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Formulario de admisión de Servicios de la corte de familia

Usted ha sido remitido a Servicios de la corte de familia para que lo ayuden a desarrollar un plan de crianza o de visitas para los niños en este caso. El propósito de este formulario de admisión es recopilar la información necesaria para ayudar a las partes a llegar a un acuerdo sobre las decisiones de crianza y la crianza compartida o las visitas con los niños, y para detectar posibles problemas de seguridad. Este formulario es para uso exclusivo del mediador/consejero recomendante y no se presentará en el caso judicial. Cualquier papeleo que desee que la corte considere tiene que presentarse por separado ante el secretario de la corte.

Todos los campos con asterisco (*) son obligatorios

Las sesiones de asesoría de recomendación de custodia de los hijos y mediación voluntaria se llevarán a cabo en privado, y todas las comunicaciones escritas y verbales se considerarán “información oficial” (Código de Pruebas, sección 1040). Sin embargo, cualquier información puede ser compartida con la corte.

Hay dos tipos de mediación que se ofrecen en el condado de Tulare. Si no está seguro del tipo de cita que tiene, comuníquese con Servicios de la corte de familia para obtener más información.

  • Asesoría de recomendación de custodia de los hijos (CCRC, por sus siglas en inglés): ordenada por la corte: el contenido de la sesión no es confidencial a la corte. Si las partes llegan a un acuerdo en la sesión, el consejero recomendante redacta el acuerdo, las partes firman (si está representado por un abogado, el abogado firma) y se entrega el informe al funcionario judicial para que lo firme. Una vez que el informe se convierte en una orden de la corte, se proporciona una copia del informe a las partes y se archiva en la parte pública del expediente de la corte.

    Si no hay un acuerdo entre las partes, el consejero prepara un informe con recomendaciones para la corte que se archiva en una sección confidencial del expediente de la corte y se entrega a las partes antes de la audiencia en la corte. El informe es confidencial para todos excepto para las partes, el funcionario judicial y algunos miembros del personal de la corte.

  • Mediación confidencial (voluntaria): el contenido de la sesión es confidencial para todos menos para las personas en la sesión y sus abogados. Si las partes llegan a un acuerdo en la sesión, este acuerdo es redactado y firmado por las partes y sus abogados y luego entregado al funcionario judicial para su firma. Las partes recibirán copias de la orden firmada. Este informe se archiva en la parte pública del expediente de la corte. Si las partes no llegan a un acuerdo en la sesión, no se redacta ningún informe para la corte. Si una parte desea modificar una orden de custodia y visitas, la parte deberá presentar una moción ante la corte y las partes pueden ser enviadas a una sesión ordenada por la corte en ese momento.

Tanto en la Asesoría de recomendación de custodia de los hijos como en la mediación, hay ciertas situaciones en las que el mediador puede revelar información sin su permiso. No están obligados a informarle de sus acciones a este respecto.

  • Si amenaza con lastimar a otra persona, si amenaza con lastimarse a sí mismo, o si el mediador/consejero recomendante tiene motivos para sospechar maltrato o negligencia de menores, el mediador/consejero recomendante puede comunicarse con la persona/agencia protectora correspondiente.

Case Information

Mandatory Orientation Prior to Mediation Session

Have you completed the required 30 minute video entitled: Orientation to Family Court Mediation and Child Custody Recommending Counseling?

If No, STOP and complete Part One of the orientation before continuing.

The following 2-3 hour Parenting After Separation Online Course is HIGHLY RECOMMENDED to prepare you for your session. This Course also provides a Certificate of Completion at the end and you may file this with the Court, although this is voluntary. https://pas.familieschange.ca.gov/

Is this your first time you have attended mediation in Tulare County?
Do you currently have a Court order for custody and visitation in Tulare County?
Do you have a full agreement with the other parent that you would like written up by the Court?
Do you currently have a Court order for custody and visitation in another County?

Personal Information

Distance Between Homes and Availability of Transportation

Distance between the home of the parties:
I have the following transportation available:

Employment

If unemployed, enter “unemployed”:

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Your Attorney

Name Phone Number Fax Number

Minor Children in This Case

First Name Last Name Date of Birth Age School

Other People Living in Your Home

First and Last Name Age Relationship

Current Relationship

Do you and your current spouse, or partner, reside in the same home?

History of Relationship to Parent in this Case

If not married to the other parent, did you live together?

Well Being

Do the children have any special educational/emotional/health needs that could impact custody and/or visitation?

Safety

Do you have any safety concerns regarding the children spending parenting time with the other parent?
If No, proceed to the next section. If Yes, please mark the safety areas below:

Domestic Violence

Is there currently a Protective Order (Restraining Order or Criminal Protective Order) in effect protecting you, your children, the other parent, or the significant other of the other parent?

*THIS IS A REQUIRED FIELD
If No, proceed to the next section.

Are you, under penalty of perjury, alleging that there is a history of domestic violence between you and the other parent?

*THIS IS A REQUIRED FIELD
If no, proceed to the next section. If YES, please complete Part Three of this Orientation (on the previous page).

After reading Family Code Section 3044, please answer the following questions:

Family Code Section 3044

Pursuant to Family Code Section 3113 and 3181, are you requesting a separate mediation session due to a history of domestic violence between you and the other parent?

If yes, enter date of last incident 
If no, marking below indicates you are waiving your right to separate mediation session.

If there is a protective order in place, pursuant to Family Code Section 6303, are you requesting a support person be present during your session?

If no, marking below indicates you are waiving your right to having a support person present.
If yes, provide the name and relationship of the person. That person will sign a confidentiality agreement at the beginning of the session.

Criminal History

Have you ever been arrested, or been in jail or prison?

If Yes, please provide the arrest information below:
 

Date of Arrest County/State in Which Arrest Occurred Reason for Arrest Arresting Agency
Are you, under penalty of perjury, required to be registered as a sex offender under Section 290 of the Penal Code where the victim was a minor?
Is anyone else in your household, or your significant other required to be registered as a sex offender under Section 290 of the Penal Code where the victim was a minor?

Alcohol / Drug Abuse

Do you or have you ever abused the following:

Child Abuse

FAMILY CODE §3027: Monetary Sanctions for False Accusations of Child Abuse or Neglect. (a) If a Court determines that an accusation of Child Abuse or Neglect made during a child custody proceeding is FALSE at the time the accusation was made, the Court may impose reasonable monetary sanctions not to exceed ALL COSTS INCURRED BY THE PARTY ACCUSED AS A DIRECT RESULT OF DEFENDING THE ACCUSATION and reasonable attorney fees incurred in recovering sanctions against the person making the accusation. For the purpose of this section, “person” includes “a witness”, a “party” or a “party’s attorney.
 

Is there currently, or has there ever been, a reasonable suspicion of child abuse?

If Yes, please provide this information in the Incident table below. If no, proceed to the Parenting Plan And Strengths Assessment.
 

Has Juvenile Court filed a dependency petition for any of the children in this case?

 If Yes, when and for whom was dependency initiated?

Type of Abuse (check all that apply)
Was the Incident Reported to CPS or Police?
Type of Abuse (check all that apply)
Was the Incident Reported to CPS or Police?
Type of Abuse (check all that apply)
Was the Incident Reported to CPS or Police?

Parenting Plan and Strengths Assessment

What kinds of communication do you have with the other parent regarding the children? (Check all that apply)
Is this communication working?

Session Attendance Preferences

Do you prefer to attend your session (select all that apply)

When you select “Submit”, this intake form will be electronically sent to Family Court Services. You will also receive a confirmation email with a copy of your submitted intake form. This is confirmation that we received your email. Please check your spam and junk folders in your email in case the confirmation is sent there. When the Court ordered for you to attend Child Custody Recommending Counseling or Mediation, you were provided an information sheet with instructions on how to participate in your session (it has a QR code on it which led you to this orientation site).

Should your contact information change prior to your mediation session, you must notify Family Court Services immediately at: (559) 730-5000 Option 6. Failure to provide correct contact information may result in delays to your case.
 

 

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