State of Jharkhand - Act
Jharkhand Juvenile Justice (Care and Protection of Children) Rules, 2017
JHARKHAND
India
India
Jharkhand Juvenile Justice (Care and Protection of Children) Rules, 2017
Rule JHARKHAND-JUVENILE-JUSTICE-CARE-AND-PROTECTION-OF-CHILDREN-RULES-2017 of 2017
- Published on 13 June 2017
- Commenced on 13 June 2017
- [This is the version of this document from 13 June 2017.]
- [Note: The original publication document is not available and this content could not be verified.]
1. Short title and commencement.
2. Definitions.
Chapter VII
Juvenile Justice Board
3. Board.
- There shall be one or more Boards in each district to be constituted by the State Government through a notification in the Official Gazette.4. Composition of the Board.
5. Term of Members of the Board.
6. Sittings of the Board.
7. Functions of the Board.
Chapter III
Procedure in Relation to Children in Conflict With Law
8. Pre-Production action of Police and other Agencies.
9. Production of the child alleged to be in conflict with law before the Board.
10. Post-production processes by the Board.
10A. Preliminary assessment into heinous offences by Board.
11. Completion of Inquiry.
12. Pendency of Inquiry.
13. Procedure in relation to Children's Court and Monitoring Authoritites.
14. Record Keeping and Destruction of records.
Chapter IV
Child Welfare Committee
15. Composition, Qualifications and Term of Members of the Committee.
16. Rules and Procedures of Committee.
17. Additional Functions and Responsibilities of the Committee.
- In addition to the functions and responsibilities of the Committee under section 30 of the Act, the Committee shall perform the following functions to achieve the objectives of the Act, namely:Chapter V
Procedure in relation to children in need of care and Protection
18. Production before the Committee.
19. Procedure for inquiry.
20. Pendency of cases.
Chapter VI
Rehabilitation and Social Re-Integration
21. Manner of Registration of Child Care Institutions.
22. Open Shelter.
23. Foster Care.
24. Sponsorship.
25. After Care of Children Leaving Institutional Care.
26. Management and Monitoring of Child Care Institutions.
| S. No | Personnel/ Staff | Number |
| 1 | Person-in-charge (Superintendent) | 1 |
| 2 | Probation Officer/Child Welfare Officer/CaseWorkers (NGOs) A Child Welfare Officer may be designated asRehabilitation-cum-Placement Officer | 3 |
| 3 | Counselor/ Psychologists/mental health expert | 2 |
| 4 | House Mother/ House Father | 4 |
| 5 | Educator/ Tutor | 2(Part time) |
| 6 | Medical Officer (Physician) | 1 (on call) |
| 7 | Para-medical staff/ Staff Nurse/Nursing Orderly | 1 |
| 8 | Store Keeper cum Accountant | 1 |
| 9 | Art & Craft & activity teacher | 1(Part time) |
| 10 | PT Instructor-cum-Yoga trainer | 1 (Part time) |
| 11 | Cook | 2 |
| 12 | Helper | 2 |
| 13 | House keeping | 2 |
| 14 | Driver | 1 |
| 15 | Gardener | 1(Part time) |
27. Fit Facility.
28. Fit Person.
29. Physical infrastructure.
| (i) | 2 Dormitories | Each 1000 Sq.ft. for 25 children i.e. 2000 Sq.ft. |
| (ii) | 2 Class rooms | 300Sq.ft. for 25 children i.e. 600 Sq. ft. |
| (iii) | Sickroom/First aid room | 75 Sq.ft. per children for 10 i.e. 750 Sq. ft. |
| (iv) | Kitchen | 250 Sq. ft. |
| (v) | Dining hall | 800 Sq. ft. |
| (vi) | Store | 250 Sq.ft. |
| (vii) | Recreation room | 300 Sq.ft. |
| (viii) | Library | 500 Sq.ft. |
| (ix) | 5 Bathroom 25 Sq.ft. each i.e. 125 Sq. ft. | |
| (x) | 8 Toilets | 25 Sq. ft. i.e. 200 Sq.ft. |
| (xi) | Office rooms | 300 Sq.ft. (b) Person-in-charge room 200 Sq.ft. |
| (xii) | Counselling and Guidance room | 120 Sq.ft. |
| (xiii) | Workshop | 1125 Sq. ft. for 15 children @ of 75 Sq.ft. pertrainee |
| (xiv) | Residence for Person-incharge | 2 rooms of 250 Sq.ft. each (b) Kitchen 75 Sq.ft.(b) bathroom cum toilet 50 Sq ft. |
| (xv) | 2 rooms for Juvenile Justice Board or ChildWelfare Committee | 300 Sq. ft each i.e. 600 Sq.ft. |
| (xvi) | Playground | Sufficient area according to total number ofchildren |
| Total | 8495 Sq.ft. |
30. Clothing, Bedding, Toileteries and other Articles.
| A. Bedding | ||
| S. No. | Article | Quantity to be provided per child |
| 1. | Mattress | 1 at the time of admission and subsequently 1after every 1 year. |
| 2. | Cotton Durry | 2 at the time of admission and subsequently 2after every 2 years. |
| 3. | Cotton bed sheets | 2 at the time of admission and subsequently 1after every 6 months. |
| 4. | Pillow (Cotton stuffed) | 1 at the time of admission and subsequently 1after every 1 year. |
| 5. | Pillow covers | 1 at the time of admission and subsequently 1after every 1 year. |
| 6. | Cotton blankets/ Khes | 2 at the time of admission and subsequently 1after every 2 years. |
| 7. | Cotton filled quilt | 1 at the time of admission and subsequently 1after every 2 years (in cold region in addition to the blankets). |
| 8. | Mosquito net | 1 at the time of admission and subsequently 1after every 6 months. |
| 9. | Cotton towels | 2 at the time of admission and subsequently 1after every 3 months. |
| B. Clothing for Girls | ||
| S. No. | Article | Quantity per child |
| 1 | Skirts and Blouse or Salwar Kameez or Half Sariwith Blouse and Petticoat | 5 sets per year for girls depending on age andregional preferences. |
| 2 | Age appropriate undergarments | 3 sets every quarter. |
| 3 | Sanitary Towels | 12 packs per year for older girls. |
| 4 | Woollen Sweaters (full sleeves) | 2 sweaters yearly. |
| 5 | Woollen Sweaters (Half sleeves) | 2 sweaters yearly. |
| 6 | Woollen Shawls | 1 per year. |
| 7 | Nightwear | 2 sets every 6 months. |
| C. Clothing for Boys | ||
| S. No. | Article | Quantity per child |
| 1 | Shirts | 2 at the time of admission and subsequently 1after every 6 months. |
| 2 | Shorts | 2 at the time of admission and subsequently 1after every 6 months for younger boys. |
| 3 | Pants | 2 at the time of admission and subsequently 1after every 6 months for older boys. |
| 4 | Age appropriate undergarments | 3 sets every quarter. |
| 5 | Woollen jerseys(full sleeves) | 2 yearly. |
| 6 | Woollen jerseys (half sleeves) | 2 yearly. |
| 7 | Woollen Caps | 1 in 1 year. |
| 8 | Kurta Pyjama for night wear | 2 sets every 6 months. |
| D. Miscellaneous Articles | ||
| 1. | Slippers | 1 pair at the time of admission and subsequentlyafter every 6 months. |
| 2. | Sports shoes | 1 pair at the time of admission and subsequently1 pair after every 1 year. |
| 3. | School uniform | 2 sets every six months for children attendingschools. |
| 4. | School bag | 1 every year for children attending schools. |
| 5. | School shoes | 1 pair at the time of admission in school andsubsequently 1 pair after every 6 months. |
| 6. | Handkerchiefs | 2 at the time of admission and subsequently 2after every 2 months. |
| 7. | Socks | 3 pairs every six months. |
| 8. | Stationery | As per need. |
| S. No. Night clothing and bedding Scale forsupply | ||
| 1. | Mattress | One per bed per 3 years. |
| 2. | Cotton bed sheets | Four per bed per year. |
| 3. | Pillows | One per bed per two year. |
| 4. | Pillow covers | Four per bed per year. |
| 5. | Woollen blankets | One per bed per 2 years. |
| 6. | Pyjamas and loose shirts (hospital type forboys) | 3 pairs per child per year. |
| 7. | Skirts and blouses or salwar kameez for girls | 3 pairs per child per year. |
| 8. | Cotton durry | One per bed per three years. |
| S. No. | Items | Quantity to be issued per child |
| 1. | Hair Oil for grooming the hair | 100 ml per month. |
| 2. | Toilet soap/handwash | 2 bars of 100gm per month. |
| 3. | Tooth brush | 1 in every 3 months. |
| 4. | Toothpaste | 100gm (a tube) per month. |
| 5. | Comb | 1 in every 3 month. |
| 6. | Shampoo sachets | 8 in a month (10ml/ per sachet). |
| 7. | Bathing soap | 2 bars of 125gm per month. |
| 8. | Hair clip/ band | 2 bands in 3 month. |
| 9. | Moisturiser or coldcream (during winters) | 250 ml in a month. |
| S. No. | Items | Scale of Supply |
| 1. | Broom stick | 25 to 40 per month depending on the area of theinstitution. |
| 2. | Pesticide spray | As per the institution doctor's advice. |
| 3. | Effective bugs killing agent | As required. |
| 4. | Phenyl and cleaning acid | Depending on the area of lavatories to be(daily) cleaned as per institution doctor's advice. |
| 5. | Mosquito repellent machines | 2 per room per month with adequate fillets. |
31. Sanitation and Hygiene.
32. Daily Routine.
33. Nutrition and Diet Scale.
| S.No. | Name of the articles of diet | Scale per head per day |
| 1 | Rice/Wheat/Ragi/Jowar | 600 gms, (700 gms for16-18 yrs age) of whichatleast 100 gms to be either Wheat or Ragi or Jowar or Rice. |
| 2 | Dal/ Rajma/ Chana | 120 gms. |
| 3 | Edible Oil | 25 gms. |
| 4 | Onion | 25 gms. |
| 5 | Salt | 25 gms. |
| 6 | Turmeric | 05 gms. |
| 7 | Coriander Seed Powder | 05 gms. |
| 8 | Ginger | 05 gms. |
| 9 | Garlic | 05 gms. |
| 10 | Tamarind/ Mango powder | 05 gms. |
| 11 | Milk (at breakfast) | 150 ml. |
| 12 | Dry Chillies | 05 gms. |
| 13 | Vegetables Leafy Non V leafy | 100 gms. 130gms. |
| 14 | Curd or Butter Milk | 100 gms/ml. |
| 15 | Chicken once a week or Eggs 4 days | 115 gms. |
| 16 | Jaggery& Ground Nut Seeds or Paneer(vegetarian only) | 60 gms each (100 gms for paneer) Once in a week. |
| 17 | Sugar | 40 gms. |
| 18 | Tea/Coffee | 5gm. |
| 19 | Sooji/Poha | 150 gms. |
| 20 | Ragi | 150 gms. |
| Following items for 50 Children per day | ||
| 21 | Pepper | 25 gms. |
| 22 | Jeera Seeds | 25 gms. |
| 23 | Black Gram dal | 50 gms. |
| 24 | Mustard Seeds | 50 gms. |
| 25 | Ajwain Seeds | 50 gms. |
| On Chicken Day for 10 Kg. of Chicken | ||
| 26 | Garam Masala | 10 gms. |
| 27 | Kopra | 150 gms. |
| 28 | KhasKhas | 150 gms. |
| 29 | Groundnut Oil | 500 gms. |
| For Sick Children | ||
| 30 | Bread | 500 gms. |
| 31 | Milk | 500 ml. |
| 32 | Khichadi | 300 gms. |
| Other Items | ||
| 33 | LP Gas for Cooking only |
34. Medical Care.
35. Mental Health.
36. Education.
37. Vocational Training.
38. Recreational Facilities.
39. Management Committee.
40. Children's Committees.
41. Inspection.
42. Evaluation.
Chapter VII
Adoption
43. Adoption Related Reporting.
44. Children who are not being adopted after being declared legally free for adoption may be eligible for Foster Care.
45. Procedure before the Court.
46. Period for disposal of applications.
47. Special provision for protection of adopted children.
- Any case of offence committed against adopted child shall be dealt as per the law applicable to any other child.48. Linkage of Child Care Institutions to Specialised Adoption Agencies.
- Linkage of Child Care Institutions with Specialized Adoption Agencies for the purpose of adoption shall be governed by the provisions of section 66 of the Act and Adoption Regulations.49. Additional Functions of the Authority.
50. Terms and conditions of appointment of Members of the Steering Committee of the Authority.
51. Transaction of business of the Steering Committee of the Authority.
52. Annual Report of the Authority.
53. Accounts and audit of the Authority.
Chapter VIII
Offences Against Children
54. Procedure in cases of offences against children.
55. Procedure in case of offence under section 75 of the Act.
56. Procedure in case of offence under section 77 of the Act.
57. Procedure in case of offence under section 78 of the Act.
58. Procedure in case of offence under section 80 of the Act.
59. Procedure in case of offence under section 81 of the Act.
60. Procedure in case of offence under section 82 of the Act.
Chapter IX
Miscellaneous
61. Duties of the Person-in-charge of a Child Care Institution.
62. Duties of the Child Welfare Officer or Case Worker.
63. Duties of the House Mother or House Father.
64. Duties of a Probation Officer.
65. Rehabilitation-cum-Placement Officer.
66. Staff Discipline.
67. Security measures.
68. Searches and Seizures.
69. Institutional Management of Children.
- A. (1) Every child shall be received by the Person-in-charge of the Child Care Institution or such other official duly authorised by the Person-in-charge to receive a child, referred to as the Receiving Officer.70. Prohibited Articles.
71. Articles found on search and inspection.
72. Disposal of articles.
73. Maintenance of case file.
74. Visits to and communication with children.
75. Death of a Child.
76. Abuse and Exploitation of the Child.
77. Maintenance of Registers.
| S.No.(1) | Register and forms (2) | To be maintained by (3) | Custodian (4) |
| 1. | Admission and Discharge Register which willindicate change of nature of custody. | Child Welfare Officer/Case Worker/ReceivingOfficer | Person-in-charge |
| 2. | Attendance Registers for staff and children. | Shift Incharge | Person-incharge |
| 3. | Budget Statement file. | Person-in-charge | Person-incharge |
| 4. | Case file of each child. | Child Welfare Officer or Case Worker | Person-incharge |
| 5. | Cash Book. | Accounts Officer/Cashier | Person-incharge |
| 6. | Children's Suggestion Book. | Children's Committee | Person-incharge |
| 7. | Counselling Register. | Counsellor | Person-incharge |
| 8. | Drug de-addiction programme enrolment andprogress register. | Child Welfare Officer/ Case Worker | Person-incharge |
| 9. | Handing over Charge Register. | Shift Incharge | Person-incharge |
| 10. | House-keeping and Sanitation Register. | House Parent | Person-incharge |
| 11. | Inspection Book. | Person-in-charge | Person-incharge |
| 12. | Legal Services Register. | Child Welfare Officer/ Case Worker | Person-incharge |
| 13. | Library Register. | Teacher | Person-incharge |
| 14. | Log Book. | Driver | Person-incharge |
| 15. | Meals Register/Nutrition Diet File. | House Parent | Shift Incharge |
| 16. | Medical File of each child. | Staff Nurse | Person-incharge |
| 17. | Meeting Book. | Child Welfare Officer/ Case Worker | Person-incharge |
| 18. | Minutes Register of Children's Committees. | Child Welfare Officer/ Case Worker | Person-incharge |
| 19. | Minutes Register of Management Committee. | Person-in-charge | Person-incharge |
| 20. | Order Book. | Person-in-charge | Person-in-charge |
| 21. | Personal Belongings Register. | Child Welfare Officer/Case Worker | Person-incharge |
| 22. | Production Register | Probation Officer/ Child Welfare Officer/ CaseWorker | Person-incharge |
| 23. | Staff Movement Register. | Incharge of Security | Person-incharge |
| 24. | Stock Register. | L.D.C. or U.D.C. | Person-incharge |
| 25. | Visitor's Book | Security Guards | Main Gate's Keeper |
78. Openness and Transparency.
79. Release of a child from a Child Care Institution.
80. Child suffering from disease requiring prolonged medical treatment in an approved place and transfer of a child who is mentally ill or addicted to alcohol or other drugs.
81. Transfer of Child.
82. Restoration and Follow-up.
83. Juvenile Justice Fund.
84. State Child Protection Society.
85. District Child Protection Unit.
86. Special Juvenile Police Unit.
87. Selection Committee and its composition.
88. Selection of Chairperson and Members of the Committee or Board.
89. Training of Personnel Dealing with Children.
| S. No. | Personnel |
| 1 | Staff of Children's Court and PrincipalMagistrates of Juvenile Justice Boards |
| 2 | Members of Juvenile Justice Boards |
| 3 | Chairpersons and Members of Child WelfareCommittees |
| 4 | Child Welfare Police Officers and other policeofficers of Special Juvenile Police Units |
| 5 | Programme Managers and Programme Officers ofState Child Protection Societies and State Adoption ResourceAgency |
| 6 | Staff of State Adoption Resource Agency |
| 7 | Legal-cum-Probation Officers under DistrictChild Protection Units and Probation Officers in Child CareInstitutions |
| 8 | Staff of District Child Protection Units andState Child Protection Society |
| 9 | Persons-in-charge of Child CareInstitutions(including Open Shelters) |
90. Pending Cases.
91. Monitoring by National Commission for Protection of Child Rights and State Commissions for Protection of Child Rights.
92. Inquiry in case of a Missing Child.
93. Non-Compliance of the Act and the Rules.
- Any officer/institution, statutory body etc., who fails to comply with the provisions of the Act and the Rules framed there under, the State Government may take action against such officer/ institution, statutory body etc. after due inquiry and simultaneously make alternative arrangements for discharge of functions for effective implementation of the Act.94. Repeal.
- The Juvenile Justice (Care and Protection of Children) State Rules, 2007 notified vide 770 dated 25/05/2009,are hereby repealed:Provided that any action taken or order issued under the provisions of the Rules of 2007 prior to the notification of these rules shall, in so far it is not inconsistent with the provisions of these rules, be deemed to have been taken or issued under the provisions of these rules.Form 1[Rules 8 (1), 8 (5) and 8(7)]Social Background ReportFIR/DD No .............................................U/Sections ..............................................Police Station ..............................................Date & Time .............................................Name of I.O. ..............................................Name of CWPO ...............................................1. Name .............................................................................................
2. Father/Mother/Guardian¡¦s name...........................................................
3. Age/ Date of birth .............................................................................
4. Aadhaar Card No.............................................................................
5. Address............................................................................................
6. Religion
7. Whether the child is differently abled:
8. Family Details:
| S.No(1) | Name and Relationship (2) | Age(3) | Sex (4) | Education (5) | Occupation (6) | Income (7) | Health status (8) | History of Mental Illness (if any) (9) | Addictions (if any) (10) |
9. Reasons for leaving home ........................................................................
10. Whether there is a history of involvement of family members in offences, if any
| Yes | No |
11. Habits of the child
| A | B |
| (i) Smoking | (i) Watching TV/movies |
| (ii) Alcohol consumption | (ii)Playing indoor/ outdoor games |
| (iii) Drug use (specify) | (iii) Reading books |
| (iv) Gambling | (iv)Drawing/painting/acting/singing |
| (v) Begging | (v) Any other |
| (vi) Any other |
12. Employment Details, if any..................................................................
13. Details of income utilization:
| (i) | Sent to family to meet family need | Yes | No | |
| (ii) | Used by self for: | Yes | No |
14. The details of education of the child:
15. The reason for leaving School
16. The details of the school in which studied last:
17. Vocational training, if any ..................................................................
18. Majority of the friends are
19. Whether the child has been subjected to any form of abuse: Yes/No
| S.No | Type of Abuse | Remarks |
| 1. | Verbal abuse - parents/siblings/employers/others , (pl. specify) | |
| 2. | Physical abuse(pl. specify) | |
| 3. | Sexual abuse parents/siblings/ Employers/others(pl. specify) | |
| 4. | Others (pl. specify) |
20. Whether the child is a victim of any offence:
| Yes | No |
21. Whether the child is used by any gangs or adults or group of adults or has been used for drug peddling:
| Yes | No |
22. Reason for alleged offence such as parental neglect or over protection, peer group influence etc.....................................................................................................
23. Circumstances in which the child was apprehended ............................................................................................
24. Details of articles recovered from the child: ....................................................................................................................................................................................
25. Alleged role of the child in the offence:.........................................................................................................................................................................................
26. Suggestions of Child Welfare Police Officer......................................................................................................................................................
Signed byChild Welfare Police OfficerForm 2[Rule 8 (8)]Undertaking By The Parent Or Guardian or Fit Person Given Interim Custody Pending InquiryWhereas I,............... (Name) resident of House no........ Street ............ Village/Town............................District....................State.................do hereby declare that I am willing to take charge of (name of the child).......................... aged................ under the orders of the Board ......................... subject to the following terms and conditions:1. That I have annexed true, correct and authentic identification and address proof of myself.
2. That I undertake to produce him/her before the Board as and when required.
3. That I shall do my best for the welfare and education of the child as long as he/ she remains in my charge and shall make proper provision for his/her maintenance.
4. That in the event of his/her illness, he/she shall have proper medical attention in the nearest hospital and a report of it followed by a fitness certificate shall be submitted before the Board.
5. That I shall do my best to ensure that the child will not be subjected to any form of abuse/ neglect or exploitation
6. That if his/her conduct requires further supervision or care and protection, I shall at once inform the Board.
7. That if the child goes out of my charge or control, I shall immediately inform the Board.
Date this ..........................day of ....................20Signature of person executing the Undertaking/ Bond,(Signed before me)Juvenile Justice Board.Form 3[Rule 10 (1)(iii)]Supervision OrderWhen the child is placed under the care of a fit person/fit institution/Probation Officer pending inquiry FIR/DD No. ............ of............ 20..........PS...............Whereas ...................... (name of the child) is alleged to have committed an offence and is placed under the care of (Name)................................... (address)..........................................on executing a bond by the said ........................................ and the Board is satisfied that it is expedient to deal with the said child by making an order placing him/her under supervision.It is hereby ordered that the said child be placed under the supervision of ..............................for a period of...............subject to the following conditions:1. That the child shall reside at..................... for a period of..............and shall be produced before the Board as and when directed.
2. That the child shall not be allowed to quit the district jurisdiction of ..............without the permission of the Board.
3. That the child shall not be allowed to associate with such person who shall negatively influence the child.
4. That the person under whose care the child is placed shall arrange for the proper care, education and welfare of the child.
5. That the preventive measures will be taken by the person under whose care the child is placed to see that the child does not commit any offence punishable by any law in India.
6. That the child shall be prevented from taking narcotic drugs or psychotropic substances or any other intoxicants. The person under whose supervision the child is placed shall report any such act of the child to the Board.
Dated this................day of.................................. 20...............1. Name..........................................................................................
2. Age/Date/Year of birth..................... ............................................
3. Aadhaar Card No ......................................................................
4. Sex.......................................
5. Caste....................................
6. Religion...............................
7. Father's Name................................................................................
8. Mother's Name ..............................................................................
9. Guardian's Name...........................................................................
10. Permanent Address........................................................................
11. Landmark of the address.................................................................
12. Address of last residence.................................................................
13. Contact no. of father/mother/family member...........................................
14.
Whether the child is differently abled: Yes/No15.
Family Details:| S.No (1) | Name and Relationship (2) | Age (3) | Sex (4) | Education (5) | Occupation (6) | Income (7) | Health status (8) | History of Mental Illness (if any) (9) | Addictions (if any) (10) |
16. If the child or person is married, name, age and details of spouse and children:
......................................................................................................................................................................... ..............................................................................17. Relationship among the family members:
| i. Father & mother | Cordial/ Non cordial/ Not known |
| ii. Father & child | Cordial/ Non cordial/ Not known |
| iii. Mother & child | Cordial/ Non cordial/ Not known |
| iv. Father & siblings | Cordial/ Non cordial/ Not known |
| v. Mother & siblings | Cordial/ Non cordial/ Not known |
| vi. Child & siblings | Cordial/ Non cordial/ Not known |
| vii. Child & grandparents(paternal/maternal) | Cordial/ Non cordial/ Not known |
18.
History of involvement of family members in offences, if any:| S. No. | Relationship | Nature of Crime | Legal status of the case | Arrest if any made | Period of confinement | Punishment awarded |
| 1. | Father | |||||
| 2. | Step father | |||||
| 3. | Mother | |||||
| 4. | Step mother | |||||
| 5. | Brother | |||||
| 6. | Sister | |||||
| 7. | Others (uncle/ aunty/ grandparents) |
19. Attitude towards religion of child and family.................................................
20. Present living conditions .........................................................................
21. Other factors of importance if any.............................................................
22. (i) Habits of the child (Tick as applicable)
| A | B |
| (a) Smoking | (g) Watching TV/movies |
| (b) Alcohol consumption | (h) Playing indoor/ outdoor games |
| (c) Drug use (specify) | (i) Reading books |
| (d) Gambling | (j) Religious activities |
| (e) Begging | (k) Drawing/painting/acting/singing |
| (f) Any other | (l) Any other |
23. Child's opinion/reaction towards discipline in the home...................................
24. Employment Details of the child, if any.........................................................
25. Details of income utilization and manner of income utilization...........................
26. Work record (reasons for leaving vocational interests, attitude towards job or employers)..................................................................................................
27. The details of education of the child:
28. Attitude of class mates towards the child......................................................
29. Attitude of teachers and classmates towards the child....................................
30. The reason for leaving School (tick Yes/No as applicable)
31. The details of the school in which studied last:
32. Vocational training, if any......................................................................
33. Majority of the friends are
34. Attitude of the child towards friends.........................................................
35. Attitude of friends towards the child.........................................................
36. Observations of neighbours towards the child............................................
37. Observations about neighborhood (to assess the influence of neighborhood on the child).......................................................................................
38. Whether the child has been subjected to any form of abuse, if applicable: Yes/No
| S.No | Type of Abuse | Remarks |
| 1. | Verbal abuse - parents/ siblings / employers /others , (pl. specify) | |
| 2. | Physical abuse(pl. specify) | |
| 3. | Sexual abuse parents/siblings/ Employers/others(pl. specify) | |
| 4. | Others (pl. specify) |
39. Whether the child is a victim of any offence: Yes/No
40. Whether the child is used by any gangs or adults or group of adults or has been used for drug peddling: Yes/No
41. Does the child has tendency to run away from home, give details if any: Yes/No
42. Circumstances of apprehension of the child.................................................
43. Alleged role of the child in the offence.......................................................
44. Reason for alleged offence:
45. Whether the child has been apprehended earlier for any offence, if yes give details including stay in a child care institution .................................................................................... Yes/No
46. Previous institutional/case history and individual care plan, if any:
47. Physical appearance of the child:
48. Health condition of the child (including medical examination report, if applicable)
49. Mental condition of the child:
50. Any other remark
Result of Inquiry1. Emotional factors ...........................................................................
2. Physical condition ..........................................................................
3. Intelligence .................................................................................
4. Social and economic factors............................................................
5. Suggestive causes of the problems...................................................
6. Analysis of the case, including reasons/contributing factors for the offence
7. Opinion of experts consulted............................................................
8. Recommendation regarding rehabilitation by Probation Officer/Child Welfare Officer...........................................................................................
Signature of the Probation Officer/ Child Welfare Officer/ Social WorkerStamp and Seal where availableForm 7[Rules 11(3), 13(7)(vi), 13(8)(ii), 19(4), 19(17), 62(6)(vii), 62(6)(x), 69 I (3)]Individual Care PlanChild in Conflict with Law/ Child in Need of Care and Protection(tick whichever is applicable)Name of Case Worker/Child Welfare Officer/Probation officer........................Date of preparing the ICP ...........................................................................Case/Profile No...............of 20.....................FIR No................................................................U/Sections (Type of offence),applicable in case of Children in Conflict with Law......Police Station..............................................................................................Address of the Board or the Committee............................................................Admission No.(if child is in an institution)..........................................................Date of Admission (if child is in an institution)...................................................Stay of the child (Fill as applicable)| (i) | Short term (up to six months) | |
| (ii) | Medium Term (six months to one year) | |
| (iii) | Long term (more than 1 year) |
1. Name of the Child.......................................
2. Age/Date of Birth.................................
3. Aadhaar Card No.............................
4. Sex: Male/Female........................
5. Father's name:............................................
6. Mother's name..........................................
7. Nationality...........................................
8. Religion..............................................
9. Caste................................................
10. Language spoken................................
11. Level of Education.............................................................................
12. Details of Savings Account of the child, if any.........................................
13. Details of child's earnings and belongings, if any....................................
14. Details of awards/rewards received by the child, if any..............................
15. Based on the results of Case History, Social Investigation report and interaction with the child, give details on following areas of concern and interventions required, if any
| S.No. | Category | Areas of concern | Proposed Interventions |
| 1. | Child's expectation from care and protection | ||
| 2. | Health and nutrition needs | ||
| 3. | Emotional and psychological support needs | ||
| 4. | Educational and Training needs | ||
| 5. | Leisure, creativity and play | ||
| 6. | Attachments and Inter-personal Relationships | ||
| 7. | Religious beliefs | ||
| 8. | Self care and life skill training for Protectionfrom all kinds of abuse, neglect and maltreatment | ||
| 9. | Independent living skills | ||
| 10. | Any other such as significant experiences whichmay have impacted the development of the child like trafficking,domestic violence, parental neglect, bullying in school, etc.(Please specify) |
1. Name of the Probation Officer/Case Worker/Child Welfare Officer......................
2. Period of the report.................................................................................
3. Admission No.........................................................................................
4. Board or Committee...............................................................................
5. Profile No....................................................
6. Name of the Child.........................................
7. Stay of the child (Fill as applicable)
8. Place of interview .......................... Dates.........................
9. General conduct and progress of the child during the period of the report ..........................................................................................................................
10. Progress made with regard to proposed interventions as mentioned in point 14 of Part A of this Form.
| S.No. | Category | Proposed Interventions | Progress of the child |
| 1. | Child's expectation from care and protection | ||
| 2. | Health and nutrition needs | ||
| 3. | Emotional and psychological support needed | ||
| 4. | Educational and Training needs | ||
| 5. | Leisure, creativity and play | ||
| 6. | Attachments and Interpersonal Relationships | ||
| 7. | Religious beliefs | ||
| 8. | Self care and life skill training for Protectionfrom all kinds of abuse, neglect and maltreatment | ||
| 9. | Independent living skills | ||
| 10. | Any other such as significant experiences whichmay have impacted the development of the child like trafficking,domestic violence, parental neglect, bullying in school, etc.(Please specify) |
11. Any proceedings before the Committee or Board or Children's Court
12. Period of supervision completed on.............................................
Result of supervision with remarks (if any)........................................Name and Addresses of the parent or guardian or fit person under whose care the child is to live after the supervision is over...................................................Date of report.....................Signature of the Probation Officer.......................C. Pre-Release Report (to be prepared 15 days prior to release)1. Details of place of transfer and authority concerned responsible in the place of transfer/release
2. Details of placement of the child in different institutions/family
3. Training undergone and skills acquired
4. Last progress report of the child (to be attached, refer Part B)
5. Rehabilitation and restoration plan of the child ( to be prepared with reference to progress reports of the child)
| S.No. | Category | Rehabilitation and restoration plan of thechild |
| 1. | Child's expectation from care and protection | |
| 2. | Health and nutrition | |
| 3. | Emotional and psychological | |
| 4. | Educational and Training | |
| 5. | Leisure, creativity and play | |
| 6. | Attachments and Inter-personal Relationships | |
| 7. | Religious belief | |
| 8. | Self care and life skill training for Protectionfrom all kinds of abuse, neglect and maltreatment | |
| 9. | independent living skills | |
| 10. | Any other |
6. Date of release/transfer/repatriation.............................................................
7. Requisition for escort if required................................................................
8. Identification Proof of escort such as driving license, Aadhar Card, etc............
9. Recommended rehabilitation plan including possible placements/sponsorships....
10. Details of Probation Officer/non-governmental organization for post-release followup............................................................................................
11. Memorandum of Understanding with non-governmental organisation identified for post-release follow-up (Attach a copy)........................................................
12. Details of sponsorship agency/individual sponsor, if any................................
13. Memorandum of Understanding between the sponsoring agency and individual sponsor (Attach a copy)............................................................................
14. Medical examination report before release...................................................
15. Any other information...........................................................................
D. Post-Release/restorastion Report Of The Child1. Status of Bank Account : Closed / Transferred
2. Earnings and belongings of the child: handed over to the child or his parents/guardians - Yes/No
3. First interaction report of the Probation Officer/Child Welfare Officer/Case Worker /social worker/non-governmental organisation identified for follow-up with the child post-release..............................................................................
4. Progress made with reference to Rehabilitation and Restoration Plan.................
5. Family's behavior/attitude towards the child....................................................
6. Social milieu of the child, particularly attitude of neighbours/community................
7. How is the child using the skills acquired........................................................
8. Whether the child has been admitted to a School or vocation? Give date and name of the school/institute/any other agency ................................................... Yes/No
9. Report of second and third follow-up interaction with the child after two months and six months respectively....................................................................
10. Efforts towards social mainstreaming and child's opinion/views about it............
11. Identity Cards and Compensation
[Instruction: Please verify with the physical documents]| Identity Cards | Present status (Please tick whichever isapplicable) | ||
| Yes | No | Action taken | |
| Birth Certificate | |||
| School certificate | |||
| Caste certificate | |||
| BPL Card | |||
| Disability Certificate | |||
| Immunization card | |||
| Ration Card | |||
| Adhaar Card | |||
| Received compensation from Government |
1. That I shall not change my place of residence without giving previous intimation in writing to the Juvenile Justice Board through the Probation Officer;
2. That I shall not remove the said child from the limits of the jurisdiction of the Juvenile Justice Board without previously obtaining the written permission of the Board;
3. That I shall send the said child daily to school/to such vocation as is approved by the Board unless prevented from so doing by circumstances beyond control;
4. That I shall sincerely give effect to the Individual Care Plan with the help of the Probation Officer;
5. That I shall report immediately to the Board whenever so required by it and also produce the child before the Board as and when directed to do so;
6. That I shall produce the said child in my care before the Board, if he/she does not follow the orders of Board or his/her behavior is beyond my control;
7. That I shall report to the Board if the child goes out of my control or charge;
8. That I shall render all necessary assistance to the Probation Officer to enable him to carry out the duties of supervision;
In the event of my making default herein, I undertake to appear before the Board and bind myself to pay to Government the sum of Rs .................... (Rupees..................................). Dated this ....................day of ...................................20.Signature of person executing the Undertaking/Bond.(Signed before me)Principal Magistrate/ Member Juvenile Justice BoardAdditional conditions, if any, by the Juvenile Justice Board may be entered numbering them properly;(Where a bond with sureties is to executed add)I/We ................................ of ........................... (place of residence with full particulars) hereby declare myself/ourselves as surety/sureties for the aforesaid .................... (name of the person executing the undertaking/bond) to adhere to the terms and conditions of this undertaking/bond. In case of ...................... (name of the person executing the bond) making fault therein, I/We hereby bind myself/ourselves jointly or severally to forfeit to government the sum of Rs................../- (Rupees..................................) dated this the........... day of ................20.............. in the presence of ..............................Signature of Surety(ties)(Signed before me)Principal Magistrate/ Member, Juvenile Justice BoardForm 9[Rules 11(7)]Personal Bond By ChildWhereas I, ........................ inhabitant of..........................(give full particulars such as house number, road, village/town, tehsil, district, state) have been ordered to be sent back/restored by the Juvenile Justice Board .......................under section ........... of the Juvenile Justice (Care and Protection of Children) Act, 2015 on my entering into a personal bond to observe the conditions mentioned herein below. Now, therefore, I do solemnly promise to abide by these conditions during the period.................................I hereby bind myself as follows:1. That during the period.............. I shall not ordinarily leave the village/town/district to which I am sent and shall not ordinarily return to.........................or go anywhere else beyond the said district without the prior permission of the Board;
2. That during the said period I shall attend school/ vocational training in the village/town or in the said district to which I am sent;
3. That in case of my attending school/ vocational training at any other place in the said district I shall keep the Board informed of my ordinary place of residence.
I hereby acknowledge that I am aware of the above conditions which have been read over/explained to me and that I accept the same.(Signature or thumb impression of the child)Certified that the conditions specified in the above order have been read over/explained to (Name of child) ..........................and that he has accepted them as the conditions upon non-compliance of which he/she may be placed in safe custody. Certified accordingly that the said child has been released/ relieved on (date) ......................SignaturePrincipal Magistrate/Members Juvenile Justice BoardForm 10[Rules 11(9) and 64 (3) (xiii)]Periodic Report By Probation Officer When A Child Is Released On ProbationFIR No................ Police Station ..............U/Sections............... In the matter of.................... vs..........................................Whereas (name of the child) ......................., age............, has on....... (date) been found to be a child in conflict with law, and has been placed under the care of .................. (parent/ guardian/ fit person/fit facility) and under the supervision of .....................(name of Probation Officer)| Reg. No. :- | Age (approximately):-Aadhaar Card No: - | Sex:- Male / Female / |
| Name:- | Fathers Name:- | Religion:- |
| Education: - | Vocational Training, if any | Language(s) known:- |
| Next court date:- | Employment, if any | Date of admission (in case of fit person/fitfacility) |
1. Preliminary details:
2. Observations:
3. Visit to school/ vocational training centre
4. Visit to place of employment:
5. Did you spend time speaking privately with the child If no, give reasons............................................ Yes No
6. Progress made as per Rehabilitation and Restoration Plan under the Individual Care Plan (refer point 14 of form 7).................................................................. ..........................
7. Recommendations for modifications in Rehabilitation and Restoration Plan under the Individual Care Plan , if any:
Prepared by: ...............................................(Probation Officer ...../...../.... (date)Plan: Date of next visit: ........................Action point if any: ....................................Signature(Probation Officer)Form 11[Rule 12(1)]Case Monitoring Sheet(Separate Sheet may be used in case there are more than one child)Juvenile Justice Board, District..................Case No. .............................of.............................Case Name:| Police Station..................................................U/S................................................................... | Date........................................................FIR/ GD/ DD No........................................ |
| Name of Probationofficer...............................Name of Lawyer............................................(If not represented provide Legal Aid Lawyer) | Name of IO..............................................Name of Child Welfare Police Officer...... |
| Nature of OffencePetty(maximum punishmentupto three years)Serious(maximum punishmentbetween three to seven years)Heinous(minimum punishment for seven years or more) |
| Particulars Of Child | |||
| Name | Parents/ Guardian with Contact No. | Present address | Permanent address |
| Date and Time child Apprehended | ||
| Date And Time Of First Production | ||
| Date Of Medical Examination Under Section 54Cr.P.C. | ||
| Age Determination | ||
| Age on the Date of offence | ||
| Date of age Determination | ||
| Time taken for age determination | ||
| Determination by | Board | Court |
| Evidence Relied: | Documents | Medical |
| Custody of the child | ||
| In Observation Home/ Place of Safety | Date of grant of bail | Sent under supervision (Name of Institution) |
| From...........To............ |
| Steps to be taken | Scheduled Date | Actual Date |
| Day 1: Social Background Report by Police (inForm No. 1) | Dated........ | |
| Day 1: Consideration of Bail | Dated........ | |
| Day 2: Age determination | Dated......... | |
| Day 2: SIR (Form No.6) by Probation Officer | Dated.......... | |
| Day 2: Section 173 CrPC Final Report by Policeon completion of Investigation | Dated.......... | |
| Day 3: Submission of Report on Provisions offurther investigation, if any | Dated............ | |
| Day 3: Section 251 CrPC Notice | Dated............. | |
| Day 4-6: ProsecutionEvidence (From......... to.......)Depending on the number of witnesses continuousdates may be fixed) | Dated........Dated.........Dated......... | |
| Day 7: Statement of child under Section 281 CrPC | Dated............ | |
| Day 8: Defence Evidence | Dated........... | |
| Day 8: Individual Care Plan (In case of child ininstitutional care Individual Care Plan should be prepared withinone month of admittance | Dated............. | |
| Day 9: Final Arguments | Dated............ | |
| Day 10: Dispositional (Final) Order | Dated........... | |
| Day 11: Post Dispositional Review | Dated.......... |
| S.No. | Details | Date of Appointment | Training attended |
| 1. | Principal Magistrate | ||
| 2. | Member 1 | ||
| 3. | Member 2 | ||
| 4. | Member 3 |
| Visit to Child CareInstituion by BoardDate of visit:Name and Address ofHome :Remark: |
| Visit To Jails ByPrincipal MagistrateDate of Visit:Whether any childrenfound:Action taken: |
| Cases Instituted During The Quarter: | ||||
| Petty | Serious | Heinous | Total | |
| Number cases | ||||
| Number of Children | ||||
| Children granted bail | ||||
| Children sent to Observation Home | ||||
| Number of cases where preliminary reports weresubmitted in stipulated time |
| Pendency of cases | |||||||
| Nature of case | Old cases | New cases | Disposal | Current pendency | |||
| Less than 4 months | 4 months to 6 months | 6 months to 1 year | More than 1 year | ||||
| Petty | |||||||
| Serious | |||||||
| Heinous | |||||||
| Total |
| Final OrderTotal number of final orders passed | |||||||
| Discharged | Transfer to other JJB | Abated on Death | Repatriated to Foreign Country | Transferred to Children's Court | Declared Compounded & file consigned | Terminate d under rule ....... (postproductionprocess) | Acquitted/ Finding of commission in offence |
| Nature of Dispositional Orders where child hascommitted Offence (mention the No. of orders) | |||||||
| Complaint/suggestion,if any, Received and Action Taken________________________________________________________________________ |
| Remark/suggestionby Boarda. PrincipalMagistrate________________________________________________________b. Member : 1______________________________________________________________c. Member: 2_______________________________________________________________ |
| Principal Magistrate | Member -1 | Member -2 |
1. Case details and summary............................ ............................................................................................................. ............................................................................................................
2. Individual Care Plan (Attach a copy).......... ............................................................................................................ ............................................................................................................
3. Fortnightly progress made as per Individual Care Plan..................................... ............................................................................................................
4. Development of new interests...................................................................... .............................................................................................................
5. Psycho-social progress made by the child: (to be prepared with the help of a psycho-social expert).................................................................................
I. Mental Status Evaluationa.Appearance (Observed) - Possible descriptors: • posture, clothes, grooming.b.Behavior (Observed) - Possible descriptors: • Mannerisms, gestures, psychomotor activity, expression, eye contact, ability to follow commands/requests, compulsionsII. Attitude (Observed) - Possible descriptors: • Cooperative, hostile, open, secretive, evasive, suspicious, apathetic, easily distracted, focused, defensive.III. Level of Consciousness (Observed) - Possible descriptors: • Vigilant, alert, drowsy, lethargic, stuporous, asleep, comatose, confused, fluctuating.IV. Orientation (Inquired) - Possible questions: • "What is your full name?" • "Where are we at (floor, building, city, county, and state)?" • "What is the full date today (date, month, year, day of the week, and season of the year)?" • "How would you describe the situation we are in?"V. Speech and Language (Observed) A. Quantity - Possible descriptors: • Talkative, spontaneous, quiet B. Rate - Possible descriptors: • Fast, slow, normal, pressured. C. Volume (Tone).VI. Mood (Inquired): A sustained state of inner feeling - Possible questions: • "How are you feeling?" • "Have you been discouraged/depressed/low?" • "Have you been energized/elated/high/out of control lately?" • "Have you been angry/irritable?"VII. Affect (Observed): An observed expression of inner feeling.VIII. Thought Processes or Thought Form (Inquired/Observed): logic, relevance, organization, flow and coherence of thought in response to general questioning during the interview. - Possible descriptors: goaldirected, circumstantial, loose associations, incoherent, evasive, perseveration.IX. Thought Content (Inquired/Observed)X. Suicidality and Homicidality - AssessmentXI. Insight (Inquired/Observed) -XII. Attention (Inquired/Observed) -XIII. Feelings of guilt/ remorse: present/ absent6. Status of Current Educational/ Vocational Rehabilitation Programme
• Motivation for the programme.............................................................• Level of cooperativeness....................................................................• Regularity........................................................................................• Quality of work/performance...............................................................7. Impact of institutionalization on the person..............................................
8. Approach to evaluation/ periodic follow ups.............................................
Willingness /ability to participate in treatment and rehabilitation in programs/facilities, consistent with public safety.Recommendations (including whether the person may be released or released on conditions or requires further institutionalization with justification)Date : / /Place :Name :Designation :Signature :Recommendations/Findings: ..................Signature / SealPrepared by: ...............................................(Probation Officer/Social Worker/ Child Protection Officer ...../...../.... (date)Form 14[Rules 7 (1) (ii), 13(8)(vi)( C ) (cd), 17(1)(vi), 19(20), 65(3)(viii), 69E(2), 69 I (4), 69J(1), 69J(3)]Rehabilitation CardFIR No. /Case No.U/SectionsPSNature of Offence: heinous, serious or petty (in case of child in conflict with law)Name of Probation Officer/Child Welfare Officer/Rehabilitation cum Placement Officer:........................................................Name of the child:Age:Aadhaar Card No :Sex:Father's name:Mother's name:Admission No.Date of Admission:Date of Provisional Release / Release:Services availed under Individual Care Plan -| Indicators | Child's expectation from care and protection |
| First Month | Plan :Outcome : |
| Second Month | Plan :Outcome : |
| Third Month | Plan :Outcome : |
| Fourth Month | Plan :Outcome : |
| Health and Nutrition | |
| First Month | Plan :Outcome : |
| Second Month | Plan :Outcome : |
| Third Month | Plan :Outcome : |
| Fourth Month | Plan :Outcome : |
| Emotional and psychological support needed | |
| First Month | Plan :Outcome : |
| Second Month | Plan :Outcome : |
| Third Month | Plan :Outcome : |
| Fourth Month | Plan :Outcome : |
| Education and Training | |
| First Month | Plan :Outcome : |
| Second Month | Plan :Outcome : |
| Third Month | Plan :Outcome : |
| Fourth Month | Plan :Outcome : |
| Leisure, creativity and play | |
| First Month | PlanOutcome |
| Second Month | PlanOutcome |
| Third Month | PlanOutcome |
| Fourth Month | PlanOutcome |
| Attachments and Inter-personal Relationships | |
| First Month | PlanOutcome : |
| Second Month | PlanOutcome : |
| Third Month | PlanOutcome : |
| Fourth Month | PlanOutcome : |
| Self Care and Life Skill Training forProtection from all kinds of abuse, neglect and maltreatment | |
| First Month | PlanOutcome : |
| Second Month | PlanOutcome : |
| Third Month | Plan Outcome : |
| Fourth Month | PlanOutcome : |
| Independent living skills | |
| First Month | PlanOutcome : |
| Second Month | PlanOutcome : |
| Third Month | PlanOutcome : |
| Fourth Month | PlanOutcome : |
| Any other such as significant experienceswhich may have impacted the development of the child liketrafficking, domestic violence, parental neglect, bullying inschool etc. | |
| First Month | PlanOutcome : |
| Second Month | PlanOutcome : |
| Third Month | PlanOutcome : |
| Fourth Month | PlanOutcome : |
1. Overall progress shown by the child on the above mentioned aspects of the Individual Care Plan
2. Child's acceptance and understanding of his actions and its consequences
3. Child's willingness to reform
4. Child's behavior and conduct
5. Offence committed by the child , if any reported by family or neighbourhood, in case of a child in conflict with law who is not placed in a Child Care Institution
Signed byJJB/ CWCForm 15[Rule 17 (1)(i)]Case Summary Maintained by the Child Welfare CommitteeCase No.................................In Re.........................................Case Record..........................1. Name of the child..............................................................
2. Aadhaar Card No..............................................................
3. Father's/Mother's/Guardian's name (if available)......................
4. Date of production of the child.............................................
5. Name of person producing the child....................................
6. A list of all follow up dates (of the child, before the Committee).....................
7. Orders passed by the CWC (tick as applicable)
8. Medical Records including but not limited to age verification......................
9. Social Investigation Report under Form 22.............................................
10. Individual Care Plan under Form 7.....................................................
11. Rehabilitation Card in Form 14............................................................
12. Case History Form 43........................................................................
13. All details, documents and records with regards to Sponsorship/Foster Care/Adoption services (if applicable).
Date:Place:| S.No. | Details | Date of Appointment | Training attended |
| 1. | Chairperson | ||
| 2. | Member 1 | ||
| 3. | Member 2 | ||
| 4. | Member 3 | ||
| 5. | Member 4 |
| S.No. | Number of cases at the beginning of Quarter | Number of cases received during the quarter | Number of cases disposed of during the quarter | Number of cases pending at the end of quarter | Reasons for pendency |
| Final Order | |||||||
| Total number of final orders passed during thequarter | |||||||
| Released to parent/guardian/ fit person/fit institution | Transfer to other CWC | Ordered to stay inCCI | Repatriated toForeign Country | Declared legally freefor adoption | Ordered for fostercare / sponsorship/ Aftercare | Recommend to JJB forfiling FIR | Initiate process ofcompensation to child, if eligible |
1. Details of person who is producing the child:
2. The child who is being produced:
3. Details of parents / guardians (if available):
4. Place where the child was found..................................
5. The details of the person (if any) with whom the child was found:
i. Name ...........................ii. Age..................................iii. Address.....................................iv. Contact number..............................v. Occupation............................6. Circumstances under which the child was found............................
7. Allegation by the child of any offence/ abuse committed on the child in any manner................................................
8. Physical condition of the child..................................................
9. Belongings of the child at the time of production...................................
10. Date and Time at which the child came to the CCI/SAA...............................
11. Immediate efforts made to trace family of the child ...................................
12. Medical treatment, if provided to the child ...................................
13. Whether police has been informed ....................................................
Signature/ Thumb impression of the childSignature/ Thumb impression of the person who produced the childPolice-Local Police/Special Juvenile Police Unit/ designated child welfare police officer / Railway Police/Probation Officers/ any public servant/Social Welfare Organization/Social Worker/ Person in-charge CCI/ SAA/ any citizen/Child himself/herself (fill as applicable)Form 18[Rules 18 (5), 18 (9) and 19 (26) ]Order of Placement of a Child in an Institution(Children's Home/Fit Facility/SAA)Case No....................................To,The Officer-in-Charge,Whereas on the .......................day of ................20 ............. (name of the child) ........................., son/daughter of ................... aged ...........residing at ...................... being in care and protection under the Juvenile Justice (Care and Protection) Act 2015 is ordered by the Child Welfare Committee ....................., to be kept in the Children's Home/SAA/Fit Facility..........................for a period of .....................This is to authorize and require you to receive the said child in your charge, and to keep him/her in the Children's Home/ Fit Facility /SAA.................... for the aforesaid order to be carried into execution according to law. The concerned official shall upload the details in case of an orphan or abandoned child in the TrackChild/ relevant Web Portal.Given under my hand and the seal of Child Welfare Committee.This ................ day of .............................1. the child along with the copies of the order and the bond, if any, executed by the said............................... shall be produced before the Committee as and when required by the person executing the bond
2. the child shall reside at ............................. for a period of ......................
3. the child shall not be allowed to quit the district jurisdiction of .....................without the permission of the Committee.
4. the child shall go to school/ vocational training centre regularly. The child shall attend ...................(name of) school/ vocational training centre (if already identified) at ......................(address of school/ vocational training centre).
5. the person under whose care the child is placed shall arrange for the proper care, education and welfare of the child.
6. the child shall not be allowed to associate with undesirable characters and shall be prevented from coming in conflict with law.
7. the child shall be prevented from taking narcotic drugs or psychotropic substances or any other intoxicants.
8. the directions given by the Committee from time to time, for the due observance of the conditions mentioned above, shall be carried out.
Dated this ______________day of _____________20 _____________1. If his conduct is unsatisfactory I shall at once inform the Committee.
2. I shall do my best for the welfare and education of the said child as long as he remains in my charge and shall make proper provision for his maintenance.
3. In the event of his/her illness, he shall have proper medical attention in the nearest hospital.
4. I agree to adhere to the conditions that may be imposed by the Committee from time to time and also to keep the Committee informed about the compliance with the conditions.
5. I undertake to produce him/her before the Committee as and when required.
6. I shall inform the Committee immediately if the child goes out of my charge or control.
Date this ..................day of ....................SignatureSigned before Child Welfare CommitteeForm 21[Rule 19(3)]Order for social investigation report of child in need of care and ProtectionToChild Welfare Officer/ Social Worker/Case Worker/ Person in-charge of Home/ representative of Non- Governmental OrganizationWhereas a report under section 31 (2) of the Juvenile Justice (Care and Protection of Children) Act, 2015 has been received from ...................... in respect of (name of the child)..............., aged (approximate)........., son/daughter of ..............................residing at........................, who has been produced before the Committee under section 31 of the Juvenile Justice (Care and Protection of Children) Act, 2015.You are hereby directed to conduct Social Investigation as per Form 22 for the above child. You are directed to enquire into socio economic and family background of the said child.You are directed to submit the Social Investigation Report on or before ................. (date).Dated this .............day of .......................20...........................1. Name.............................................................
2. Age/Date/Year of birth.....................
3. Sex......................................................................
4. Caste..................................................................
5. Religion.....................................................................
6. Aadhaar Card No.........................................................
7. Father's Name............................................................
8. Mother's Name ......................................................
9. Guardian's Name...............................................
10. Permanent Address...............................................
11. Landmark of the address.....................................
12. Address of last residence.......................................
13. Contact no. of father/mother/family member....................
14. Whether the child is differently abled: Yes/ No
15. Family Details:
| S.N . (1) | Name and Relati onshi p (2) | Age (3) | Sex (4) | Education (5) | Occupation (6) | Income (7) | Health status (8) | History of Mental Illness (9) | Addictions (10) |
16. Relationship among the family members:
| i. Father & mother | Cordial/ Non cordial/ Not known |
| ii. Father & child | Cordial/ Non cordial/ Not known |
| iii. Mother & child | Cordial/ Non cordial/ Not known |
| iv. Father & siblings | Cordial/ Non cordial/ Not known |
| v. Mother & siblings | Cordial/ Non cordial/ Not known |
| vi. Chile Non | cordial/ Not known |
| vii. Child & relative | Cordial/ Non cordial/ Not known |
17. If child is married, name, age and details of spouse and children....................... ...............................................................................................................
18. History of involvement of family members in offences, if any:
| S. No. | Relationship | Nature of Crime | Legal status of the case | Arrest if any Made | Period of Confinement | Punishment awarded |
| 1. | Father | |||||
| 2. | Step father | |||||
| 3. | Mother | |||||
| 4. | Step mother | |||||
| 5. | Brother | |||||
| 6. | Sister | |||||
| 7. | Others (uncle/ aunty/ grandparents) |
19. Attitude towards religion....................................................................
20. Present living conditions ...............................................................
21. Other factors of importance if any...............................................
22. Habits of the child
| A | B |
| (i) Smoking | (i) Watcing TV/movies |
| (ii) Alcohol consumption | (ii) Playing indoor/outdoor games |
| (iii) Drug use (specify) | (iii) Reading books |
| (iv) Gambling | (iv) Religious activities |
| (v) Begging | (v) Drawing/painting/acting/singing |
| (vi) Any other | (vi) Any other |
23. Extra-curricular interests..............................................................
24. Outstanding characteristics and personality traits..................................
25. The details of education of the child (tick as applicable)
26. The details of the school in which studied last(tick as applicable) :
a. Corporation/Municipal/Panchayatb. Government/SC Welfare School/BC Welfare Schoolc. Private management27. Attitude of class mates towards the child......................................................
28. Attitude of teachers and classmates towards the child....................................
29. The reason for leaving School (tick as applicable)
a. Failure in the class last studiedb. Lack of interest in the school activitiesc. Indifferent attitude of the teachersd. Peer group influencee. To earn and support the familyf. Sudden demise of parentsg. Bullying in schoolh. Rigid school atmospherei. Absenteeism followed by running away from schoolj. There is no appropriate level of school nearbyk. Abuse in schooll. Humiliation in schoolm. Corporal punishmentn. Medium of instructiono. Others (pl. specify)30. Vocational training, if any............................................................
31. Employment Details, if any............................................................
32. Details of income utilization............................................................
33. Work record (reasons for leaving vocational interests, attitude towards job or employers)......................................................................................
34. Majority of the friends are (tick as applicable)
35. Attitude of the child towards friends...............................................
36. Attitude of friends towards the child.......................................................
37. observation about neighbourhood (to assess the influence of neighbourhood on the child)....................................................................................................
38. Mental condition of the child: (Present and past)........................................
39. Physical condition of the child: (Present and past)........................................
40. Health status of the child
i. Respiratory disorders - present / not known / absentii. Hearing impairment - present / not known / absentiii. Eye diseases- present / not known / absentiv. Dental disease- present / not known / absentv. Cardiac diseases- present / not known / absentvi. Skin disease-present / not known / absentvii. Sexually transmitted diseases- present / not known / absentviii. Neurological disorders- present / not known / absentix. Mental handicap- present / not known / absentx. Physical handicap- present / not known / absentxi. Urinary tract infections -present / not known / absentxii. Others (pl. specify) -41. Whether the child has any addiction Yes/ No
42. With whom the child was staying prior to production before the Committee
43. History/ tendency of the child to run away from home, if any..........................
44. Parents attitude towards discipline in the home and child's reaction................
45. Reasons for leaving the family (tick as applicable)
46. Whether the child is a victim of any offence Yes/No
47. Types of abuse met by the child (tick as applicable)
48. Types of ill-treatment met by the child(tick as applicable).
49. Exploitation faced by the child
50. Whether the child has been bought or sold or procured or trafficked for any purpose Yes/ No
51. Whether the child has been used for begging Yes/ No
52. Whether the child is used by any gangs or adults or group of adults or has been used for drug peddling: Yes/ No
53. Previous institutional/case history and individual care plan, if any:....................
54. Details of perpetrator: ( such as Name, Age, Contact number, Address details, Physical Characteristics, Relationship with the family, middle men involved, is there any other child from the same village who is abused / harassed / taken / sent by the perpetrator, how the child came in contact with the perpetrator)............................. ...............................................................................................................
55. Attitude of the child towards the perpetrator..................................................
56. Whether the police have been informed.......................................................
57. Action taken, if any against the perpetrator..................................................
58. Any other remark......................................................................
Observations of Inquiry1. Emotional factors.......................................
2. Physical condition..........................................
3. Intelligence......................................................
4. Social and economic factors..................................
5. Suggestive causes of the problems...........................
6. Analysis of the case, including reasons/contributing factors for the offence...
7. Reasons for child's need for care and protection.............................
8. Opinion of experts consulted.........................................
9. Psycho-social expert's assessment......................
10. Religious factors.................................................
11. Risk analysis for the child to be restored to the family ...................
12. Previous institutional/case history and individual care plan, if any:.............
13. Recommendation of Child Welfare Officer/Case Worker/Social Worker regarding psychological support, rehabilitation and reintegration of the child and suggested plan...................................
Signature(Of the Person assigned)Form 23[Rule 19(22)]Application for surrender of childDate ..........ToChild Welfare Committee,District...................I/ We..................(name of the applicant/s) ................(relation with the child) of...................(name of the child), aged about..........years , intend to surrender.......................name of child) before this Child Welfare Committee as................................................................(reason/s for surrender).I/we am /are fully conscious and making this application before this Child Welfare Committee. I have not been forced or unduly influenced by anyone to take this decision of surrendering......................... (name of child). I shall have no objection if the child is given in adoption. I am fully aware of the consequences of surrendering the child.Full signature of the applicant(s)/Thumb impression (if the CWC deems appropriate)Name and address...................................(Signature of the Chairperson/ memberBefore whom such application is submitted)Committee member/s present:____________________Date.......................Time........................Place.......................Form 24[Rule 19(22)]Deed of surrenderDeclaration by Person surrendering the child or childrenCase No..............In Re......................I/We, the undersigned..................Family name/First name(s).........residing at, surrender the child (named)..........Aged.........having date of birth.....................for the reason:........................2. Declaration by Witnesses
We the undersigned have witnessed the above surrender.3. Certification of child welfare committee
We hereby certify that the person and the witness (es) named or identified above appeared before me this date and signed this document in our presence.Done at ................ on..............Signature & Seal of Members/ChairpersonChild Welfare CommitteeForm 25[Rule 19(29)]Certificate declaring the child legally free for adoption1. In exercise of the powers vested in the Child Welfare Committee......................under section 38 of the Juvenile Justice (Care and Protection of Children) Act, 2015, child............... date of birth...............placed in the care of the Specialized Adoption Agency/Child Care Institution (name & address) vide order no................dated......................... of this Committee, is hereby declared legally free for adoption on the basis of the following:
• Inquiry report of the Probation Officer/ Child Welfare Officer / Social Worker / Case Worker/any other (as the case may be);• Deed of surrender executed by the biological parent(s) or the legal guardian of the child before this Committee on (date);• Declaration submitted by District Child Protection Unit and the Child Care Institution or Specialized Adoption Agency concerned to the effect that they have made restoration efforts as required under Section 40(1) of the Act, the Rules and Adoption Regulations, but, nobody has approached them for claiming the child as biological parents or legal guardian as on date of the said declaration.2. This is to certify that:
The biological parent(s) / legal guardian, wherever available, has/have been counselled and duly informed of the effects of their consent including the placement of the child or children in adoption which would result in the termination of the legal relationship between the child and his or her family of origin;The biological parents / legal guardian have given their consent freely, in the required legal form, and the consents have not been induced by payment or compensation of any kind and the consent of the mother (where applicable), has been given only after the birth of the child.The Specialized Adoption Agency/ Child Care Institution to which the aforesaid child is entrusted shall post the photograph and other essential details of the child in the CARINGS and shall place such child in adoption as per the procedure laid down in the Act and Adoption Regulations.SignatureChairperson and Members of the Committee(Seal of the Child Welfare Committee)Date:Place:To: Child Care Institution /Specialized Adoption Agency/ District Child Protection UnitConcerned - for information and necessary action.(Signature: & Seal)Date:Form 26[Rule 20(1)]Case Monitoring Sheet for CommitteeCase Monitoring Sheet(Separate Sheet may be used in case there are more than one child)Child Welfare Committee, District..................Case No. .............................of.............................Case Name:| Police Station................................................U/S................................................................... | Date........................................................FIR/ GD/ DD No........................................ |
| Name of ProbationOfficer............................... | Name of IO |
| Particulars of child | |||
| Name | Parents/ Guardian with Contact No. | Present address | Permanent address |
| Date and time child produced before thecommittee | ||
| Date and time of first production | ||
| Date of medical examination under section 54Cr.P.C. (If Any) | ||
| Age Determination | ||
| Age on the Date of offence | ||
| Date of age Determination | ||
| Time taken for age determination | ||
| Determination by | Committee | |
| Evidence Relied: | Documents | Medical |
| Placement of the child | |
| In Children's Home | Sent undersupervision(Name of Institution) |
| From................To….................. |
| Steps to be taken | Scheduled Date | Actual Date |
| Age determination | Dated........ | |
| Social Investigation Report (Form No.22) | Dated......... | |
| Submission of Report on Provisions of furtherinvestigation, if any | Dated.......... | |
| Statement of Child | Dated............ | |
| Individual Care Plan (In case of child ininstitutional care Individual Care Plan should be prepared withinone month of admittance | Dated............. | |
| Dispositional (Final) Order | Dated........... | |
| Post Dispositional Review | Dated............ |
1. Detail of Applicant/ Institution which proposes to run the Child Care Institution:
2. Details of the proposed Child Care Institution
3. Connectivity (Name and Distance from the proposed Child Care Institution):
4. Infrastructure
5. Capacity of the Institution/ Organization
i. No. of children (0-6 years) present in the home , (if any)ii. No. of children (6-10 years) present in the home , (if any)iii. No. of children (11-15 years) present in the home , (if any)iv. No. of children (16-18 years) present in the home , (if any)v. No. of persons (18-21 years) present in the home , (if any)6. Whether the Child Welfare Committee/Juvenile Justice Board has been informed about the children being housed in the Institution Yes/ No
7. Facilities Available
8. Staffing
9. Background of the Applicant (Institution / Organization)
| i. Auditors report |
| ii. Income and expenditure account |
| iii. Receipt and payment account |
| iv. Balance sheet of the organization. |
1. Name of the Open Shelter.....................
2. Name of the In charge ........................
3. Registration No...............................
4. Address of the Home..........................
5. Period of the Report................................
6. Details of children available on
| Sr. No | Name of the child | Father's name | Address of the Child, if available | Date of admission | Reason for admission | Duration of stay | Facilities availed | Produced before CWC (Yes / No) | Remarks , if any |
7. Total number of children admitted during the month..............................
8. Total number of children in the Open Shelter on the last day of the month.......
9. Total number of children who availed the facilities of the Open Shelter during the month...................................................................
10. Out of these the number of children who availed the services only during the day in the month:
SignatureIn charge of the Open Shelter HomeForm 30[Rule 23(9)]Home study report for prospective foster parentsReplace with Form in Foster care Guidelines| Date of Registration | - |
| Aadhar Card No of PFP : | - |
| Name of the Social Worker | - |
| Date of Home Visit | - |
| Particulars of the foster parents | |
| Full Name | |
| Date of birth & age | |
| Place of birth | |
| Complete Address with e-mail ID (Present &Permanent Address) | |
| Identity Proof | |
| Religion | |
| Language(s) | |
| Date of Marriage | |
| Present Educational Qualification | |
| Employment/occupation | |
| Name & Address of the presentEmployer/Business concern | |
| Annual Income | |
| Health Status |
| Details about Parents of the Applicants | ||
| Father | Mother | |
| Name in full | ||
| Age | ||
| Nationality/Citizenship | ||
| Occupation | ||
| Previous occupation | ||
| Presently residing with |
| Name of the Child | Sex | Date of Birth | Educational Status |
| Name | Nature of Relationship | Age | Gender | Occupation |
| Foster Father | |||
| Organisation | Employer Details (Name & Address) | Job Title | From To |
| Foster Mother | |||
| Organisation | Employer Details (Name & Address) | Job Title | From To |
1. Factual Assessment
2. Psychosocial Assessment:
3. Recommendation for Foster care
| Child Study Report | ||
| S. No. | Item | Response |
| 1 | Date of Assessment | |
| 2 | Source of Referral | |
| 3 | Photograph of the Child to be refreshedperiodically | {| |
| Signature: | |
| Place : | Name: |
| Date : | Designation: |
| 1. | Date of Visit: | |
| 2. | (a) Name : | |
| (b) Date of Birth & Age : | {| | |
| (Affix Recent Photo) |
| (Affix recent Photo) |
| (Affix recent Photo) |
4. Interaction with the Foster Child
| (a) | Child's experience being part of the family ( with reference towhether the child is properly cared for - physical, emotional andhealth) describe(i) Health Indicators(a) Present HealthStatus(b) Any record ofIllness(c) Any other treatment that the child isundergoing ii) Emotional | Happy andwell-adjustedIn process ofadjustingmaladjusted |
| (b) | How is the childperforming in his studies? (i) check in relation with thegrades/marks the child achieved in previous examinations,(ii) Foster parentshave regular conversations with the child regarding his/herstudies, extra curriculal activities(iii) Do they attend PTA meetings? | YesNoSometimesYesNoSometimes |
| (c) | ( i) The amount oftime parents (foster) spend with the child either alone ortogether with their own children.(ii) How do theyspend time together as a family and for what?iii) Does the foster child share with the fosterparent's problems he /she is facing either at home, school in theneighbourhood or emotionally feeling not happy? | Having conversationsDiningPlayingWatching TVGoing to schoolDoing homeworktogetherOthers (specify)YesNoSometimes |
| (d) | Does the child get support from foster parents'children? ( do they mutually help each other) | YesNoSometimes |
| (e) | Has there been any incident that made the fosterchild feel discriminated against? | |
| (f) | Has there been anyincident/incidents that made you uncomfortable?(i) The way a fosterparent/older sibling/any other member touched you.(ii)The conversationsfoster parents/older siblings/any other member had with you(iii) Any materials-visuals, printed you were made to watch or read(iv) Were you at anytime sexually assaulted or abused?* *if the answers are"yes"immediate stepsshould be taken to remove the child and send to a place of safetyand support the child with medical and psychosocial therapy.** Actions to betaken against the foster carers or parents according to theprocedures laid down.*** Is similar treatment being meted out totheir biological child also? Then the biological child shouldalso be treated as a child in need of care and protection andappropriate action may be taken. | YesNoYesNoYesNoYesNo |
| (g) | Whether the child keeps in contact with his/herfamily of origin (by telephone, letters, visits). Specify | YesNo |
| (h) | Have you been beaten by the foster parent at anytime? | YesNo |
| (i) | Have you been spoken to in a manner that youfelt humiliated? | YesNo |
| (j) | Are you made to do household chores? | YesNo |
| (k) | Do the biological children of the foster parentsmade to do the same household chores? | YesNo |
5.
Interaction with Foster Parents| (a) | Parent's impressions about the behavior(emotional well-being) of the child in the family | Happy andwell-adjustedIn process ofadjustingMaladjusted |
| (b) | Perception about his/her adjustment with thehousehold and with other members in the family | Happy andwell-adjustedIn process ofadjustingMaladjusted |
| (c) | How do you discipline the child? | Reason with the childScolding , ChastiseBeat the childOther Methods (Specify) |
| (d) | What are the behavior traits that are ofconcern and how do you as parents deal with them? | Lack of co-operationLack of AdjustmentIntrovertAggressiveNot CommunicativeAny Other |
| (e) | Do you spend time together with the fosterchild and biological children? Describe. | YesNoSometimes |
| (f) | Views on theprogress of Child's education and other talents(i)Child is faringwell in school(ii) If the child isnot faring well in school do you seek to find out the reasons(a)from the child(b) the school teacher(iii) Do you attend PTA meetings? | YesNoYesNoYesNoSometimes |
| (g) | Do the foster parents consult the child whiletaking decisions on behalf of him/her? | YesNoSometimes |
| (h) | How does the child show hisapproval/disapproval to the foster parent's decisions? | Accept the decisionwith happinessAccept the decisionsbut unhappyRefuse to accept the decision and showsaggressive behavior) |
| (i) | Are the foster parents aware of the socialnetworks of the child? | YesNo |
| (j) | Views on child's social relationship with theneighbors, school friends and teachers. | Good and regularinteractionPeriodic Interactions |
| (k) | What is their plan for the child?(To be noteddown) | |
| l) | Does the foster child maintain the contact withhis/her family of origin? (by telephone, letters, visits).Specify | YesNoSometimes |
| m) | Who maintains the bank account of the fosterchild as a parent? |
6. Interaction with biological children of the Foster Parents:
| a) | The things they do together with the fosterchild | DiningPlayingWatching TVGoing to schoolDoing homework together |
| b) | Do they have quarrels or fights betweenthemselves and the foster child? If yes, how often, on whatissues, and how do they resolve it. Please note down. | YesNoSometimes |
| c) | How do you feel when your parents show love,affection and care to the foster child? | HappyUnhappyAngryJealous |
7. Interaction with the School Teachers:
| a) | Information about the academic performance ofthe child in the school(verify with progress cards to see ifthe child has shown any progress) | GoodFairSatisfactoryPoor |
| b) | Teacher's observation: if the child hasadjusted to his/her foster parents | Happy andwell-adjustedIn process ofadjustingMaladjusted |
| c) | Do the foster parents attend parent-teachermeetings? | YesNoSometimes |
| d) | Do they seem interested in the child's studies?(by enquiring of his academic achievements, his relationshipwith teachers and classmates) | YesNoIndifferent |
| e) | Observation on child's behavior in the school(his relationship with teachers, classmates) | Happy andwell-adjustedIn process ofadjustingMaladjusted |
| f) | Any concerns of the child in the school. If yes,give details |
8. Interaction with Parents of Origin
| a) | Have the parents of origin maintained contactwith their child (by telephone calls, letters, and visits? Howfrequently? | YesNoSometimes |
| b) | Was the child happy to meet them? | YesNoUpset while meeting them |
| c) | Did the child raise any issues with regard tohis or her foster carers/parents/family with them? | YesNo |
| d) | Do they have any interaction with the fosterfamily regarding the well being of the child? | YesNoSometimes |
| e) | The family's status to receive back the child | Family is interestedand in a position to receive back the child.Family is interestedbut not in a position to receive back the child.Family is not interested to receive back thechild. |
| f) | Received any supportfrom the government or any other agency in helping them toreceiveback the child from the foster carers (If yes,give details) | YesNo |
9. Interaction with Neighbours
| a) | Knowledge about the neighbor fostering a child. | YesNo |
| b) | Information about the attitude and behavior ofthe foster family towards the child | Positive and HappyIndifferent AttitudeNegative AttitudeMisbehavior towards foster children |
| c) | Observed any quarrel or issues between thefamily members and foster child or between neighborhood and thefoster child ( if yes, give detail) | YesNo |
| 1. | Detail of Institution/ Agency/ Organizationwhich seeks recognition as fit facility | |
| 1.a | Name of the Institution /Agency/ Organization | |
| 1.b | Registration numberand date of Registration of the Institution/ Organization underthe relevant Act(Annex- Relevant documents of registration,bye-laws, memorandum of association) | |
| 1.c | Complete address of the Applicant/ Institution/organization | |
| 1.d | STD code/ Telephone No. | |
| 1.e | STD code Fax No. | |
| 1.f | E-mail address | |
| 1.g | Whether the organization is of all Indiacharacter, if yes, give address of its branches, in other states | |
| 1.h | If the Institutionhad been denied recognition earlier? If yesi. Reference No. ofapplication leading to denial of recognitionii. Date of denialiii. Who had denied the recognition iv Reasonfor denial of recognition | |
| 2. | Details of the proposed fit facility: | |
| 2.a | Complete address/ location of proposed FitFacility | |
| 2.b | STD code/ telephone no | |
| 2.c | STD code fax no | |
| 2.d | ||
| 3. | Connectivity (Name and Distance from theproposed Fit Facility): | |
| 3.a | Main Road | |
| 3.b | Bus -stand | |
| 3.c | Railway Station | |
| 3.d | Any landmark | |
| 4. | Infrastructure: | |
| 4.a | No. of Rooms (Mention with measurement) | |
| 4.b | No. of toilets (mention with measurement) | |
| 4.c | No. of Kitchens (mention with measurement) | |
| 4.d | No. of sick room | |
| 4.e | Annex - Copy of blue print of the building(authentic sketch plan of building) | |
| 4.f | Arrangement to dealwith unforeseen disaster also mention the kind of arrangementmade:FireEarth quakeAny other arrangement | |
| 4.g | Arrangement of Drinking water Annex-Certifiedfrom public health engineering (PHE) Department. | |
| 4.h | Arrangement tomaintain sanitation and hygiene:Pest ControlWaste disposalStorage areaAny other arrangement | |
| 4.i | Rent agreement/ building maintenance estimate(whichever is applicable)(Annex- copy of Rent agreement) | |
| 5. | Capacity of the Fit Facility | |
| 6. | Facilities Available (would depend on thepurpose for which recognition as fit facility is to be given) | |
| 6.a | Any other facility that shall impact on theoverall development of the child | |
| 7. | Staffing | |
| 7.a | Detailed staff list | |
| 7.b | Name of partner organizations | |
| 8. | Background of the Applicant | |
| 8.a | Major activities of the organization in last twoyears | |
| 8.b | An updated list of members of the managementcommittee/ governing body in the enclosed format (Annex-resolution of the annual meeting) | |
| 8.c | List of assets/ infrastructure of theorganization | |
| 8.d | If the organization is registered under theForeign Contribution (Regulation) Act, 1976 (Annex - certificateof registration) | |
| 8.e | Details of foreign contribution received lasttwo years (Annexrelevant documents) | |
| 8.f | List of other sources of grant- in - aid funding(if any )with the name of the scheme / project , purpose amount,etc. (separately) | |
| 8.g | Details of existing bank account of the agencyindicating branch code account no. | |
| 8.h | Whether the agency agrees to open a separatebank account for the grant proposed | |
| 8.i | Annex -Photocopy ofAccounts of last three years:Auditors reportIncome andexpenditure accountReceipt andpayment accountBalance sheet of the organization. |
| Sr. No. | Name of Child | FIR/DD/Case No. | PS | Date of Next Production |
1. Name of the child :
2. Age of the child :
3. Mother's Name :
4. Father's Name :
5. Name of Guardian :
6. Relationship with Child :
7. Address of parent/guardians :
8. Date of receiving by Organization/Institution :
9. Name & contact details of the person producing child :
10. Date of Inquiry :
This is to authorize and direct you to receive the above named child in your Child Care Institution and keep her/him in your charge for protective custody under the J.J. Act, 2015. And to produce the child on ......Next Date of hearing.................1. Child Welfare Police Officer
2. Board / Committee
3. The Person in charge of the Institution
Dated this ___________________ day of _____________________ 20| (Signature) | (Signature) |
| The Person in charge of the Institution | Child Welfare Police Officer |
| Case/Profile No. .....................Date & Time .............................. | Affix a latestPhotographhere |
1. Name.............................................................................................
2. Male / Female (tick the appropriate category) .........................................
3. Age at the time of admission.................................................................
4. Aadhaar Card No..........................................................................
5. Present age.......................................
6. Category (tick as applicable):
7. Religion
8. Native District & State:
9. Description of the Housing:
10. By whom the child was brought before the Child Welfare Committee/Juvenile Justice Board (tick as applicable):
i. Police-Local Police/Special Juvenile Police Unit/ designated Child Welfare Police Officer / Railway Police/ Women Policeii. Probation Officersiii. Social Welfare Organizationiv. Social Workerv. Parent(s)/Guardian (s) (please Specify the relationship)vi. Any public servantvii. Any public spirited citizenviii. Child himself/herself11. Reasons for leaving the family
i. Abuse by parent(s)/guardian(s)/step parents(s)ii. In search of employmentiii. Peer group influenceiv. Incapacitation of parentsv. Criminal behaviour of parentsvi. Separation of Parentsvii. Demise of parentsviii. Povertyix. Others (please specify)12. Types of abuse met by the child
i. Verbal abuse - parents/siblings/ employers/others (pl. specify)ii. Physical abuseiii. Sexual abuse parents/siblings/ Employers/others(Pl. specify)iv. Others - parents/siblings/ employers/others (pl. Specify)13. Types of ill-treatment met by the child.
14. Exploitation faced by the child
15. Health status of the child before admission.
| (i) Respiratory disorders | - present / not known / absent |
| (ii) Hearing impairment | - present / not known / absent |
| (iii) Eye diseases | - present / not known / absent |
| (iv) Dental disease | - present / not known / absent |
| (v) Cardiac diseases | - present / not known / absent |
| (vi) Skin disease | - present / not known / absent |
| (vii) Sexually transmitted diseases | - present / not known / absent |
| (viii) Neurological disorders | - present / not known / absent |
| (ix) Mental handicap | - present / not known / absent |
| (x) Physical handicap | - present / not known / absent |
| (xi) Urinary tract infections | - present / not known / absent |
| (xii) Others (pl. specify) | - present / not known / absent |
16. With whom the child was staying prior to admission
i. Parent(s) - Mother / Father / Bothii. Siblings / Blood relativeiii. Guardian(s) - Relationshipiv. Friendsv. On the streetvi. Night sheltervii. Orphanages / Hostels/ Similar Homesviii. Other (pl. specify)17. Visit of the parents to meet the child
Prior to institutionalization- Frequently / Occasionally / Rarely / NeverAfter institutionalization - Frequently / Occasionally / Rarely / Never18. Visit of the Child to his parents
Prior to institutionalization - Frequently / Occasionally / Rarely / During festival times / During summer holidays / Whenever fallen sick / NeverAfter institutionalization - Frequently / Occasionally / Rarely / During festival times / During summer holidays / Whenever fallen sick / Never19. Correspondence with parents -
Prior to institutionalization - Frequently / Occasionally / Rarely / During festival times / During summer holidays / Whenever fallen sick / NeverAfter institutionalization - Frequently / Occasionally / Rarely / During festival times / During summer holidays / Whenever fallen sick / Never20. Details of disability
21. Type Family: Family / joint family/ broken family / single parent
22. Relationship among the family members:
| i Father & mother | Cordial/ Non cordial/ Not known |
| ii Father & child | Cordial/ Non cordial/ Not known |
| iii Mother & child | Cordial/ Non cordial/ Not known |
| iv Father & siblings | Cordial/ Non cordial/ Not known |
| v Mother & siblings | Cordial/ Non cordial/ Not known |
| vi Child & siblings | Cordial/ Non cordial/ Not known |
| vii Child & relative | Cordial/ Non cordial/ Not known |
23. History of crime committed by family members, if any:
| S. No. | Relationship | Nature of Crime | Legal status of the case | Arrest if any Made | Period of confinement | Punishment Awarded |
| 1. | Father | |||||
| 2. | Step father | |||||
| 3. | Mother | |||||
| 4. | Step mother | |||||
| 5. | Brother(a)(b)(c)(d) | |||||
| 6. | Sister(a)(b)(c)(d) | |||||
| 7. | Child | |||||
| 8. | Others (uncle/ aunty/ grandparents) |
24. Properties owned by the family:
25. Marriage details of family members:
26. Social activities of family members:
i. Participate in social and religious functionsii. Participate in cultural activitiesiii. Does not participate in social and religious functionsiv. Not known27. Parental care towards child before admission:
i. Over protectionii. Affectionateiii. Attentiveiv. Not affectionatev. Not attentivevi. RejectionAdolescence History (Between 12 and 18 years)28. At what age did the child attain puberty?
29. Details of delinquent behaviour if any
i. Stealingii. Pick pocketingiii. Arrack sellingiv. Drug pedalingv. Petty offencesvi. Violent crimevii. Rapeviii. None of the aboveix. Others (please specify)30. Reason for delinquent behaviour
i. Parental neglectii. Parental overprotectioniii. Parents criminal behavioriv. Parents influence (negative)v. Peer group influence - To buy drugs/alcoholvi. Others (pl. specify)31. Habits
| A | B |
| (i) Smoking | (i) Watching TV/movies |
| (ii) Alcohol consumption | (ii) Playing indoor/outdoor games |
| (iii) Drug use (specify) | (iii) Reading books |
| (iv) Gambling | (iv) Religious activities |
| (v) Begging | (v) Drawing/painting/acting/singing |
| (vi) Any other | (vi) Any other |
32. Employment details of the child prior to entry into the Home:
| S.No. | Details of employment | Timing and Duration | Wages earned |
| (i) | Cooly | ||
| (ii) | Rag picking | ||
| (iii) | Mechanic | ||
| (iv) | Hotel work | ||
| (v) | Tea shop work | ||
| (vi) | Shoe polish | ||
| (vii) | Household works | ||
| (viii) | Others (pl specify) |
33. Details of income utilization:
Sent to family to meet family needi. For dress materialsii. For gamblingiii. For prostitutioniv. For alcoholv. For drugvi. For smokingvii. Savings34. Details of savings
i. With employersii. With friendsiii. Bank/Post Officeiv. Others (pl. specify)35. Duration of working hours
i. Less than six hoursii. Between six and eight hoursiii. More than eight hoursEducational Details36. The details of education of the child prior to the admission to Children's Home
i. Illiterateii. Studied up to V Standardiii. Studied above V Std but below VIII Standardiv. Studied above VIII Std but below X Standardv. Studied above X Standard37. The reason for leaving the School
a. Failure in the class last studiedb. Lack of interest in the school activitiesc. Indifferent attitude of the teachersd. Peer group influencee. To earn and support the familyf. Sudden demise of parentsg. Rigid school atmosphereh. Absenteeism followed by running away from schooli. There is no age appropriate school nearbyj. Others (pl. specify)38. The details of the school in which studied last:
i. Corporation/Municipal/Panchayatii. Government/SC Welfare School/BC Welfare Schooliii. Private management/ Convents39. Medium instruction: Hindi/English/Urdu/Tamil/Malayalam/Kannada/ Telugu/Marathi / Gujarati/ Bengali / Other language (please specify)
40. After admission to Children's Home, the educational attainment from the date of admission till date;
| No. of years | Class studied | Promoted /detained |
41. Vocational training undergone form the date of admission into Children's Home till date.
No. of yearsName of Vocational TradeProficiency AttainedDetails of certification?42. Extra-curricular activities developed form the date of admission into the Children's Home till date
43. Height and weight at the time of admission:
44. Physical condition:
45. Medical history of child (gist):
46. Medical history of parent/guardian (gist):
47. Present health status of the child:
| Sl. No. | Annual Observation | 1st Quarter | 2nd Quarter | 3rd Quarter | 4th Quarter |
| Date of Review | |||||
| Height | |||||
| Weight | |||||
| Nutritious diet gien | |||||
| Stree disease | |||||
| Dental | |||||
| ENT | |||||
| Eye |
48. Height and Weight Chart
| Date, Month and Year | Height | Admissible Weight | Actual Weight |
49. Details of friendship prior to admission into Children's Home:
i. Co-workersii. School/Classmateiii. Neighboursiv. Others (pl. specify)50. Majority of the friends are
i. Educatedii. Illiterateiii. The same age groupiv. Older in agev. Younger in agevi. Same sexvii. Opposite sex51. Details of membership in group (please specify details)
i. Associated with cine fans associationii. Association with religious groupiii. Associated with arts and sports clubiv. Associated with gangsv. Associated with voluntary social service leaguevi. Others (please specify)52. The position of the child in the groups/league
i. Leaderii. Second level leaderiii. Middle level functionaryiv. Ordinary member53. Purpose of taking membership in the group:
i. For social service activitiesii. For leisure time spendingiii. For pleasure seeking activitiesiv. For deviant activitiesv. Others (please specify)54. Attitude of the group / league
i. Respect the social norms and follow the rulesii. Interested in violating the normsiii. Impulsive in violating the rules55. The location/meeting point of the groups
i. Usually at fixed placeii. Places are changed frequentlyiii. No specific placesiv. Meeting point is fixed conveniently56. The reaction of the society when the child first came out of the family
i. Supportiveii. Rejectioniii. Abuseiv. Ill-treatmentv. Exploitation57. The reaction of the police towards children
i. Compassionateii. Harshiii. Aggressive and abusiveiv. Exploitativev. Ill-treated58. The response of the general public towards the child ...............................
History of the child (brief)1. The discharged person shall proceed to ................... and live under the supervision and authority of ........................ until the expiry of the period of his stay in Children's Homes or fit facility/ detention in observation home/ special homes/ place of safety unless the remission is sooner cancelled.
2. He shall not, without the consent of the .................... remove himself from that place or any other place, which may be named by the said .....................
3. He shall obey such instruction as he may receive from the said .................................... with regard to punctual and regular attendance at school/vocation or otherwise.
4. He shall not get involved in any offence and shall lead a sober and industrious life to the satisfaction o f......................................
6. In the event of his committing a breach of any of the above conditions the remission of the period of stay in the Institution hereby granted shall be liable to be cancelled and on such cancellation he/she shall be dealt with under section 97 of the Juvenile Justice (Care & Protection of Children) Act 2015.
I hereby acknowledge that I am aware of the above conditions which have been read over/ explained to me and that I accept the same.(Signature or mark of the released child)Certified that the conditions specified in the above order have been read over/explained to (Name of child).......................... and that he/she has accepted them as the conditions upon which his/her release may be revoked.Certified accordingly that the said child has been discharged on the......................Signature and Designation of the certifying authority i.e. Person-in-charge of the institutionForm 45[Rules 82(4)]Escort order| Case No................ | In the matter ofBoy/Girl Child .....................................Aged about ............ year taken |
1.
The Person in charge, Child Care Institution.2.
The District Child Protection Unit or non-governmental organization or ChildlineRef.: 1. Order of admission of minor............... born on ........... Profile No ...............Form 46[Rule 41(3) and 41 (9)]Inspection by inspection committee(Fill as applicable)Date of visit: ............................ Time of visit: ..............................Name of the officials inspecting the Home:1. ...................................
2. .................................
3. .................................
A. General Information :i. Name and address of the Organisation: .................................................................................................................ii. Registration No. (Under JJ Act, 2015): ............................Date of issue : .............................................................................Date of expiry : .................................................................................iii. Complete address of the CCI : ..............................................................................................................................................iv. Name of the Officer/Person-in-Charge: ....................................................................................v. Contact No: ............................... Email Id: .......................................................vi. Type of Home (Please tick ? one):Observation Home/ Special Home/ Place of Safety/ Children's Home/ Open Shelter / Any other (please specify):vii If Aided/supported: by State Government, Name of the Department:viii If run by Government:B. Status of Children:| No. of rooms / dormitories | Details |
| Provision of sick room / medical unit | |
| Counseling room | |
| Recreational /activity room for Children• Is there a TV setavailable with Cable network• How often arechildren allowed to view TV• Are children playinggames indoors• What games areavailable to them• Are children playinggames outdoors• Do they haveequipments/ accessories to play• Do children go forpicnics/excursions• Do they haveinteractions with eminent personalities• Is there a recreation room available to children | Yes Noin the evenings orany timeYes Noage appropriate gamesor notYes NoYes NoYes NoYes No |
| Kitchen / Dining Room• Is the cooking areaand pantry separate• Do children getindividual thalis, mugs glasses• Are cooking utensilsadequate and clean• Is there a fridgeavailable for children• Is there a Ovenavailable for children• Is there a Gas stoveavailable in kitchen• Is there a chimneyavailable• What is thearrangement to keep the gas cylinders• Adequate water supplyfor washing, cooking• Adequate drinkingwater available ( RO)• Is cooking done by machines or by cook | Yes NoYes NoYes NoYes NoYes NoYes NoYes NoYes Nosafe/away from children or notYes Nomanual or mechanicalYes NoYes No |
| Number of toilets &bathrooms for Children• Flush is working• Taps in the washbasin are functioning• Is the floor slippery• Drains clean• Drains are clogged• Fittings for hangingclothes/ towels in place• Cob webs are removed• Door has a latch• Door has peep holes• Frequency of bath achild is allowed• Water is adequatelyavailable• Adequate numbers ofbuckets and mugs• Personal toiletriesare provided• Is washing powder orsoap given• Do children washtheir own clothes• Is there a washer manavailable• Is the washing machine functional | Yes NoYes NoYes NoYes NoYes NoYes Noonce or more in a dayYes NoYes NoYes NoYes NoYes NoYes NoYes NoYes NoYes NoYes NoYes No |
| Open space for outdoor activities | |
| Class rooms | |
| space for vocational training |
| Premises | |
| • Does the home have a child friendly indoors? | Yes No |
| • How often is the sweeping, swabbing done? | Twice a day or more |
| • Are the children involved in cleaning exercise during classhours? | Yes No |
| • Are the facilities of coolers/ heaters available for children? | Yes No |
| • Are the doors and windows maintained properly? | Yes No |
| • Are the rooms and dormitories well ventilated? | Yes No |
| • Is there an alternate provision for lights and fans when there isno electricity available? | Yes No |
| • Are the outdoors clean, pleasant and child friendly? | Yes No |
| Clothing / Bedding/Lockers/ Toiletries providedto the children: | |
| • Are the clothes provided as per size and season | Yes No |
| • Frequency of changing undergarments | Yes No |
| • New clothes are stitched or bought | stitched or bought |
| • Are the mattresses given individually | Yes No |
| • Are pillows given individually | Yes No |
| • Are the mattress and pillows clean | Yes No |
| • Do children have separate cupboards | Yes No |
| • Are bed sheets and Khes available | Yes No |
| • Are blankets available in winters | Yes No |
| • Number of sets provided on arrival | one/two/three/four |
| • Frequency of providing new clothes | Monthly/ Quarterly |
| • Are these sets of same color or different colors? | Same/different |
| • Are children provided with individual lockers to keep theirpersonal items | Yes No |
| Other articles provided to the children: ................................................................................................................................................................................................................................................................................................................................................. |
| Time | Activities / Schedule |
| Morning | |
| Day Time | |
| Afternoon | |
| Evening | |
| Late evening/ Night |
| • Is the facility of Computer withinternet available? | Yes No |
| • Is the facility functional? | Yes No |
| • Are the children allowed to usethe facility? | Yes No |
| • Is the telephone for officialpurposes only | Yes No |
| • Are the children allowed to usetelephone | fixed timing/ as and when required |
| • Is the number of Childline (1098)displayed near the phone | Yes No |
| S.N. | Name | Designation | Date of Joining | Attendance at the time of visit | Remarks |
| 1 | |||||
| 2 | |||||
| 3 | |||||
| 4 | |||||
| 5 | |||||
| 6 | |||||
| 7 | |||||
| 8 | |||||
| 9 | |||||
| 10 | |||||
| 11 | |||||
| 12 | |||||
| 13 | |||||
| 14 |
| F. Children's Committee /Management Committee | |
| • Formation of Children's Committee: | {| |
| Yes | No |
| Yes | No |
| Staff attendance register | |
| Children attendance register | |
| Central admission register | |
| Individual case file with individual care plan | |
| Communication with CWC/JJB | |
| Children's suggestion book | |
| Children's suggestion box | |
| Medical file / medical cards | |
| Personal belongings register | |
| Management Committee - minutes register | |
| Children's Committee - minutes register | |
| Nutrition / Diet File | |
| Any other record maintained |
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| Police Station................................. | Date: |
| u/s.................................................. | FIR/GD: |
| 1 | Name of the Child In Conflict withLaw | |
| 2 | Sex | M/F/Transgender |
| 3 | Category | SC/ST/OBC/General/PVTG |
| 4 | Name of the Parent/Guardian withaddress and contact number | |
| 5 | Present address of the child | |
| 6 | Permanent address of the child | |
| 7 | Place of apprehension | |
| 8 | Time and date of apprehension | |
| 9 | Name, address and contact number ofparent/ guardian to whom the information of apprehension wasgiven | |
| 10 | Name, rank, number of the CWPO towhom the charge of the child in conflict with law is handedover/who is dealing with the case | |
| 11 | Date and time of production beforeJJB | |
| 12 | Name, contact number of theprobation officer informed about the apprehension and the timewhen PO was given the information | |
| 13 | Medical examination | |
| 14 | Custodyof the Child In Conflict Law before production of JJB:(1)Given to parent/guardian/fit person(2) Sent to Observation Home(3) With CWPO/Police | |
| 15 | Copy ofFIR/GD given to- Parent/Guardian- Probation Officer | {| |
| No |