F.C.A.§756-a Form 7-18 (Person in Need of Supervision-Petition for Extension of Placement and Permanency Hearing) 12/2015 FAMILY COURT OF THE STATE OF NEW YORK COUNTY OF In the Matter of Docket No. PETITION (Extension of Placement and Permanency Hearing) A Person Alleged to be a Person in Need of Supervision, Respondent DEADLINES: THIS PETITION MUST BE FILED BY [Specify date]:1 AND THE PERMANENCY HEARING MUST BE COMPLETED BY [Specify date]: . TO THE FAMILY COURT: The undersigned Petitioner respectfully alleges upon information and belief that: 1. Petitioner [specify name and title]: , is the [specify]: Q person Q official acting on behalf of an agency or institution duly authorized for the placement of persons in need of supervision under Article 7 of the Family Court Act. Petitioner's Q residence Q principal office is located at [specify address]: , New York. 2. a. Under an Order of Fact-finding and Disposition of this Court, dated , the above-named Respondent, born [specify]: , , was adjudicated to be a person in need of supervision within the meaning of Article 7 of the Family Court Act, and was placed with Petitioner pursuant to section 756 of the Family Court Act for a period of months, terminating on . b. Placement was last extended on [specify date]: , terminating on [specify date]: 3. A permanency hearing is required at this time because [check applicable box(es)]: A finding by the Court that reasonable efforts to reunify the child with his or her parent(s) person(s) legally responsible for his or her care are not necessary was made on [specify date]: The last permanency hearing with respect to this child was held on [specify]: No permanency hearing has been held since the child was deemed to have entered foster care.2 4. a. The following are the names and addresses of the parents or other persons legally responsible for the care of the Respondent: The petition must be filed at least 60 days prior to the date by which the hearing must be completed. The date should conform to the deadline indicated on the prior Permanency Order, if any, or Order of Fact-finding and Disposition. 2 1 A Respondent is deemed to have entered foster care 60 days after removal from the home. American LegalNet, Inc. www.FormsWorkFlow.com Form 7-18 page 2 Name Residence Relationship b. In addition to the persons named in ķa, the following individuals must be notified of this proceeding: Attorney for the Respondent [specify]: Prospective adoptive parent(s)[specify]: Foster parent(s)[specify]: Relative(s)[specify]: Other [specify]: 5. Return of Respondent to the home would be contrary to the Respondent's best interests and the placement should be extended because [specify facts and reasons, including safety considerations, if any]: This conclusion is supported by the following information [check applicable box(es)]: 9 Case Record, dated [specify]: 9 Service Plan, dated [specify]: 9 Probation Department report, dated [specify]: 9 Mental health evaluation, dated [specify]: 9 The report of [specify]: 9 Other [specify]: , dated [specify]: 6. a. The permanency plan for the Respondent is as follows [check applicable box(es) and indicate time frame(s)]: reunification with the parent(s) person(s) legally responsible for Respondent's care by [specify date]: placement for adoption upon filing of a petition to terminate parental rights by [specify date]: referral for legal guardianship by [specify name and date]: permanent placement with the following fit and willing relative [specify name]: by [specify date]: . [Applicable ONLY to Respondents who are 16 years of age or older]: permanent placement in the following alternative planned living arrangement [specify]: [REQUIRED in all APPLA plan cases]:3 (i) Documentation, made available to the Court, provides the following compelling reason(s) indicating that it would not be in the Respondent's best interests to return home, be referred for termination of parental rights and adoption, placed with a fit and willing relative, or placed with a legal guardian [specify compelling reason(s), indicating documentary sources of information, if any]: (ii) APPLA is the best permanency plan for the Respondent because [specify]: (iii) The following intensive, ongoing, and, as of the date of this petition, unsuccessful efforts were made to return the Respondent home or secure a placement for the Respondent with a fit and Although applicable to all youth in care, the requirement for documentation regarding subparagraphs (v) and (vi) to be submitted to the Court applies only to youth with APPLA goals. American LegalNet, Inc. www.FormsWorkFlow.com 3 Form 7-18 page 3 willing relative, including adult siblings, a legal guardian, or an adoptive parent, including through efforts that utilize search technology including social media to find biological family members of Respondent [specify]: (iv) The following individual, with whom Respondent has a significant connection, is willing and should be designated as the Respondent's permanency resource [specify]: (v) The "reasonable and prudent parent" standard of care has been applied to Respondent in the facility or home in which he or she resides as follows [specify]: (vi) Respondent has been provided with regular, ongoing opportunities to engage in age or developmentally appropriate activities and has been consulted in an age-appropriate manner about the opportunities to participate in activities as follows [specify]: b. This permanency plan [check applicable box]: has not changed since the dispositional hearing or last permanency hearing; has changed as follows [specify, indicating documentary sources of information, if any]: c. This permanency plan is appropriate without modification because [specify reasons, indicating documentary sources of information, if any]: d. The service plan for the Respondent is appropriate without modification because [specify reasons, indicating documentary sources of information, if any]: 7. a. 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. §754(2) that the authorized agency was not required to make reasonable efforts to reunify the Respondent with the Q parent(s) Q person(s) legally responsible for Respondent's care [specify date of finding]: Q be