IN THE DISTRICT COURT OF ___________________________ COUNTY STATE OF OKLAHOMA JUVENILE DIVISION IN THE MATTER OF: DOB: ______________ DOB: ______________ DOB: ______________ DOB: ______________ DOB: ______________ DOB: ______________ ) ) JD- __________________________________ ) ) Date: _______________________________ ) Judge: ______________________ ) ) Alleged Deprived Child(ren). EMERGENCY CUSTODY HEARING ORDER NOW on this _______ day of _______________________, 20_____, the following appearances were made and proceedings held: APPEARANCES: State Mother Mother Father Father Father Father Legal Guardian Child Child Child Child Child Child Tribal Representative GAL/CASA Foster Parent or Placement Interpreter for Mother Father Other Court Reporter Other DHS Attorney Attorney Attorney Attorney Attorney Attorney Attorney Attorney Attorney Attorney Attorney Attorney Attorney Attorney Other Attorney Interpreter for Father Other Other Other Mother Minor children was/were placed out of home on the ______day of ___________________, 20______. Emergency Custody Hearing Order OK-J-UO- 0002 Version 1.1.16.2 Page 1 of 6 OCIS Docket Code: CEM American LegalNet, Inc. www.FormsWorkFlow.com FINDINGS AND ORDERS OF THE COURT The Court has reviewed and considered the evidence, oral and written, submitted by the parties on this date including the testimony of witnesses, exhibits admitted into evidence, statements and arguments of counsel, reports of DHS and any previous orders of this Court OR the stipulation to the evidence and emergency custody by Mother Father Legal Guardian AND HEREBY FINDS, ORDERS AND DECREES: I. There is is not a reasonable suspicion that all named child(ren)/or these specified child(ren) ______________________________________________________ is/are in need of immediate protection due to abuse or neglect or the circumstances or surroundings of the child(ren) are such that continuation of the child(ren) in the child(ren)'s home or in the care or custody of the parent or legal guardian would present an imminent danger to the child(ren). REASONABLE EFFORTS A. The continuation of the all named child(ren)/or these specified child(ren) ______________________________________________________ in the home is is not contrary to the health, safety or welfare of the child(ren), to wit:___________________________________ _________________________________________________________________________________________________ . AND B.1. Efforts to prevent the removal of all named child(ren)/or these specified child(ren) ______________________________________________________, from the home were not made because removal was due to an emergency and was necessary for the purpose of providing for the health, safety and welfare of all named child(ren)/or these specified child(ren) ______________________________________________________ such absence of efforts was reasonable under the circumstances, to wit: _________________________________ ________________________________________________________________________________________________; Reasonable efforts have or have not been made to prevent the need to remove all named child(ren)/or these specified child(ren) ______________________________________________________ from the home, to-wit: ________________________________________________________________________________________________; Reasonable efforts are not required pursuant to 10A O.S. �1-4-809 and a permanency hearing will be held 30 days from this date. II. OR B.2. OR B.3. C.1. If siblings have been removed, reasonable efforts have have not been made to place the siblings together in the same placement, to wit: ________________________________ __________________________________________________________________________________________________; AND C.2. If siblings are separated, reasonable efforts have have not been made to provide for frequent visitation or other on-going interaction; or have not been Emergency Custody Hearing Order OK-J-UO- 0002 Version 1.1.16.2 Page 2 of 6 OCIS Docket Code: CEM American LegalNet, Inc. www.FormsWorkFlow.com made, as it is contrary to the safety or well-being of the child(ren) or sibling because ________________________________________________________________________________________________. D. The correct legal name(s) and date(s) of birth for the child(ren) are: Child: Child: Child: Child: Child: Child: III. ________________________________________ ________________________________________ ________________________________________ ________________________________________ __________________________________________ __________________________________________ DOB: ________________ DOB: ________________ DOB: ________________ DOB: ________________ DOB: ________________ DOB: _________________ INDIAN CHILD WELFARE ACT and ACTIVE EFFORTS A1. The Indian Child Welfare Act does does not apply to all named child(ren)/or these specified child(ren) ________________________________________________ The name of the Tribe is: ____________________________________________. Tribe and BIA, if tribe unknown, has been notified has not been notified. Other __________________________________________________________ OR A2. All named child(ren)/or these specified child(ren) _____________________________ _____________________may be subject to the Indian Child Welfare Act, and notice shall be given pursuant to law; OR A3. There is insufficient information to determine whether or not all named child(ren)/or these specified child(ren) ________________________________________________ are Indian; B. If ICWA applies, active efforts have have not been made to maintain and prevent the breakup of the Indian child(ren)'s family; the active efforts made were: ____________________________________________________________________________________________________ ___________________________________________________________________________________________________. IV. CUSTODY The custody of the child(ren) is granted as follows: A. All named child(ren)/or these specified child(ren) _____________________________________ is/are released to custody of _________________________ (the parent, legal guardian or custodian) from whom the child(ren) was/were removed under the following conditions: _________________________________________________ with without DHS supervision; OR B. All named child(ren)/or these specified child(ren) _____________________________________ is/are placed in the custody of ________________________