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STATE OF MICHIGAN

JUDICIAL CIRCUIT - FAMILY DIVISION
COUNTY

ORDER AFTER PRELIMINARY HEARING
(CHILD PROTECTIVE PROCEEDINGS)

ORDER 

 

 OF 
 

CASE NO.

PETITION NO.

JUDGE

Court address

Court telephone no.

1. Date of hearing: 

 

  Judge/Referee: 

In the matter of 

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

 2. Removal date: 

 

 

THE COURT FINDS:

 3. Military/nonmilitary affidavit attached.

 (Specify for each child if different.)

 

4. A petition has been submitted alleging that the above child(ren) come(s) within the provisions of MCL 712A.2(b).
 

 The child(ren) is/are alleged dependent under MCL 712A.2(b)(3).

5. The child(ren) 

 

 is/are 

 

 is not/are not 

  subject to the continuing jurisdiction of another court. 

Court: 
 

7. 
 

        putative.)

6. 

 Notice of hearing was given as required by law. 

 

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

 a. There is probable cause to believe the legal/putative father(s) is/are: (Name each child, his/her father, and whether legal or 

 

 b. The putative father of 

 

 is unknown and cannot be identified.

 8. The probable-cause determination was waived by all parties present.

9. There 

 

 is 

 

 is not 

  probable cause that one or more of the allegations in the petition are true.

 10.  There is good cause to adjourn the preliminary hearing because 
      

 .
 Petitioner recommends removal of the child(ren) from the home to assure the immediate safety of the child(ren).

 

 11.  There is probable cause the 
      child(ren)'s home abused the child(ren). Presence of the alleged abuser in the home 
      present a substantial risk of harm to the child(ren)'s life, physical health, or mental well-being and he/she
     
      Home, as appropriate.)

  be ordered out of the home. (Use form JC 65, Order Removing Alleged Abuser from Child's 

 other person 
 does   

 legal custodian   

 should not 

 guardian   

residing in the 
 does not

 parent   

 should 

 

 

 

 

Use Note: Do not use this form for removals if a petition has already been authorized in this case. Use JC 75 instead.
Reference Note: The term “department” refers to the Michigan Department of Health and Human Services.

Approved, SCAO
Form JC 11a, Rev. 12/22
MCL 712A.2(b), MCL 712A.13a, MCL 712A.14, MCL 712A.19a(2), 
MCL 712A.19b(4), MCL 722.638, MCR 3.002, MCR 3.920(C), MCR 3.921(B), 
MCR 3.965, MCR 3.976(B)(1)
Page 1 of 5

 

   

 

 
 
 
 

PCS Code: PRH/PHR/PHNTCS Code: PRH/OFPH 
 
 
 
 
 
 

 
 
 
 
 
 

 
 
 
 
 
 
 
 
 
 
 
 

Order After Preliminary Hearing (Child Protective Proceedings) 
Page 2 of 5

(12/22) 

Case No. 
 

 12.  The child(ren) has not/have not been removed prior to this hearing and an order to take the child(ren) into 
      protective custody is necessary because: 
      a. the child(ren) is/are at substantial risk of harm or is/are in surroundings that present an imminent risk of harm and 
          the child(ren)’s immediate removal from those surroundings is necessary to protect the child(ren)’s health and 
          safety, 
      b. the circumstances warrant issuing this order; and 
      c. no remedy other than protective custody is reasonably available to protect the child(ren).
          (If item 12 is checked, contrary to the welfare and reasonable efforts findings must be made. See items 14 and 15.)

 The preliminary hearing must be adjourned pending conclusion of a removal hearing required by MCR 3.967.
 The removal hearing required by MCR 3.967 was conducted in conjunction with this hearing  (see required findings in 

 13.  The child(ren) is/are Indian as defined in MCR 3.002(12). The petitioner 
      of the preliminary hearing as required by MCR 3.920(C)(1).
     
     
          item 15).   
          
          A qualified expert, 

 

 

 has 

 

 has not 

  given notice 

 , testified as required by law.

14. 
      

 a. Contrary to the welfare findings were made in a prior order.
 b. It is contrary to the welfare of the child(ren) to remain in the home because: (Attach separate sheets as necessary.)

OR

 b. Consistent with the circumstances, reasonable efforts were made to prevent or eliminate removal of the 

 c.  The child(ren) is/are Indian, and the court finds by clear and convincing evidence and the testimony of a 

 a. Consistent with the circumstances, reasonable efforts to prevent or eliminate removal of the child(ren) from 

 15. 
              the home were made as determined in a prior order.  
     
              child(ren) from the home.  Those efforts include: (Specify below.) 
     
              qualified expert witness who has knowledge about the child-rearing practices of the Indian child’s tribe, that 
              active efforts 
              programs designed to prevent the breakup of the Indian family. These efforts have proved 
             
             
             
      The efforts for 15b. or 15c. are:  (Specify the efforts from 15b. or 15c. here. If the child is an Indian child, specify active efforts as 
      defined by MCR 3.002[1] and MCL 712B.3[a].)

the continued custody of the child(ren) by the parent or Indian custodian 
likely to result in serious emotional or physical damage to the child(ren), and the child(ren) 

  been made to provide remedial services and rehabilitative  

 unsuccessful, 
 is not 
 is 
 
 
 should 

  be removed from the home. (Specify below.)

 successful,   

 should not 

 have not 

 have 

OR

 
 

 

 

 

 

     

 d. Reasonable efforts to prevent or eliminate removal of the child(ren) from the home were not made.

 
 

 

 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
 

 
 

 

 

Order After Preliminary Hearing (Child Protective Proceedings) 
Page 3 of 5

(12/22) 

Case No. 
 

 16.  a. Reasonable efforts are not required to prevent or eliminate the child(ren)'s removal from the home due to the
         
             

  subjecting the child(ren) to the aggravated circumstance(s) of

 as provided in section MCL 722.638(1) and (2), and as evidenced

 mother 

 father 

 

              by  
 

             

 

 

 

 .

 

 father's 

 mother's 

 father's 
 father's 
 father's 

 mother's 
 mother's 
 mother's 

conviction for murder of another child of the parent.
conviction for voluntary manslaughter of another child of the parent.
conviction for aiding or abetting in the murder or manslaughter of 

         
         
         
              another child of the parent, attempting to murder the child(ren) or another child of the parent, or conspiring or 
              soliciting to commit the murder of the child(ren) or another child of the parent.
         
              child(ren) or another child of the parent.
         
              and failure by that parent to rectify the conditions that led to that termination.
         
      b. Reasonable efforts to preserve and reunify the family to make it possible for the child(ren) to safely return home 
          are 
         
              stated above. 
              OR
         

 not required because the parent subjected the child or another child of the parent to one of the circumstances 

conviction for felony assault that resulted in serious bodily injury to the

involuntary termination of parental rights to a sibling of the child(ren) 

being required to register under the Sex Offender Registration Act. 

 still recommended because: 

 mother's 

 father's 

 mother  

 father 

 

      (When item 16 is checked, either complete item 18 below or schedule a permanency planning hearing within 28 days of this determination.)

 a. Reasonable efforts shall be made to preserve and reunify the family to make it possible for the child(ren) to 

  b. Reasonable efforts shall not be made to preserve and reunify the family because it would be detrimental to the

 17. 
              safely return home.
     
               child(ren)'s health and safety.

 18.  Because reasonable efforts to prevent or eliminate removal or to reunite the child(ren) and family are not required, 
      a permanency planning hearing was conducted. (Use and attach form JC 19, Order Following Dispositional Review/Permanency 
      Planning Hearing.)

 a. presents a substantial risk of harm to the child(ren)'s life, physical health, or mental well-being.

 No provision of service or other arrangement except removal of the child(ren) is reasonably available to 

19.  Custody of the child(ren) with the parent/guardian/legal custodian
 
 
 
 
 
 
 

  
         
              adequately safeguard the child(ren) from the risk of harm to the child(ren)'s life, physical health, or mental well-
              being.
         
              is/are placed are adequate to safeguard the child(ren)'s health and welfare.
 

 Conditions of custody at the placement away from the home and with the individual with whom the child(ren) 

 b. does not present a substantial risk of harm to the child(ren)'s life, physical health, or mental well-being.

 20. 
     

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

              Sibling contact 

 is occurring according to law. 

 is not occurring because (see item 27 to order sibling contact):

 21. Parenting time with 
 

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

Order After Preliminary Hearing (Child Protective Proceedings) 
Page 4 of 5

(12/22) 

Case No. 
 

IT IS ORDERED: 
22.  The petition 
 

 is authorized. 

 is not authorized. 

 is not authorized pending resumption of the preliminary hearing.

 23.  Notice is to be given to the legal/putative father(s) as required by law. 
      appear at the next hearing. 
      within 14 days.

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

 The father was not present and must 

 24.  This matter is set for a continued preliminary/removal hearing on 
 
       The petitioner shall give notice of these proceedings as required by MCR 3.920(C)(1). (Use form JC 48.)

 pursuant to MCR 3.967.  

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

 25.  The child(ren)  
      
              1) the parent(s), 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 for the child(ren) shall release the medical records of the child(ren) to
                  the department.
              2)  if the child(ren) is/are placed in the home of a relative, a home study 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).

 

 

 

 The child(ren) shall be taken into protective custody. To effect this order, 
 

             
                  is authorized to enter the premises located at 
 
                  This authorization to enter the premises and take the child(ren) into protective custody expires 
 
                 

 Enter on LEIN

      

 b. is/are released to 

 under the supervision of the department.

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

             

 The following terms and conditions apply to the parent(s), guardian, or legal custodian:

 26.  The child(ren) named 
      shall have 
      parenting time.

 

 

 27.  Sibling contact shall be as follows:

 a psychological evaluation 

 

 counseling  to determine appropriateness and conditions of

 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.

 

 28. 
             
             
   
     
             
             

     

 d. 

 .
 .

 
 
 

 is 

 is

 is 

 
 
 

 
 

 
 
 
 
 
 
 
 
 
 

 
 
 
 

 

 

 

 
 

 
 
 
 
 
 

 
 
 

 

Order After Preliminary Hearing (Child Protective Proceedings) 
Page 5 of 5

(12/22) 

Case No. 
 

IT IS ORDERED:  (continued)

29.  Until further order of the court, placement shall continue pending 

 

 resumption of the preliminary hearing 

 

 

 pretrial 

 

 trial 

 

 disposition 

  on 

 .

Date and time

 30.  Other:

 

 

 

 

 

 

 

 

 

 

 

       Referee signature and date

Recommended by:

 

                     

Judge signature and date

JC 11a, Order After Preliminary Hearing (Child Protective Proceedings)

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About This Form:

Sourced from www.courts.michigan.gov/juvenile-proceedings (2023-03)
Page(s): 5
Fields(s): 151
Average fields per page: 30
Reading Level: Grade 11
LIST Grouping(s): Unknown

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Identified Data Fields:

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JC 11a, Order After Preliminary Hearing (Child Protective Proceedings)

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