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

LIT Lab Home | About The Explorer | Find & Compare | Explore: California Lists

Here is the text we could read:

CHILD'S NAME:

CASE NUMBER:

JV-417 

DISPOSITIONAL ATTACHMENT: IN-HOME PLACEMENT WITH FORMAL SUPERVISION
(Welf. & Inst. Code, § 361)

1. 

The child is a person described by Welf. & Inst. Code, § 300 (check all that apply):
300(e)
300(f)

300(g)
300(h)

300(a)
300(b)

300(c)
300(d)

300(i)
300(j)

and is adjudged a dependent of the court.

2.  

  The county agency is ordered to immediately return the child to the   

mother
presumed father
other (specify):

biological father
Indian custodian

legal guardian

3.

Reasonable efforts

were

were not

made to prevent or eliminate the need for removal from the home.

Case plan development

a.
4.    

b.

c.

The county agency solicited and integrated into the case plan the input of the

representative of child's identified Indian tribe

father
other (specify):                                                                        .

mother

child

The county agency did not solicit and integrate into the case plan the input of the

child

mother

father

representative of child's identified Indian tribe

other (specify):                                                                        ,

and  the agency is ordered to do so and submit an updated case plan within 30 days of the date of this hearing. 

The county agency did not solicit and integrate into the case plan the input of the

child

mother

father

representative of child's identified Indian tribe

other (specify):                                                                        ,

and the county agency is not required to do so because these persons are unable, unavailable, or unwilling to 
participate. 

Custody of the child

5. Custody of the child is retained by   

6.   The child and the   

mother
presumed father
other (specify):

mother
presumed father
other (specify):

biological father
Indian custodian

legal guardian

biological father
Indian custodian

legal guardian

are placed under the supervision of the county agency.

Family maintenance services

7.

The county agency must provide, and the     

mother
presumed father
other (specify):

biological father
Indian custodian

legal guardian

must participate in, family maintenance services designed to keep the family together as specified in the family's case plan.

 

Form Approved for Optional Use 
Judicial Council of California 
JV-417 [Rev. July 1, 2011]

 DISPOSITIONAL ATTACHMENT: IN-HOME 
PLACEMENT WITH FORMAL SUPERVISION 
(Welf. & Inst. Code, § 361)

Page 1 of 2

Welfare and Institutions Code, § 361;

Cal. Rules of Court, rules 5.651 and 5.695   

www.courts.ca.gov

CASE NUMBER:

JV-417 

CHILD'S NAME:

Education

8.    

a.

b.

A limitation on the right of the parents to make educational decisions for the child is not necessary. The parents hold 
educational rights and responsibilities in regard to the child's education, including those described in rule 5.650(e)–(f) of 
the California Rules of Court. A copy of rule 5.650(e)–(f) may be obtained from the court clerk. 

A limitation on the right of the parents to make educational decisions for the child is necessary, and those rights are 
limited as stated in Findings and Orders Limiting Right to Make Educational Decisions for the Child, Appointing 
Educational Representative, and  Determining Child's Educational Needs (form JV-535) filed in this matter. The 
educational rights and responsibilities of the educational representative are described in rule 5.650(e)–(f) of the 
California Rules of Court. A copy of rule 5.650(e)–(f) may be obtained from the court clerk.                                                  

9.     a. The child's educational needs
b. The child's physical needs

c. The child's mental health needs
d. The child's developmental needs

are

are

are

are

are not

are not

are not

are not

being met.

being met.

being met.

being met.

10.  

The additional services, assessments, and/or evaluations the child requires to meet the unmet needs specified in item 9 or 
other concerns are:

11.

The following persons are ordered to take the steps necessary for the child to begin receiving the services, assessments, 
and/or evaluations identified in item 10:
a.

Social worker

a.

b.

b.

c.

d.

e.

stated in the social worker's report.

specified here:

Parent (name):

Surrogate parent (name):

Educational representative (name):

Other (name):

12.

The     

mother

presumed father

other (specify):

biological father
Indian custodian

legal guardian

must ensure the child's regular school attendance and make reasonable efforts to obtain the education services 
necessary to meet the child's specific needs.

JV-417 [Rev. July 1, 2011]

Page 2 of 2

 DISPOSITIONAL ATTACHMENT: IN-HOME 
PLACEMENT WITH FORMAL SUPERVISION 
(Welf. & Inst. Code, § 361)

Dispositional Attachment: In-Home Placement With Formal Supervision (Welf. & Inst. Code, § 361)

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): 2
Fields(s): 82
Average fields per page: 41
Reading Level: Grade 11
LIST Grouping(s): FA-00-00-00-00, ES-03-00-00-00.

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

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.

check_box__1 was CheckBox154 (0.55 conf)
check_box__2 was CheckBox152 (0.37 conf)
check_box__3 was CheckBox151 (0.37 conf)
check_box__4 was CheckBox153 (0.37 conf)
check_box__5 was CheckBox150 (0.37 conf)
check_box__6 was CheckBox149 (0.37 conf)
check_box__7 was CheckBox148 (0.37 conf)
check_box__8 was CheckBox147 (0.37 conf)
check_box__9 was CheckBox146 (0.37 conf)
check_box__10 was CheckBox145 (0.37 conf)
check_box__11 was CheckBox144 (0.37 conf)
check_box__12 was CheckBox142 (0.37 conf)
check_box__13 was CheckBox141 (0.37 conf)
check_b was CheckB141 (0.37 conf)
chck_bx was ChckBx141 (0.35 conf)
chck_box was ChckBox141 (0.35 conf)
cck_box was CckBox141 (0.33 conf)
check_bx was CheckBx141 (0.37 conf)
fill_text__1 was FillText.02.other (0.38 conf)
fill_text_b__1 was FillText.04.b.other (0.38 conf)
fill_text_c__1 was FillText.04.c.other (0.38 conf)
fill_text__2 was FillText.04.a.other (0.38 conf)
fill_text__3 was FillText.05.0 (0.38 conf)
fill_text__4 was FillText.06.0 (0.38 conf)
fill_text__5 was FillText.07.0 (0.38 conf)
check_box_child was CheckBox.04.a.child (0.37 conf)
check_box_mother__1 was CheckBox.04.a.mother (0.37 conf)
check_box_father was CheckBox.04.a.father (0.37 conf)
check_box_representative was CheckBox.04.a.representative (0.37 conf)
check_box__14 was CheckBox.04.a.other (0.37 conf)
check_box_b_child was CheckBox.04.b.child (0.37 conf)
check_box_b_mother was CheckBox.04.b.mother (0.37 conf)
check_box_b_father was CheckBox.04.b.father (0.37 conf)
check_box_b_representative was CheckBox.04.b.representative (0.37 conf)
check_box_b__1 was CheckBox.04.b.other (0.37 conf)
check_box_c_child was CheckBox.04.c.child (0.37 conf)
check_box_c_mother was CheckBox.04.c.mother (0.37 conf)
check_box_c_father was CheckBox.04.c.father (0.37 conf)
check_box_c_representative was CheckBox.04.c.representative (0.37 conf)
check_box_c__1 was CheckBox.04.c.other (0.37 conf)
check_box_biological_father__1 was CheckBox.05.biological.father (0.37 conf)
check_box_legal_guardian__1 was CheckBox.05.legal.guardian (0.37 conf)
check_box_presumed_father__1 was CheckBox.05.presumed.father (0.37 conf)
check_box_alleged_father__1 was CheckBox.05.alleged.father (0.37 conf)
check_box__15 was CheckBox.05.other (0.37 conf)
check_box_biological_father__2 was CheckBox.06.biological.father (0.37 conf)
check_box_presumed_father__2 was CheckBox.06.presumed.father (0.37 conf)
check_box_legal_guardian__2 was CheckBox.06.legal.guardian (0.37 conf)
check_box_alleged_father__2 was CheckBox.06.alleged.father (0.37 conf)
check_box__16 was CheckBox.06.other (0.37 conf)
check_box_presumed_father__3 was CheckBox.07.presumed.father (0.37 conf)
check_box_biological_father__3 was CheckBox.07.biological.father (0.37 conf)
check_box_alleged_father__3 was CheckBox.07.alleged.father (0.37 conf)
check_box_legal_guardian__3 was CheckBox.07.legal.guardian (0.37 conf)
check_box__17 was CheckBox.07.other (0.37 conf)
check_box_mother__2 was CheckBox05.mother (0.37 conf)
check_box_mother__3 was CheckBox06.mother (0.37 conf)
check_box_mother__4 was CheckBox07.mother (0.37 conf)
fill_text_b_specify was FillText.10.b.specify (0.38 conf)
fill_text_b__2 was FillText.11.b (0.38 conf)
fill_text_c__2 was FillText.11.c (0.38 conf)
fill_text__6 was FillText.11.d (0.38 conf)
fill_text_e was FillText.11.e (0.38 conf)
fill_text__7 was FillText.12.0 (0.38 conf)
check_box_b__2 was CheckBox.08.b (0.37 conf)
check_box__18 was CheckBox.08.a (0.37 conf)
check_box__19 was CheckBox.10.a (0.37 conf)
check_box__20 was CheckBox.10.0 (0.37 conf)
check_box_b__3 was CheckBox.10.b (0.37 conf)
check_box_presumed_father__4 was CheckBox.12.presumed.father (0.37 conf)
check_box__21 was CheckBox.12.other (0.37 conf)
check_box_mother__5 was CheckBox.12.mother (0.37 conf)
check_box_biological_father__4 was CheckBox.12.biological.father (0.37 conf)
check_box_alleged_father__4 was CheckBox.12.alleged.father (0.37 conf)
check_box_legal_guardian__4 was CheckBox.12.legal.guardian (0.37 conf)
check_box_b__4 was CheckBox11.b (0.37 conf)
check_box_c__2 was CheckBox11.c (0.37 conf)
check_box__22 was CheckBox11.d (0.37 conf)
check_box_e was CheckBox11.e (0.37 conf)
check_box__23 was CheckBox11.a (0.37 conf)
check_box__24 was CheckBox11.0 (0.37 conf)
check_box__25 was CheckBox12.0 (0.37 conf)

Create an Interactive Version of this Form:

The Weaver creates a draft guided interview from a template form, like the one provided here. You can use the link below to open this form in the Weaver. To learn more, read "Weaving" your form into a draft interview.

Launch Form in Weaver

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

Dispositional Attachment: In-Home Placement With Formal Supervision (Welf. & Inst. Code, § 361)

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

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