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JV-418
CHILD'S NAME:
CASE NUMBER:

DISPOSITIONAL ATTACHMENT: APPOINTMENT OF GUARDIAN (Welf. & Inst. Code, § 360(a))
1. The child is a person described under Welf. & Inst. Code, § 300 (specify all that apply): 300(a) 300(c) 300(e) 300(g) 300(i) 300(b) 300(d) 300(f) 300(h) 300(j) The child is adjudged a dependent of the court. Reasonable efforts were were not made to prevent or eliminate the need for removal from the home.

2. 3. 4.

The court advised the mother biological father legal guardian presumed father Indian custodian alleged father other (specify): that no reunification services will be provided as a result of the guardianship of the child established in this matter. legal guardian mother biological father presumed father Indian custodian alleged father other (specify): signed a Guardianship (Juvenile)--Consent and Waiver of Rights (form JV-419), agreeing to the guardianship of the child, the waiver of his or her rights to family maintenance services and family reunification services, and, in the case of an Indian child, the waiver of his or her rights under the Indian Child Welfare Act. A signed form JV-419 for each individual indicated above was filed with the court. The child signed a Guardianship (Juvenile)--Child's Consent and Waiver of Rights (form JV-419A), agreeing to the establishment of the guardianship and the waiver of his or her rights to family maintenance services and family reunification services. The child's signed form JV-419A was filed with the court. The child is prevented from providing a meaningful response to the request for guardianship and a waiver of his or her rights to family maintenance services and family reunification services because of the child's (1) age. (2) physical condition. (3) emotional condition. (4) mental condition. The child is an Indian child, and an authorized representative of the child's tribe signed a form JV-419 setting forth the tribe's agreement to the guardianship of the child, the waiver of the tribe's interests in family maintenance services and family reunification services, and the waiver of the tribe's rights under the Indian Child Welfare Act. The establishment of a legal guardianship is in the child's best interest. The county agency is ordered to release the child to the legal guardian named in item 10.

5. The

6.

a.

b.

7.

8. 9.

10. The court appoints (name): as the legal guardian of the child's guardianship.

person

estate

and orders the clerk of the court to issue letters of

Page 1 of 1 Form Approved for Optional Use Judicial Council of California JV-418 [Rev. January 1, 2007]

DISPOSITIONAL ATTACHMENT: APPOINTMENT OF GUARDIAN (Welf. & Inst. Code, § 360(a))

Welfare and Institutions Code, § 360(a); Cal. Rules of Court, rule 5.695 www.courtinfo.ca.gov American LegalNet, Inc. www.FormsWorkflow.com