OUTLINE OF A REPORT (use size 14 pt font)
Date
The Honorable (Judge’s first and last name)
Circuit Court Judge
425 N. Dakota Ave.
Sioux Falls, SD 57104
In the Matter Of:Name of ChildAge:
Court File Number:JUV(Insert the file number of your case)
Example: JUV 99-1
This case is scheduled for a dispositional hearing on (Insert date). The children were removed from their home on (Insert date). I was appointed as the CASA volunteer to this case on (Insert date).
Contacts:List each contact you have made and the date you made the contact. Include attempted contacts.
Name of SW, Social Worker, Department of Social Services:
1-1-99, 1-10-99, 1-15-99
Name of Parent, mother: 1-5-99, 1-7-99
Attempted contacts: 1-8-99, 1-9-99, 1-10-99
Name of Parent, father: 1-3-99, 1-8-99
Attempted contacts: 1-8-99, 1-9-99, 1-10-99
Child’s Name, child: 1-1-99, 1-10-99, 1-15-99
Attempted contacts: 1-8-99, 1-9-99, 1-10-99
Last Name of Case
JUV (Insert the number of your case)
Page 2
Foster Parents Name, foster parents: 1-1-99, 1-10-99, 1-15-99
Attempted contacts: 1-8-99, 1-9-99, 1-10-99
Parenting Instructor’s Name, Provider Location: 1-1-99, 1-10-99
Attempted contacts: 1-8-99, 1-9-99, 1-10-99
Dear Judge (Last name):
(The following sentence needs to be stated this way and first in this section)
The following report is to inform you of the activity in the abuse and neglect case of the above-named children.
The following italicized portion of this report is according to the petition dated ______. Insert the reason the children came into care. This information should be taken straight off of the petition. (word for word)
(CASA Case Managers can add this petition information rather than volunteer retyping it.)
Summarize any information that is applicable to all the children; ex: where they are living etc.
Status of Children:
List each child separately with his/her age:
Child’s first and last name, DOB:
Give pertinent information about that child. (Ex: Child is a __ year old Caucasian child. He is living with… He is in __ grade at __Elementary School.)
Child’s age? Where is the child living? How are they doing there?
What are the concerns in placement?
What are the positives in the placement?
Do they go to daycare or school? If so, where? How are they doing?
What progress or lack of it has there been in daycare or school?
Last Name of Case
JUV (Insert the number of your case)
Page 3
Any counseling? Progress and concerns in counseling?
Any outside activities? Relationship with parents?
Relationship with siblings?
Relationship with peers?
Any tribal enrollment? If so, where.
Document your writing by identifying how you got this information.
Example: In speaking with her counselor, (name of counselor and name of facility) or Tommy tells me……….etc.
Status of Parents:
Mother’s full name, DOB:
Give all information that you know.
How old she is, enter age?
Is she Native American or Caucasian or Hispanic?
What is her marital history?
Is she with the father?
What has been and is her involvement in the children’s lives?
What is her family history?
Has mom met with you? When? Was she cooperative? Was she open to discussion regarding her family and her progress?
Has she had any psychological assessments/treatment, alcohol assessment/treatment? How many times? What was success and follow
through? Any parenting classes? When and where? What was the participation and follow through? Any other services?
Any criminal involvement? If so, when and what happened, and what was the outcome.
Is she working? What is the work history?
Where is she living?
What is the visitation? How is she during visitation? How many visits has she attended? How many were offered? Where are visits held?
What are her concerns regarding the children?
What are her wishes regarding her children?
Last Name of Case
JUV (Insert the number of your case)
Page 4
Did she sign stipulations in the case? Is she working on them? List progress or lack of progress on stipulations. If different Did she sign a family service
agreement? List progress or lack of progress on the family service agreement?
Father’s full name, DOB:
List all fathers’ involvement and answer the above questions.
Others involved: If applicable
List other significant persons in the children’s lives and the impact they are making? This may be positive or negative. The children may have a very positive grandparent. A boyfriend of mom’s may be a very negative influence on the children.
Strengths:
List each strength that you have identified, numbering as you go. Strengths should be noted in the body of the report also, not just under this section.
Example:
1. Mother’s name has attended every visit with her children that was offered at DSS.
2.
3.
Last Name of Case
JUV (Insert the number of your case)
Page 5
Concerns:
List each concern that you have identified, numbering as you go. Concerns should be noted in the body of the report also, not just under this section.
Example:
1. Mother’s name has shown little interest in visiting her children. She has missed 8 out of 10 visits offered at DSS.
2.
3.
Recommendations:
Make your recommendation for:
- Legal Custody:
Should there be termination of parental rights? Should the children remain in legal custody of DSS for a period of time (three or six months) pending a review? Should the children return home?
Example:
I recommend termination of parental rights of Mothers Name to all four of her children (list there names).
I recommend termination of rights to each father with their respective child. (List child and there father separately)
I recommend that custody of the children remain with DSS and that their current placement continue, if possible.
Last Name of Case
JUV (Insert the number of your case)
Page 6
- Physical Custody:
Where should the children live?
Example:
I recommend that all the children remain in their current foster care placement until such time that they can be cleared for adoption.
Other Recommendations:
What else do you recommend? Should someone obtain therapy?
Respectfully submitted by,Reviewed by,
Your nameJackie Horton
CASA VolunteerExecutive Director
First and Last name, CASA Case Manager monitored this case.
cc: First and last name, Deputy State’s Attorney
Social Worker name, DSS Social Worker
Name of Attorney, Attorney at Law for child’s name, child
Name of Attorney, Attorney at Law for father’s name, father
Name of Attorney, Attorney at Law for mother’s name, mother
Tribe if applicable