JUVENILE JUSTICE CASE PLAN
Name - Youth[TM1] / Birthdate - Youth
[TM2] / Case Number
[TM3] / Expiration Date
[TM4]
Date JJCP Developed
[TM5] / Current Program / Placement
[TM6] / Name - Worker
[TM7]
Last Review Date
[TM8] / Scheduled Review Period
[TM9] / Community Transition / Placement Plan
[TM10]
I. Case Plan Participants
Name / Title / Address / Telephone1.[TM11] / [TM12] / [TM13] / [TM14]
II. Case Plan Analysis
(Describe strengths of family, family’s understanding of their strengths and needs, youth’s attitudes / beliefs regarding change and readiness for change, quality of relationship between worker / youth / family, barriers to change which will have to be managed, and other pertinent information.)
[TM15]
III. Case Plan Goals
Goal:[TM16]
Objectives, interventions, or services to achieve stated goal / Participant / Start Date / Completion Date
1. [TM17] / [TM18] / [TM19] / [TM20]
2. [TM21] / [TM22] / [TM23] / [TM24]
3.[TM25] / [TM26] / [TM27] / [TM28]
4. [TM29] / [TM30] / [TM31] / [TM32]
5. [TM33] / [TM34] / [TM35] / [TM36]
6. [TM37] / [TM38] / [TM39] / [TM40]
[TM41]
How goal achievement / progress will be measured: [TM42]
Goal:[TM43]
Objectives, interventions, or services to achieve stated goal / Participant / Start Date / Completion Date
1. [TM44] / [TM45] / [TM46] / [TM47]
2. [TM48] / [TM49] / [TM50] / [TM51]
3.[TM52] / [TM53] / [TM54] / [TM55]
4. [TM56] / [TM57] / [TM58] / [TM59]
5. [TM60] / [TM61] / [TM62] / [TM63]
6. [TM64] / [TM65] / [TM66] / [TM67]
[TM68]
How goal achievement / progress will be measured: [TM69]
Goal:[TM70]
Objectives, interventions, or services to achieve stated goal / Participant / Start Date / Completion Date
1. [TM71] / [TM72] / [TM73] / [TM74]
2. [TM75] / [TM76] / [TM77] / [TM78]
3.[TM79] / [TM80] / [TM81] / [TM82]
4. [TM83] / [TM84] / [TM85] / [TM86]
5. [TM87] / [TM88] / [TM89] / [TM90]
6. [TM91] / [TM92] / [TM93] / [TM94]
[TM95]
How goal achievement / progress will be measured: [TM96]
Goal:[TM97]
Objectives, interventions, or services to achieve stated goal / Participant / Start Date / Completion Date
1. [TM98] / [TM99] / [TM100] / [TM101]
2. [TM102] / [TM103] / [TM104] / [TM105]
3.[TM106] / [TM107] / [TM108] / [TM109]
4. [TM110] / [TM111] / [TM112] / [TM113]
5. [TM114] / [TM115] / [TM116] / [TM117]
6. [TM118] / [TM119] / [TM120] / [TM121]
[TM122]
How goal achievement / progress will be measured: [TM123]
IV. Summary
Worker / Provider Tasks / Responsibilities
[TM124]
Family Responsibilities
[TM125]
Comments
[TM126]
V. Signatures
[TM127] / [TM128]
Name - Worker / Telephone Number - Worker
[TM129]
SIGNATURE - Worker / Date Signed
[TM130] / [TM131]
Name - Supervisor / Telephone Number - Supervisor
[TM132]
SIGNATURE - Supervisor / Date Signed
[TM133]
Juvenile Justice Case PlanPage 1 of 2
CFS-2268-15W (Rev. 02/2004)
[TM1]1This field is pre-filled.
This field is not editable on the template.
The data can be corrected as follows: the child’s Name can be changed in the First/Last Name fields on the Person Management page/Basic tab.
[TM2]1This field is pre-filled.
This field is not editable on the template.
The data can be corrected as follows: the child’s Birth Date can be changed in the Birth Date field on the Person Management page/Basic tab.
[TM3]1This field is pre-filled (system generated).
This field is not editable on the template and cannot be updated.
[TM4]1This field is user-entered.
[TM5]1This field is user-entered.
[TM6]1This field is user-entered.
[TM7]1This field is user-entered.
[TM8]1This field is user-entered.
[TM9]1This field is user-entered.
[TM10]1This field is user-entered.
[TM11]1This field is user-entered.
[TM12]1This field is user-entered.
[TM13]1This field is user-entered.
[TM14]1This field is user-entered.
[TM15]1This field is user-entered.
[TM16]1This field is user-entered.
[TM17]1This field is user-entered.
[TM18]1This field is user-entered.
[TM19]1This field is user-entered.
[TM20]1This field is user-entered.
[TM21]1This field is user-entered.
[TM22]1This field is user-entered.
[TM23]1This field is user-entered.
[TM24]1This field is user-entered.
[TM25]1This field is user-entered.
[TM26]1This field is user-entered.
[TM27]1This field is user-entered.
[TM28]1This field is user-entered.
[TM29]1This field is user-entered.
[TM30]1This field is user-entered.
[TM31]1This field is user-entered.
[TM32]1This field is user-entered.
[TM33]1This field is user-entered.
[TM34]1This field is user-entered.
[TM35]1This field is user-entered.
[TM36]1This field is user-entered.
[TM37]1This field is user-entered.
[TM38]1This field is user-entered.
[TM39]1This field is user-entered.
[TM40]1This field is user-entered.
[TM41]1This field is user-entered.
[TM42]1This field is user-entered.
[TM43]1This field is user-entered.
[TM44]1This field is user-entered.
[TM45]1This field is user-entered.
[TM46]1This field is user-entered.
[TM47]1This field is user-entered.
[TM48]1This field is user-entered.
[TM49]1This field is user-entered.
[TM50]1This field is user-entered.
[TM51]1This field is user-entered.
[TM52]1This field is user-entered.
[TM53]1This field is user-entered.
[TM54]1This field is user-entered..
[TM55]1This field is user-entered.
[TM56]1This field is user-entered.
[TM57]1This field is user-entered.
[TM58]1This field is user-entered.
[TM59]1This field is user-entered.
[TM60]1This field is user-entered.
[TM61]1This field is user-entered.
[TM62]1 This field is user-entered.
[TM63]1 This field is user-entered.
[TM64]1This field is user-entered.
[TM65]1This field is user-entered.
[TM66]1 This field is user-entered.
[TM67]1 This field is user-entered.
[TM68]1This field is user-entered.
[TM69]1This field is user-entered.
[TM70]1This field is user-entered.
[TM71]1This field is user-entered.
[TM72]1This field is user-entered.
[TM73]1 This field is user-entered.
[TM74]1 This field is user-entered.
[TM75]1This field is user-entered.
[TM76]1This field is user-entered.
[TM77]1 This field is user-entered.
[TM78]1 This field is user-entered.
[TM79]1This field is user-entered.
[TM80]1This field is user-entered.
[TM81]1 This field is user-entered.
[TM82]1 This field is user-entered.
[TM83]1This field is user-entered.
[TM84]1This field is user-entered.
[TM85]1 This field is user-entered.
[TM86]1 This field is user-entered.
[TM87]1This field is user-entered.
[TM88]1This field is user-entered.
[TM89]1 This field is user-entered.
[TM90]1 This field is user-entered.
[TM91]1This field is user-entered.
[TM92]1This field is user-entered.
[TM93]1 This field is user-entered.
[TM94]1 This field is user-entered.
[TM95]1This field is user-entered.
[TM96]1This field is user-entered.
[TM97]1This field is user-entered.
[TM98]1This field is user-entered.
[TM99]1This field is user-entered.
[TM100]1 This field is user-entered.
[TM101]1 This field is user-entered.
[TM102]1This field is user-entered.
[TM103]1This field is user-entered.
[TM104]1 This field is user-entered.
[TM105]1 This field is user-entered.
[TM106]1This field is user-entered.
[TM107]1This field is user-entered.
[TM108]1 This field is user-entered.
[TM109]1 This field is user-entered.
[TM110]1This field is user-entered.
[TM111]1This field is user-entered.
[TM112]1 This field is user-entered.
[TM113]1 This field is user-entered.
[TM114]1This field is user-entered.
[TM115]1This field is user-entered.
[TM116]1 This field is user-entered.
[TM117]1 This field is user-entered.
[TM118]1This field is user-entered.
[TM119]1This field is user-entered.
[TM120]1 This field is user-entered.
[TM121]1 This field is user-entered.
[TM122]1This field is user-entered.
[TM123]1This field is user-entered.
[TM124]1This field is user-entered.
[TM125]1This field is user-entered.
[TM126]1This field is user-entered.
[TM127]1This field is pre-filled.
This field is not editable on the template.
The data can be corrected as follows: the worker’s name can be updated (by supervisor) on the Person Management page/Basic tab.
[TM128]1This field is pre-filled.
This field is not editable on the template.
The data can be corrected as follows: the worker’s phone number can be updated (by supervisor) on the worker's Maintain Worker Information page.
[TM129]1 This field is user-entered.
[TM130]1This field is pre-filled.
This field is not editable on the template.
The data can be corrected as follows: the supervisor’s name (spelling) can be updated (by supervisor) on the Person Management page/Basic tab. An incorrect supervisor selection can be updated in the Supervisor Name field on the Maintain Worker Information window for the worker who created the document.
[TM131]11This field is pre-filled.
This field is not editable on the template.
The data can be corrected as follows: the supervisor's phone number can be updated (by the supervisor's supervisor) on the supervisor's Person Management page/Basic tab.
[TM132]1 This field is user-entered.
[TM133]1This field is user-entered.