WPC! !\W&ֈLk E(gSP(%/Y < S~BsS+X~Av^H66XJ:bP Ӓ124o.? (pt.~t#j2pkʦ0(y 季K  (qz!vg*KʭtJszNv 1C%89hciNupš_%N>$#5QIGbZS }qSP&JDE1$:PvU+ sLDDqq$ ҿ)xyoWFz~dh&lpco_w(y10_M#v TW_1XmSlTC_JMT{7D*'慂W*!'2{cH B rXKoB%Iw&p-|IY)ZȘA+`-dR X#UN % 0: ^ ' w3 47 K Z m\ 0ds U)> Uw> NS 0UU U | b& 0U@    0 0 0a 0 0 0z 0! 0 0] 0 0bZ 0 0 0P 0          0  0 06 0 0 0d 0 0 0>      0. 0 0<> z       !!:!U @R! ! ! ! !\\KJCDC01\SAVIN 90600(9 Z6Times New Roman RegularX($USUS.,v=e}i=:i+003|xU0.Header (#XXXS \  `&Times New RomanSA7X` hp x (#AS \  `&Times New RomanSXXX\  `&Times New Roman\  `&Times New Roman(-2$ !USUS.,   r 'USUS.,  _"XA"11/23/10Page of &*+ (_2623  ..Text5Text6Text7*D+D (_25   ," <DL,23  ..," <DL,   *5+5 (_24  ) <DL)23  ..) <DL)  *2+2 (_23 ` &<<DL&23  ..&<<DL& ` */+/ (_22  #DL#23  ..#DL#  *,+, (_21   DL 23  .. DL  *)+) (_20 h DDL23  ..DDL h *&+& (_19  L23  ..L  *#+# (_18   L23  .. L  *>> (_17  2( 4 <DL223  Ԁ2( 4 <DL2  *DD (_16   ," <DL,23  Ԁ," <DL,   *55 (_15  ) <DL)23  Ԁ) <DL)  Page of &8DocumentManagement::ModifiedBooleanTRUE*22 (_14 ` &<<DL&23  Ԁ&<<DL& ` *// (_13  #DL#23  Ԁ#DL#  *,, (_12   DL 23  Ԁ DL  *)) (_11 h DDL23  ԀDDL h Text19Text8Text9Text10Text11Check25Text12Text13Text14*&& (_10  L23  ԀL  (## &_9   L23  Ԁ L  (>> &_8  2( 4 <DL223  2( 4 <DL2  (DD &_7   ," <DL,23  ," <DL,   (55 &_6  ) <DL)23  ) <DL)  (22 &_5 ` &<<DL&23  &<<DL& ` (// &_4  #DL#23  #DL#  (,, &_3   DL 23   DL  ()) &_2 h DDL23  DDL h Check20Text27Text28Text29Check21(&& &_1  L23  L  &## $_   L23   L  <:Default ParaCheck22Check43Check44Check45Check46Check47Text33Check23 0#h%d#  Z2A$`(Arial Unicode MSCheck13Check14Check12Check11 !USUS.,  _Ry"8%%dd8@**(132a d  =XXdd=__ XXXX@@@ INTHEDISTRICTCOURTOF__________________COUNTY,KANSAS P  INTHEINTERESTOF (   #XXX X6# XXXXName_____________________________     p   CaseNo._____________   DOB#XXX X# XXXXxx#XXX X# XXXX/#XXX X'# XXXXxx#XXX Xj# XXXX/____A&#XXX X# XXXXԀmale&#XXX X# XXXXԀfemale   Name_____________________________     p   CaseNo._____________  ` DOB#XXX XK# XXXXxx#XXX X+# XXXX/#XXX Xp# XXXXxx#XXX X# XXXX/____A&#XXX X# XXXXԀmale&#XXX XG# XXXXԀfemale L  #XXX X# XXXXName_____________________________     p   CaseNo._____________ $  DOB#XXX X# XXXXxx#XXX X# XXXX/#XXX X# XXXXxx#XXX X># XXXX/____A&#XXX X# XXXXԀmale&#XXX X# XXXXԀfemale t  #XXX X # XXXX#XXX X} # XXXX -px (#X-     &X X*# XX & #ORDEROFTEMPORARYCUSTODY 8   #XXX X #L  M  L  M  <4!T$px (#<L  M  L  M   XXXXPursuanttoK.S.A.382243,K.S.A.382258,orK.S.A.382259and42U.S.C.671#XXX XO #L  M   XXXXetseq.#XXX X #L  M   XXXX r    #XXX X] #   XXXXSeparatejournalentrymustbeattached. ^ B p x (#4!T$B    Onthis%  _____% Ԁdayof%  -  _______________-  % ,%  20_____%Ԁtheabovecaptionedmattercomesbefore 6 theCourt. "      p      x   TheCourtfindsthattheIndianChildWelfareAct(_ICWA_) 0is#XXX X # XXXXapplicable0isnot  applicable0applicabilityisundetermined .Petitioner 0neednotgive0hasgiven0shall  give noticetotheTribe#XXX X}# XXXXԀandtheCourthasjurisdictiontoproceedtohearing. v   #XXX X# XXXXAjournalentryfullysettingouttheappearances,findingsandordersisattached.#XXX X%# XXXX R #XXX X# XXXX-XpX-  THECOURTFURTHERFINDSthereisprobablecausetobelievethattheallegationsin  * theapplicationforcustodyaretrueandthat: z! % A %A#XXX X# ,&0  AppropriatepublicorprivateagencieshavemadereasonableeffortsbuthavefailedtoL  M   XXXX R# maintainthefamilyandpreventtheremovalofthechildfromthechildshomeasfollows: >$  #XXX X#L  M   XXXX(Specifybasisforfindingforeachchild.)#XXX X#_______________________________________*%!(#(# Ѐ  ______% B -  __________________________________________________________________ &"   ________________________________________________________________________-  %BԀ ' #   ________________________________________________________________________ '!$   _______________________________________________________________________. (v"% % C %C_% D %D} )b#&    OR *N$' Ry R8%%d%%d8" R  X$ (#X$ % E %E ,  &  AppropriatepublicorprivateagenciesarenotrequiredtomakereasonableeffortstoL  M   XXXX d  maintainthechildinthehomebecauseanemergencyexistswhichthreatensthesafetyofthe P child.#XXX XG#L  M   XXXX(Specifybasisforfindingsforeachchild.)#XXX X7#L  M   XXXX__________________________________ <   ________________________________________________________________________ (  ________________________________________________________________________     ________________________________________________________________________     _______________________________________________________________________.     t   X! (#(#!  OR  `  % I %I,#XXX X# XXXX ,  &#XXX Xm#0  AppropriatepublicorprivateagenciesarenotrequiredtomakereasonableeffortsL  M   XXXXwith 8  respecttoaparentbecausetheparenthasbeenfoundbyacourttohave:#XXX X@# XXXX$ (#(# B+` 4` hp x (#(#B% J  ,&%Jd 4 committedmurderinthefirstdegree,K.S.A.213401,andamendmentsthereto;murder t  intheseconddegree,K.S.A.213402,andamendmentsthereto;capitalmurder,K.S.A. `  213439,andamendmentsthereto;voluntarymanslaughter,K.S.A.213403,and L  amendmentsthereto;orviolatedalawofanotherstatewhichprohibitssuchmurderor 8  manslaughterofanotherchildoftheparent; $ E.` 4` hp x (#` 4` XE% K &%K! 4 aidedorabetted,attempted,conspired,orsolicitedtocommitsuchmurderorvoluntary  manslaughterofanotherchildoftheparent;  _.*` 4` (#` , X*% L &%L" 4 committedafelonybatterythatresultedinbodilyinjurytothechildoranotherchildof  theparent; p ._E.` 4` hp x (#` ,(#E% M &%M# 4 subjectedthechildtoaggravatedcircumstancesasdefinedinK.S.A.382202_(c)_; \ _.*` 4` (#` , X*% N &%N$0 4 parentalrightsoftheparenttoasiblinghavebeenterminatedinvoluntarily.H4(#4(# (Specifybasisforfindingforea% O chchild)_______________________________________ 4 ________________________________________________________________________   ________________________________________________________________________ p  ________________________________________________________________________ \ ________________________________________________________________________ H  4 0 ! %O% !(#!(#     $ (#` ,(#$ OR  !  % P %P$(#XXX X# XXXX , , X  &#XXX Xe(# XXXXԀ#XXX X(#0  AppropriatepublicorprivateagencieshavenotmadeL  M   XXXXr#XXX Xy)#L  M   XXXXeasonable#XXX X)#L  M   XXXXԀefforts.#XXX X/*#L  M   XXXX(Specifybasisfor " findingforeachchild.)#XXX X*#L  M   XXXXԀ#XXX X++# XXXX_____________________________________________________# (#(#   ________________________________________________________________________ $l!   ________________________________________________________________________ %X"   ________________________________________________________________________ &D #   _______________________________________________________________________. '0!$  X( ,( ("%   ,AND l)#&   X*#'  #XXX Xn+# XXXX  ,&#XXX X>.# XXXX0  #XXX X.#ThereisprobablecausetobelievethatL  M   XXXX:#XXX X'/#L  M   XXXX&#XXX X/#SXMXXXԀ#XXXSXM/#L  M   XXXXthechildislikelytosustainharmifnot d immediatelyremovedfromthehome; #XXX X0#L  M   XXXXԀ#XXX X0#L  M   XXXX&#XXX X41#SXMXXXԀ#XXXSXMz1#L  M   XXXXremaininginthehomeorreturninghome p   wouldbecontrarytothewelfareofthechild; #XXX X1#L  M   XXXXand/or#XXX X2#L  M   XXXXԀ#XXX X2#L  M   XXXX&#XXX XV3#SXMXXXԀ#XXXSXM3#L  M   XXXXimmediateplacementisinthe | bestinterestofthechild #XXX X3#L  M   XXXX,specifically:(#XXX X4#L  M   XXXXSpecifybasisforfindings.#XXX X5#L  M   XXXX)#XXX Xv5#_______________  $ ________________________________________________________________________x (#(#   ________________________________________________________________________ d    ________________________________________________________________________ P    _______________________________________________________________________. <       THECOURTTHEREFOREORDERSTHATtheabovenamedchild% T %T7ԀL  M   XXXXshallbe #XXX X 8#L  M   XXXX% U %U8placedinthe   temporarycustodyof:    ,#XXX Xn8# 3` ` L!T$(#3L  M   XXXX 4 #XXX X~9# XXXX&#XXX X9#L  M  SXMXXXԀ#XXXSXM&:#L  M  SXMXXX__________________________________________,#XXXSXM}:#L  M   XXXXaparent. x   4 #XXX X:# XXXX&#XXX Xl;#L  M  SXMXXXԀ#XXXSXM;#L  M   XXXX_________#XXX X<#L  M   XXXX_____________#XXX X|<#L  M   XXXX____________________,#XXX X<#L  M  SXMXXXԀ#XXXSXMJ=#L  M   XXXXarelative.    4 #XXX X=# XXXX&#XXX X>#L  M  SXMXXXԀ#XXXSXMi>#L  M   XXXX______#XXX X>#L  M   XXXX_____________#XXX X?#L  M   XXXX______#XXX X?#L  M   XXXX_________________,anunlicensedpersonwith    4 #XXX X?#L  M   XXXXcloseemotion#XXX X@#L  M   XXXXal#XXX X@#L  M   XXXXԀtiesto#XXX X:A#L  M   XXXXԀ#XXX XA#L  M   XXXXthechild.   4 #XXX XA# XXXX&#XXX X\B#L  M  SXMXXXԀ#XXXSXMB#L  M   XXXX____#XXX X C#L  M   XXXX_____________#XXX XgC#L  M   XXXX___________#XXX XC#L  M   XXXX______________#XXX X+D#L  M   XXXX_,ayouthresidentialfacility.   4 #XXX XD# XXXX&#XXX XE#L  M  SXMXXXԀ#XXXSXMlE#L  M   XXXX_____#XXX XE#L  M   XXXX___________________________#XXX XF#L  M   XXXX___________,ashelterfacility.#XXX XF#L  M   XXXX  #XXX XG#L  M   XXXX% V  4 #XXX XpG# XXXX&#XXX XG#%VGL  M   XXXXԀTheSecretary#XXX X6H#L  M   XXXX% W %WH,ifthechildis15yearsofageoryounger,or16or17yearsofageifthe  childhasnoidentifiableparentalorfamilyresourcesorshowssignedofphysical,mental,  emotionalorsexualabuse#XXX XH#L  M   XXXX.#XXX XI#L  M  d XXXX x  d#XXX XVJ# XXXX   #XXX XJ# XXXX AND  P #XXX X$K# XXXX  9,XI` ` X![9  &#XXX XK# XXXXԀAchildsupportordershallissue. ( #XXX XL# XXXX0  &#XXX XL# XXXXԀEachparentshallsubmitinformationtothechildsupportofficeforachildsupportorder d tobeprepared,orpresentdocumentationofacurrentchildsupportorderwithin____days#XXX XL# XXXX.#XXX XM# XXXXP (#(# #XXX X9N# XXXXB p x (#,XI[B    * (#pX*  dTHECOURTFURTHERORDERSallprovidersofservices#XXX XN#L  M   XXXXԀ #XXX XO#L  M   XXXXincludingeducationalservices#XXX XP#L  M   XXXX, # treatment,#XXX XP#L  M   XXXXeducation#XXX XQ#L  M   XXXXԀorcareofthechildandfamily,evenifnotspecificallyreferredtoherein,to $ provideinformation#XXX XaQ#L  M   XXXXincluding#XXX X1R#L  M   XXXXԀ#XXX XR#L  M   XXXXanyandalleducationalrecords#XXX XR#L  M   XXXXԀtothesecretary,anyentityproviding $  servicestothechildandfamily,counselforthepartiesincludingthecountyordistrictattorney, %x! appointedCASA,CitizenReviewBoardmembers,thecourt,andeachothertotheextentneededto &d " ensurethesafetyofthechild,preventfurtherabuseorneglect,andtoprovideappropriatetreatment#XXX X\S#L  M   XXXX, 'P!# careandservices#XXX XAU#L  M   XXXXԀtothechildandfamily.Thisorderencompasses#XXX XU#L  M   XXXXandcomplieswith#XXX XEV#L  M   XXXXԀtheprovisions (<"$ ofthe#XXX XV#L  M   XXXXFamilyEducationRightsandPrivacyAct(20U.S.C.1232g;34_C.F.R._Ԁ99#XXX X-W#L  M   XXXXԀ#XXX XW#L  M   XXXXandthe#XXX X@X#L  M   XXXXԀPrivacy )(#% RuleoftheHealthInsurancePortabilityandAccountabilityActof1996(_HIPAA_),45_C.F.R._ x*$& 164.512(e)(1).#XXX XX#d XXXX d+%' #XXX XY# P,%(  XXXX ,&#XXX X,Z#0  Arestrainingordershallbepreparedby________________________,filed,andserved d upon_______________________________________. XXXXP(#(# #XXX X"[# XXXX <  (    THECOURTFURTHERORDERSthismattersetfor% . -  ________________-  %.\Ԁhearing#XXX X[# XXXXbefore#XXX X\#   theCourtonthe% / -  ______-  %/]Ԁdayof% 0 -  ___________________-  %0V],% 1 -  20_____-  %1],at% 2 -  ____:____-  %2]Ԁ  XXXX&#XXX X;^#Ԁa.m.% 4 %4^ XXXX&#XXX X^#Ԁp6 p x (#(#6.m.  v    z < rp x (#pX< r ITISSOORDEREDTHIS% 5 -  _____-  %5_Ԁdayof% 6 -  ____________________-  %6_,% 7 -  20_____-  %7V`. @  [< p x (#rpX<     p  *  3pf!(#pX3     p ________________________ z       p JudgeoftheDistrictCourt f  @*  L  M  L  M  642!T$pf!(#6L  M  L  M   XXXX&#XXX Xb#L  M  SXMXXXԀ#XXXSXMc#L  M   XXXXThecourtprovidedtheparents,grandparentsand/orinterestedparties,whowerepresentat >  thishearingandwhohadnotpreviouslyreceivedthem,withinformationmaterialspertainingtotheir J respective#XXX Xmc#L  M   XXXXrightsandresponsibilities#XXX Xd#L  M   XXXXԀinconnectionwiththeproceedings#XXX X)e#L  M   XXXX.#XXX Xe#L  M   XXXX 6   #XXX Xe#  @*         n  Z  F  2   @jj&Authority n   Z  K.S.A.382243and XXXX42U.S.C.#XXX Xg# XXXXԀ671etseq.#XXX Xg# F! @* #! @$NotesonUse  $"  $#     Thisistheshorttemporarycustodyformforuseinconjunctionwithajournalentrydrafted %~$ bycounselthatrecitestheappearances,findingsandordersofthecourt.Form132b,thelong &j % temporarycustodyform,maybeusedwithoutaseparatejournalentry,asitincludesarecitationof 'V!& appearancesandspaceforfindingsandorderofthecourt. (B"'   Ifthecourt,inissuingthisorder,removesthechildfromthehome,andifitisthefirstorder ).#( removingthechildfromthehomeorthefirstorderofremovalwhenthechildhasbeenhomeforsix ~*$) monthsorlonger,SupremeCourtAdministrativeOrderNo.155appliesandrequirestheuseofthis j+%* formoranotherformapprovedbytheSupremeCourtasmeeting_ASFA_Ԁrequirements.Failureto d makeandproperlydocumentthefindingsrequiredby_ASFA_Ԁwillresultinthelossoffederalfunding P fortheplacement,oranysubsequentplacement,ofthechildinthepresentcase.L  M   XXXXFederalfundingis < notavailable#XXX Xrm#L  M   XXXXԀunlessthecourtfindsboththatitiscontrarytothewelfareofthechildtoremaininthe (  home#XXX Xm#L  M   XXXXԀ#XXX Xn#L  M   XXXXandreasonableeffortshavebeenmade#XXX Xo#L  M   XXXXor#XXX Xo#L  M   XXXXԀwerenotrequired.Failuretomakethesefindings   doesnotbarthecourtfromremovingthechild.#XXX Xo#     Whenacourthasreasontobelieveachildinvolvedinachildinneedofcareproceedingis   anIndianchild,ICWAapplies;noticerequirements,findingsandprocedurearedictatedbyICWA,  t andtheICWAforms(Forms210!223)mustbeused.RemovalofanIndianchildfromthehome  ` isprohibitedwithoutthespecificfindingsrequiredbyICWAeitherenteredwiththeorderof L  removal,orwithin90daysiftheremovalwasduetoanemergency.Thecircumstancesunderwhich 8  acourthasreasontobelieveachildisanIndianchildinclude,butarenotlimitedto,thefollowing: $  anypartytothecase,Indiantribe,oragencyinformsthecourtthatthechildisanIndianchild;any t  agencyinvolvedinchildprotectionservicesorfamilysupporthasdiscoveredinformationsuggesting `  thatthechildisanIndianchild;thechildgivesthecourtreasontobelieveheorsheisanIndian L  child;theresidenceofthechild,parent(s),orcustodianisknowntobeapredominantlyIndian 8  community;aparentofthechildisenrolledinatribe;oranofficerofthecourthasknowledgethat $ thechildmaybeanIndianchild.DepartmentoftheInterior,BIAGuidelinesforStateCourts,Indian  ChildCustodyProceedings.ThecourtshouldinquireaboutpossibleIndianheritageofthechild,  andthestateandthesecretaryshouldbepursuingICWAinformationatthistime.    Thecourtmayissueatemporarycustodyorderafterahearinganduponmakingprobable p causefindingsasrequiredby_ASFA_ԀandK.S.A.382243(_i_),whicharesetoutinthisform.The \ statuterequiresthatthetemporarycustodyhearingtakeplacewithin72hours(notincluding H Saturday,SundayL  M   XXXX,#XXX X y#L  M   XXXXԀlegalholidays#XXX Xcy#L  M   XXXXanddaysonwhichtheclerkofthecourtisnotavailable#XXX Xy#L  M   XXXX)ofthe 4 executionofaprotectivecustodyorder(Form106)orofachildsbeingadmittedtoaplacement   whileinpoliceprotectivecustodypursuanttoK.S.A.382232(e).Noticeofthetemporarycustody p  hearingshallbegiventoallpartiesandinterestedpartiesatleast24hourspriortothehearing.Oral \ noticemaybeusedifthereisinsufficienttimetogivewrittennotice.Oralnoticeiscompletedupon H thefilingofacertificateoforalnotice(Form131). 4  #XXX XXz#  Thecourtmayenterarestrainingorder(Form134)againstanyallegedperpetratorof  ! physical,sexual,mentaloremotionalabuseofthechild.Thereisaprovisioninthisformdirecting  " thatarestrainingorderissuepursuanttoK.S.A.382243(h). "   IfthepetitionallegesthatthechildisarunawaypursuanttoK.S.A.382202(d)(9)or(d)(10), #  butthechildhasnotyetbeenadjudicatedasarunaway,thentheordermaydirectthatthechildbe $l! detainedinasecurefacility,whichmaybeajuveniledetentionfacility,butnotformorethan24 %X" hours,notincludingSaturdays,SundaysL  M   XXXX,#XXX X#L  M   XXXXԀlegalholidays#XXX X5#L  M   XXXXԀanddaysonwhichtheclerkofthecourtis &D # notavailable#XXX X#L  M   XXXX.Thetimelimitationof24hoursisthetotaltimepermittedinasecurefacilitywhether '0!$ bypoliceprotectivecustodyorcourtorder.Ifthecourtawardscustodyofthechildtothesecretary ("% thenthesecretaryshallhavetheauthoritytoplacethechild,andthecourtmaymakeplacement l)#& recommendations.Ifthecourtawardscustodytothesecretary,thenthecourtisrequiredtoprovide X*#'  thesecretarywithacopyofanyordersentered.#XXX X># D+$(   Theorderoftemporarycustodyshallremainineffectuntilmodifiedorrescindedoruntila d  dispositionorderisentered,butnotexceeding60days,unlessgoodcauseisshownandstatedonthe P record.Thecourtshallmakeachildsupportdeterminationifthechildisplacedwithapersonother < thantheparent. (    Whentheterm orstandsalonebetweenoptionalfindings/orders,morethanonechoicemay   bechecked.Eachchoicecheckedmustbejustifiedasinstructed,e.g.specifybasisforfindingfor   eachchild.     t   ` @::&Comments L   8    Anorderoftemporarycustodyisafinalorderthatmustbeappealedwithin30daysafter $  entryofjudgment.Inre_D.I.G._,3 XXXX4_Kan_.App.2d34,114P.3d173(2005).#XXX X# t