Professional Documents
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PSI Report Sample
PSI Report Sample
1 C. RENETZKY CRT
PHONE #
2 (818) 509-0266
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SUPERIOR COURT OF CALIFORNIA
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COUNTY OF LOS ANGELES
5 JUVENILE COURT
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DEPT. DATE APP. / NON-APP.
205 02/26/2009 APPEARANCE
COURT NO.: CJ211 DCFS COURT NO.:
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JAIN: 8675309 DCFS JAIN:
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IN THE MATTER OF: PDJ NO.: A187 SID NO.:
10 SSN:
CASE NAME (LAST, FIRST, MIDDLE)
11 SMITH, JANE
AKA
12 LADY JANE MANSON
PROBATION OFFICER’S REPORT
USUALLY LIVES WITH CURRENT WHEREABOUTS
13 MOTHER JUVENILE HALL
CURRENT STATUS AREA DPO MAX CONFINEMENT TIME: 1 YEAR
654 WIC DKC CP-21 TIME SERVED:
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D.P.O RECOMMENDATION - CODE
654.2 WIC - 13 SCHOOL DATA
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SCHOOL
16 BEVERLY HILLS HIGH SCHOOL
GRADE ATTENDANCE STATUS
17 PERSONAL & FAMILY DATA: 9 POOR FULL-TIME
SEX AGE VERIFIED BIRTH DATE ETHNICITY LEGAL CUSTODY NATURAL PARENT’S MARITAL STATUS MOTHER’S MAIDEN NAME
18 F 14 04/20/1994 WHITE MOTHER DIVORCED SWEET
FATHER – (LAST, FIRST, MIDDLE I.) ADDRESS, ZIP CODE PHONE SSN DATE OF BIRTH
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STEPPARENT OR GUARDIAN
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STEPPARENT OR GUARDIAN
5 PRESENT OFFENSE:
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- 2- (– )
Prob. 1264-RO (Rev. 04/06)
RESTITUTION INFORMATION:
SOURCES OF INFORMATION:
✘ Victim(s) ✘ Witness(es) Police Report(s)
Probation Records Juvenile Court Records
Other (specify):
VICTIM INFORMATION ( ):
STATEMENT TAKEN (DATE): 02/03/2009
IN PERSON ✘ BY PHONE NO CONTACT MADE
LOCATION:
WRITTEN VICTIM’S STATEMENT
NO WRITTEN VICTIM’S STATEMENT
✘ VICTIM INFORMED OF RIGHT TO MAKE
STATEMENT AND TO BE PRESENT AT HEARING
VICTIM’S STATEMENT:
EVAN RACHEL WOOD STATED THAT AT THE TIME OF THE ATTACK BY THE
MINOR, SHE WAS KNOCKED DOWN TO THE FLOOR. UP TO AND INCLUDING THE TIME OF THE ATTACK
BY THE MINOR, SHE HAD DONE NOTHING TO PROVOKE OR WARRANT THE ATTACK BY THE MINOR. AS
A RESULT OF THIS BEATING AND KICKING BY THE MINOR, SHE SUFFERED SEVERE PERSONAL
INJURIES, INCLUDING BUT NOT LIMITED TO MULTIPLE CONTUSIONS, ABRASIONS, AND A FRACTURED
JAW WHICH HAD TO BE WIRED SHUT. AS A RESULT OF THE INJURIES SUSTAINED AS AFORESAID, SHE
WAS CAUSED TO SUFFER GREAT PAIN OF BODY AND ANGUISH OF MIND, HER EARNING CAPACITY AS
AN ACTRESS HAS BEEN AND WILL BE IMPAIRED FOR A LONG PERIOD OF TIME, AND SHE HAS
EXPENDED AND WILL CONTINUE TO EXPEND LARGE SUMS OF MONEY FOR MEDICAL CARE AND
ATTENDANCE.
DESPITE THIS INCIDENT, NEITHER SHE NOR THE MINOR’S FATHER IS IN ANY
WAY VINDICTIVE. THEY HAVE ASKED FOR A DEMONSTRATION OF REMORSE AND HAVE REQUESTED
THE FATHER’S PRIMARY CONCERN IS, OF COURSE, FOR THE WELL BEING OF HIS DAUGHTER.
DEPENDENCY HISTORY:
SOURCES OF INFORMATION:
✘ Minor ✘ Parent(s) ✘ DCFS Records JAI/JCMS
Probation Records Juvenile Court Records
Other (Specify):
There are no prior § 300 WIC referrals for neglect or abuse known at this time.
✘ There are prior § 300 WIC referrals for neglect or abuse.
FATHER, ALLEGEDLY A "SATANIC PRIEST," HAS SEXUALLY ABUSED THE MINOR FROM THE AGES OF BIRTH
AND SIX AND THERE IS A SUBSTANTIAL RISK THAT THE MINOR WILL BE SEXUALLY ABUSED AGAIN, AS
DEFINED IN SECTION 11165.1 OF THE PENAL CODE, BY HIM. THE MINOR'S MOTHER HAS FAILED TO
ADEQUATELY PROTECT THE CHILD FROM SEXUAL ABUSE WHEN SHE KNEW OR REASONABLY SHOULD
DELINQUENCY HISTORY:
SOURCES OF INFORMATION:
Minor Parent(s) JAI/JCMS ✘ Police Report(s)
✘ Juvenile Court Records Probation Records
Other (specify):
AKAs:
LADY JANE MANSON
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RESIDENCE STATUS: Other Country:
3 U.S. Citizen: ✘ Yes No
6 ADDITIONAL INFORMATION:
13 ADDITIONAL INFORMATION:
MINOR DENIES ANY GANG-ASSOCIATION.
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ALCOHOL / SUBSTANCE ABUSE: SOURCES OF INFORMATION:
15 ✘ Minor ✘ Parent(s) JAI/JCMS Police Report(s)
Juvenile Court Records Probation Records
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Other (specify):
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NO Record / Indication of Use
18 ✘ Alcohol / Substance Use (See below)
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SOURCES OF INFORMATION:
25 ✘ Minor
✘ Parent(s)
26 JCMS
Probation Records
27 Other (specify):
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HEALTH INFORMATION:
1 A. Immunization record attached.
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Evaluation attached / X Not attached. X Evaluation on file with:
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Name of mental health professional: LACO DEPARTMENT OF MENTAL HEALTH
25 Date of the evaluation: 02/04/2009 Evaluation Requested: 02/04/2009
Evaluation is not available to Probation at present. Reason:
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ADDITIONAL INFORMATION:
27 MINOR COMMENTED THAT AS A KID SHE HAD BEEN AROUND DRUGS.
28 HER MOTHER CONFIRMS THAT THE MINOR'S FATHER FREQUENTLY SUPPLIED THE MINOR
WITH MDMA AND ROHYPNOL. MINOR ADMITS TO REGULAR USE OF THESE SUBSTANCES
THUS DEVELOPING AN ADDICTION TO THEM. SHE DENIES THE USE OF ALL OTHER DRUGS
3 STRESS DISORDER (PTSD) AND RECOGNIZES THAT SHE HAS SEVERE MENTAL HEALTH
4 ISSUES THAT NEED TO BE ADDRESSED. MINOR WAS IN COUNSELING OFF AND ON FOR A
5 NUMBER OF YEARS WITH A FAMILY PSYCHIATRIST. MINOR FELT THAT SHE NEEDED TO TALK
6 TO SOMEONE ABOUT HER FEELINGS, AS WELL AS OTHER THINGS GOING ON IN HER LIFE,
7 INCLUDING THE HIGH-PROFILE DIVORCE OF HER CELEBRITY PARENTS. SHE HAS COMPLIED
9 COUNSELING. MINOR'S MOTHER HAS EXPRESSED CONCERN FOR HER DAUGHTER'S MENTAL
10 WELL-BEING AND BELIEVES SHE NEEDS INTENSIVE CARE FOR THESE ISSUES.
11 ADDITIONAL INFORMATION:
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22 UNABLE TO OBTAIN THE RECORDS FROM HIGH SCHOOL THE MINOR IS CURRENTLY
23 ATTENDING.
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28 SCHOOLWORK AND SOCIALIZING DIFFICULT. HER GRADES IN SCHOOL SUBJECTS ARE D'S
AND ONE F. MINOR'S BEHAVIOR IN THE CLASSROOM HAS BEEN DISRUPTIVE AT TIMES.
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9 L. The above person (para K) has been contacted. Probation letter sent:
M. Special considerations/comments (SARBs, IEP, special educational needs):
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MINOR’S EMPLOYMENT: ✘ Minor Not Employed
12 Minor Employed (See below)
EMPLOYER ADDRESS PHONE MONTHLY EARNINGS
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14 ADDITIONAL INFORMATION:
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16 FAMILY INFORMATION:
17 RESIDENCE:
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23 SOURCE AMOUNT
NONE
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1 SIBLINGS:
6 (3)
SSN:
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(4)
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SSN:
9 (5)
10 SSN:
11 (6)
12 SSN:
(7)
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SSN:
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(8)
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SSN:
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(9)
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SSN:
18 (10)
19 SSN:
ADDITIONAL INFORMATION:
20 MINOR'S MOTHER COMMENTED THAT NEITHER SHE NOR THE MINOR HAS
21 CONTACTED THE MINOR'S ONLY KNOWN SIBLING JOHN SMITH SINCE LATE DECEMBER OF 2007
22 AND HIS WHEREABOUTS REMAIN UNKNOWN.
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Has anyone in the household been arrested, on probation or parole: ✘ YES NO
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SOURCES OF INFORMATION: Minor ✘ Parent(s) Probation Files Criminal Record Check
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STEPMOTHER
YES
17 STATE PRISON OR
CYA COMMITMENT NO
18 GANG INVOLVED
21 GANG INVOLVED
22 OTHER IN HOME
YES
STATE PRISON OR
23 CYA COMMITMENT NO
24 GANG INVOLVED
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MINOR’S STATEMENT: MINOR INFORMED OF RIGHTS: STATEMENT TAKEN (DATE): 02/03/2009
2 LOCATION: CENTRAL JUVENILE HALL
✘ YES NO
✘ IN PERSON BY PHONE
3 VIDEO CONFERENCE
(A) SELF-ASSESSMENT OF STRENGTHS:
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MINOR FEELS SHE HAS AN OPTIMISTIC OUTLOOK ON SELF-IMPROVEMENT AND
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IMPROVING HER GRADES IN SCHOOL.
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(B) SELF-ASSESSMENT OF RISKS/NEEDS:
7 MINOR FEELS SHE NEEDS TO WORK ON DEVELOPING A POSITIVE SELF-IMAGE
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(C) OFFENSE:
10 REGARDING THE PRESENT OFFENSE, THE MINOR HAS INDICATED THAT THE ACT
11 WAS NOT PREMEDITATED, THAT IT WAS SPONTANEOUS. SHE HAS EXPRESSED SINCERE REMORSE AT
12 ANY HARM THAT HAD BEEN DONE TO THE FEMALE VICTIM BY HER UNTHINKING ACT, HER FAILURE
14 (D) PLAN:
MINOR IS NOT SUITABLE FOR THE CAMP COMMUNITY PLACEMENT PROGRAM.
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MINOR’S NEEDS MAY BE BETTER SUITED IN A SMALLER POPULATED FACILITY WITH MORE INTENSE
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MENTAL HEALTH ASSISTANCE. AT THIS TIME, CAMP COMMUNITY PLACEMENT CANNOT PROVIDE
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MINOR WITH THE INTENSIVE PSYCHOLOGICAL COUNSELING SHE NEEDS. SUPERVISION IS ALSO
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RECOMMENDED FOR THE MINOR WHO HAS DEMONSTRATED GENUINE REMORSE AT HAVING
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COMMITTED THE PRESENT OFFENSE.
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(E) ADDITIONAL INFORMATION:
22 MINOR NEEDS INTENSIVE MENTAL HEALTH ASSISTANCE FOR PTSD DUE TO
23 REPEATED SEXUAL ABUSE OR “SATANIC RITUAL ABUSE” AS A RESULT OF HER CULT, OCCULT, OR
24 SATANIC FAMILY UPBRINGING. FURTHERMORE, MINOR MAY ALSO NEED SPECIAL COUNSELING FOR
26
PARENT’S STATEMENT: STATEMENT TAKEN (DATE): 02/03/2009
27 LOCATION:
IN PERSON
28 ✘ BY PHONE
OTHER (Specify):
1 MINOR’S MOTHER WAS CONTACTED VIA TELEPHONE FOR STATEMENT. SHE
2 UNDERSTANDS WHY HER DAUGHTER MUST BE REMOVED BY THE COURT AND HOPES THE MINOR CAN
3 GET THE SPECIAL HELP SHE NEEDS. MINOR’S MOTHER FEELS THAT HER DAUGHTER’S MENTAL
4 CONDITION PLAYS A MAJOR ROLE IN WHY THE SHE CANNOT CONTROL HER BEHAVIOR AT TIMES.
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(A) ASSESSMENT OF FAMILY STRENGTHS:
6 MINOR’S MOTHER HAS GIVEN THE MINOR MORAL SUPPORT THROUGHOUT ALL
7 HER ARRESTS AND OTHER TROUBLES. MINOR’S MOTHER HAS STAYED IN CONTACT WITH THE MINOR
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(B) ASSESSMENT OF FAMILY RISKS/NEEDS:
10 MINOR’S PARENTS ARE THE ONLY FAMILY MEMBERS THAT HAVE
11 CONSISTANTLY BEEN IN HER LIFE. MINOR’S MOTHER LOVES HER DAUGHTER, BUT IS NOT SURE IF SHE
18 (D) PLAN:
AT THIS TIME, MINOR’S MOTHER PLANS TO ASSIST THE MINOR BY TAKING HER
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TO A CULT DEPROGRAMMING RECOVERY CENTER. SHE AGREES THAT MINOR NEEDS EXTENSIVE
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MENTAL HEALTH COUNSELING FOR PTSD AND HOPES THAT HER DAUGHTER’S BEHAVIOR AND
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PSYCHOLOGICAL CONDITION MAY IMPROVE. MINOR’S MOTHER ALSO PLANS TO TAKE THE MINOR TO
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A DRUG TREATMENT FACILITY.
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(E) ADDITIONAL INFORMATION:
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6 INTERESTED PARTIES:
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THIS PROBATION OFFICER INTERVIEWED THE MINOR’S FATHER, WHO IS ALSO
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THE VICTIM’S BOYFRIEND, IN HIS HOME. HE WAS ACCOMPANIED BY HIS ATTORNEY. REGARDING THE
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PRESENT OFFENSE, HE INDICATED THAT HE IS NOT VINDICTIVE. “I DON’T WANT TO SEE MY
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DAUGHTER IN JAIL. SHE IS PRECIOUS AND IN THE MIDST OF GROWING UP. ALL I WANT IS AN
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ASSURANCE OF REMORSE. OUR FAMILY DOESN’T NEED ANY MORE UNREASONABLE PUBLICITY.” HE
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INDICATED THAT THE MINOR HAS SPENT MORE TIME WITH HER MOTHER SINCE SHE HAD DIVORCED
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HIM IN LATE DECEMBER OF 2007. HE FURTHER INDICATED THAT THE MINOR GOT ALONG WELL WITH
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HIS GIRLFRIEND PRIOR TO THE OFFENSE.
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17 FAMILY PSYCHIATRIST. THE MINOR WAS ORDERED EXAMINED PER 6307 WELFARE AND INSTITUTIONS
18 CODE BY DOCTOR NORMAN SHAPIRO WHOSE REPORT INDICATES IN PART, “…. MINOR IS MENTALLY
19 ILL, DOES HAVE A CLINICALLY OBSERVABLE CASE OF POST TRAUMATIC STRESS DISORDER.
20 HOWEVER, SHE IS CREATIVE, INTELLIGENT, HAS GOOD JUDGMENT, STRONG MORAL AND ETHICAL
21 VALUES, AND HAS NORMAL REMORSE FOR HER OFFENSE AND NORMAL REGRET FOR HER
23 JUDGMENT WITH SOME COINCIDENTAL DRUG INTOXICATION. MINOR HAS ADEQUATE INTELLIGENCE,
24 JUDGMENT, REMORSE, REGRET, AND MOTIVATION – SUCH THAT SHE IS MOST UNLIKELY TO
26 CAMP COMMUNITY PLACEMENT WOULD SERVE NO NECESSARY OR USEFUL PURPOSE BUT WOULD
27 IMPOSE AN UNUSUAL DEGREE OF STRESS AND HARDSHIP. FROM THE NEGATIVE MEDIA PUBLICITY
28 AND LOSS OF TIME AT SCHOOL, SHE HAS ALREADY SUFFERED SEVERE PUNISHMENT…EVEN WITH
1 THE MANY MITIGATING CIRCUMSTANCES, MINOR FREELY ADMITTED HER POOR JUDGMENT IN THE
2 OFFENSE; AND SHE EXPRESSED SINCERE REMORSE FOR ANY INJURY TO THE PERSONALITY OR
3 REPUTATION OF THE VICTIM, AND REGRET FOR THE CONSEQUENCES TO HERSELF. SHE IS ESPECIALLY
4 FEARFUL OF INTERFERENCE WITH HER TREATMENT BECAUSE HER COUNSELING SESSIONS HAVE
5 BEEN HER SALVATION AGAINST DEPRESSION AND DESPAIR SINCE THE MEDIA HIGHLY PUBLICIZED
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THIS PROBATION OFFICER HAS SPOKEN WITH DR. STEEL WHO INDICATED THAT
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THE EXAMINATION REVEALED THE MINOR IS SUFFERING FROM POST TRAUMATIC STRESS DISORDER
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DUE TO REPEATED SEXUAL ABUSE OR “SATANIC RITUAL ABUSE.” HER HIGH-PROFILE PARENTS ARE
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DESCRIBED AS BEING PART OF A CULT, OCCULT, OR SATANIC GROUP. THE “RITUALIZED ABUSE OF
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CHILDREN” INFLICTS REPEATED PHYSICAL, EMOTIONAL, MENTAL, AND SPIRITUAL ASSAULTS
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COMBINED WITH A SYSTEMATIC USE OF SYMBOLS AND SECRET CEREMONIES DESIGNED TO TURN A
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CHILD AGAINST ITSELF, FAMILY, SOCIETY, AND GOD. SEXUAL ASSAULTS OF THIS TYPE HAVE
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RITUALISTIC MEANING AND ARE NOT FOR SEXUAL GRATIFICATION. THE BIZARRE ACTIVITY OFTEN
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INCLUDED STRANGE GAMES, WEARING OF ROBES OR COSTUMES, CHANTING, INSERTION OF FOREIGN
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OBJECTS, TORTURE, WITNESSING MUTILATIONS, HUMAN AND ANIMAL SACRIFICES, BLOOD RITUALS,
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AND PHOTOGRAPHING OR FILMING SEXUAL ACTIVITIES. THE MINOR IS A VICTIM OF A SEVERELY
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TRAUMATIZED CHILDHOOD IN WHICH BEING SEXUALLY ABUSED WAS JUST ONE OF THE MANY
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NEGATIVE EVENTS AFFECTING HER LIFE. ADDITIONALLY, DRUGS HAVE BEEN DELIBERATELY USED TO
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CONFUSE THE MINOR AND DISTORT HER PERCEPTIONS, AND THEREFORE, SHE NEEDS
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HOSPITALIZATION. FURTHERMORE, DR. STEEL INDICATED THAT HE BELIEVED THE MINOR WOULD
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GREATLY BENEFIT FROM VISITING A CULT DEPROGRAMMING RECOVERY CENTER.
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1 CONDUCT UNDER SUPERVISION:
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(B) PARTICIPATION IN SERVICES:
15 MINOR HAS PARTICIPATED IN PEER COUNSELING AND MENTAL HEALTH
16 COUNSELING ONCE A WEEK. CONSEQUENTLY, MINOR HAS BEEN OPEN AND RESPONSIVE TO THE HELP
17 AND COUNSELING SHE WAS OFFERED. DURING COUNSELING SESSIONS THE MINOR WAS TAUGHT
18 TECHNIQUES ON HOW TO BETTER MANAGE HER BEHAVIOR, AND THUS FAR SHE HAS WILLINGLY
19 APPLIED WHAT SHE HAS LEARNED. MINOR CAN BE GUIDED THROUGH A SUITABLE PLACEMENT
20 PROGRAM BECAUSE SHE HAS DEMONSTRATED ACCOUNTABILITY FOR IMPROVING HER OWN
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PRIOR SERVICES SUMMARY:
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DCFS Services (for minor or family) known to probation provided through DCFS: X
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DESIRED OUTCOMES SUMMARY
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X Crime-Free Lifestyle
3 X Positive Family Functionality
X Academic Progress
4 X Positive Peer Relationships
X Substance-Free Lifestyle
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Other (Specify)
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MEASURABLE OBJECTIVES SUMMARY
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1. X No New Arrests/Police Contacts 2. X No Gang Involvement
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For period: to For period: to
9 3. Participation/Completion – Alcohol Treatment 4. X Participation/Completion – Drug Education/Treatment
Date of completion: Date of completion:
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5. X Participation/Completion – Drug Testing 6. X Participation/Completion – Psychological Counseling
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Date of completion: Date of completion:
12 7. X Participation/Completion – Psychiatric Intervention 8. X Participation/Completion – Family Counseling
13. X Participation in Extracurricular Activities 14. X Satisfactory School Attendance & Behavior
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Date of completion: For period: to
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15. X Satisfactory School Grades 16. Fulfilled Financial Obligation
19 For period: to Date of completion:
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1 SERVICE DELIVERY PLAN SUMMARY
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RESPONSIBLE PARTY FOR PROVIDING AND/OR MONITORING SERVICES
3 SERVICES TO BE PROVIDED Minor Mother Father School CBO DPO Agency / Individual (Identify)
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1 ANALYSIS AND PLAN:
IN THE BEGINNING, THE MINOR HAS HAD A DIFFICULT TIME WITH STABILITY,
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ROUTINE, RULES, AND BOUNDARIES. SHE WAS IMPULSIVE, CHALLENGED EVERYTHING, AND HAD SOME
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DEGREE OF DIFFICULTY WHEN SHE DID NOT GET HER WAY. HOWEVER, IT IS APPARENT THAT THE MINOR
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HAS TAKEN THE OPPORTUNITY TO REFLECT ON HER MISTAKES AND HAS MADE SOME NECESSARY
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CHANGES IN HER ACTIONS. AT THIS TIME, THIS PROBATION OFFICER BELIEVES THAT SUPERVISION OF THE
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MINOR SHOULD CONTINUE WITH THE OPPORTUNITY TO HOPEFULLY EXCEL IN AN INTENSIVE MENTAL
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HEALTH FACILITY INDICATIVE OF THE DOROTHY KIRBY CENTER.
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CURRENTLY, IT IS THE RECOMMENDATION OF THIS PROBATION OFFICER THAT
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THE MINOR BE REMOVED FROM JUVENILE HALL AND THAT SHE IS ORDERED AND SUITABLY PLACED INTO
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THE DOROTHY KIRBY CENTER. WHILE IN THIS PLACEMENT, MINOR MAY ATTEND COUNSELING IN SMALLER
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SETTINGS AND WILL HOPEFULLY CONTINUE TO RECOGNIZE THE NEED FOR HER TO CHANGE HER CURRENT
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PATH OF SELF-DESTRUCTION AND REDIRECT HER FOCUS ONTO A MORE POSITIVE AND PRO-SOCIAL
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DIRECTION.
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RESIDENTIAL CARE SHALL BE REQUIRED IF THE MINOR VIOLATES COURT
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ORDERS OR ENGAGES IN BEHAVIOR RESULTING IN REMOVAL FROM THE COMMUNITY PURSUANT TO COURT
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ORDER.
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DETENTION/REMOVAL MATTERS:
1. ✘ It IS necessary to remove minor from the home. Continuance in the home is contrary to the minor’s welfare.
The reasons that removal from the PARENT and detention or out-of-home placement are in the best interest
of the minor’s welfare:
2. Prior services aimed at reducing or eliminating the need for out-of-home placement have been delivered.
Additional Information:
3. In Juvenile Hall, available services to facilitate the return to parental home and to reduce the need for removal include:
Schooling, special education classes, educational assessment, participation in counseling modules as appropriate,
medical/dental assessment, mental health evaluation, family visits. Minor HAS been referred for a mental health
evaluation.
Additional Information:
4. It is not deemed necessary to REMOVE the minor from the home at this time. Services reducing or eliminating
the need for removal will be delivered. Case factors, including deterioration of behavior or the failure of
intervention services to accomplish results, may require removal from the home in the future.
6. ✘ Absent preventive services or if preventive services fail, the probation officer’s plan is removal from the
home.
RECOMMENDATION:
It is recommended that:
Minor REMAIN a ward of the court under Section 602 WIC;
Minor be found in violation of probation;
The order for SPECIFIC PLACEMENT made 02/03/2009
✘ Remain in full force and effect;
Be terminated;
Be vacated and set aside;
✘ Minor be placed on probation, under the terms and conditions as attached, pursuant to:
✘ 654.2 WIC;
725 (a) WIC;
790 (a) WIC;
Minor’s care, custody, control and conduct be placed under the supervision of the Probation Officer; that minor be
permitted to remain in the home of the parents (or guardian) under the terms and conditions as attached;
✘ Custody of minor be taken from the parents and guardians and that minor be:
✘ Committed to the care, custody and control of the Probation Officer for Suitable Placement as detailed in the
Juvenile Court’s “Suitable Placement” order form Closed/Open ✘ , under the terms and conditions as attached;
that the parents right to make educational decisions be limited;
Committed to the care, custody and control of the Probation Officer for placement in the Camp-Community
Placement Program under the terms and conditions as attached;
Committed to the California Youth Authority; that the Probation Officer be directed to transport minor to the
Reception Center of the Youth Authority on the date designated by it;
Minor be detained in Juvenile Hall for days;
Minor at Juvenile Hall pending execution of said order;
Other .
1 Matter be continued to:
✘ Appearance Calendar of 02/26/2009, Dept. 205 for COURT;
2
Non-Appearance Calendar of , Dept. for report;
3 Non-Appearance Calendar of , Dept. for 15-Day Review;
6 RESPECTFULLY SUBMITTED,
7
ROBERT B. TAYLOR
8 CHIEF PROBATION OFFICER
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BY: _________________________________________ ________________________________________
10 CLEMENTINE JOHNSON, DPO DATE
TELEPHONE: (323) 226-8601
11 EAST LOS ANGELES AREA OFFICE
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READ AND APPROVED:
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BY: ________________________________________ ________________________________________
14 JIM DANGLE, SDPO DATE
TELEPHONE: (323) 226-8608
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I HAVE READ AND CONSIDERED THE FOREGOING REPORT OF THE PROBATION OFFICER.
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______________________________________________ _________________________________
20 JUDGE OF THE SUPERIOR COURT DATE
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COUNTY OF LOS ANGELES PROBATION DEPARTMENT
1. ✘ Obey all laws. Obey all orders of the Probation Officer and of any court.
2. ✘ __ Obey all instructions and orders of Parents/Guardians Teacher(s) School Officials Other
3. ✘ Report to the Probation Officer as directed.
4. ✘ __ Notify the Probation Officer before changing address, school, school schedule or place of employment.
5. Seek and maintain training or employment as directed by the Probation Officer.
6. ✘ __ Do not engage in .
7. ✘ Do not leave camp or suitable placement without permission.
8. ✘ __ Perform hours of work under the supervision of the Probation Officer.
9. ✘ Attend a school program approved by the Probation Officer. Maintain satisfactory grades and attendance, and citizenship. Promptly notify
Probation Officer of every absence.
12. ✘ __ Do not be within one block of any school ground unless enrolled, attending classes, on approved school business, or with school official, parent
or guardian.
13. ✘ Do not be out of residence between and except with parental consent.
14. ✘ __ Do not stay away from residence for more than hours, nor leave Los Angeles County except at times and places specifically permitted in
advance by the Probation Officer.
15. Do not associate with co-minors anyone disapproved of by Parent Probation Officer Other
15a. ✘ __ Do not participate in any type of gang activity.
16. ✘ Do not have any dangerous or deadly weapon in your possession, nor remain in the presence of any unlawfully armed person.
17. ✘ __ Do not contact or cause any contact with, nor associate with the victim(s) or witness(es) of any offense alleged against you.
18. Do not associate with children under years except in presence of a responsible adult.
19. ✘ __ Do not drink any alcoholic beverages.
20. ✘ Cooperate in a plan to control abuse of alcohol, controlled substances or poisons.
21. ✘ __ Do not use or possess narcotics, controlled substances, poisons, or related paraphernalia; stay away from places where users congregate.
21a. Do not own, use or possess an electronic paging device.
22. ✘ __ Do not associate with persons known to be users or sellers of narcotics/controlled substances, except with the prior written permission of the
Probation Officer.
23. ✘ Submit to urinalysis and skin checks as directed by the Probation Officer to detect the use of narcotics/controlled substances.
24. ✘ __ Submit to testing of blood, breath or urine to detect the use of alcohol, narcotics/controlled substances or poisons whenever requested by any
peace officer.
25. ✘ Submit person, residence or property under your control to search and seizure at any time of the day or night by any law enforcement officer with
or without a warrant. [§ 790.4 WIC]
26. ✘ __ Cooperate in a plan for psychiatric/psychological testing or treatment.
27. Pay $ fine to the general fund of the county through the Probation Officer in such manner as the Probation Officer shall order; plus penalty
assessment and surcharge (1464 Penal Code and 76000 Government Code).
28. ✘ __ Make reparation on all related losses as determined by the Probation Officer, including a service charge as authorized by 276(c) WIC.
28a. Make restitution to the Restitution Fund in the amount of $ (no VICTIM LOSS).
29. __ Do not drive a motor vehicle unless licensed and properly insured as required by law.
30. Do not drive any motor vehicle.
31. __ Do not drive a motor vehicle except to and from school work.
32. Surrender operator’s license to the court clerk, who shall comply with Section 13352 V.C.
33. __ Do not use any name other than ; do not possess or display any identification in any other name.
34. Do not have blank checks in possession; do not write any portion of any check; do not have bank account upon which you may draw checks; do
not use or possess any credit card.
36. ✘ __ Participate in a program of counseling with or without Parent/Guardian.
37. ✘ Minor’s parents are ordered, pursuant to 727 WIC, to complete ten class sessions of a Parent education program on or before 12/31/2009 and file
proof of completion with Probation.
38. __ Spend not less than days nor more than days in Juvenile Hall.
39. Participate in the Juvenile Alternative Work Services Program for a period of days.
40. Other .
41. ✘ Participate in after school and weekend tutorial, vocational and recreational activities as directed by Probation Officer.
42. __ Participate in the High School Graduate/GED/WIN program and make continuing progress towards completion of high school.
43. ✘ Conditions of Probation as ordered on remain in full force and effect except where modified herein.
44. Register with the local law enforcement agency in the county in which you reside, within 10 days. [§186.32]
45. ✘ Do not possess any lighters, matches, or other incendiary devices. Do not possess any spray cans, markers or other marking devices.
46. Report to Juvenile Hall for Medical exam DNA testing on . Central (East Los Angeles) Nidorf (San Fernando)
Los Padrinos (Downey)
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Prob. 1264-RO (Rev. 04/06)