Form JV-535(A) "Attachment to Order Designating Educational Rights Holder" - California

What Is Form JV-535(A)?

This is a legal form that was released by the California Judicial Branch - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2020;
  • The latest edition provided by the California Judicial Branch;
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  • Fill out the form in our online filing application.

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Download Form JV-535(A) "Attachment to Order Designating Educational Rights Holder" - California

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JV-535(A)
CASE NUMBER:
CHILD'S NAME:
General Information
1.
Child's or youth's date of birth:
Child's Statewide Student Identifier (SSID):
Indian child's tribe (if applicable):
Address:
City:
Zip Code:
Email:
Phone No.:
School information
2.
a.
School district (local educational agency or LEA):
b.
School (name and address):
c.
Foster youth educational liaison (Ed. Code, § 48853.5) (name and contact information):
d.
The child is currently expelled from school and may be eligible for readmission on or after (date):
3.
County office of education (name and address):
Foster youth service coordinator (name and contact information):
4.
Regional center (name and address):
Service coordinator (name and contact information):
5.
County placing agency (specify):
a.
Assigned social worker or probation officer (name and contact information):
b.
Supervising social worker or probation officer (name, address, and contact information):
6.
CASA organization (name and address):
Court Appointed Special Advocate (CASA) (name and contact information):
7.
Child's or youth's attorney (name, address, and contact information):
THE COURT FINDS AND ORDERS
The child or youth is the subject of a petition filed under section 325. The child's parent, guardian, or Indian custodian is
8.
unavailable, unable, or unwilling to exercise educational or developmental services rights; the agency has made diligent
efforts to locate and secure the participation of the parent, guardian, or Indian custodian in educational and developmental-
services decisionmaking; and the child's or youth's educational and developmental-services needs cannot be met without the
temporary appointment of a responsible adult as educational rights holder.
Limitation of the rights of the parent(s), guardian(s), or Indian custodian(s)
educational
developmental services
9.
to make decisions is necessary to protect the child or youth.
The youth is at least 18 years old and
10.
has chosen not to make
educational
developmental-services
decisions for the youth.
a.
is deemed incompetent to make educational or developmental-services decisions for the youth.
b.
(If 10a or 10b is checked): The appointment of an educational rights holder to make developmental-service decisions for the
11.
youth is in the youth's best interests.
Page 1 of 3
Form Approved for Mandatory Use
Welfare and Instituions Code, §§ 361, 726
ATTACHMENT TO ORDER
Judicial Council of California
Cal.Rules of Court, rules 5.502, 5.649, 5.650, 5.651
DESIGNATING EDUCATIONAL RIGHTS HOLDER
JV-535(A) [Rev. September 1, 2020]
www.courts.ca.gov
JV-535(A)
CASE NUMBER:
CHILD'S NAME:
General Information
1.
Child's or youth's date of birth:
Child's Statewide Student Identifier (SSID):
Indian child's tribe (if applicable):
Address:
City:
Zip Code:
Email:
Phone No.:
School information
2.
a.
School district (local educational agency or LEA):
b.
School (name and address):
c.
Foster youth educational liaison (Ed. Code, § 48853.5) (name and contact information):
d.
The child is currently expelled from school and may be eligible for readmission on or after (date):
3.
County office of education (name and address):
Foster youth service coordinator (name and contact information):
4.
Regional center (name and address):
Service coordinator (name and contact information):
5.
County placing agency (specify):
a.
Assigned social worker or probation officer (name and contact information):
b.
Supervising social worker or probation officer (name, address, and contact information):
6.
CASA organization (name and address):
Court Appointed Special Advocate (CASA) (name and contact information):
7.
Child's or youth's attorney (name, address, and contact information):
THE COURT FINDS AND ORDERS
The child or youth is the subject of a petition filed under section 325. The child's parent, guardian, or Indian custodian is
8.
unavailable, unable, or unwilling to exercise educational or developmental services rights; the agency has made diligent
efforts to locate and secure the participation of the parent, guardian, or Indian custodian in educational and developmental-
services decisionmaking; and the child's or youth's educational and developmental-services needs cannot be met without the
temporary appointment of a responsible adult as educational rights holder.
Limitation of the rights of the parent(s), guardian(s), or Indian custodian(s)
educational
developmental services
9.
to make decisions is necessary to protect the child or youth.
The youth is at least 18 years old and
10.
has chosen not to make
educational
developmental-services
decisions for the youth.
a.
is deemed incompetent to make educational or developmental-services decisions for the youth.
b.
(If 10a or 10b is checked): The appointment of an educational rights holder to make developmental-service decisions for the
11.
youth is in the youth's best interests.
Page 1 of 3
Form Approved for Mandatory Use
Welfare and Instituions Code, §§ 361, 726
ATTACHMENT TO ORDER
Judicial Council of California
Cal.Rules of Court, rules 5.502, 5.649, 5.650, 5.651
DESIGNATING EDUCATIONAL RIGHTS HOLDER
JV-535(A) [Rev. September 1, 2020]
www.courts.ca.gov
JV-535(A)
CASE NUMBER:
CHILD'S NAME:
The court has denied or terminated reunification services for the parent, guardian, or Indian custodian, and the child or youth
12.
is placed in a planned permanent living arrangement under section 366.21(g)(5), 366.22, 366.26, 366.3(i), or 727.3(b)(5)
(6).
is
is not
13. There
a responsible adult relative, nonrelative extended family member, or other adult known to the child
who is available and willing to serve as the educational rights holder.
14. The child or youth is receiving special education, general education accommodations and modifications, early intervention services,
Yes
No
or developmental services.
The child or youth is receiving services under the following plan (check all that apply):
15.
Individualized education program (IEP)
a.
Section 504 plan
b.
Individualized family service plan (IFSP)
c.
Individual program plan (IPP)
d.
Special education local plan area (SELPA)
e.
Other (explain):
f.
The LEA, SELPA, or regional center must provide a copy of any plan to the designated educational rights holder.
The child or youth needs the following educational or developmental assessments or services (check all that apply):
16.
The child is 0–3 years old, is at risk for a disability or has a developmental delay, and needs assessment for services.
a.
The child is 0–3 years old, has a disability, and needs the development of an IFSP.
b.
The child or youth is 3 years old or older, may have a disability, and needs intake and assessment for services.
c.
d.
The child or youth is 3 years old or older, has a disability, and needs the development or revision of an IEP, IPP, or
Section 504 plan.
17. The appointed educational rights holder must (check all that apply):
Submit to the LEA a written referral for assessment for special education and related services or for services under
a.
section 504 of the Rehabilitation Act of 1973.
Submit to the regional center a written referral for an initial intake and eligibility assessment or evaluation.
b.
Submit to the LEA a written referral for assessment or services, or a written request to convene the IEP team to
c.
develop, review, or revise the pupil's IEP.
Submit a written request to the regional center to convene the IFSP team to develop, review, or revise the IFSP.
d.
Submit a written request to the regional center to convene the IPP team to develop, review, or revise the IPP.
e.
Other:
f.
The following person is directed under rule 5.649(c)–(d) to take whatever steps are necessary to request any assessments
18.
or services identified in item 14 or 15 (name and address unless confidential):
The current educational program and school placement are in the best interests of the child or youth.
19.
The current IFSP, IPP, or other developmental services plan is in the best interests of the child or youth.
20.
is
is not
The child or youth
attending the child's or youth's school of origin. If not,
21.
has
has not
a. The educational rights holder
waived the child's or youth's right to attend the school of origin.
has not
has
b. The child or youth
waived the child's or youth's right to attend the school of origin.
The county placing agency has considered educational stability and the opportunity to be educated in the least restrictive
22.
educational program when making placement decisions for the child or youth.
ATTACHMENT TO ORDER
JV-535(A) [Rev. September 1, 2020]
Page 2 of 3
DESIGNATING EDUCATIONAL RIGHTS HOLDER
JV-535(A)
CASE NUMBER:
CHILD'S NAME:
Educational Rights Holder Service of Process Check Box
Mandatory:
4.
Attorney for child or youth
1.
Social worker
Probation officer
a.
Name:
a.
Name:
b.
Mailing or electronic service address:
b.
Mailing or electronic service address:
c.
Date of service:
c.
Date of service:
d.
Method of service:
d.
Method of service:
County Office of Education Foster Youth Services
5.
Child (if 10 years of age or older)
2.
Coordinator
a.
Name:
a.
Name:
b.
Mailing or electronic service address:
b.
Mailing or electronic service address:
c.
Date of service:
c.
Date of service:
d.
Method of service:
d.
Method of service:
Local Foster Youth Educational Liaison
6.
Educational Rights Holder
3.
a.
a.
Name:
Name:
b.
Mailing or electronic service address:
b.
Mailing or electronic service address:
c.
Date of service:
c.
Date of service:
d.
Method of service:
d.
Method of service:
Mandatory, if applicable:
1.
Regional Center Service Coordinator
Tribe/Bureau of Indian Affairs
3.
a.
Name:
a.
Name:
b.
Mailing or electronic service address:
b.
Mailing or electronic service address:
c.
Date of service:
c.
Date of service:
d.
Method of service:
d.
Method of service:
2.
CASA Volunteer
If requested and entitled to notice under § 293:
a.
Name:
Other (specify):
1.
b.
Mailing or electronic service address:
a.
Name:
b.
Mailing or electronic service address:
c.
Date of service:
d.
Method of service:
c.
Date of service:
If appropriate:
d.
Method of service:
Other (specify):
2.
1.
Mother
Father
Legal guardian
a.
Name:
a.
Name:
b.
Mailing or electronic service address:
b.
Mailing or electronic service address:
c.
Date of service:
c.
Date of service:
d.
Method of service:
d. Method of service:
Other (specify):
3.
2.
Indian custodian
a.
Name:
a.
Name:
b.
Mailing or electronic service address:
b.
Mailing or electronic service address:
c.
Date of service:
c.
Date of service:
d. Method of service:
d.
Method of service:
ATTACHMENT TO ORDER
JV-535(A) [Rev. September 1, 2020]
Page 3 of 3
DESIGNATING EDUCATIONAL RIGHTS HOLDER
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