File No. STATE OF NORTH CAROLINA In The General Court Of Justice County District Court Division IN THE MATTER OF: Name And Address Of Juvenile ORDER TO CEASE OBSTRUCTION OF OR INTERFERENCE WITH Date Of Birth Age JUVENILE INVESTIGATION Name Of Petitioner G.S. 7B-303Name And Address Of Respondent 1 Name And Address Of Respondent 2 This case having been heard before the undersigned judge, the Court finds that the matter is properly before the Court and that the Court has jurisdiction over the subject matter and the parties. The following persons were present at the hearing: FINDINGS Based on the evidence presented, the Court finds the following facts by clear, cogent, and convincing evidence: 1. On or about (date) , the Department of Social Services (DSS) of the county named above received a report of suspected abuse, neglect, or dependency of the juvenile named above, or a report that the juvenile had died as a result of suspected maltreatment, which report required DSS to conduct an investigation pursuant to G.S. 7B-302. More specifically: 2. On or about [date(s)] , the respondent(s) named above obstructed or interfered with DSSs investigation of the report by: a. refusing to disclose to DSS the whereabouts of the juvenile. b. refusing to allow DSS personal access to the juvenile. c. refusing to allow DSS to observe and/or interview the juvenile in private. d. refusing to allow DSS access to confidential information/records after a proper request. e. refusing to allow DSS to arrange for an evaluation of the juvenile by a physician or other expert. f. engaging in other conduct making it impossible for DSS to carry out its duty to investigate. More specifically: 3. Respondent(s) has/have not established a lawful excuse for the obstruction or interference described above. 4. Other Findings: AOC-J-123, New 7/99 1999 Administrative Office of the (See ADDITIONAL FINDINGS on Reverse) >>>> 2 ADDITIONAL FINDINGS CONCLUSIONS OF LAW Based on the foregoing Findings of Fact, the Court concludes as a matter of law: That grounds do do not exist for the issuance of an order under G.S. 7B-303 directing respondent(s) to cease obstructing and/or interfering with an investigation by DSS of suspected abuse, neglect, or dependency, or death by suspected maltreatment, of the above-named child. ORDER It is hereby ORDERED AND DECREED that: 1. The respondent(s) named above: a. disclose the whereabouts of the juvenile. b. allow representatives of the DSS personal access to the juvenile. c. allow representatives of the DSS to observe and interview the juvenile in private. d. allow representatives of the DSS access to the following information/records: . e. allow DSS to arrange for an evaluation of the juvenile by a physician or other expert. f. Other: . 2. That this matter be dismissed. 3. Other: Date Name Of District Court Judge (Type Or Print) Signature Of District Court Judge AOC-J-123, Side Two, New 7/99 1999 Administrative Office of the