Sample Report Form with Guidance

IN THE DISTRICT OF THE FIRST JUDICIAL DISTRICT OF THE STATE OF IDAHO,

IN AND FOR THE COUNTY OF ______MAGISTRATE DIVISION

In the Matter of:
Child Name DOB:
A child under the age of 18 years / Case No. CV
Review Report of the Guardian Ad Litem

STATE OF IDAHO )

: ss.

County of ______)

I, ______, being first sworn under oath, state that I am a Guardian ad Litem for The First Judicial District CASA Program assigned to this case, and that the statements contained therein are true and correct to the best of my knowledge.

As part of my duties as the Guardian ad Litem assigned to this case, I have personally assessed this matter and submit the following report:

Child / Placement
Child 1 / Name:
Age:
Removal Date: / Number of placement since removal:
Type of Placement:
Placed with siblings:
Relatives notified:
Attending original school:
ICWA status:
Child / Placement
Child 2 / Name:
Age:
Removal Date: / Number of placement since removal:
Type of Placement:
Placed with siblings:
Relatives notified:
Attending original school:
ICWA status:
Child / Placement
Child 3 / Name:
Age:
Removal Date: / Number of placement since removal:
Type of Placement:
Placed with siblings:
Relatives notified:
Attending original school:
ICWA status:

CASA/Child Contacted Date and place:

XX/XX/XX child (ren) contact at XXXXXXX

Persons Contacted:

Name, child

Name, mother

Name, bio father

Documents Reviewed:

History:

1. Reason for placement

2. History

See previous report of the Guardian Ad Litem.

Guardian ad Litem Concerns:

Child(ren)’s Current Situation:

1. Current Services:

2. Visitation:

3. Education:

4. Medical:

5. Placement:

Child’s Expressed Wishes (not required):

Name is too young to express his wishes at this time:

Name, have chosen to communicate with the court (choose one):

through their letters will be sent to the court within the week.

through the Guardian ad Litem, he/she has stated “ ….”

In person, “child’s name will be in court during today’s proceedings”.

has chosen not to communicate with the court today

Parent’s Situation:

1. Mother’s Current Situation:

2. Father’s Current Situation:

Summary:

RECOMMENDATIONS:

Respectfully submitted this ___day of ______, 2017:

______

Name

CASA Guardian ad Litem Advocate

Review Hearing Report of the Guardian ad Litem Page 3 of 3