STATE OF MICHIGAN

JUDICIAL CIRCUIT - FAMILY DIVISION
COUNTY

ORDER AFTER DISPOSITIONAL REVIEW/
PERMANENCY PLANNING HEARING
(CHILD PROTECTIVE PROCEEDINGS)

CASE NO.

PETITION NO.

JUDGE

ORDER 

 

 OF 
 

Court address

Court telephone no.

In the matter of 

First and last name(s), alias(es)

1. Date of hearing: 
 

 2. Removal date: 

 

 

  Judge/Referee: 

 (Specify for each child if different.)

 

 

    Last permanency planning hearing date: 

 (Specify for each child if different.)

 

3. As of the last order, the child(ren) named above was/were in the protective/temporary custody of the court, and
 

 was/were placed with the department.

 remained in the home. 

 

. Notice of hearing for the 

 

 review 

 

  hearing was served as required by law.     

 permanency planning 
 Notice of proceedings is to be given as required by law.

 combined review and permanency planning 

 

 5. This hearing is being conducted under MCR 3.974(D)(2) for an Indian child who was removed from the home. The 
    Indian child removal hearing 
   

 was held with this hearing. 

 was previously held. 

 

 

 . 

 
 

 is scheduled for 
 

THE COURT FINDS:
6. The lawyer-guardian ad litem 

 

 has 

 

 has not 

  complied with the requirements of MCL 712A.17d. 

 a. There is probable cause to believe the legal/putative father(s) is/are:

        (Name each child, his/her father, and whether legal or putative.)

 b. The putative father of 
 c.  The putative father was notified as required by law and failed to establish paternity within the time set by the court.
        The putative father waives all rights to further notice, including the right to notice of termination of parental rights 
        and the right to an attorney.

 
 
 
 
8. The court has considered the case service plan and other evidence presented. The findings below are specific to this 
 the following report(s): 
  case and are based upon this hearing and 

 is unknown and cannot be identified.

 

Identify report(s) and date(s) of report(s)

    occur or was infrequent and the reasons why.

  Specific conditions reviewed on the record as required by MCL 712A.19(6) were
  a. compliance with the case service plan with respect to services provided or offered to the child and his or her parent(s),
    guardian, or legal custodian and whether the parent(s), guardian, or legal custodian complied with and benefited from 
 
 
    those services.
  b. compliance with the case service plan with respect to parenting time with the child and whether parenting time did not 
 
  c.  the extent to which the parent(s), guardian, or legal custodian complied with each provision of the case service plan, 
 
  d. likely harm to the child if the child continued to be separated from his or her parent(s), guardian, or legal custodian.
  e. likely harm to the child if the child was returned to his or her parent(s), guardian, or legal custodian.
Note: If it comes to the court’s attention or new allegations are made during this hearing that require the removal of the child(ren), removal must be done 
in accordance with MCR 3.974. 

    prior court orders, and any agreement between the parent(s), guardian, or legal custodian and the agency.

Approved, SCAO
Form JC 19, Rev. 12/22
MCL 712A.17d(1)(c), MCL 712A.18f, MCL 712A.19, MCL 712A.19a, 
MCL 712A.20, MCL 712B.9, MCL 722.123a, MCR 3.002, MCR 3.921, 
MCR 3.972(A), MCR 3.974(A)(3), MCR 3.975, MCR 3.976, MCR 3.979
Page 1 of 5

Use  Note:  Do  not  use  this  form  for  review  or  permanency  planning 
hearings after termination. Use form JC 76 instead.

Reference  Note:  The  term  “department”  refers  to  the  Michigan 
Department of Health and Human Services.

  4

7. 
 

PCS Code: IDR/SRE/PPH-ORH/OPPTCS Code: SRE/PPHOrder After Dispositional Review/Permanency Planning Hearing 
(Child Protective Proceedings) 
Page 2 of 5
9. Returning the child(ren) to the parent(s), guardian, or legal custodian 
 would 
  substantial risk of harm to the child(ren)’s life, physical health, or mental well-being.

(12/22)

 

Case No. 
 

 

 would not 

  cause a 

 

 should 

 a. The agency 

 10.  The child(ren) should not be returned to the parent(s), guardian, or legal custodian. (State reasons for a. or b. in the space 
      below.)
     
              because:
     
             
             
                  reasons:   
 

 should initiate proceedings to terminate the parental rights to the child(ren).
  should  not  initiate  proceedings  to  terminate  the  parental  rights  to  the  child(ren)  for  the  following  compelling 

 b. The child has been in foster care for 15 months of the most recent 22 months, and the agency

  initiate proceedings to terminate the parental rights to the child(ren) 

 should not 

 

 a. Reasonable efforts 

 11. 
               child(ren) to safely return to the child(ren)’s home. (Specify reasonable efforts below, and if applicable, the reasons for return.)
             
             

 1) Reasonable efforts for reunification should be continued.
 2) Those reasonable efforts were successful and the child(ren) should be released to

 were not  made to preserve and reunify the family to make it possible for 

 were 

                      

Name(s) of parent(s), guardian, or legal custodian

              The reasonable efforts include: (Specify.)
           
     

 b.  Reasonable efforts to preserve and reunify the family to make it possible for the child(ren) to safely return to 

     
              the child(ren)’s home are not required based on a prior order. 
 12.  In accordance with MCL 712A.19(7), progress toward alleviating or mitigating the conditions that caused the 
      child(ren) to be placed or to remain in temporary foster care

     

 was made by 

List names

     

 was not made by 

List names

 is necessary and appropriate and is meeting the child(ren)’s needs.

3.  The child(ren)’s continued placement 

 
 is no longer necessary or appropriate.

 
 14. The needs of the child 
     
 cannot be met in a foster family home, placement of the child in a qualified residential treatment program provides 
          the most effective and appropriate level of care for the child in the least restrictive environment, and is consistent 
          with the goals in the permanency plan for the child.
     
          provide the most effective and appropriate level of care for the child in the least restrictive environment, and is not 
          consistent with the goals in the permanency plan for the child.

 can be met in a foster family home, placement of the child in a qualified residential treatment program does not 

 .

 .

 .  

 
 
 
 
 
 
 
 

 
 
 

 

 
 
 

 
 

 

 

 

 
 
 
 
 
 

  1

 

Order After Dispositional Review/Permanency Planning Hearing 
(Child Protective Proceedings) 
Page 3 of 5

(12/22)

Case No. 
 

 

 

 does 

  have 

 remains 

 does not 

 
  comply with MCR 3.967(F). 

 15.  The child(ren) is/are Indian as defined in MCR 3.002(12), and placement 
 
      appropriate and 
 16. The child(ren) is/are Indian and the court finds that active efforts 
       remedial services and rehabilitative programs designed to prevent the breakup of the Indian family.
 17.  *Reasonable efforts 
     
     
     
     
     
             
              due to the compelling reasons that: (Specify the compelling reasons for another planned permanent living arrangement by 
              entering the language that corresponds to the number[s] from the list on the last page.)

 a. return to the parent, guardian, or legal custodian for the child(ren) named 
 
 b. adoption for the child(ren) named 
 c. legal guardianship for the child(ren) named
 d. placement with a fit and willing relative for the child(ren) named 
 e. placement in another planned permanent living arrangement (APPLA) for the child(ren) age 16 or older named

  have not  been made to finalize the court-approved permanency plan of 

  have not  been made to provide

 does not remain

  have 

 

 

 

 

       The reasonable efforts made to finalize the court-approved permanency plan identified above include:
       (Specify the permanency plan for each child and the reasonable efforts made toward finalizing that plan.) 

  

 

 Because adoption is the court-approved permanency plan, the department shall be ordered to initiate proceedings 

     
          to  terminate parental rights. 
 18.  The permanency planning goal in item 17 

 

 

  is appropriate. 

 

  is no longer appropriate and shall be: 

      

 

 .

 19. The appointment of a juvenile guardian is in the best interest of the child(ren) named above in item 17c. 
 The court 
      has received and considered the information required by MCR 3.979(A)(1), and the proposed guardian should be  
      appointed.
 20.  The department, foster home, or institutional placement 
      parenting standard that the child(ren) has/have regular opportunities to engage in age or developmentally appropriate 
      activities.
 21. 
     

 a. All siblings are in joint placement.
 b. All siblings are not in joint placement because:

followed the reasonable prudent 

 has not 

 has 

              Sibling contact 

 is occurring according to law. 

 is not occurring because (see item 31 to order sibling contact):

 22. Parenting time with 

 

 , even if supervised, may be harmful to the child(ren).

 23.  A juvenile guardian was appointed and jurisdiction over  
      under MCL 712A.2(b) should be terminated. (This finding is considered at the first review hearing after the appointment.)

 

 

 24.  A juvenile guardianship for 
      MCR 3.979(F), and this hearing is held under MCR 3.979(F)(7).

 

 was revoked under 

Note: *MCL 712A.19a provides that these reasonable efforts findings must be made within 12 months from when the child was removed from his/her 
home and every 12 months thereafter.

 

 

 
 
 
 
 
 
 
 

 
 

 
 

 

 
 

 
 

 

 

 

 

Order After Dispositional Review/Permanency Planning Hearing 
(Child Protective Proceedings) 
Page 4 of 5
IT IS ORDERED: 

(12/22)

Case No. 
 

 The father was not present and must 

 b. remain home with or is/are released to 

 a. is/are placed with the department for care and supervision, and

 The putative father was present at this hearing and shall establish paternity within 

 4)  after thorough consideration of the assessment made by the qualified individual, the child’s placement in 

 25.  Notice is to be given to the legal/putative father(s) as required by law. 
      appear at the next hearing. 
      14 days.
 26.  The child(ren) is/are continued in the protective/temporary custody of this court, and  (Check only a, b, c, or d.)
      
              1) the parent, guardian, or legal custodian shall execute all documents necessary to release confidential 
                  information regarding the child(ren), including medical, mental, and educational reports, and shall also, 
                  within 7 days, provide the department with the name(s) and address(es) of the medical  provider(s) for the 
                  child(ren). Any medical provider of the child(ren) shall release the medical records of the child(ren) to the 
                  department.
              2) if a home study has not yet been completed, then one shall be performed by the department and a copy of 
                  the home study submitted to the court not more than 30 days after the placement.
              3) upon request, the department shall release to the foster parent the information concerning the child(ren) in
                  accordance with MCL 712A.13a(18).
             
                       a qualified residential treatment program   
     
              supervision of the department. 
              custodian: 
     
              1) conduct a criminal record check and central registry clearance of the residents of the home of the proposed 
                  juvenile guardian and submit the results to the court within 7 days.
              2) perform a home study with a copy submitted to the court within 28 days, unless a home study has been 
                  performed within the immediately preceding 365 days of this order, in which case, a copy of that home study 
                  shall be submitted to the court.
     
 27.  While the child(ren) is/are placed out of the home, the friend of the court must take the necessary steps to appropriately 
      assign or redirect child support pursuant to law.
 28.  The department shall comply with MCR 3.967(F).
 29.  The department shall initiate proceedings to terminate parental rights to the child(ren) no later than 28 days from the 
      date of this hearing.
 30.  The adjudicated respondent(s) 
 
      shall comply with, and benefit from, the case service plan. 
     

 under the
 The following terms and conditions apply to the parent(s) guardian/legal 

 c.  the current placement with the department shall continue. The department shall:

 d. placed under guardianship under MCR 3.979(B). (See separate order, form JC 91.)  

 is not    approved. 

 In addition,

 is   

  

 

 

 

 

 31.  Sibling contact shall be as follows:

 a.  Parenting time of 
 unsupervised. 
 The department has discretion to allow unsupervised or supervised parenting time by its designee.

 supervised until further order of the court.

 

 b.  Parenting time of  
 
 unsupervised. 
 The department has discretion to allow unsupervised or supervised parenting time by its designee.

 supervised until further order of the court.

     
             
             

 c.  Parenting time of 
 unsupervised. 
 The department has discretion to allow unsupervised or supervised parenting time by its designee.

 supervised until further order of the court.

 

 is 

 is

 is 

 32. 
             
             
 
 
     
             
             

     

 d. 

 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
 
 
 
 
 
 

 

 

 
 

 

 
 
 
 
 
 

 
 
 

 

Order After Dispositional Review/Permanency Planning Hearing 
(Child Protective Proceedings) 
Page 5 of 5
IT IS ORDERED: (continued)

(12/22)

Case No. 
 

 

 33.  Jurisdiction of this court is terminated. The court reserves the right to enforce payments of reimbursement that have
 .
      accrued up to and including the date of this order. The child(ren) is/are released to 
 34.  Previous reimbursement orders shall continue.
 35.  Other: (Attach separate sheets as necessary.)

 

 36.  Prior orders remain in effect except as modified in this order.
 37.  Review hearings shall be held as follows: 
      (Note: The review hearing shall not be delayed beyond the number of days required regardless whether a petition to terminate parental rights    
      or another matter is pending. MCL 712A.19a provides that the permanency planning hearing shall not be delayed beyond 12 months from the 
      date of removal of the child and every 12 months thereafter.) 
     
     
      The supervising agency shall provide documentation of progress relating to all aspects of the last court-ordered
      treatment plan, including copies of evaluations and therapy reports and verification of parenting time, no less 
      than 7 days before the scheduled hearing. 

  dispositional review hearing 
 dispositional review hearing to terminate jurisdiction under MCR 3.979(C) 

 permanency planning hearing 

 

 

 

 

 
 

 
 
 
 
 
 

 38.  A hearing to appoint the juvenile guardian under MCR 3.979(B) shall be held 

 .

 

 39. 

 Notice of the next hearing has been provided as required by law. 

 

 Notice of the next hearing shall be provided.

 

                     

Recommended by:

Referee signature and date

 

                     

Judge signature and date

The following are examples of compelling reasons for a permanency plan other than return to parent, legal 
guardianship, placement with a fit and willing relative, or adoption.
1. No relative has been identified who is appropriate or available to assume the permanent custody of the child.
2. The current caregiver is not an adoptive resource.
3. Reasonable efforts to recruit an adoptive home have been unsuccessful.
4. The child does not want to be adopted and is of an age where due consideration must be given to his/her wishes.
5. It is contrary to the child’s best interests to break the child’s attachment to the current caregivers.
6. The current caregiver is committed to providing a permanent placement for the child.
7. The placement allows the siblings to remain together.
8. The child’s special needs can best be met in this placement.
9. The child wants to remain in the current placement, which is only available as foster care.
10.  The placement is preparing the child for transition into independent living (specify the services being provided to the 
 
 
 
 
11.  The child comes under the Indian Child Welfare Act and Michigan Indian Family Preservation Act, and the child’s tribe
 
12.  Other (specify in the findings in item 17e).

  child to assist with transition such as referral to an independent living skills program, enrollment in a vocational program, 
  referral for a mentor, continued out-of-home placement in foster care beyond age 18 to allow the child to complete 
  secondary school, placement in a resource that provides on-site training for independent living, and other similar 
  services).

  recommends permanent placement in long-term foster care.