(Copy Receipt) (Clerk's Date Stamp) SUPERIOR COURT OF WASHINGTON COUNTY OF SPOKANE In the Guardianship of: ________________________________ An Alleged Incapacitated Person CASE NO. ______________________________ ORDER APPOINTING GUARDIAN AD LITEM AND NOTICE OF HEARING RCW 11.88.090 Clerks Action Required I. FINDINGS OF FACT 1. The facts set forth in the Petition include those necessary to give the Court jurisdiction over this matter. 2. Pursuant to RCW 11.88.090, a Guardian ad Litem should be appointed. 3. The Guardian ad Litem should be the person whose name next appears on the Spokane County Guardian ad Litem registry; or 4. The Guardian ad Litem should not be the person whose name next appears on the registry because the Court finds extraordinary circumstances exist as follows:_____________________ __________________________________________________________________________ 5. Payment of the filing fee, and the fees-costs of the Guardian ad Litem by Alleged Incapacitated Person would result in a substantial hardship upon such person because ________ __________________________________________________________________________. ORDER APPOINTING GUARDIAN AD LITEM AND NOTICE OF HEARING SPO GDN 02.0300 PAGE 1 OF 7 Rev: 05/2012 American LegalNet, Inc. www.FormsWorkFlow.com II. ORDER The Court orders: The Clerk's filing fee is waived. The Guardian ad Litem shall be appointed at public expense, to be paid by Spokane County at a rate not to exceed $60.00 per hour up to a maximum of $900.00 without further, prior Court approval. Should evidence hereafter be submitted showing that hardship did not exist or no longer exists, the Court shall be reimbursed the filing fee and all other fees and costs. The Guardian ad Litem shall be appointed at private expense. The Guardian ad Litem shall be paid at a rate of $___________ per hour. The hearing on the Guardianship petition shall occur: Date to be set by separate notice; OR Date: __________________________ Department: Address: Hour: ________________ ______________________________________________________________ ______________________________________________________________ ________________________is found or known by the Court to be a suitable disinterested person with the requisite knowledge, training or expertise, who is hereby appointed as Guardian ad Litem for the above-named person. The address and/or phone/fax or the Guardian ad Litem are: _________________________________________________________________________. The Guardian ad Litem shall have the following duties as mandated by statute: (a) To file within five days of receipt of Notice of Appointment, and serve all parties personally or by certified mail with return receipt requested, his or her written statement required by RCW 11.88.090(3)(b), which shall include: his or her history as defined in RCW 9.94A.030 for the period covering ten years prior to the appointment; his or her hourly rate, if appointed at private expense; whether the Guardian ad Litem has had any contact with a party to the proceeding prior to his or her appointment; and whether he or she has an apparent conflict of interest. (b) To meet and consult with the Alleged Incapacitated Person as soon as practicable following appointment and explain, in language which such person can reasonably be expected to understand, the substance of the petition, the nature of the resultant proceedings, the person's ORDER APPOINTING GUARDIAN AD LITEM AND NOTICE OF HEARING SPO GDN 02.0300 PAGE 2 OF 7 Rev: 05/2012 American LegalNet, Inc. www.FormsWorkFlow.com right to contest the petition, the identification of the proposed Guardian or Limited Guardian, the right to a jury trial on the issue of his or her alleged incapacity, the right to independent legal counsel as provided by RCW 11.88.045, and the right to be present in court at the hearing on the petition; (c) To obtain a written report according to RCW 11.88.045; and such other written or oral reports from other qualified professionals as are necessary to permit the Guardian ad Litem to complete the report required by RCW 11.88.090 and to advise Alleged Incapacitated Person of the identity of the health care professional selected by the Guardian ad Litem to prepare the medical report. If Alleged Incapacitated Person opposes said health care professional selected by the Guardian ad Litem , the Guardian ad Litem shall use the health care professional selected by Alleged Incapacitated Person , but may obtain a supplemental examination by a different physician or psychologist; (d) To meet with the person whose appointment is sought as Guardian or Limited Guardian and ascertain: (i) The proposed Guardian's knowledge of the duties, requirements, and limitations of a Guardian; (ii) The steps the proposed Guardian intends to take or has taken to identify and meet the needs of Alleged Incapacitated Person; and (iii) Ensure the proposed professional guardian's Statement of Fees is filed. (e) To consult as necessary to complete the investigation and report by this section with those known relatives, friends, or other persons the Guardian ad Litem determines to have had a significant, continuing interest in the welfare of Alleged Incapacitated Person: (f) To investigate alternate arrangements made or which might be created, by or on behalf of the Alleged Incapacitated Person, such as revocable or irrevocable trusts, durable powers of attorney or blocked account(s); whether good cause exists for any such arrangements to be discontinued; and why such arrangements should not be continued or created in lieu of a Guardianship: (g) To provide the Court with a written report which shall include the following: ORDER APPOINTING GUARDIAN AD LITEM AND NOTICE OF HEARING SPO GDN 02.0300 PAGE 3 OF 7 Rev: 05/2012 American LegalNet, Inc. www.FormsWorkFlow.com (i) A description of the nature, cause and degree of incapacity, and the basis upon which this judgment was made; (ii) A description of the needs of the Incapacitated Person for care and treatment, the probable residential requirements of the Alleged Incapacitated Person and the basis upon which these findings were made; (iii) An evaluation of the appropriateness of the Guardian or Limited Guardian whose appointment is sought and a description of the steps the proposed Guardian has taken or intends to take to identify and meet current and emerging needs of the Incapacitated Person; (iv) A description of any alternative arrangements previously made by