F.C.A.§§ 346.1, 350.2, 352. 1, 352.2, 353.1, 353.3, 353.6 Form 3-30 (Juvenile DelinquencyOrder of Disposition After Order of Removal) 8/2010 At a term of 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, ORDER OF DISPOSITION (After Order of Removal with Finding) Respondent. An Order of Removal pursuant to section [check applicable box]: “ 220.10 “ 310.85 “ 330.25 of the Criminal Procedure Law, deemed to be a petition in accordance with section 311.1 of the Family Court Act, having been duly filed with this Court on [specify date]: , and containing a finding [check applicable box]: “ upon the above-named Respondent's plea of guilty “ after a juvenile delinquency fact-determination “ after a verdict of guilty beyond a reasonable doubt that the above-named Respondent, while [specify]: years of age, committed an act which would constitute the crime(s) of [specify as to each count]: as defined by section(s) of the “ Penal Law “ Other [specify]: in that said Respondent did the following act(s)[specify as to each count]: American LegalNet, Inc. www.FormsWorkFlow.com Form 3-30 Page 2 ;and Notice having been duly given to Respondent, the Presentment Agency and [check applicable box]: “ Respondent's parent(s) “ the person(s) legally responsible for the Respondent's care pursuant to section 341.2 of the Family Court Act; And the Respondent having [check applicable box(es)]: “ appeared “ not appeared, and counsel for Respondent having “ appeared “ not appeared before this Court to answer the petition; And the matter having thereafter duly come on for a dispositional hearing pursuant to section 350.2 of the Family Court Act before the Court; The Court, after making an examination and inquiry into the facts and circumstances of the case and after making reports available to counsel in accordance with section 351.1 of the Family Court Act, finds upon a preponderance of the evidence that: I. Dispositional Findings A. Respondent requires supervision, treatment, or confinement; and B. The Court, having fully considered the matter of a particular disposition pursuant to section 352.2 of the Family Court Act, has determined that the Respondent requires the following disposition for the following reasons [specify; if the Respondent has been found to be sexually exploited, as defined in Social Services Law §447-a, so indicate]: II. Required Findings in Cases in Which the Respondent is Placed: 1 [The following determinations are required when order is placement; check applicable boxes and provide case-specific reasons]: And the Court has determined that: A. Best Interests Finding: Continuation in, or return to, the Respondent’s home Q would Q would not be contrary to Respondent’s best interests based upon the following facts and for the following reasons [specify]: This determination was based upon the following information [check applicable box(es)]: 1 Note: These findings need not be made where the Respondent is placed restrictively pursuant to Family Court Act §353.5. American LegalNet, Inc. www.FormsWorkFlow.com Form 3-30 Page 3 9 Probation Department report, dated [specify]: 9 Mental health evaluation, dated [specify]: 9 Uniform Case Review, dated [specify]: 9 Summary of the Uniform Case Record, dated [specify]: 9 Service Plan, dated [specify]: 9 The report of [specify]: , dated [specify]: 9 Testimony of [specify]: 9 Other [specify]: B. Reasonable Efforts Findings: 1. Reasonable efforts, where appropriate, to prevent or eliminate the need for removal of the child from the home [check applicable box (es); state reasons as indicated. If prior finding was made, so indicate, including date]: Q were made as follows [specify]: Q were not made but the lack of efforts was appropriate [check all applicable boxes]: Q because of a prior judicial finding pursuant to F.C.A. §352.2(2)(c) that the authorized agency was not required to make reasonable efforts to reunify the Respondent with the Q parent(s) Q guardian(s) [specify date of finding]: Q because of other reasons [specify other reasons]: Q were not made. This determination was based upon the following information [check applicable box(es)]: 9 Probation Department report, dated [specify]: 9 Mental health evaluation, dated [specify]: 9 Uniform Case Review, dated [specify]: 9 Summary of the Uniform Case Record, dated [specify]: 9 Service Plan, dated [specify]: 9 The report of [specify]: , dated [specify]: 9 Testimony of [specify]: 9 Other [specify]: 2. Reasonable efforts, where appropriate, to return the Respondent home safely [check applicable box and state reasons as indicated]: Q were made as follows [specify]: Q were not made but the lack of efforts was appropriate [check all applicable boxes]: Q because of a prior judicial finding pursuant to F.C.A. §352.2(2)(c) that the authorized agency was not required to make reasonable efforts to reunify the child American LegalNet, Inc. www.FormsWorkFlow.com Form 3-30 Page 4 with the Q parent(s) Q guardian(s) [specify date of finding]: Q because of other reasons [specify]: Q were not made. This determination was based upon the following information [check applicable box(es)]: 9 Probation Department report, dated [specify]: 9 Mental health evaluation, dated [specify]: 9 Uniform Case Review, dated [specify]: 9 Summary of the Uniform Case Record, dated [specify]: 9 Service Plan, dated [specify]: 9 The report of [specify]: , dated [specify]: 9 Testimony of [specify]: 9 Other [specify]: 3. Reasonable Efforts: Goal Other Than Return Home: [Applicable in cases in which the Respondent’s permanency plan is adoption, guardianship or permanent living arrangement other than reunification]: Reasonable efforts to make and finalize the Respondent’s permanency plan of [specify]: Q have been made as follows [specify]: Q were not made based upon the following facts and for the following reasons [specify]: This determination was based upon the following information [check applicable box(es)]: 9 Probation Department report, dated [specify]: 9 Mental health evaluation, dated [specify]: 9 Uniform Case Review, dated [specify]: 9 Summary of the Uniform Case Record, dated [specify]: 9 Service Plan, dated [specify]: 9 The report of [specify]: , dated [specify]: 9 Testimony of [specify]: 9 Other [specify]: C. Transitional Services Finding [Required where Respondent is 16 or older]: The services, if any, needed to assist the Respondent to make the transition from foster care to independent living are [specify]: American LegalNet, Inc. www.FormsWorkFlow.com Form 3-30 Page 5 NOW therefore, upon the Order of Removal and the findings made in the dispositional hearing, and upon all proceeding had herein, it is hereby ORDERED and ADJUDGED that the above-named Respondent is a juvenile delinquent based on the Order of Removal and on the further ground that the Respondent requires supervision, treatment, or confinement; and it is therefore ORDERED that [check applicable boxes]: “ Respondent is conditionally discharged for a period of [specify]: the following terms and conditions: months upon “ Respondent is placed on probation under the supervision of the Probation Department of the County of for a period of upon the following terms and conditions: “ T his proceeding is continued and the Respondent is placed for a period of [specify]: “ less the period spent in detention pending disposition2 in the custody of [specify suitable relative or other person]: , subject to the further orders of this Court.) “ The position of the Commissioner of Social Services of [specify]: County having been considered by the Court, this proceeding is continued and the Respondent is placed for a period of [specify]: “ less the period spent in detention pending disposition3 in the custody of the Commissioner of Social Services of the County of for placement with [specify agency or class of agencies; if the Respondent has been found to be sexually exploited, as defined in Social Services Law §447-a, so indicate if Respondent should be placed in an available long-term safe house]: , subject to the further orders of this Court. In the event that the Commissioner of Social Services is unable to so place the child, the Commissioner “ shall “ need not apply to the Court for an order to stay, modify, set aside, or vacate such directive pursuant to section 355.1 of the Family Court Act; and the Commissioner “ shall “ need not return the Respondent to this Court for a new dispositional hearing and orders. 2 Applicable unless all or part of such credit would not serve the needs and best interests of the Respondent or the need for protection of the community. See F.C.A.§353.3(5). 3 Applicable unless all or part of such credit would not serve the needs and best interests of the Respondent or the need for protection of the community. See F.C.A. §353.3(5). American LegalNet, Inc. www.FormsWorkFlow.com Form 3-30 Page 6 “ The position of the New York State Office of Children and Family Services having been considered by the Court, this proceeding is continued and the Respondent is placed for a period of [specify]: “ less the period spent in detention pending disposition,4 in the custody of the New York State Office of Children and Family Services, which is authorized to place the Respondent in a [specify]: “ secure facility at any time or from time to time during the first 60 days of residency;5 “ limited secure facility “ non-secure facility, subject to further orders of this Court. “ The position of the New York State Office of Children and Family Services having been considered by the Court, this proceeding is continued and the Respondent is placed for a period of [specify]: “ less the period spent in detention pending disposition,6 in the custody of the New York State Office of Children and Family Services for placement with [specify agency or class of agencies; if the Respondent has been found to be sexually exploited, as defined in Social Services Law §447-a, so indicate if Respondent should be placed in an available long-term safe house]: , subject to further orders of this Court. In the event that the New York State Office of Children and Family Services is unable to place the Respondent in accordance with the direction hereof, or discontinues the placement with the authorized agency, the Respondent shall be deemed to have been placed with the New York State Office of Children and Family Services pursuant to paragraph (b) or (c) of subdivision three of section 353.3 of the Family Court Act. In such cases, the New York State Office of Children and Family Services shall notify the court, Presentment Agency, attorney for the Respondent and parent or other person responsible for the Respondent’s care, of the reason for discontinuing the placement with the authorized agency and the level and location of the youth’s placement. [Optional where Respondent is placed with the New York State Office of Children and Family Services]: “ The New York State Office of Children and Family Services shall photograph the Respondent pursuant to Executive Law § 507-a(3). [Optional where Respondent is 16 years of age and is placed with the New York State Office of Children and Family Services or Commissioner of Social Services ]: “ The placement agency is directed to provide the following services determined above to be needed to assist the child to make the transition from foster care to independent living [specify]: 4 Applicable unless all or part of such credit would not serve the needs and best interests of the Respondent or the need for protection of the community. See F.C.A. §353.3(5). 5 See F.C.A. §353.3(3)(a). 6 Applicable unless all or part of such credit would not serve the needs and best interests of the Respondent or the need for protection of the community. See F.C.A. §353.3(5). American LegalNet, Inc. www.FormsWorkFlow.com Form 3-30 Page 7 [Optional where Respondent is placed upon adjudication for a felony with the New York State Office of Children and Family Services pursuant to F.C.A.§353.3(9); delete if inapplicable]: “ Respondent shall be confined in a residential facility for a period of [specify period not to exceed six months]: (And it is further) [Required where Respondent is placed with the Commissioner of Social Services or the New York State Office of Children and Family Services, pursuant to F.C.A.§353.3 or §353.4, and is in or may be transferred to a foster home or non-secure facility with 25 beds or fewer]: ORDERED that if the child remains in foster care, the “ New York State Office of Children and Family Services “ Commissioner of Social Services of [specify]: County shall file a petition for the next permanency hearing NOT LESS THAN 60 DAYS BEFORE [specify date]: and the permanency hearing shall be completed by [specify date]:7 And it is further ORDERED that: Dated: ENTER Judge of the Family Court PURSUANT TO SECTION 1113 OF THE FAMILY COURT ACT, AN APPEAL FROM THIS ORDER MUST BE TAKEN WITHIN 30 DAYS OF RECEIPT OF THE ORDER BY APPELLANT IN COURT, 35 DAYS FROM THE DATE OF MAILING OF THE ORDER TO APPELLANT BY THE CLERK OF COURT, OR 30 DAYS AFTER SERVICE BY A PARTY OR THE ATTORNEY FOR THE CHILD UPON THE APPELLANT, WHICHEVER IS EARLIEST. Check applicable box: “ Order mailed on [specify date(s) and to whom mailed]: “Order received in court on [specify date(s) and to whom given]: 7 A petition for a permanency hearing shall be filed 60 days prior to the expiration of the placement or 60 days prior to end of 12 months following the entry of the child into foster care, whichever is earlier. The Respondent shall be deemed to have entered foster care 60 days following removal from the home. See F.C.A. §355.5(4). Except in cases where the permanency hearing is required prior to an extension of placement –e.g., 18-month felony placements or cases in which a determination is made that reasonable efforts are not required pursuant to F.C.A. §352.2(2)(c) – the permanency hearing petition shall be combined with the petition for extension of placement. See F.C.A. §355.5(2). American LegalNet, Inc. www.FormsWorkFlow.com Form 3-30 Page 8 American LegalNet, Inc. www.FormsWorkFlow.com