The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02

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Here is the text we could read:

SUPERVISED VISITATION PROVIDER (Name and address):

FL-324(P)

FOR COURT USE ONLY

STATE:

ZIP CODE:

FAX NO. (Optional):

NAME:

CITY:

STREET ADDRESS:

TELEPHONE NO.:

E-MAIL ADDRESS (Optional):

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

PETITIONER:

RESPONDENT:

OTHER PARTY/PARENT:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

DECLARATION OF SUPERVISED VISITATION PROVIDER
(PROFESSIONAL)

CASE NUMBER:

1. Purpose. I submit this form to declare that I comply with all mandatory requirements for professional providers of supervised

visitation under Family Code and of the Standards of Judicial Administration.

2. Type of submission. I am (check a or b):

completing this form before I provide initial supervised visitation services in the case.

updating this form and attaching an original report of the supervised visitation that I monitored.

(1) The report is dated (specify date):
(2)

Copies of the report were also sent to all parties and their attorneys

and the attorney for the child.

I am paid to provide supervised visitation services as an independent contractor, employee, intern, or volunteer operating
independently or through a supervised visitation center or agency.

4. Qualifications. I meet the qualifications listed in Family Code section 3200.5 for this position as follows (check all that apply):

I am 21 years of age or older.

I have no record of a conviction for driving under the influence (DUI) within the last five years.

I have not been on probation or parole for the last 10 years.

I have no record of a conviction for child molestation, child abuse, or other crimes against a person.

I have proof of automobile insurance for transporting the child.

I have had no civil, criminal, or juvenile restraining orders within the last 10 years.

There is no current or past court order in which I am the person being supervised.

I agree to speak the language of the party being supervised and of the child, or I will provide a neutral
interpreter over the age of 18 years who is able to do so.

I agree to adhere to and enforce the court order regarding supervised visitation.

I completed a Live Scan criminal background check before providing services.
I am registered as a TrustLine provider.

5. Training. I meet the training requirements under Family Code section 3200.5 as follows (check all that apply):

I completed 24 hours of training, including at least 12 hours of classroom instruction in all required subjects.

I completed the California Department of Social Services' online training course required for mandated reporters.

I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

j.
k.

Date:

(TYPE OR PRINT NAME)

(SIGNATURE OF DECLARANT)

NOTICE: See standard 5.20 of the California Standards of Judicial Administration for further requirements that may apply.

Form Adopted for Mandatory Use
Judicial Council of California
FL-324(P) [Rev. September 1, 2021]

DECLARATION OF SUPERVISED VISITATION PROVIDER
(PROFESSIONAL)

Page 1 of 1
Family Code § 3200.5

Declaration of Supervised Visitation Provider (Professional)

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 1
Fields(s): 37
Average fields per page: 37
Reading Level: Grade 10
LIST Grouping(s): Unknown

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Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

f_l_p_page_case_number_ft was FL-324P[0].Page1[0].CaseNumber[0].CaseNumber_ft[0] (0.56 conf)
f_p_page_provider_info_name was FL-324P[0].Page1[0].ProviderInfo[0].Name[0] (0.37 conf)
f_l_p_page_provider_info was FL-324P[0].Page1[0].ProviderInfo[0].Street[0] (0.37 conf)
f_p_page_provider_info_city was FL-324P[0].Page1[0].ProviderInfo[0].City[0] (0.37 conf)
f_p_page_provider_info_state was FL-324P[0].Page1[0].ProviderInfo[0].State[0] (0.37 conf)
f_l_p_page_provider_info_zip was FL-324P[0].Page1[0].ProviderInfo[0].Zip[0] (0.37 conf)
f_l_p_page_info_phone was FL-324P[0].Page1[0].ProviderInfo[0].Phone_ft[0] (0.35 conf)
f_l_p_page_provider_info_fax was FL-324P[0].Page1[0].ProviderInfo[0].Fax_ft[0] (0.44 conf)
f_l_p_page_provider_info_ft was FL-324P[0].Page1[0].ProviderInfo[0].AttyFor_ft[0] (0.42 conf)
f_l_p_page_court_info_county was FL-324P[0].Page1[0].CourtInfo[0].CrtCounty_ft[0] (0.39 conf)
f_l_p_page_court_info_street was FL-324P[0].Page1[0].CourtInfo[0].Street_ft[0] (0.37 conf)
f_l_p_page_court_info_add was FL-324P[0].Page1[0].CourtInfo[0].MailingAdd_ft[0] (0.35 conf)
f_l_p_page_info_city_ft was FL-324P[0].Page1[0].CourtInfo[0].CityZip_ft[0] (0.36 conf)
f_l_p_page_court_info_branch was FL-324P[0].Page1[0].CourtInfo[0].Branch_ft[0] (0.40 conf)
f_l_p_page_title_party_name__1 was FL-324P[0].Page1[0].TitlePartyName[0].Party1_ft[0] (0.35 conf)
f_l_p_page_title_party_name__2 was FL-324P[0].Page1[0].TitlePartyName[0].Party2_ft[0] (0.35 conf)
f_l_p_page_title_party_name__3 was FL-324P[0].Page1[0].TitlePartyName[0].Party3_ft[0] (0.35 conf)
f_l_p_page_list_check_box__1 was FL-324P[0].Page1[0].List2[0].LI1[0].CheckBox_2a[0] (0.35 conf)
f_p_page_list_check_box_b__1 was FL-324P[0].Page1[0].List2[0].LI2[0].CheckBox_2b[0] (0.35 conf)
f_p_page_list_b_date_dt was FL-324P[0].Page1[0].List2[0].LI2[0].SB_2b[0].LI1[0].DateField_dt[0] (0.39 conf)
f_p_page_b_check_box_report was FL-324P[0].Page1[0].List2[0].LI2[0].SB_2b[0].LI2[0].CheckBox_CopyReport[0] (0.40 conf)
f_p_page_list_b_check_box was FL-324P[0].Page1[0].List2[0].LI2[0].SB_2b[0].LI2[0].CheckBox_attny[0] (0.38 conf)
f_l_p_page_list_check_box__2 was FL-324P[0].Page1[0].List4[0].LI1[0].CheckBox_4a[0] (0.35 conf)
f_p_page_list_check_box_b__2 was FL-324P[0].Page1[0].List4[0].LI2[0].CheckBox_4b[0] (0.35 conf)
f_p_page_list_check_box_c was FL-324P[0].Page1[0].List4[0].LI3[0].CheckBox_4c[0] (0.35 conf)
f_l_p_page_list_check_box__3 was FL-324P[0].Page1[0].List4[0].LI4[0].CheckBox_4d[0] (0.35 conf)
f_l_p_page_check_box_e was FL-324P[0].Page1[0].List4[0].LI5[0].CheckBox_4e[0] (0.35 conf)
f_l_p_page_list_check_box__4 was FL-324P[0].Page1[0].List4[0].LI6[0].CheckBox_4f[0] (0.35 conf)
f_l_p_page_list_check_box__5 was FL-324P[0].Page1[0].List4[0].LI7[0].CheckBox_4g[0] (0.35 conf)
f_p_page_list_check_box_h was FL-324P[0].Page1[0].List4[0].LI8[0].CheckBox4h[0] (0.35 conf)
f_l_p_page_list_check_box__6 was FL-324P[0].Page1[0].List4[0].LI9[0].CheckBox_4i[0] (0.35 conf)
f_p_page_list_check_box_j was FL-324P[0].Page1[0].List4[0].LI10[0].CheckBox4j[0] (0.35 conf)
f_l_p_page_list_check_box__7 was FL-324P[0].Page1[0].List4[0].LI11[0].CheckBox_4k[0] (0.35 conf)
f_l_p_page_list_check_box__8 was FL-324P[0].Page1[0].List5[0].LI1[0].CheckBox_5a[0] (0.35 conf)
f_p_page_list_check_box_b__3 was FL-324P[0].Page1[0].List5[0].LI2[0].CheckBox_5b[0] (0.35 conf)
f_p_area_date_time_dt was FL-324P[0].Page1[0].DeclarationSub[0].#area[0].DateTimeField_dt[0] (0.43 conf)
f_p_page_type_print_name was FL-324P[0].Page1[0].DeclarationSub[0].#area[0].TypePrintName[0] (0.40 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Declaration of Supervised Visitation Provider (Professional)

About This Form:

Identified Data Fields:

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The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02