At the initial hearing for a WIC 300, WIC 342, or WIC 387 petition, the Hearing Officer will, by law, direct each parent/legal guardian present to provide complete medical, dental, mental health, and educational information on the child and on the child’s mother and biological father to his/her attorney, court staff, the CSW, or other DCFS representative. The JV-225, Health and Education Questionnaire, is used to obtain this information. The Questionnaire includes the California Rules of Court 5.668, which clarifies when and how to complete and distribute the JV-225.

When ordered by the Hearing Officer, the parent/legal guardian’s attorney will provide the parent with the JV-255 to complete. Upon the parent/legal guardian’s completion of the form, the attorney will give the JV-225 to the Juvenile Court Services (JCS) CSW. The JCS CSW is required to provide the child’s attorney with a copy of the completed Questionnaire by attaching the completed JV-225 to the jurisdictional/dispositional hearing report.

The Health and Education Questionnaire procedures apply to all new court cases. They do not apply to Voluntary Family Reunification (VFR)The foster care placement of a child by or with the participation of DCFS acting on behalf of CDSS, after the parent(s)/guardian(s) of the child have requested the assistance of DCFS and signed a voluntary placement agreement form. or Voluntary Family Maintenance (VFM)The provision of non-court, time-limited protective services to families whose children are in potential danger of abuse, neglect, or exploitation when the children can safely remain in the home with DCFS services. In order to receive VFM services, the family must be willing to accept them and participate in corrective efforts to ensure that the child's protective needs are met. There is a six-month time limit for this service. cases. They also do not apply to parents/legal guardians who are not present at the initial hearing.

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PROCEDURE

Receiving the Questionnaire at the Detention Hearing

Juvenile Court Services CSW Responsibilities

Review the JV-225, Health and Education Questionnaire, upon receipt from the parent/legal guardian’s attorney.

Date the bottom of the JV-225.

Attach the JV-225 to the petition packet.

Forward the petition packet to the Juvenile Court Services liaison support staff for processing and distribution to the Regional Offices.

Document on the Detention Calendar that the JV-225 was sent to the Regional OfficeThe DCFS office that is responsible for providing services to the child, youth, dependent, or nonminor dependent. Usually, the office where the child's CSW is located.(s).

If the JV-225 was not received from the parent/legal guardian’s attorney or was incomplete upon receipt, document the reason why it was not received or was incomplete on the Detention Calendar and on the box copy.

Dependency Investigator (DI) or Case-Carrying CSW Responsibilities

Upon receipt of the jurisdictional/dispositional hearing packet, review the information documented on the JV-225.

If the child has medical, dental, psychological, or educational concerns and/or needs, inform the child’s case-carrying CSW.

Make two (2) copies of the JV-225.

Forward one (1) copy to the Public Health Nurse (PHN) and one (1) copy to the case-carrying CSW.

Place the original JV-225 in the Court Document folder.

If the JV-225 is incomplete:

Make reasonable efforts to have the parent(s)/legal guardian(s) complete the form prior to the jurisdictional/dispositional hearing.

Document in the jurisdictional/dispositional hearing report the reason given by the Juvenile Court Services (JCS) CSW as to why the JV-225 was not complete prior to the hearing.

Attach the completed JV-225 to the jurisdictional/dispositional hearing report.

Attach the JV-225 to the jurisdictional/dispositional hearing report and forward it to the SCSW for approval.

The legal requirement to provide the JV-225 to the child’s attorney is fulfilled by attaching it to the jurisdictional/dispositional report.

DI or Case-Carrying SCSW Responsibilities

Review the jurisdictional/dispositional hearing report for accuracy and completeness.

Ensure that a copy of the completed JV-225 is attached.

If not, ensure that the reason why it is not attached is documented in the court report.

If the submitted jurisdictional/dispositional hearing report meets all requirements, approve it and submit the report to the court.

If the submitted jurisdictional/dispositional hearing report does not meet all requirements, return it to the CSW for corrective action.

Case-Carrying SCSW Responsibilities

Upon receipt of the JV-225, review the form for accuracy and completeness.

If the child has medical, dental, psychological, or educational concerns and/or needs, document this information in the appropriate sections of CWS/CMS.

Inform the child’s caregiver of the concern(s)/need(s), and take the appropriate action(s) to ensure that the child’s needs are met.

File the JV-225 in the Psychological/Medical/Dental/School Report folder.

Public Health Nurse (PHN) Responsibilities

Upon receipt of the JV-225, review the form for accuracy and completeness.

Enter all of the following, appropriate information regarding the child in the Health Notebook:

Birth history

Allergies

Injuries

Diseases

Disabilities

Include the following additional information, as appropriate:

Medication information

Information about medical equipment

The child’s use of glasses or hearing aids

Service provider information when linked to a specific diagnosis

Significant information about the child’s biological parent, under the Birth History tab.

If there are concerns regarding the information documented on the JV-225, discuss an appropriate course of action with the case-carrying CSW.

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APPROVALS

SCSW Approval

Jurisdictional/Dispositional hearing report

HELPFUL LINKS

Forms

LA Kids

JV-225, Health and Education Questionnaire

Referenced Policy Guides

0300-301.05, Filing Petitions

0300-503.10, Writing the Jurisdictional/Dispositional Hearing Report

Statutes

California Rules of Court (CROC) Chapter 12, Rule 5.668 – States, in part, that the court must order each parent and guardian to either complete “Your Child’s Health and Education” (form JV-225) or to provide the information necessary for the social worker or probation officer, court staff, or local child welfare agency representative to complete the form. Also states that the social worker or probation officer assigned to the dependency matter must provide the child’s attorney with a copy of the completed form.

Welfare and Institutions Code (WIC) Section 16010(f) – States, in part, that at the initial hearing, the court shall direct each parent to provide to the child protective agency complete medical, dental, mental health, and educational information, as well as the medical background, of the child and of the child’s mother and biological father, if known. Also states that the Juvenile Court shall create a form (JV-225) for the purpose of obtaining health and education information from the child’s parents or legal guardians at the initial hearing.

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