with capacities of 25 beds or fewer or are placed for re-placement with authorized agencies for foster or residential care. The petition must be filed at least 60 days prior to the date by which the hearing must be completed. See Uniform Rules of the Family Court, 22 N.Y.C.R.R. §205.17(b). Family Court Act §355.5 requires a permanency hearing regarding juveniles who are placed in non-secure facilities, although all juveniles placed pursuant to Family Court Act §353.3 are subject to extensions of placement. See F.C.A. §355.3, 355.5. 2 1 American LegalNet, Inc. www.FormsWorkFlow.com Form 3-39 Page 2 delinquent within the meaning of Article 3 of the Family Court Act, and an Order of Disposition, dated [specify]: , having been issued placing Respondent with [check applicable box]: a suitable person the New York State Office of Children and Family Services [Non-NYC cases]: the Commissioner of Social Services of [specify]: County, [NYC cases]: the Commissioner of the New York City Administration for Children's Services And the petition of [specify]: , for an extension of placement and permanency hearing , sworn to on [specify date]: , having been filed in this Court [check applicable box]: at least 60 days prior to the expiration of the period of placement; less than 60 days prior to the expiration of the period of placement, and good cause having [check applicable box] been not been found for the delay; in the case of a placement of 12 months or more, at least 60 days prior to the date the permanency hearing must be held; in the case of a placement of 12 months or more, less than 60 days prior to the date the permanency hearing must be held, and good cause having [check applicable box] been not been found for the delay; And notice having been duly given to the following person(s), who appeared as follows: [specify; check applicable boxes]: Respondent with counsel without counsel Parent(s)[specify]: Other person(s) legally responsible for Respondent's care [specify]: Prospective adoptive parent(s)[specify]: Foster parent(s)caring for Respondent [specify]: Relative(s) caring for Respondent [specify]: Authorized Agency caring for Respondent [specify]: Parents of siblings of the respondent [specify]: 3 Other [specify]: And the matter having duly come on to be heard, and the above-named persons appearing having been given an opportunity to be heard, And the position and information provided by the [check applicable box(es)]: NYS Office of Children and Family Services [Non-NYC cases]: the Commissioner of Social Services of [specify]: County, [NYC cases]: the Commissioner of the New York City Administration for Children's Services having been considered by the Court; Federal law [Public Law 113-183; 42 U.S.C. §675], requires permanency hearing notification to parents who have legal custody of the respondent's sibling or siblings. Siblings include those who would be siblings under NYS law, but for termination of parental rights or other disruption of parental rights, including death of a parent. 3 American LegalNet, Inc. www.FormsWorkFlow.com Form 3-39 Page 3 The Court, after having made an examination and inquiry into the facts and circumstances of the case and into the surroundings, conditions, and capacities of the persons involved, finds and determines the following [Note: judicial findings must be made pursuant to both I and II, below]: I. Required "Best Interests" and "Reasonable Efforts" Findings [check applicable boxes and provide case-specific reasons in both A and B below]: A. "Best Interests" Finding: Return of the Respondent to the home would would not be contrary to the best interests of the Respondent because [specify facts and reasons]: This determination is based upon the following information [check applicable box(es)]: The Permanency Petition, dated [specify]: Probation Department report, dated [specify]: Mental health evaluation, dated [specify]: Uniform Case Record, dated [specify]: Risk Assessment Instrument Summary of the Uniform Case Record, dated [specify]: Service Plan, dated [specify]: The report of [specify]: , dated [specify]: Testimony of [specify]: Other [specify]: B. "Reasonable Efforts" Findings: 1. Reasonable efforts, where appropriate, to return the Respondent home safely [check applicable box and state reasons as indicated]: were made as follows [specify]: were not made but the lack of efforts was appropriate [check all applicable boxes]: because of a prior judicial finding pursuant to Family Court Act §352.2(2)(c)that the authorized agency was not required to make reasonable efforts to reunify the Respondent with the parent(s) person(s) legally responsible for Respondent's care [specify date of finding]: because of other reasons [specify]: