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:

SUPERIOR COURT OF CALIFORNIA, COUNTY OF
STREET ADDRESS:

MAILING ADDRESS:

CITY AND ZIP CODE:

BRANCH NAME:

CHILD'S NAME:

HEARING DATE AND TIME:

FOR COURT USE ONLY

JV-290

CAREGIVER INFORMATION FORM

CASE NUMBER:

To the current caregiver, preadoptive parent, community care facility, or foster family agency caring for the child: You may
submit written information to the court, and you may attend review and permanency hearings. You may use this optional
form to provide written information to the court. Please type or print clearly in ink and submit the original and eight copies
of the form to the court clerk's office at least five calendar days (or seven calendar days, if filing by mail) before the
hearing. Be aware that other individuals involved in the case have access to this information. See form JV-290-INFO for
instructions on how to complete this form and file it with the court.

1. a.

Child's name:

Child's date of birth:

Caregiver Information (Answer only if you are a caregiver, skip #3.):
a. Name of caregiver:

c. Child's age:

b. Type of caregiver:

Foster parent
Nonrelative extended family member

Relative

Other

(specify):

Legal guardian

Preadoptive parent

c. The child has been living in my home for (specify): years months.

Agency or Facility Information (Answer only if you are an agency or facility, skip #2.):
a. Name of agency or facility:
b. Address:
c. Telephone number:
d. Type of facility:

Community care agency

Foster family agency

e. The child has been placed with our agency/facility for (specify): years months and in the

current home for (specify): years months.

f. Name of person completing form:

Title:

g. Hours per week the person completing this form spends with the child (specify): hours/week.

h. The information on this form consists of

(1)
(2)

the observations and recommendations of the person filling out this form.
the observations and recommendations of a group or team made up of the following individuals (specify):

Other

(specify):

4. Current Status of Child's Medical, Dental, and General Physical and Emotional Health

There is no new or additional information since the last court hearing.

There is new or additional information since the last court hearing, as follows (do not include the names of doctors):

Current Status of Child's Education
a.
b.

There is no new or additional information since the last court hearing.
There is new or additional information since the last court hearing, as follows (do not include the names of schools):

Form Approved for Optional Use
Judicial Council of California
JV-290 [Rev. September 1, 2020]

CAREGIVER INFORMATION FORM

Page 1 of 2

Welfare and Institutions Code, §§ 366.21(c), (d);
Cal. Rules of Court, rule 5.534(k)
www.courts.ca.gov

Date:

CHILD'S NAME:

CASE NUMBER:

JV-290

Child's Special Education Status
a.
b.
c.

The child is a special education student. Date of last Individualized Education Plan (IEP):
The child is not a special education student.
I do not know the child's special education status.

Current Status of Child's Adjustment to Living Arrangement
a.
b.

There is no new or additional information since the last court hearing.
There is new or additional information since the last court hearing, as follows:

Current Status of Child's Social Skills and Peer Relationships
a.
b.

There is no new or additional information since the last court hearing.
There is new or additional information since the last court hearing, as follows:

Current Status of Child's Special Interests and Activities
a.
b.

There is no new or additional information since the last court hearing.
There is new or additional information since the last court hearing, as follows:

10.

Other Helpful Information
a.
b.

There is no new or additional information since the last court hearing.
There is new or additional information since the last court hearing, as follows:

11.

Recommendation for Disposition (Outcome)
a.
b.

I have no recommendation for disposition (outcome).
I am recommending the following disposition (outcome):

12.

If you need more space to respond to any section on this form, please check this box and attach additional pages.

Number of pages attached:

NOTICE
If you are not the child, child's parent, or child's legal guardian, you may have a right to challenge a decision by the juvenile court, but
only in very limited circumstances. You may need a court order granting you access to records in the juvenile case file. For more
information, please see Information on Requesting Access to Records for Persons With a Limited Right to Appeal (form JV-291-
INFO). You can get form JV-291-INFO at any courthouse or county law library or online at www.courts.ca.gov/forms.

(TYPE OR PRINT NAME)

(SIGNATURE OF CAREGIVER OR FACILITY/AGENCY STAFF PERSON
WHO HAS COMPLETED THIS FORM)

JV-290 [Rev. September 1, 2020]

CAREGIVER INFORMATION FORM

Page 2 of 2

Caregiver Information Form

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): 69
Average fields per page: 34
Reading Level: Grade 7
LIST Grouping(s): Unknown

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.

j_v_page_party was JV-290[0].Page1[0].Party1[0] (0.47 conf)
j_v_page_item_h_cb was JV-290[0].Page1[0].item3h2_cb[0] (0.35 conf)
j_v_page_item_h_tf was JV-290[0].Page1[0].item3h2_tf[0] (0.35 conf)
j_v_page_person_cb was JV-290[0].Page1[0].person_cb[0] (0.35 conf)
j_page_caption_party_crt_county was JV-290[0].Page1[0].p1Caption[0].AttyPartyInfo[0].CrtCounty[0] (0.39 conf)
j_v_page_p_caption_atty_party_info_crt_street was JV-290[0].Page1[0].p1Caption[0].AttyPartyInfo[0].CrtStreet[0] (0.39 conf)
j_v_page_p_caption_atty_party_info_crt_mailing_add was JV-290[0].Page1[0].p1Caption[0].AttyPartyInfo[0].CrtMailingAdd[0] (0.38 conf)
j_v_page_p_caption_atty_party_info_crt_city_zip was JV-290[0].Page1[0].p1Caption[0].AttyPartyInfo[0].CrtCityZip[0] (0.36 conf)
j_v_page_p_caption_atty_party_info_crt_branch was JV-290[0].Page1[0].p1Caption[0].AttyPartyInfo[0].CrtBranch[0] (0.39 conf)
j_v_page_court_info_party__1 was JV-290[0].Page1[0].p1Caption[0].CourtInfo[0].Party2[0] (0.28 conf)
j_v_page_court_info_party__2 was JV-290[0].Page1[0].p1Caption[0].CourtInfo[0].Party1[0] (0.28 conf)
j_v_page_p_case_number was JV-290[0].Page1[0].p1Caption[0].CaseNumber[0].CaseNumber[0] (0.32 conf)
j_v_page_fill_text__1 was JV-290[0].Page1[0].FillText1[0] (0.38 conf)
j_v_page_fill_text__2 was JV-290[0].Page1[0].FillText1[1] (0.38 conf)
j_v_page_fill_text__3 was JV-290[0].Page1[0].FillText1[2] (0.38 conf)
j_v_page_area_petitioner_cb__1 was JV-290[0].Page1[0].#area[0].petitioner_cb[0] (0.35 conf)
j_v_page_area_petitioner_cb__2 was JV-290[0].Page1[0].#area[1].petitioner_cb[1] (0.35 conf)
j_v_page_area_petitioner_cb__3 was JV-290[0].Page1[0].#area[2].petitioner_cb[2] (0.35 conf)
j_v_page_area_petitioner_cb__4 was JV-290[0].Page1[0].#area[3].petitioner_cb[3] (0.35 conf)
j_v_page_area_petitioner_cb__5 was JV-290[0].Page1[0].#area[4].petitioner_cb[4] (0.35 conf)
j_v_page_area_text_field was JV-290[0].Page1[0].#area[5].TextField2[0] (0.31 conf)
j_v_page_area_check_box was JV-290[0].Page1[0].#area[5].CheckBox61[0] (0.27 conf)
j_v_page_text_field__1 was JV-290[0].Page1[0].TextField6[0] (0.31 conf)
j_v_page_text_field__2 was JV-290[0].Page1[0].TextField6[1] (0.31 conf)
j_v_page_fill_text__4 was JV-290[0].Page1[0].FillText1[3] (0.38 conf)
j_v_page_area_ffa_cb was JV-290[0].Page1[0].#area[6].ffa_cb[0] (0.35 conf)
j_v_page_area_cca_cb was JV-290[0].Page1[0].#area[7].cca_cb[0] (0.35 conf)
j_v_page_item_area_specify_tf was JV-290[0].Page1[0].Item3dOther[0].#area[0].Item3dSpecify_tf[0] (0.34 conf)
j_v_page_item_area_cb was JV-290[0].Page1[0].Item3dOther[0].#area[0].Item3dOther_cb[0] (0.34 conf)
j_v_page_text_field__3 was JV-290[0].Page1[0].TextField6[2] (0.31 conf)
j_v_page_text_field__4 was JV-290[0].Page1[0].TextField6[3] (0.31 conf)
j_v_page_fill_text__5 was JV-290[0].Page1[0].FillText1[4] (0.38 conf)
j_v_page_fill_text__6 was JV-290[0].Page1[0].FillText1[5] (0.38 conf)
j_v_page_text_field__5 was JV-290[0].Page1[0].TextField6[4] (0.31 conf)
j_v_page_text_field__6 was JV-290[0].Page1[0].TextField6[5] (0.31 conf)
j_v_page_fill_text__7 was JV-290[0].Page1[0].FillText1[6] (0.38 conf)
j_v_page_fill_text__8 was JV-290[0].Page1[0].FillText1[7] (0.38 conf)
j_v_page_text_field__7 was JV-290[0].Page1[0].TextField6[6] (0.31 conf)
j_v_page_item_cb__1 was JV-290[0].Page1[0].item4a_cb[0] (0.35 conf)
j_v_page_item_b_cb__1 was JV-290[0].Page1[0].item4b_cb[0] (0.35 conf)
j_v_page_item_b_tf__1 was JV-290[0].Page1[0].item4b_tf[0] (0.35 conf)
j_v_page_item_cb__2 was JV-290[0].Page1[0].item5a_cb[0] (0.35 conf)
j_v_page_item_b_cb__2 was JV-290[0].Page1[0].item5b_cb[0] (0.35 conf)
j_v_page_item_b_tf__2 was JV-290[0].Page1[0].item5b_tf[0] (0.35 conf)
j_v_page_fill_text__9 was JV-290[0].Page2[0].FillText1140[0] (0.38 conf)
j_page_caption_title_party_name was JV-290[0].Page2[0].pxCaption[0].TitlePartyName[0].Party1[0] (0.31 conf)
j_v_page_caption_case_number was JV-290[0].Page2[0].pxCaption[0].CaseNumber[0].CaseNumber[0] (0.32 conf)
j_v_page_fill_text__10 was JV-290[0].Page2[0].FillText56[0] (0.38 conf)
j_v_page_item_cb__3 was JV-290[0].Page2[0].item6a[0].item6a_cb[0] (0.35 conf)
j_v_page_item_date was JV-290[0].Page2[0].item6a[0].item6aDate[0] (0.35 conf)
j_v_page_item_b_cb__3 was JV-290[0].Page2[0].item6b_cb[0] (0.35 conf)
j_v_page_item_c_cb was JV-290[0].Page2[0].item6c_cb[0] (0.35 conf)
j_v_page_item_cb__4 was JV-290[0].Page2[0].item7a_cb[0] (0.35 conf)
j_v_page_item_b_cb__4 was JV-290[0].Page2[0].item7b_cb[0] (0.35 conf)
j_v_page_item_b_tf__3 was JV-290[0].Page2[0].item7b_tf[0] (0.35 conf)
j_v_page_item_cb__5 was JV-290[0].Page2[0].item8a_cb[0] (0.35 conf)
j_v_page_item_b_cb__5 was JV-290[0].Page2[0].item8b_cb[0] (0.35 conf)
j_v_page_item_b_tf__4 was JV-290[0].Page2[0].item8b_tf[0] (0.35 conf)
j_v_page_item_cb__6 was JV-290[0].Page2[0].item9a_cb[0] (0.35 conf)
j_v_page_item_b_cb__6 was JV-290[0].Page2[0].item9b_cb[0] (0.35 conf)
j_v_page_item_b_tf__5 was JV-290[0].Page2[0].item9b_tf[0] (0.35 conf)
j_v_page_item_cb__7 was JV-290[0].Page2[0].item10a_cb[0] (0.35 conf)
j_v_page_item_b_cb__7 was JV-290[0].Page2[0].item10b_cb[0] (0.35 conf)
j_v_page_item_b_tf__6 was JV-290[0].Page2[0].item10b_tf[0] (0.35 conf)
j_v_page_item_cb__8 was JV-290[0].Page2[0].item11a_cb[0] (0.35 conf)
j_v_page_item_b_cb__8 was JV-290[0].Page2[0].item11b_cb[0] (0.35 conf)
j_v_page_item_b_tf__7 was JV-290[0].Page2[0].item11b_tf[0] (0.35 conf)
j_v_page_check_box was JV-290[0].Page2[0].CheckBox3[0] (0.27 conf)
j_v_page_fill_text__11 was JV-290[0].Page2[0].FillText[0] (0.38 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

Caregiver Information Form

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