Please Print
I
am filing this official complaint to you and your agency in a plea for help for
my child who has been abused or neglected. I want all records and reports
relating to my childs abuse that you have filed against the abusers. I am prepared to take any and all
administrative and legal actions to protect my child. My child’s State,
Federal, Civil and Constitutional Rights are being violated and will lead to severe
and permanent harm. Please respond to
this complaint within 30 days or less as this harm is life threatening.
MY COMPLAINT CONSISTS OF BUT IS NOT LIMITED TO THE
FOLLOWING:
CHECK THE ITEMS
THAT APPLY
¨ A. The case worker(s)
and local agency’s use of many false and misleading statements in petitions,
letters, social study reports, etc., submitted to the Superior court and
others, did prejudice and harm claimant.
¨ B. In the beginning,
the case worker(s) and local agency failed to provide the services needed to
prevent the removal of the minor(s) from the care and custody of the
claimant(s).
¨ C. Failure of the case
worker(s) and local agency to provide the proper reunification / family
preservation services in a timely manner.
Briefly describe
what services were needed and how long it took to receive them.
¨ D. Failure of the case
worker(s) and local agency to provide the paper work in a timely manner and in
some instances, not at all (e.g. petitions, reports, etc.).
¨ E. Failure of the case
worker(s) to meet with claimant on a regularly scheduled basis. The caseworker or social worker has to meet
with you in person at least once a month.
¨ F. Failure of case
worker(s) to accept and recognize claimant’s case plan completions of the court
ordered “case plan.”
¨ G. Failure of the case
worker(s) and local agency to protect minor from maltreatment (e.g. abuse,
neglect, medical neglect, etc.) while in foster care placement.
Briefly list the
abuse, neglect, etc.
¨ H. Failure of the
social worker and the local agency to clear and place minor(s) with minor’s
family. List relatives’ names,
addresses and relationship to minor(s).
¨ I. The case worker(s)
and local agency’s prejudice toward claimant, through their abuse of power and
discretion while under the color of authority, did harm claimant. (You must have documentation,
witnesses, etc., to prove this).
¨ J. Failure of the case
worker(s) and local agency to provide and/or assist with reasonable visitation
and/or interference with visitation (e.g. monitors, visitation times, dates,
etc.).
Briefly state
visitation issue or problem.
¨ K. Failure of the case worker(s) and local agency to follow the
Manual of Policies and Procedures Title 22, Division 30 & 31 of the
California Code of Regulations (CCR).
State what violations they committed.
NOTE: if you don’t have a copy
of the CCR Divisions 30 & 31, you may obtain them by calling (916)
445-2890, the MMP copies are usually available for inspection and copying at
your local law library or public library. (Contact the libraries to see if
these documents are available as ordering your own copy might possibly take 4-6
wks. to receive) If you are
representing yourself, you must get a copy of CCR Division 22.
¨ L. Failure of the case worker(s) and local agency to observe
and respect the minor’s and claimant’s religious beliefs.
Briefly state your
religion and the problem.
¨ M. Other issues.
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¨ N. Further issues.
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Sincerely:
___________________________ ____________________________ ____________
Print Name Signature Date
Witness:
_______________________________ _______________________________ _____________
Print
Name Signature Date
Cc: ____________________________ ____________________________
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