Skip to content
LitigationForms
JV-421Optional

Dispositional Attachment: Removal From Custodial Parent—Placement With Nonparent (Welf. & Inst. Code, §§ 361, 361.2)

California · Judicial Council of California · Effective January 1, 2026

This form is used to record the court's decisions, or orders, during a hearing where the court decides to move a child from a parent's home to a relative's home or to foster care. It asks the court to document the reasons for the removal and the type of placement that is necessary.

The court describes it as: States more of the court’s decisions (orders) made at a dispositional hearing where the court places the child in the home of a relative or in foster care.

Open the official PDFfrom Judicial Council of California

Where this fits in a case

Hearing

Stage: Hearing

This form is used after a dispositional hearing in a juvenile case when the court is deciding to remove a child from the custodial parent and place the child with someone other than the parent.

Prepared by the court or clerk.

Official instructions

How-to guides published by the court for this form.

Common questions

What is this form for?
This form is used to write down the court's official decisions about removing a child from a parent and placing the child with someone else, like a relative or in foster care.
Who fills out this form?
The form is titled for the court, meaning the judge or court staff are responsible for completing it.
Does this form involve a fee?
The provided text does not mention any filing fees associated with this form.

Revision history

No changes recorded since we started tracking this form on October 9, 2026. The current version took effect January 1, 2026.

Related forms

  • JV-132

    Financial Declaration—Juvenile Dependency

    This form is a detailed financial report used to show a court how much money a person earns and how much money they spend. It helps a financial evaluator decide if a parent can afford to pay for legal services.

    OptionalFillable PDF4 translations
  • JV-175

    Review of Voluntary Admission of Child to Psychiatric Residential Treatment Facility

    This form is used by the court to review whether a child's voluntary admission to a psychiatric residential treatment facility should continue. It asks the court to make orders regarding the child's stay and future care.

    MandatoryFillable PDF
  • JV-176

    Review of Voluntary Admission of Nonminor or Nonminor Dependent to Psychiatric Residential Treatment Facility

    This form is used by the court to review if a young person or dependent who voluntarily admitted themselves to a psychiatric residential treatment facility still needs to be there. It asks the court to make findings and issue orders about the person's continued stay or discharge.

    MandatoryFillable PDF
  • JV-190

    Waiver of Rights—Juvenile Dependency

    This form is used when a parent is giving up certain rights related to a child's dependency case. It asks the parent to confirm understanding of the case details and to agree to waive specific rights, such as the right to a trial or an attorney.

    MandatoryFillable PDF1 translation
  • JV-214

    Request for Hearing on Waiver of Presumptive Transfer

    This form is used to ask the court to review a decision about where the responsibility for specialty mental health services should be located. It is used when a child or nonminor is placed in a county different from where they originally lived.

    MandatoryFillable PDF
  • JV-214-INFO

    Instructions for Requesting a Hearing to Review Waiver of Presumptive Transfer of Specialty Mental Health Services

    This form provides instructions for asking the court to hold a hearing to review if the county where a child lived before being placed in foster care should keep responsibility for the child's mental health services, instead of the county where the child is now living.

    OptionalFillable PDF2 translations
  • JV-224

    County Report on Psychotropic Medication

    This form is used to give the court a report about any medications that are psychotropic (medication that affects the mind). It asks for information about the child's and caregiver's observations regarding the medicine's effects and any follow-up care.

    MandatoryFillable PDF
  • JV-225

    Your Child's Health and Education

    This form asks a parent or guardian to give the court detailed information about a child's health, education, and development. It collects details about medical history, school attendance, and any special needs the child may have.

    MandatoryFillable PDF1 translation