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Italicized notes are for instructional purposes only and should be deleted from any court report.

SUPERIOR COURT OF WASHINGTON

IN AND FOR BENTON AND FRANKLIN COUNTIES

In re the :
,
Petitioner,
and
,
Respondent. / NO.
SEALED CONFIDENTIAL REPORT of:
______,
GUARDIAN AD LITEM (GAL)

COMES NOW, ______, GAL, pursuant to the court order of Judge/Commissioner ______dated ______, and files the following confidential report:

GUARDIAN AD LITEM QUALIFICATIONS:

I,______, confirm to the court that I possess the requisite knowledge and training to perform the duties required under the state statute and local court rules. I am on the Title 26 Guardian ad Litem Registry forBenton and Franklin Counties and a current Background Information Record listing my background, knowledge, training and experience is on record with the court.

Additionally, I attest to this court that I am free of influence from any person(s) that may have an interest in the outcome of these proceedings.

I. SCOPE OF INVESTIGATION:

In compliance with the Court’s request to investigate and make recommendations regarding (RCW ______) for the minor children, ______(include dobs) the GALs final investigation included:

Materials Reviewed:

(simple listing of relevant materials - this is NOT an all-inclusive list)

– e.g. Superior Court file, in-take packets, criminal backgrounds, police reports, DSHS/CPS disclosure/intakes, school records, health care records, counseling records, professional reports, etc.

List of Interviews/Consultations/Observations:

(one line identification for each person interviewed – by telephone or personal)

– e.g. January 1, 2015 - telephone conference withJane Smith

January 5, 2015 – home visit with Jane Smith

List of Attachments:

(one line identification of attachments/relevance to investigation. Materials to attach include, but are not limited to, police reports, CPS reports,school records, health care records, counseling records, professional reports, etc.)

– e.g. Attachment A – School records

Criminal History:

Simple listing of each party’s criminal history. Include details or specific concerns within the appropriate party’s section of the report and in the conclusion section, if relevant.

DSHS/CPS Records Request:

If applicable.

A request for records was made to Department of Social and Health Services Children’s Administration for the Disclosure Unit on ______. (State the outcome/status of the request – e.g. records have been reviewed or status of request. Include details of any intakes in this portion and include specific concerns within the conclusion section of the report.)

II. PRESENTING ISSUES:

The court order appointing ______, as GAL orders the following issues to be investigated:

  1. Residential placement provisions consistent with the children’s best interest and the provisions of RCW 26.09.187 and 26.09.191.
III. INVESTIGATION FINDINGS:
Include a short history of the parties’ relationship that led to the filing of this case. Also include a brief summary of the history of the case and state specifically what each party is asking the Court to order.
Petitioner,
Include summary of the findings pertaining to the petitioner.
Home Visit
Include summary of findings at home visit(s)
Criminal History
If applicable.
Medical History
If applicable.
Petitioner’s References
Include summary of the findings of relevant information provided by the references.
Respondent,
Include summary of the findings pertaining to the petitioner.
Home Visit
Include summary of findings at home visit(s)
Criminal History
If applicable.
Medical History
If applicable.
Petitioner’s References
Include summary of the findings of relevant information provided by the references.
Child (ren)
Include any relevant information gathered during interviews and observations with the child(ren). Feel free to include any information about the child(ren)’s appearance or personality.
Collateral Contacts
Professionals
IV. FINALCONCLUSIONS:
(Include applicable statutory factors as ordered to be investigated by the Court.Conclusions must be based upon findings and must be reasoned. There should be no new information introduced in this section. DO NOT merely summarize the information gathered but include an analysis of how the findings support your recommendations. This is the factual basis/reasoning for the recommendations that follow.)
V. FINALRECOMMENDATIONS:
Based on the information provided above, the GAL respectfully recommends the following:

2.

THIS REPORT SHOULD NOT BE READ OR DISCUSSED WITH THE MINOR CHILDREN, OR WITH ANY OTHER PERSON IN THE CHILD’S PRESENCE OR HEARING RANGE.

Respectfully submitted on the day of , 201.

______

GUARDIAN AD LITEM

Listing of parties that receive a copy (as included on the Declaration of Mailing or equivalent)

e.g.

Original filed with the Court

CC:

______, Attorney for Petitioner

______, Attorney for Respondent

Sealed Confidential GAL ReportPage 1 of 6

Revised: 7/2015