Or on Review of Out-of-Home Placement (OROHC) - Page 1 of 4 WPF JU 12.0400 (07/2018) - JuCR 3.7; RCW 13.34.270; RCW 74.13.350 Superior Court of Washington County of Juvenile Court In Re the Welfare of: D.O.B.: No: Order on Review of Out-of-Home Placement (OROHC) Clerk222s Action Required: Paragraphs 4.1, 4.7. The court will hear dependency review permanency planning on [date] at a.m./p.m.at: Court, Room/Department: , located at: I. Hearing 1.1 A petition was filed requesting the court to make a determination that continued out-of-home placement is in the best interests of the child, and a hearing was held on [date]. 1.2 The following persons appeared: Child Child's Lawyer Mother Mother's Lawyer Father Father's Lawyer Guardian or Legal Custodian Guardian's or Legal Custodian's Lawyer Child's GAL GAL's Lawyer DCYF DCYF222s Lawyer Interpreter for mother father Other other 1.3 The court heard testimony. American LegalNet, Inc. www.FormsWorkFlow.com Or on Review of Out-of-Home Placement (OROHC) - Page 2 of 4 WPF JU 12.0400 (07/2018) - JuCR 3.7; RCW 13.34.270; RCW 74.13.350 II. Findings 2.1 Child222s Indian status: On this date On , the court asked each participant on the record whether the participant knows or has reason to know the child is an Indian child. The petitioner has has not made a good faith effort to determine whether the child is an Indian Child. Based upon the following, there is not a reason to know the child is not an Indian child as defined in RCW 13.38.040 and 25 U.S.C. 247 1903(4), and the Federal and Washington State Indian Child Welfare Acts do not apply to this proceeding: Based upon the following, there is reason to know the child is an Indian child as defined in RCW 13.38.040 and 25 U.S.C. 247 1903(4), and Federal and Washington State Indian Child Welfare Acts apply to this proceeding, unless and until it is determined on the record that the child does not meet the definition of an Indian child: Based on the following summary, the petitioner used due diligence to identify and work with the tribes of which there is reason to know the child may be a member or eligible for membership, to verify whether the child is in fact a member (or the biological parent is a member and the child is eligible for membership). The facts establish by clear, cogent and convincing evidence, including the testimony of a qualified expert witness that continued custody of the child by the mother father Indian custodian is likely to result in serious emotional or physical damage to the child. DCYF made active efforts by actively working with the parent, parents, or Indian Custodian to engage them in remedial services and rehabilitative programs to prevent the breakup of the Indian family beyond simply providing referrals to such services, but those efforts have been unsuccessful. The petitioner has has not provided notice of this proceeding as required by RCW 13.38.070 and 25 U.S.C. 247 1912(a) to all tribes to which the petitioner or court knows or has reason to know the child is may be (1) a member or (2) eligible for membership if the biological parent is also a member. 2.2 Jurisdiction: The child resides in this county. The child has a developmental disability, as defined in RCW 71A.10.020. The child has been placed in out-of-home care pursuant to RCW 74.13.350. 2.3 Facts establishing that continued out-of-home placement is in the best interest of the child have not been proved. American LegalNet, Inc. www.FormsWorkFlow.com Or on Review of Out-of-Home Placement (OROHC) - Page 3 of 4 WPF JU 12.0400 (07/2018) - JuCR 3.7; RCW 13.34.270; RCW 74.13.350 2.4 The following facts establishing that continued out-of-home placement is in the best interest of the child have been proved: III. Conclusions of Law 3.1 The court has jurisdiction over: the child the mother the father the legal guardian 3.2 The mother father legal guardian received timely and proper notice. 3.3 The Department of Children, Youth, and Families made reasonable attempts to notify the parent, whose identity and location is known, who is not a party to the placement agreement. 3.4 It is not in the best interest of the child to remain in out-of-home placement. 3.5 It is in the best interest of the child to remain in out-of-home placement. IV. Order 4.1 The child222s best interests are not served by continued out-of-home placement. The child is returned to his or her parents or legal guardians and the petition is dismissed. 4.2 The child222s best interests are served by continued out-of-home placement. 4.3 The child shall be placed or remain: at a facility to be determined by the Department of Children, Youth, and Families. at , a licensed facility approved by the Department of Children, Youth, and Families. 4.4 The placement set forth above shall be under the supervision of (agency). 4.5 The legal status of the child, and the rights and obligations of the parents or legal guardians, the child, and the Department of Children, Youth, and Families while the child is in placement, shall be as specified in the out-of-home placement agreement. 4.6 The agency report for the next review permanency hearing shall be submitted to the court at least days, and to all parties at least days, prior to the hearing. 4.7 All parties shall appear at the next scheduled hearing (see page one). Dated: Judge/Commissioner American LegalNet, Inc. www.FormsWorkFlow.com Or on Review of Out-of-Home Placement (OROHC) - Page 4 of 4 WPF JU 12.0400 (07/2018) - JuCR 3.7; RCW 13.34.270; RCW 74.13.350 Presented by: Signature Type or Print Name/Title WSBA No. Copy Received; Approved for Entry; Notice of Presentation Waived: Signature of Child Signature of Child222s Lawyer Print Name WSBA No. Signature of Mother Signature of Mother222s Lawyer Print Name WSBA No. Signature of Father Signature of Father222s Lawyer Print Name WSBA No. Signature of Guardian or Legal Custodian Signature of Guardian or Legal Custodian222s Lawyer Print Name WSBA No. Signature of Child222s GAL Signature of Lawyer for the Child222s GAL Print Name Print Name WSBA No. Signature of DCYF Representative Signature of DCYF Representative222s Lawyer Print Name Print Name WSBA No. Other American LegalNet, Inc. www.FormsWorkFlow.com