CASA REPORT

CHILD(REN)’S NAME:
GENDER(S):
DOB(S):
EMAIL:
HEARING DATE: TIME:
TYPE OF HEARING (Select One):
Ratification*, Merits, Review, Custody, Visitation, TPR, Other

*Reminder that T.C.A. § 37-2-409 requires the child (regardless of age) to appear before the court when permanency plans are being ratified.

BRIEF HISTORY OF THIS CASE


CURRENT TYPE OF PLACEMENT (Select One):

DCS Foster Home
Relative Placement
Trial Home Visit
In Home with Safety Plan
Other

HAS PLACEMENT CHANGED SINCE LAST HEARING?: Yes  No

If Yes, please explain:

PARENTAL RIGHTS TERMINATED: Yes  No

BASIS FOR COURT INVOLVEMENT (Select One):

Physical Abuse
Sexual Abuse
Neglect
Drug Exposure
Environmental Neglect
Custody
Courtesy Visit
Supervised Visitation
Other:


CRIMINAL RECORDS CHECKS COMPLETED ON THESE PARTIES



THE CASA ADVOCATE BELIEVES

The child/ren is/are safe from threat of physical injury and emotional abuse in his/her current circumstance.
Yes  No  Somewhat

If response is other than Yes, please explain:

The educational needs of each child are being appropriately addressed. Yes No      Somewhat

If response is other than Yes, please explain:

The medical needs of each child are being appropriately addressed. Yes No  Somewhat

If response is other than Yes, please explain:

Siblings are provided appropriate contact. Yes  No  Somewhat  N/A

If response is other than Yes, please explain:

Are all previous court orders being followed with regard to services ordered for the child and family? Yes  No  Somewhat

If response is other than Yes, please explain:

CHILD’S POSITION


HOMES EVALUATED FOR INCLUSION IN THIS REPORT

Please see attached reports on the following homes:

Address:

Overall, based on CASA’s observations, is this home safe for this child(ren) at this time?
Yes  No  Somewhat    N/A

If response is other than Yes, please explain:

Address:

Overall, based on CASA’s observations, is this home safe for this child(ren) at this time?
Yes  No  Somewhat N/A

If response is other than Yes, please explain:

Address:

Overall, based on CASA’s observations, is this home safe for this child(ren) at this time?
Yes   No   Somewhat  N/A

If response is other than Yes, please explain:

 

SUPERVISED VISITATION SUMMARY

Who is visiting?
What is the visitation schedule?
Have any visits been cancelled? Yes No

If Yes, who cancelled, how many times, and for what reason?
Brief summary of how the visits have gone:
Any concerns or other relevant information relating to these visits:

RECOMMENDATIONS/NEXT STEPS



Respectfully submitted by:
Court Appointed Special Advocate, Madison County CASA

CASA Staff Member Reviewing and Approving this Report:

Any other comments or concerns the court should be aware of?