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Children and Family Services Regulations

made under Section 99 of the

Children and Family Services Act

S.N.S. 1990, c. 5

O.I.C. 91-954 (August 15, 1991, effective September 3, 1991), N.S. Reg. 183/91

as amended to O.I.C. 2013-333 (September 10, 2013), N.S. Reg. 306/2013


Table of Contents

 

[Citation]

[Effective date]

[Administrator]

Interpretation

Appointment of agents and executive directors

Funding

Policy

Agency review procedure

Joint services

Evaluation

Accounts and records

Child-caring facilities

Child-caring facilities

Placement of children in care

Admission to a secure treatment facility

Temporary-care Agreements

Special-needs agreements

Application for special-needs agreement for transfer of care and custody

Application for special-needs agreement for services in child-caring facility

Application for special-needs agreement for services in child’s home

Review of application for special-needs agreement

Forms prescribed for special-needs agreements

Financial contribution of parent or guardian

Mediation costs

Health care professionals reporting requirements

Fees and disbursements of counsel and guardian ad litem

Abandoned child costs

Payment of costs

Child abuse register

Adoption

General

Transition

Form II – License to Operate a Child-caring Facility

Form III – Temporary Care Agreement pursuant to Section 17 of the Children and Family Services Act

Form IV – Special Needs Agreement pursuant to Section 18of the Children and Family Services Act

Form V – Agreement Pursuant to Section 18 of the Children and Family Services Act to Provide for Services for a Child with Special Needs in a Child-Caring Facility

Form VI – Agreement pursuant to Section 18 of the Children and Family Services Act to Provide In-home Support Services to a Child with Special Needs

Form X – Annual Permanent Care and Custody Report

Form XI – Child Abuse Register

Form XII – Report to the Child Abuse Register

Form XIV – Notice of Registration

Form XV – Agreement for Voluntary Care for the Purpose of Adoption

Form XVI – Secure Treatment Certificate

 


[Citation]

1       These regulations may be cited as the “Children and Family Services Regulations”.


[Effective date]

2       These regulations shall come into force and apply on and not before the 3rd day of September, 1991.


[Administrator]

3       For the purpose of these regulations, the Administrator has all the powers, privileges, duties, and functions of the Minister.


Interpretation

4       (1)  In these regulations

 

                (a)    “Act” means the Children and Family Services Act;

 

                (b)    “Administrator” means the Administrator of Family and Children’s Services, Department of Community Services, Province of Nova Scotia, or a person designated by the Administrator;

 

                (c)    “assessment centre” means a facility established by the Minister for the purpose of the psycho-social assessment of a child;

 

                (d)    “counselling” includes a service to assist a family in preventing a child becoming in need of protective services or to assist a child who is in need of protective services;

 

                (e)    “Director” means the Director of Family and Children’s Services, Department of Community Services, Province of Nova Scotia, unless the context otherwise requires;

 

                (f)     “facility” means a child-caring facility as defined in the Act;

 

                (g)    “foster home” means a home approved by an agency and in which a child is placed by an agency for care, supervision and such other services the child may require;

 

                (h)    “group home” means a home approved by the Minister where children who cannot function in their own home or in a foster home are cared for by adults in a family-like setting;

 

                (ha)  “hearing” includes the consideration by a judge of a consent order filed with the court;

Clause 4(1)(ha) added: O.I.C. 2003-513, N.S. Reg. 208/2003.

 

                (i)     “homemaker services” means services which provide for household management and assistance to develop parenting skills so that parents are better able to care for their children;

 

                (j)     “Indian” means a person who is registered as an Indian or entitled to be registered as an Indian under the Indian Act (Canada);

 

                (ja)   “place of safety” means a place or one of a class of places approved as a child-caring facility for the emergency temporary care and protection of a child as may be required under the Act and regulations;

Clause 4(1)(ja) added: O.I.C. 2003-236, N.S. Reg. 109/2003.

 

                (k)    “protection services” means services to protect children from abuse and neglect;

 

                (l)     “receiving home” means a facility for the temporary care of children and in which assessment of children may also be provided;

 

                (m)   “residential centre” means a facility for the care of children who are experiencing behaviour and adjustment problems and cannot function in a family setting;

 

                (n)    “working day” has the same meaning as in Rule 21 of the Family Court Rules; and

 

                (o)    “young offender facility” means a facility providing care, supervision, training and education of young offenders committed under the provisions of the Young Offenders Act.

 

         (2)  For the purpose of the Act, the following persons are considered to be related by blood or marriage to another person:

 

                (a)    the father, mother, son, daughter, grandfather, grandmother, uncle, aunt, nephew, niece, cousin, brother and sister of the person; and

 

                (b)    the father, mother, son, daughter, grandfather, grandmother, uncle, aunt, nephew, niece, cousin, brother and sister of the spouse of the person.

 

         (3)  For the purpose of the Act, the following persons are considered to be related by adoption or marriage to another person:

 

                (a)    the father, mother, son, daughter, grandfather, grandmother, uncle, aunt, nephew, niece, cousin, brother and sister by adoption of the person; and

 

                (b)    the father, mother, son, daughter, grandfather, grandmother, uncle, aunt, nephew, niece, cousin, brother and sister of the spouse of the person.

 

         (4)  In subsections (2) and (3), “cousin” means the child of one’s uncle or aunt.


Appointment of agents and executive directors

5       (1)  The Executive Director of an agency shall be a person whose appointment has been approved by the Minister and no agency may hire an Executive Director or renew the appointment of an Executive Director without the approval of the Minister.

 

         (2)  The approval of the Minister given pursuant to subsection (1) may be revoked by the Minister and where the approval is revoked, any funding provided by the Minister in relation to the salary and related expenses of the Executive Director is thereupon revoked.

 

6       (1)  In order to be eligible to be appointed as an agent under the Act a person shall have

 

                (a)    a degree in social work or equivalent degree, or be a registered member in good standing of the Nova Scotia Association of Social Workers;

Clause 6(1)(a) amended: O.I.C. 98-194, N.S. Reg. 35/98.

 

                (b)    completed the Child Protective Services Core Training Course provided by the Department of Community Services;

 

                (c)    practised in the field of child protection or the field of child welfare; and

Clause 6(1)(c) amended: O.I.C. 98-194, N.S. Reg. 35/98.

 

                (d)    a statement from the head of an Agency attesting to the fact that the person is knowledgeable regarding the Act and has the knowledge and skills in the field of child protection to warrant the person being appointed an agent under the Act.

 

         (2)  The Minister shall revoke the appointment of an agent where the person

 

                (a)    is no longer employed in a position where agent status is required;

 

                (b)    has acted outside authority of the person as an agent or contrary to the Act or these regulations; or

 

                (c)    no longer meets the qualifications prescribed in this section.

 

         (3)  A person who was an agent on September 2, 1991, under the former Act, is deemed to be an agent for the purpose of the Children and Family Services Act but the Minister shall revoke the appointment where the person

 

                         (i)     is no longer employed in a position where an agent status is required,

 

                         (ii)    has acted outside authority of the person or contrary to the Act or regulations, or

 

                         (iii)   no longer has the knowledge or skills in the field of child protection to warrant the person retaining an agent appointment.


Funding

7       (1)  In order to receive or to continue to receive any funding that may be paid pursuant to Section 7 of the Act, a child-care service, child-caring facility, a child-placing agency or agency shall provide the services and meet and maintain the conditions and standards prescribed in the Act and these regulations and shall provide to the Minister such information concerning the service, facility or agency in such form and at such times as the Minister may reasonably require.

 

         (2)  Where the standard of care or service being provided by a child-care service, child-caring facility, child-placing agency or agency to children is inadequate, or the administration thereof fails to ensure proper expenditure of government funding, the Minister may, after giving ten days notice in writing to the service, facility or agency, suspend payment of all or part of the funding provided under the Act or these regulations until such time as the Minister is satisfied that adequate care or administration is being provided.


Policy

8       (1)  An organization or person applying to the Minister for approval to operate a child-care service, child-caring facility or child-placing agency pursuant to Section 15 of the Act shall attach to the application

 

                (a)    a statement of the philosophy, aims, and objectives of the service or facility;

 

                (b)    a description of the programs and services to be provided; and

 

                (c)    such other information as the Minister may require.

 

         (2)  A child-care service, child-caring facility, child-placing agency or an agency shall adhere to the policy and procedures established for the service, facility or agency by the Department of Community Services, except that a facility, service or agency, by resolution, may adopt its own policy or procedure which, if approved by the Minister, shall be the policy or procedure of the service, facility or agency.

 

         (3)  A child-care service, child-caring facility, child-placing agency and an agency shall be operated in accordance with the provisions of the Act, these regulations and the policy and procedures referred to in this section.


Agency review procedure

9       (1)  An agency shall establish a written review procedure, which shall be approved by the Board of Directors of the agency, for hearing and dealing with complaints by any person including a foster parent regarding services sought or received from the agency or services provided on behalf of an agency.

 

         (2)  A copy of the procedure shall be provided to the Director and must be approved by the Director prior to its implementation.

 

         (3)  A copy of the review procedure shall be made available by the agency to any person on request.

 

         (4)  A person who makes a complaint and is not satisfied with the results of the review procedure may have the matter reviewed by the Director.


Joint services

10     An agency may enter into an agreement with a municipality or the Minister to provide for the establishment of joint services between an agency and any Division of the Department of Community Services for the purpose of providing, coordinating and administering social services in a territorial jurisdiction under one supervising authority.


Evaluation

11     There shall be a regular evaluation by the Administrator of each child-care service, child-caring facility, child-placing agency and agency and a copy of the evaluation shall be provided to the service, facility or agency which is the subject of the evaluation.


Accounts and records

12     (1)  Every child-care service, child-caring facility, child-placing agency and agency funded, licensed, approved, or incorporated pursuant to the Act shall keep proper books, accounts and records, maintain appropriate internal controls and comply with such systems and procedures concerning accounts, records and internal controls as the Administrator may from time to time prescribe.

 

         (2)  Every child-care service, child-caring facility, child-placing agency and agency shall have its account books and ledgers audited annually by an accountant licensed under the Public Accountants Act or other competent auditors, and shall submit an audited statement to the Administrator not later than the 30th day of June of each year for the previous fiscal year.


Child-caring facilities

13     The Minister shall not approve or license a facility that does not comply with the requirements of the Act and these regulations.


Child-caring facilities

14     (1)  A person proposing to renovate a building or buildings for the purpose of operating a facility shall first obtain approval of the Minister, in writing, for the proposed renovation.

 

         (2)  A person seeking approval under this Section shall submit to the Minister an application as prescribed by the Minister and such other information as the Minister may require.

 

         (3)  The Minister may refuse to approve the renovation of a facility where the information provided is incomplete or the Minister determines that the proposed renovation(s) will not meet the needs of the children for whom it is intended.

Section 14 replaced: O.I.C. 2010-168, N.S. Reg. 57/2010.

 

15     (1)  The license for a facility shall be in Form II of these regulations and shall expire one year from the date on which it is issued or on such other date as the Minister may prescribe.

 

         (2)  A request for the renewal of a license shall be submitted at least two months prior to the expiration of the license, and shall be accompanied by such information as the Minister may require.

 

16     Any approval or license given pursuant to the Act or these regulations for a facility is not a commitment by the Minister to provide funds to or to share in the expenses of the facility.

 

17     (1)  A facility shall have sufficient staff to ensure

 

                (a)    compliance with the requirements of these regulations; and

 

                (b)    reasonable hours of work and holidays for each member of the staff.

 

         (2)  A facility shall have on duty at all times a staff person who is capable of providing emergency care.

 

18     (1)  A facility shall have a Chief Administrative Officer who shall

 

                (a)    ensure that the operation of the facility is in compliance with the policies and procedures of the facility;

 

                (b)    ensure that the facility complies with the requirements of the Act and these regulations;

 

                (c)    be responsible for the overall management of the facility including staff orientation and in-service training; and

 

                (d)    plan and implement programs and activities in accordance with the interests and abilities of the children.

 

         (2)  The Chief Administrative Officer shall be a person who

 

                (a)    is in good physical and mental health; and

 

                (b)    has sufficient education and experience to enable the person to perform the responsibilities set forth in subsection (1).

 

19     A facility shall maintain competent food service, domestic, maintenance, program, activity and administrative support staff in accordance with standards prescribed by the Director of Child Welfare, Department of Community Services.

Section 19 amended: O.I.C. 2004-339, N.S. Reg. 198/2004.

 

20     (1)  The staff members of a facility shall be in good physical and mental health.

 

         (2)  The Director of Child Welfare may require a staff person to have a medical examination annually or at such times as is necessary to ascertain that the staff person is in good health.

Subsection 20(2) amended: O.I.C. 2004-339, N.S. Reg. 198/2004.

 

21     A facility shall provide opportunities for each child to engage in a variety of activities including normal childhood and family living experiences, according to the abilities and interests of the child.

 

22     (1)  Every facility shall provide to the children residing in the facility written information, which is appropriate to their age and their level of comprehension, concerning the facility and the rights and obligations of each child while a resident in the facility.

 

         (2)  The Director of Child Welfare may require that the written information referred to in subsection (1) be approved by him prior to it being made available to the residents of the facility.

Subsection 22(2) amended: O.I.C. 2004-339, N.S. Reg. 198/2004.

 

23     (1)  Medical information in respect of a child in a facility shall be kept up to date and each child in a facility shall have a medical examination by a qualified medical practitioner not less frequently than annually.

 

         (2)  Every three months, the facility shall complete a social, educational and vocational progress report on each child in the care of the facility which report shall include a treatment plan designed to meet the needs of the child.

 

         (3)  The reports made pursuant to this section shall be retained in the facility and shall be made available to the Administrator upon request.

 

24     (1)  No person shall be maintained in a facility or any part thereof that is not approved by the Fire Marshal with respect to fire safety.

 

         (2)  The Chief Administrative Officer of a facility shall request that the Fire Marshal inspect the facility at least once a year and shall permit the facility to be inspected by a Fire Marshal at such other times as are required to ensure that the requirements of the Fire Marshal are being complied with.

 

         (3)  A facility shall have an emergency evacuation plan including arrangements for alternative accommodation for the residents which plan shall be established in cooperation with the local fire department and the emergency measures coordinator for the municipal unit in which the facility is located.

 

         (4)  The emergency plan, including the location and operation of fire extinguishers, fire alarm boxes and telephone procedures for calling the fire department, shall be posted in a conspicuous location, and all occupants of the facility shall be informed of the plan.

 

25     A facility shall provide each child with adequate bedroom space and adequate furniture and storage space for personal belongings.

 

26     (1)  Every facility shall contain specifically designated areas for recreation, informal living and dining.

 

         (2)  Every facility shall contain adequate bathing and toilet facilities.

 

27     (1)  Every facility shall provide to the children

 

                (a)    morning, noon and evening meals in accordance with any special dietary requirements of the children and which provide the recommended dietary allowance in accordance with the Canada Food Guide; and

 

                (b)    an afternoon and bedtime snack.

 

         (2)  The Chief Administrative Officer shall designate a staff member as the supervisor of food services for the facility.

 

         (3)  The supervisor of food services shall be responsible for

 

                (a)    planning and maintaining records of daily menus and special diets; and

 

                (b)    evaluation by a dietician of the menus to determine their compliance with subsection (1).

 

28     (1)  The Chief Administrative Officer shall ensure that any medication prescribed for the children in the facility are administered properly and in accordance with the prescription.

 

         (2)  No person shall administer any drug to a child unless the person is designated for the purpose by the Chief Administrative Officer and the person is competent to do so.

 

         (3)  Drugs prescribed for one child shall not be administered to another child.

 

29     A facility shall maintain a register containing the name, age, usual place of residence and parent or guardian of every child admitted to the facility, and the date of admission and discharge of the child.

 

30     (1)  Every facility shall be inspected at least once a year by a person authorized by the Administrator.

 

         (2)  Any person authorized by the Administrator to inspect a facility may inspect the facility as many times as is necessary to ensure that the facility complies with the requirements of the Act and these regulations.

 

31     Any child or any parent or guardian of a child in a facility may submit any concern or complaint relating to the facility to the Director of Child Welfare who shall ensure that every complaint and concern is investigated and a written report is submitted to the Minister.

Section 31 amended: O.I.C. 2004-339, N.S. Reg. 198/2004.

 

32     (1)  Sections 13 to 30, inclusive, do not apply to foster homes.

 

         (2)  An agency shall not approve a home as a foster home unless the home complies with the policy of the Department of Community Services with respect to foster homes or complies with the foster home policy of the agency which has been approved by the Minister.

 

         (3)  Sections 8 and 13 to 30, inclusive, do not apply to a place of safety.

Subsection 32(3) added: O.I.C. 2003-236, N.S. Reg. 109/2003.

 

         (4)  An agency shall not approve a place as a place of safety unless the place of safety complies with the policy of the Department of Community Services with respect to places of safety.

Subsection 32(4) added: O.I.C. 2003-236, N.S. Reg. 109/2003.

 

Placement of children in care

33     (1)  No agency shall place a child who is in its care and custody in a child-caring facility unless the facility is licensed or approved pursuant to the Act and these regulations.

Section 33 renumbered 33(1): O.I.C. 2003-391, N.S. Reg. 160/2003.

 

         (2)  Despite subsection (1), an agency may place a child 16 years of age or older who is in its care and custody in

 

                (a)    a residence that is licensed or approved pursuant to other Provincial legislation; or

 

                (b)    a residence other than a residence described in clause (a), if

 

                         (i)     the placement is determined by the head of the agency having care and custody of the child to be an appropriate placement to meet the needs of the child,

 

                         (ii)    the child consents to the placement, and

 

                         (iii)   the person in charge of the residence agrees to the placement of the child in the residence.

Subsection 33(2) added: O.I.C. 2003-391, N.S. Reg. 160/2003.

 

Section 34 repealed: O.I.C. 2003-513, N.S. Reg. 208/2003.

 

35     Where a child who is in a child-caring facility or who is the subject of an agreement pursuant to Section 17 or Section 18 of the Act, reaches the age of sixteen years, the placement of the child in a facility may continue until the child reaches the age of majority, and the agreement with respect to the child may be renewed until the child reaches the age of majority if such placement or renewal is not otherwise contrary to the Act or these regulations.

 

Admission to a secure treatment facility

35A  (1)  For the purposes of Sections 54 to 66 of the Act and these regulations,

 

                (a)    “facility manager” means a manager of a secure treatment facility;

 

                (b)    “person in charge” means a facility manager or their designate;

 

                (c)    “treatment” includes treatment interventions provided in a secure treatment facility.

Section 35A renumbered 35A(1): O.I.C. 2004-197, N.S. Reg. 145/2004.

 

         (2)  For the purpose of subsection 55(1) of the Act, “five days” means 5 weekdays and does not include the day of issuance of a secure treatment certificate, Saturday, a holiday or any other day when the applicable justice centre is closed for business.

Subsection 35A(2) added: O.I.C. 2004-197, N.S. Reg. 145/2004.

Section 35A added: O.I.C. 2003-513, N.S. Reg. 208/2003.

 

35B  (1)  A secure-treatment certificate shall be in Form XVI.

 

         (2)  Service of a secure-treatment certificate shall be,

 

                (a)    for the child who is the subject of the certificate, by personal service; and

 

                (b)    for the nearest legal aid office, by

 

                         (i)     personal service,

 

                         (ii)    registered mail, or

 

                [(ii)] (iii)   facsimile transmission.

Section 35B added: O.I.C. 2003-513, N.S. Reg. 208/2003.

 

35C  (1)  No child shall be placed in a secure treatment facility and no court, judge, justice, youth justice court judge or tribunal shall order, renew or review placement of a child in a secure treatment facility unless the placement, renewal or review is approved, applied for or consented to by the Minister.

 

         (2)  The consent of the Minister to an application by an agency for a secure-treatment order or renewal or review of a secure-treatment order shall be in the form of a letter signed by the Director of Child Welfare.

Section 35C added: O.I.C. 2003-513, N.S. Reg. 208/2003.

 

35D  (1)  In order for a person in charge to grant a leave of absence for a child from a secure treatment facility pursuant to subsection 60(1) of the Act, the child must request approval from the person in charge, and include the medical, humanitarian or rehabilitative reason for the requested leave of absence and the duration of the requested leave of absence.

 

         (2)  A person in charge shall document each request for a leave of absence, including

 

                (a)    the date of the request;

 

                (b)    the reason for the requested leave of absence;

 

                (c)    whether the leave of absence is granted and any terms and conditions of the leave;

 

                (d)    the duration of the granted leave of absence;

 

                (e)    the name of the person who has charge of the child during the leave of absence,

 

and any additional relevant details.

Section 35D added: O.I.C. 2003-513, N.S. Reg. 208/2003.

 

Temporary-care Agreements

36     A temporary care agreement pursuant to Section 17 of the Act shall be in Form III of these regulations.

Subsection 36(1) renumbered 36: O.I.C. 2008-394, N.S. Reg. 340/2008.

Subsection 36(2) repealed: O.I.C. 2008-394, N.S. Reg. 340/2008.

 

Special-needs agreements

37     (1)  For the purpose of Section 18 of the Act,

 

                (a)    services for which a special-needs agreement may be entered into include residential services in a child-caring facility; and

 

                (b)    a child has special needs if the child has a need that is related to or caused by a behavioural, emotional, physical, mental or other handicap or disorder.

 

         (2)  In Sections 38 to 42, “special-needs agreement” means a written agreement under Section 18 of the Act respecting a child with special needs.

Section 37 replaced: O.I.C. 2008-394, N.S. Reg. 340/2008.

 

Application for special-needs agreement for transfer of care and custody

38     A parent or guardian may apply to an agency or the Minister to enter into a special-needs agreement for the care and custody of a child with special needs and for services to be provided to the child.

Section 38 replaced: O.I.C. 2008-394, N.S. Reg. 340/2008.

 

Application for special-needs agreement for services in child-caring facility

39     A parent or guardian may apply to the Minister to enter into a special-needs agreement for services to be provided to a child in a child-caring facility if the child’s special needs include any of the following characteristics:

 

                (a)    significant behaviours that put the child or others at risk of harm and a mild or moderate intellectual disability, as diagnosed by an approved clinician, that has been documented within the 2 years preceding the application for services;

 

                (b)    a severe to profound intellectual disability, as diagnosed by an approved clinician, that has been documented within the 2 years preceding the application for services;

 

                (c)    a significant physical disability with ongoing functional limitations that are a result of the disability and that seriously limit the child’s capacity to perform age-appropriate activities of daily living, as determined by an approved clinician.

Section 39 replaced: O.I.C. 2008-394, N.S. Reg. 340/2008.

 

Application for special-needs agreement for services in child’s home

40     A parent or guardian may apply to the Minister to enter into a special-needs agreement for services to be provided to a child with special needs in the child’s home.

Section 40 replaced: O.I.C. 2008-394, N.S. Reg. 340/2008.

 

Review of application for special-needs agreement

41     Before entering into a special-needs agreement, the Minister and, if the application was made to an agency, the agency must review each application under Sections 38 to 40, and must

 

                (a)    in accordance with policy, determine eligibility for services and, if appropriate, services in a child-caring facility, based on the assessed

 

                         (i)     special needs of the child, and

 

                         (ii)    capacity of the child’s parent or guardian to care for the child at home; and

 

                (b)    determine availability of services and child-caring facilities, as appropriate.

Section 41 replaced: O.I.C. 2008-394, N.S. Reg. 340/2008.

 

Forms prescribed for special-needs agreements

42     (1)  A special-needs agreement referred to in Section 38 for the care and custody of a child with special needs and for services to be provided to the child must be in Form IV.

 

         (2)  A special-needs agreement referred to in Section 39 for services to be provided to a child in a child-caring facility must be in Form V.

 

         (3)  A special-needs agreement referred to in Section 40 for services to be provided to a child in the child’s home may be in Form VI.

Section 42 replaced: O.I.C. 2008-394, N.S. Reg. 340/2008.

 

Section 43 repealed: O.I.C. 2008-394, N.S. Reg. 340/2008.

 

Financial contribution of parent or guardian

44     Before a temporary-care agreement under Section 17 of the Act or a special-needs agreement under Section 18 of the Act is entered into, the agency or the Minister shall inquire into the ability of the parent or guardian of the child to contribute financially toward the cost of the maintenance of and services for the child and, if the parent or guardian is able to contribute, the amount of the contribution must be stipulated in the agreement.

Section 44 replaced: O.I.C. 2008-394, N.S. Reg. 340/2008.

 

Mediation costs

45     The cost of mediation services pursuant to Section 13 or 21 of the Act may be paid for in whole or in part by the Administrator in accordance with rates established by the Administrator, provided that the services are rendered by a mediator who possesses the qualifications approved by the Administrator.

 

Health care professionals reporting requirements

45A  (1)  Where a health care professional makes a verbal report pursuant to Section 24 of the Act that a child is abused, the health care professional shall within 3 days of the report advise the agency in writing of the information upon which the verbal report is based.

 

         (2)  A health care professional who is requested by an agency to examine a child believed to be in need of protective services shall, at the request of the agency, submit a report in writing to the agency within 3 days of the examination and the report shall indicate whether or not the examination revealed injuries or findings that the child may be in need of protective services.

Section 45A added: O.I.C. 95-517, N.S. Reg. 105/95.

 

Fees and disbursements of counsel and guardian ad litem

46     For the purpose of subsection (4) of Section 37 of the Act

 

                (a)    reasonable fees and disbursements of counsel are those which are in accordance with the Nova Scotia Legal Aid Tariff of fees;

 

                (b)    reasonable fees and disbursements of a guardian ad litem shall be determined from time to time by the Administrator but shall not exceed the amounts for counsel allowable pursuant to the Nova Scotia Legal Aid Tariff of fees.

 

Abandoned child costs

47     The reasonable and necessary costs incurred by an agency pursuant to Section 28 of the Act shall be paid by the Minister provided that a child is taken into care pursuant to clause (c) of subsection (2) of Section 28 or subsection (3) of Section 28 of the Act, and the costs incurred by an agency pursuant to Section 28 shall be paid in accordance with Sections 49 to 55 of these regulations.

 

48     The Administrator may determine from time to time the costs that are reasonable and necessary in relation to Section 28 of the Act and may include the cost of

 

                (a)    temporary care of the child;

 

                (b)    clothing;

 

                (c)    transportation; and

 

                (d)    medical services.

 

Payment of costs

49     For the purposes of Sections 50 to 55 of these regulations

 

                (a)    “taking a child into care” means a proceeding as defined in Section 31 of the Act, whether initiated by an application pursuant to Section 32 of the Act or a taking into care pursuant to Section 33 of the Act;

 

                (b)    “costs of the maintenance of a child in care” means the costs of maintenance of a child in the care and custody of an agency or the cost of the services required to allow a child to remain in the care and custody of a parent, guardian or other person.

 

50     (1)  The cost of taking a child into care includes the direct cost of

 

                (a)    medical and dental care and transportation related thereto;

 

                (b)    clothing;

 

                (c)    conveying the child to and from the court;

 

                (d)    temporary care and custody of the child pending the final disposition of the proceeding;

 

                (e)    assessment, treatment or service for the child, parent, guardian, or other party;

 

                (f)     access services and supervision provided by persons other than the agency;

 

                (g)    reasonable fees required for witnesses and service of court documents;

 

                (h)    fees and disbursements of agency counsel; and

 

                (i)     any other direct costs which the Administrator may authorize.

 

         (2)  The amounts that may be included as the cost for assessment, treatment or services listed in clauses (e) and (f) of subsection (1) shall be in accordance with the fees established by the Administrator for the reasonable cost of such assessment, treatment or services by qualified persons.

Subsections 50(3), (4), (5) and (6) repealed: O.I.C. 96-139, N.S. Reg. 41/96.

 

51     At any time prior to the final disposition of a proceeding, the agency may submit to the Minister an invoice of such interim costs as prescribed in Section 50 as it deems appropriate and invoices shall be submitted at least quarterly.

Section 51 replaced: O.I.C. 96-139, N.S. Reg. 41/96.

 

52     Upon the final disposition of the proceeding, the agency shall, upon request, submit to the Minister a final statement with respect to the costs prescribed in Section 50.

Section 52 replaced: O.I.C. 96-139, N.S. Reg. 41/96.

 

53     (1)  The Minister shall pay to the agency which has incurred costs with respect to the child

 

                (a)    one hundred percent of the costs as prescribed or determined in Section 50 of these regulations; and

 

                (b)    when the child is in the permanent care and custody of an agency, the Minister shall pay one hundred percent of the costs of the maintenance of the child in care and such sum as the Minister may establish when the child is being maintained in a facility.

 

         (2)  Where a disposition order is made pursuant to Section 42 of the Act and a child has been the subject of a disposition order for more than 18 months, the Minister shall, at the expiration of the 18 months, pay one hundred percent of the costs of the maintenance of the child in care and such sum as the Minister may establish when the child is being maintained in a facility.

 

         (3)  The cost of maintenance of a child in the care and custody of an agency who is a resident in a home for special care licensed or approved under the Homes for Special Care Act and regulations shall be determined and provided for pursuant to the provisions of the Social Assistance Act.

Section 53 replaced: O.I.C. 96-139, N.S. Reg. 41/96.

 

54     Where there are any excess funds collected by an agency with respect to costs recovered pursuant to Sections 50 to 53 of these regulations or for any other reason, the agency shall disperse the funds as directed by the Administrator including refunding some or all of the amount to the Minister.

Section 54 replaced: O.I.C. 96-139, N.S. Reg. 41/96.

 

55     Where an agency is not making regular payments for the costs of the maintenance of a child in care, but makes occasional payments for food, shelter, clothing, medical care or other necessities, the agency may bill the Minister on an interim basis for the occasional costs but the amount billed for any month shall not exceed the amount that the Minister would have paid pursuant to Section 53 of these regulations.

Section 55 replaced: O.I.C. 96-139, N.S. Reg. 41/96.

 

Section 56 repealed: O.I.C. 2004-339, N.S. Reg. 198/2004.

 

57     For the purpose of subsection (11) of Section 48 of the Act, the written report to the Minister concerning a child in the permanent care and custody of an agency shall be in Form X of these regulations.

 

Child abuse register

58     (1)  For the purpose of subsection (2) of Section 63 of the Act, the information which shall be entered in the Child Abuse Register is prescribed in Form XI of these regulations and this information shall constitute the Child Abuse Register.

 

         (2)  Every court, or justice making a finding which is a finding as described in clauses (a) and (c) of subsection (2) of Section 63 of the Act shall report the finding to the Child Abuse Register.

 

         (3)  Every court, Judge or justice entering a conviction which is a conviction as described in clause (b) of subsection (2) of Section 63 of the Act shall report the conviction to the Child Abuse Register.

 

         (4)  For the purpose of clauses (a) and (c) of subsection (2) of Section 63 of the Act, the Administrator shall enter the name of a person in the Child Abuse Register when the Administrator receives from the court a notification of a finding as prescribed in Form XII of these regulations.

 

         (5)  For the purpose of clause (b) of subsection (2) of Section 63 of the Act, the Administrator shall enter the name of a person in the Child Abuse Register when the Administrator receives from the court a notification of a conviction as prescribed in Form XII of these regulations.

 

         (6)  A report of a finding shall be certified by the Family Court Officer for the Family Court or by the Clerk of the Court in which the finding is made.

 

         (7)  A report of a conviction shall be certified by the Clerk of the Court in which the conviction is entered.

 

59     (1)  Where a person provides documentation to the Administrator that establishes that

 

                (a)    an appeal has been filed in relation to a finding referred to [in] clause (a) or (c) of subsection (2) of Section 63 of the Act, or a conviction referred to in clause (b) of subsection (2) of Section 63 of the Act; or

 

                (b)    an application has been filed pursuant to subsection (2) [of] Section 64 of the Act,

 

any information provided pursuant to subsections (2), (3) and (4) of Section 66 of the Act shall include notification that the appeal or application has been filed.

 

         (2)  Where a court quashes a conviction with respect to a person referred to in clause (b) of subsection (2) of Section 63 of the Act or reverses a finding with respect to a person referred to in clause (a) or (c) of subsection (2) of Section 63 of the Act, or grants an application pursuant to subsection (2) of Section 64 of the Act, the court shall report the determination to the Child Abuse Register on Form XII of these regulations and the Administrator shall remove the name of the person from the Child Abuse Register or make such other alterations or deletions to the Child Abuse Register as the court may order.

 

60     (1)  For the purpose of subsection (4) of Section 66 of the Act, a person may apply to the Minister for disclosure of information in the Child Abuse Register concerning themself, including confirmation that their name has not been entered into the Child Abuse Register.

 

         (2)  A person applying for disclosure of information in the Child Abuse Register must submit their application using the form provided by the Administrator.

 

         (3)  On receiving an application for disclosure of information in the Child Abuse Register, the Administrator must cause the Register to be searched for the name of the applicant.

 

         (4)  The Administrator must provide an applicant with written disclosure of the results of the search of the Child Abuse Register that was conducted with respect to that applicant.

Section 60 replaced: O.I.C. 2013-333, N.S. Reg. 306/2013.

 

61     (1)  The Administrator may permit the use of the Child Abuse Register for research pursuant to clause (b) of subsection (3) of Section 66 of the Act where

 

                (a)    a written request to use the Child Abuse Register for research is made to the Administrator;

 

                (b)    the request specifies the purpose of the research, the specific information required from the Child Abuse Register, the use of the research results, and the names and qualifications of the researchers;

 

                (c)    all researchers have signed a declaration of confidentiality; and

 

                (d)    other terms and conditions as required by the Administrator are met.

 

         (2)  Only non-identifying information shall be made available for research.

 

         (3)  For the purposes of this section and clause (b) of subsection (3) of Section 66 of the Act, “research” means the study or analysis of

 

                (a)    children in need of protective services;

 

                (b)    children who are subject to abuse;

 

                (c)    the families of children described in clauses (a) and (b); and

 

                (d)    the nature and extent of child abuse.

 

62     (1)  Unless otherwise ordered by a court, no person under the age of twelve years may be recorded in the Child Abuse Register for abuse that occurred prior to the person attaining the age of twelve years.

 

         (2)  Form XIV of these regulations is prescribed for the purpose of notice of registration to a person whose name is entered on the Child Abuse Register.

 

         (3)  Service of notice under subsection (2) shall be by registered mail to the person’s last known mailing residence as shown on Form XII of these regulations.

 

Subsections 62(4), (5) and (6) repealed: O.I.C. 95-518, N.S. Reg. 106/95.

 

         (7)  For the purposes of subsection 64(1) of the Act, notice to a person under the age of 16 years may be made by serving a notice by registered mail on

 

(a)the person;

 

(b)the parent or guardian of the person; or

 

(c)both the person and the parent or guardian of the person,

 

at the last know[n] mailing residence of the person, parent or guardian as shown on Form XII of these regulations.

Subsection 62(7) added: O.I.C. 94-613, N.S. Reg. 126/94.

 

63     (1)  For the purpose of clause (b) of subsection (2) of Section 63 and subsection (2) of Section 104 of the Act, the following offences are hereby prescribed by reference to the appropriate section numbers of the Criminal Code of (Canada);

 

                (a)    151 – sexual interference

                (b)    152 – invitation to sexual touching

                (c)    153 – sexual exploitation

                (d)    155 – incest

                (e)    159 – anal intercourse

                (f)     160(3) – bestiality in the presence of or by a child

                (g)    170 – parent or guardian procuring sexual activity

                (h)    171 – householder permitting sexual activity

                (i)     172 – corrupting children

                (ia)   172.1 – luring a child

                (j)     173(2) – indecent exposure

                (k)    212(1)(h) – aiding, abetting or compelling a person to engage in prostitution

                (l)     212(1)(j) – living on the avails of prostitution

                (m)   215(1)(a) – failure to provide necessaries

                (n)    218 – abandoning child

                (o)    220 – causing death by criminal negligence

                (p)    221 – causing bodily harm by criminal negligence

                (q)    235 – murder

                (r)     236 – manslaughter

                (s)    239 – attempted murder

                (t)     244 – causing bodily harm with intent

                (u)    266 – assault

                (v)    267 – assault with weapon or causing bodily harm

                (w)   268 – aggravated assault

                (x)    269 – unlawfully causing bodily harm

                (y)    271 – sexual assault with a weapon

                (z)    272 – threats to a third party or causing bodily harm

                (aa)  273 – aggravated sexual assault

                (ab)  279 – kidnapping.

Clause 63(1)(ia) added: O.I.C. 2010-119, N.S. Reg. 49/2010.

         (2)  A conviction of a young offender for assault under Section 266 of the Criminal Code (Canada) is not a prescribed offence for the purpose of subsection (1).

Subsection 63(2) added: O.I.C. 95-518, N.S. Reg. 106/95.

 

64     For the purpose of the accurate identification of a person whose name is on the Child Abuse Register or whose name is to be placed on or removed from the Child Abuse Register, the Minister or the judge or justice of any court may require the person to provide the Social Insurance Number of the person or the Motor Vehicle Master number of the person or may require the applicable department of government or government agency to provide this information to the Minister.

 

Section 64A added: O.I.C. 2008-203, N.S. Reg. 251/2008; repealed: O.I.C. 2013-333, N.S. Reg. 306/2013.

 

Adoption

65     For the purposes of subclause (iv) of clause (f) of subsection (1) of Section 67 of the Act, an individual stands in loco parentis to a child when the individual

 

                (a)    cohabits with a member of the opposite sex who is the father or mother of the child and who has the care of that child;

 

                (b)    contributes to the financial support of the child; and

 

                (c)    behaves towards the child as if the child was the son or daughter of the individual.

 

66     (1)  Where a child-placing agency enters into an agreement pursuant to Section 68 of the Act, the agency shall where feasible in the circumstances, ensure that the signature of the parent is witnessed by a person, other than an employee of the agency, who understands and can explain to the parent the nature and effect of the agreement and that the agreement constitutes a consent for the purposes of adoption.

 

         (2)  An agreement pursuant to Section 68 of the Act is not defective because the signature of the parent is witnessed by a person contrary to the requirements of subsection (1).

 

67     An adoption agreement under Section 68 of the Act shall be in Form XV of these regulations.

 

68     For the purpose of Section 72 of the Act, “legitimate parent” means either the mother or father of a legitimate or legitimated child who is the subject of the adoption application.

 

69     (1)  A notice of proposed adoption shall be in a form prescribed by the Administrator.

 

         (2)  Failure to include all of the information required in a notice of proposed adoption does not render the notice invalid for the purposes of subsection (4) of Section 48, subsection (2) of Section 67, subsection (5) of Section 68, and Section 76 of the Act.

 

70     Where, pursuant to clause (a) of subsection (7) of Section 68 of the Act, an agency declares an adoption agreement to be terminated, the agency shall take all reasonable steps to inform the parent who signed the adoption agreement that the adoption agreement has been terminated.

 

71     (1)  The Executive Director of an agency or any other person specifically designated by the agency’s Board of Directors, may sign an adoption agreement pursuant to Section 68 of the Act on the agency’s behalf, or consent to an adoption on behalf of the agency, pursuant to subsection (7) of Section 74 of the Act.

 

         (2)  When a person signs or executes an adoption agreement or a consent to adoption pursuant to subsection (1), the person shall refer to the name of the office or position of the person together with the words “Authorized under subsection (1) of Section 71 of the Children and Family Services Regulations”, and when a document contains such reference, the document

 

                (a)    shall be received in evidence without further proof of the authority of the person who signs or executes the document; and

 

                (b)    may be relied upon by the person to whom the document is directed or given and by all other persons as an effective exercise of the power or function to which the document relates.

 

72     Where the Minister receives notice of the hearing of an application for adoption pursuant to clause (b) of subsection (1) of Section 76 of the Act and the Minister has information that the person proposed to be adopted is or may be an Indian child, the Minister shall so advise the court of that information prior to the hearing.

 

Section 73 repealed: O.I.C. 97-5, N.S. Reg. 2/97.

 

74     For informational purposes, when a child in care is placed for adoption, the agency shall,

 

                (a)    where the whereabouts of the parent are known, advise the parent

 

                         (i)     that the child has been placed in a home for the purpose of adoption, and

 

                         (ii)    that a final order for adoption has been granted, provided the agency has this information;

 

                (b)    where the whereabouts of the parent are not known, provide the information described in clause (a), upon request by the parent.

 

Section 75 repealed: O.I.C. 97-5, N.S. Reg. 2/97.

Section 76 repealed: O.I.C. 97-5, N.S. Reg. 2/97.

 

General

77     Nothing in the Act or these regulations relieves a municipal unit of its responsibilities under the Social Assistance Act to provide assistance to persons who are in need within the meaning of the Social Assistance Act.

 

Section 77A added: O.I.C. 2002-278, N.S. Reg. 82/2002; repealed: O.I.C. 2006-244, N.S. Reg. 73/2006.

 

Transition

78     Any license or approval, under the former Act, to operate a child-care service, a child-caring facility, or a child-placing agency that was in force on September 2, 1991, continues in effect until it expires or is cancelled, suspended or renewed in accordance with the provisions of the Act and these regulations.

 

79     Where an agreement pursuant to Sections 8, 9 or 10 of the former Act is in force on September 2, 1991, the agreement continues in effect until it is terminated, expires or is renewed in accordance with the provisions of the Act.

 

 ________________________________________________________________ 

 

Form I repealed: O.I.C. 2010-168, N.S. Reg. 57/2010.


Form II – License to Operate a Child-caring Facility

Children and Family Services Act

Province of Nova Scotia

Department of Community Services

__________________ of _________________ is hereby licensed to operate a ______________ at _________________ in the County of _________________ subject to the provisions of the Children and Family Services Act and the regulations made thereunder and subject to any terms, conditions, or restrictions hereby prescribed by the undersigned.

 

Terms, conditions or restrictions

                                                                                                                                                   

                                                                                                                                                   

 

This license expires on the ___ day of ___________, 19___ unless sooner cancelled or suspended.

 

Issued at Halifax, Nova Scotia, this ____ day of __________, 19___.

 

                                                                                                                                                  

Witness                                                                     Minister of Community Services

 

 ________________________________________________________________ 

Form III – Temporary Care Agreement pursuant to Section 17

of the Children and Family Services Act

BETWEEN:                                                                                                                              

                                                    – referred to in this Agreement as “the Agency”

 

– and –

                                                                                                                                                  

– being the Parent(s) or Guardian(s) of the child and referred to in this Agreement as “the Parent(s)”

 

1.    Purpose of agreement

       (1)    The purpose of this Agreement is to place the child(ren) named below in the temporary care and custody of the Agency and to set out the rights and obligations of both Agency and Parent(s) while the children are in the agency’s temporary care and custody.

 

       (2)    The child(ren) to be placed under this Agreement are

________________________________________________________________

Full NameBirth dateSex

__________________________________________________________

Full NameBirth dateSex

__________________________________________________________

Full NameBirth dateSex

__________________________________________________________

Full NameBirth dateSex

       (3)    The Parents are temporarily unable to care adequately for the child(ren) for the following reasons:

                                                                                                                                                  

                                                                                                                                                  

 

       (4)    The Agency shall take the child(ren) into its temporary care and custody beginning on _________________ and ending on ________________ unless this Agreement is terminated before that date in accordance with the terms of this Agreement.

 

2.    Acknowledgements

       (1)    The Parties agree that the placement of the child(ren) in the temporary care and custody of the agency is voluntary.

 

       (2)    The Parties have discussed other alternatives to the placement of the child(ren) in the temporary care and custody of the agency, including the provision of services in the child(ren)’s home.

 

       (3)    The Parties agree to work together to plan for the return of the child(ren) to the child(ren)’s home.

 

3.    Obligations of parent(s)

       (1)    The Parent(s) agree to keep in contact with the Agency and, for that purpose, to notify the Agency of any extended absence or change in address.

 

       (2)    Where it is not possible to contact the Parent(s), the Agency may contact the following person(s) concerning the child(ren):

                                                                                                                                                  

 

                (Name, Address, Phone Number and Relationship to Parent(s)).

       (3)    The Parent(s) shall visit with the child(ren) regularly as set out below:

                                                                                                                                                  

                                                                                                                                                  

       (4)    The Parent(s) consent to the Agency obtaining any information from other agencies, persons or organizations relating to the child(ren) that is necessary for the Agency’s care of the child(ren) and agree to execute any written consents or releases that may be required by the Agency to obtain that information.

 

4.    Obligations of agency

       (1)    The Agency worker designated for the supervision of this Agreement is

                                                                                                                                                  

                                           (Name and Phone Number).

Outside of regular office hours, the Parent(s) may call the emergency duty number of the Agency, which is _________________________.

 

       (2)    The Agency agrees to keep the Parent(s) informed of the progress of the child(ren), including notice as soon as possible of any emergency involving the child(ren) or any absence of the child(ren) from Agency care and notice of any change in placement of the child(ren).

5.    Case plan

       (1)    The following goals, objectives and services are agreed to by the Parties:

                                                                                                                                                  

       (2)    The goals, objectives and services specified in subsection (1) may be reviewed and changed by the Agency at any time during the period of this Agreement and any such changes shall be discussed by the Agency with the Parent(s).

 

6.    Consent to medical treatment

[This clause is optional. Where no consent to treatment is attached to this agreement the Parent(s) retain the right to consent to treatment.]

 

       (1)    Attached to this Agreement is a Consent to Treatment signed by the Parent(s) authorizing the Agency to consent to medical, surgical, dental, psychiatric or other necessary treatment for the child(ren) where the consent of a parent would otherwise be necessary, subject to any specific restrictions set out in the Consent to Treatment.

 

7.    Financial contribution

       (1)    The Agency and the Parent(s) have reviewed the ability to pay of the Parent(s) and the Parent(s) agree to pay the sum of _________, to be paid ___________ (monthly, quarterly, etc.) as a financial contribution to the care of the child(ren).

 

       (2)    The Agency shall apply any financial contribution towards the cost of agency care of the child(ren).

 

8.    Variation, extension and termination of agreement

       (1)    The Agency or the Parent(s) may at any time request a review of the terms of this Agreement and this Agreement may be varied on the mutual consent of the Agency and Parent(s).

 

       (2)    This Agreement may be extended by mutual agreement, but the total term of the Agreement, including any extensions, may not exceed twelve months.

 

       (3)    Unless extended, this Agreement expires on the date set out above in Clause 1.

 

       (4)    Either the Agency or the Parent(s) may terminate this Agreement earlier than the expiry date upon giving                   days’ notice in writing to the other party.

 

9.    Special terms

The following are special terms of this Agreement:

                                                                                                                                                  

                                                                                                                                                  

 

10.  Explanation of agreement and independent advice

       (1)    The Parent(s) have had the purpose and terms of this Agreement and any Consent to Treatment explained to them by the Agency before signing and have had a reasonable opportunity to review the Agreement before signing.

 

       (2)    The Parent(s) have been informed of their right to obtain independent advice before signing this Agreement and the Agency has encouraged the Parent(s) to seek independent legal advice, if not before, then immediately after, the signing of this Agreement.

 

       (3)    By signing this Agreement, the Parent(s) acknowledge receipt of a signed copy of the Agreement, including any Consent to Treatment.

 

THIS AGREEMENT has been signed and witnessed at ____________, Nova Scotia, this ____ day of ____________, 19___.

 

                                                                                                                               

Witness                                                      Person signing on behalf of the Agency

                                                                                                                               

Witness                                                      Parent

                                                                                                                               

Witness                                                      Parent

 

(If a child placed under this Agreement is twelve (12) years of age or older at the time this Agreement is signed the following should be completed if the child has the ability to understand this Agreement.)

 

I have had this Agreement explained to me by the Agency worker and I have reviewed this Agreement with the Agency worker and my Parent(s). I understand the purpose and terms of the Agreement and I have received a signed copy of this Agreement, including any Consent to Treatment.

 

                                                                                                                               

Witness                                                      Child

                                                    

Date

 

 ________________________________________________________________ 

Form IV – Special Needs Agreement pursuant to Section 18

of the Children and Family Services Act

 

Between:                                                                                                                                   

                                                    – referred to in this Agreement as “the Agency”

 

– and –

                                                                                                                                                  

                                                    – being the Parent(s) or Guardian(s) of the child and

                                                    referred to in this Agreement as “the Parent(s)”

 

1.    Purpose of agreement

       (1)    The purpose of this Agreement is to place the child(ren) named below in the care and custody of the Agency and to set out the rights and obligations of both Agency and Parent(s) while the children are in the agency’s care and custody.

 

       (2)    The child(ren) to be placed under this Agreement are

________________________________________________________________

Full NameBirth dateSex

__________________________________________________________

Full NameBirth dateSex

__________________________________________________________

Full NameBirth dateSex

__________________________________________________________

Full NameBirth dateSex

 

       (3)    The Parent(s) are unable to provide the services required by the child(ren) because of the following special needs of the child(ren):

__________________________________________________________________

__________________________________________________________________

 

       (4)    The Agency shall take the child(ren) into its care and custody beginning on ____________ and ending on _____________ unless this Agreement is terminated before that date in accordance with the terms of this Agreement.

 

2.    Acknowledgements

       (1)    The Parties agree that the placement of the child(ren) in the care and custody of the agency is voluntary.

 

       (2)    The Parties have discussed other alternatives to the placement of the child(ren) in the care and custody of the agency, including the provision of services in the child(ren)’s home.

 

3.    Obligations of parent(s)

       (1)    The Parent(s) agree to keep in contact with the Agency and, for that purpose, to notify the Agency of any extended absence or change in address.

 

       (2)    Where it is not possible to contact the Parent(s), the Agency may contact the following person(s) concerning the child(ren):

 

                                  (Name, Address, Phone Number and Relationship to Parent(s)).

 

       (3)    The Parent(s) shall visit with the child(ren) regularly as set out below:

                                                                                                                                                  

                                                                                                                                                  

 

       (4)    The Parent(s) consent to the Agency obtaining any information from other agencies, person or organizations relating to the child(ren) that is necessary for the Agency’s care of the child(ren) and agree to execute any written consents or releases that may be required by the Agency to obtain that information.

 

4.    Obligations of agency

       (1)    The Agency worker designated for the supervision of this Agreement is ____________________ (Name and Phone Number). Outside of regular office hours, the Parent(s) may call the emergency duty number of the Agency, which is ______________________.

 

       (2)    The Agency agrees to keep the Parent(s) informed of the progress of the child(ren), including notice as soon as possible of any emergency involving the child(ren) or any absence of the child(ren) from Agency care and notice of any change in placement of the child(ren).

 

5.    Case plan

       (1)    The following goals, objectives and services are agreed to by the Parties:

                                                                                                                                                  

 

       (2)    The goals, objectives and services specified in subsection (1) may be reviewed and changed by the Agency at any time during the period of this Agreement and any such changes shall be discussed by the Agency with the Parent(s).

 

6.    Consent to medical treatment

[This clause is optional. Where no consent to treatment is attached to this agreement the Parent(s) retain the right to consent to treatment.]

 

       (1)    Attached to this Agreement is a Consent to Treatment signed by the Parent(s) authorizing the Agency to consent to medical, surgical, dental, psychiatric or other necessary treatment for the child(ren) where the consent of a parent would otherwise be necessary, subject to any specific restrictions set out in the Consent to Treatment.

 

7.    Financial contribution

       (1)    The Agency and the Parent(s) have reviewed the ability to pay of the Parent(s) and the Parent(s) agree to pay the sum of ____________, to be paid _______________ (monthly, quarterly, etc.) as a financial contribution to the care of the child(ren).

 

       (2)    The Agency shall apply any financial contribution towards the cost of agency care of the child(ren).

 

8.    Variation, extension and termination of agreement

       (1)    The Agency or the Parent(s) may at any time request a review of the terms of this Agreement and this Agreement may be varied on the mutual consent of the Agency and Parent(s).

 

       (2)    This Agreement may be extended by mutual agreement on a yearly basis.

 

       (3)    Unless extended, this Agreement expires on the date set out above in Clause 1.

 

       (4)    Either the Agency or the Parent(s) may terminate this Agreement earlier than the expiry date upon giving _____ days’ notice in writing to the other party.

 

9.    Special terms

The following are special terms of this Agreement:

                                                                                                                                                  

                                                                                                                                                  

 

10.  Explanation of agreement and independent advice

       (1)    The Parent(s) have had the purpose and terms of this Agreement and any Consent to Treatment explained to them by the Agency before signing and have had a reasonable opportunity to review the Agreement before signing.

 

       (2)    The Parent(s) have been informed of their right to obtain independent advice before signing this Agreement and the Agency has encouraged the Parent(s) to seek independent legal advice, if not before, then immediately after, the signing of this Agreement.

 

       (3)    By signing this Agreement, the Parent(s) acknowledge receipt of a signed copy of the Agreement and any Consent to Treatment.

 

THIS AGREEMENT HAS BEEN SIGNED AND WITNESSED AT__________,

NOVA SCOTIA, THIS _____ DAY OF ____________, 19___.

 

                                                                                                                                                  

       Witness                                                     Person signing on behalf of the Agency

                                                                                                                                                  

       Witness                                                     Parent

                                                                                                                                                  

       Witness                                                     Parent

 

(If a child placed under this Agreement is twelve (12) years of age or older at the time this Agreement is signed the following should be completed if the child has the ability to understand this Agreement.)

 

I have had this Agreement explained to me by the Agency worker and I have reviewed this Agreement with the Agency worker and my Parent(s). I understand the purpose and terms of the Agreement and I have received a signed copy of this Agreement, including any Consent to Treatment.

                                                                                                                                                  

       Witness                                                     Child

                                                                   

       Date

 

 ________________________________________________________________ 

Form V – Agreement Pursuant to Section 18 of the Children and Family Services Act

to Provide for Services for a Child with Special Needs in a Child-Caring Facility

 

BETWEEN:

 

Her Majesty the Queen, in right of the Province of Nova Scotia, as represented by the

Minister of the Department of Community Services (“the Minister”)

- and -

Names of parent/agency/guardian, who has the care and custody of the child or the legal guardianship of the child (“the Parents”)

 

Whereas the Parents have applied to the Minister pursuant to Section 39 of the Children and Family Services Regulations for services for the child named in this Agreement, who has special needs;

 

And whereas the Parents have care and custody of the child and they and the Minister have agreed on the services to be provided to meet the child’s special needs in a child-caring facility;

 

And whereas the child-caring facility is approved or licensed by the Minister and has been determined by the Parents and the Minister to be able to meet the special needs of the child;

 

Now therefore the parties agree as follows:

 

1.   Purpose of agreement

(1)   The purpose of this Agreement is to set out the services to be provided to the child named below in a child-caring facility, the financial contribution from the Parents toward the cost of maintenance of and services for the child, and the obligations of each of the parties to this Agreement in relation to the child and services to be provided.

 

(2)    This Agreement is made in relation to the following child:

 

       ______________________________________________________________

       Full Name                            Birth date                                Sex

 

(3)   The Parents and Minister agree that the child has one or more of the special needs that are described in Section 39 of the Children and Family Services Regulations, including the following characteristics:

________________________________________________________________________

________________________________________________________________________

 

(4)   The Minister and the Parents agree that the child will reside at _______________________ (the “facility”), a child-caring facility approved or licensed by the Minister, which provides services to meet the special needs of the child.

 

2.      Obligations of the Minister and the Parents

(1)    Obligations of the Minister

 

         The Minister shall

 

         (a)   make a financial contribution toward the cost of maintenance of the child and services provided to the child as set out in Schedule “A”;

 

         (b)  periodically review the progress of the child and the need for services to the child and regularly advise the Parents of the progress of the child; and

 

         (c)   monitor and enforce the child-caring facility’s approval or licensing compliance.

 

(2)    Obligations of the Parents

 

(2.1)   The Parents shall

 

          (a) retain care and custody of the child and shall visit the child at the facility regularly, take the child on outings, and arrange for temporary visits at home, specifically as follows:

____________________________________________________________________

____________________________________________________________________

 

          (b) actively participate in planning for further care and programs required for the child upon the child’s discharge from the facility, specifically as follows:

____________________________________________________________________

____________________________________________________________________

 

          (c) provide 30 days’ notice to the Minister and to the child-caring facility before removing the child from the facility;

 

           (d) make a financial contribution toward the cost of maintenance of the child and services provided to the child, as set out in Schedule “A”, and provide financial information to the Minister on the anniversary date of this Agreement for the reassessment of the contribution amount.

 

(2.2)   The parents acknowledge their duty to report information indicating that the child is in need of protective services, or is or may be suffering or may have suffered abuse by a person other than a parent or guardian, to an agency pursuant to Sections 23 and 25 of the Children and Family Services Act.

 

(2.3)   The Parents agree that in the event that the child leaves the facility without the consent of the staff of the facility, the staff of the facility are hereby authorized to take reasonable measures to have the child returned to the facility.

 

(2.4)   The Parents agree that they shall not move out of the Province without making arrangements for the child to be discharged from the facility to the Parents.

 

(2.5)   In the event that the child is hospitalized, the Parents authorize the staff of the child-caring facility to escort the child on discharge from the hospital to the _____________________.

 

(2.6)   Consent to medical treatment

 

(This clause is optional. If no consent to treatment is attached to this agreement the Parent(s) retain the right to consent to treatment.)

 

Attached to this Agreement is a Consent to Treatment signed by the Parents authorizing the Minister to consent to medical, surgical, dental, psychiatric or other necessary treatment for the child if the consent of a parent would otherwise be necessary, subject to any specific restrictions set out in the Consent to Treatment.

 

3.       Term

This Agreement shall come into force and apply on and after ______________, 20__, and shall terminate on ______________, 20__.

 

4.       Termination

Either party to the Agreement may terminate the Agreement without cause or liability by giving 30 days’ notice in writing to the other party.

 

5.       Notice

Any notice or other communication to the Minister and to the Parents with respect to this Agreement shall be in writing and shall be given to the parties at the following addresses.

 

The MinisterParents

          Director of Services for Persons with Disabilities           Name

          Department of Community Services                                Address

          Nelson Place,

          5675 Spring Garden Road

          Halifax, NS B3J 2T7

 

6.       General

(1)      Anything that is required to be done by the Minister pursuant to this Agreement may be done by anyone authorized to act on the Minister’s behalf.

 

(2)      In this agreement “child” includes “children” and “parent” includes “parents”.

 

(3)      The parties have signed this Agreement, or caused this Agreement to be signed by their respective officers duly authorized in that behalf, on the dates set forth below.

 

Dated at _______________________ on ____________________, 20____.

 

______________________________             ___________________________________

Witness                                                            Person signing on behalf of the

Minister of Community Services

______________________________             ___________________________________

Witness                                                            Parent

 

______________________________             ___________________________________

Witness                                                            Parent

 

Form V replaced: O.I.C. 2008-394, N.S. Reg. 340/2008. ________________________________________________________________ 


 

Form VI – Agreement pursuant to Section 18 of the Children

and Family Services Act to Provide In-home Support Services

to a Child with Special Needs

 

BETWEEN:                                                                                                                              

– referred to in this Agreement as “the Agency”

 

– and –

                                                                                                                                                  

– being the Parent(s) or Guardian(s) of the child and referred to in this Agreement as “the Parent(s)”

 

Since it has been determined that ______________________ is a child who has special needs; and

 

Since the Agency wishes to assist the Parent(s) in keeping the family unit together;

 

The Agency agrees to provide the following assistance and services to the Parent(s):

                                                                                                                                                   

                                                                                                                                                   

                                                                                                                                                   

 

The Parent(s) agree to notify the Agency immediately of any change in family circumstances related to the condition or needs of the child.

 

This agreement shall come into force and apply on and after the _____ day of ____________ and shall terminate on the _____ day of ____________.

 

Either party to the agreement may terminate the agreement by giving _____ days notice in writing to the other party.

 

Dated at ___________ in the County of ___________ this ____ day of ____________, 19___.

 

                                                                                                                                                 

Witness                                                            Person signing on behalf of the Agency

                                                                                                                                                 

Witness                                                            Parent

                                                                                                                                                 

Witness                                                            Parent

 

 ________________________________________________________________ 

Form VII repealed: O.I.C. 2008-394, N.S. Reg. 340/2008.

Form VIII repealed: O.I.C. 2008-394, N.S. Reg. 340/2008.

Form IX repealed: O.I.C. 2004-339, N.S. Reg. 198/2004.

 

 ________________________________________________________________ 

Form X – Annual Permanent Care and Custody Report

(pursuant to subsection 48(11) of the Children and Family Services Act)

Child’s Comprehensive Plan of Care

(Infants to 5 Years)

 

Office:                                                              Date of meeting:

 

Child:                                                              File #:

 

Child’s D.O.B.                                                Worker:

 

Child’s NS Health #:                                      Case ID:

 

Child’s care status:                                        V7_____ V8_____ TCC____ PCC_____

 

Date of coming into care:

 

Names of birth parents:

 

Present placement:                                         Date:

 

Placement history: (Attach printout showing placement history.)

 

Date of the last plan of care meeting:

 

Case summary:

What is the plan for the child over the course of the next 12 months?

What are the long-term goals for the child?

 

A.   Health

(Provide details about matters such as medical history while in care, health issues, diet, medication, immunizations, childhood diseases, family doctor, dentist, etc.)

 

B.    Developmental/educational progress

(Provide details about matters such as preschool or daycare, progress, level, attitude, interaction with peers, routines, toys, independence, recreation or physical activities, etc.)

 

C.   Identity

(Provide details about matters such as child’s understanding of being in care, knowledge of birth family, religious and other origins, life book, self-esteem, etc.)

 

D.   Family/social relationships

(Provide details about matters such as number of placements, others in current foster home, respite, affection, access to birth family, impact of visits, holidays, etc.)

 

E.    Emotional/behavioural development

(Provide details about matters such as excessive behaviours, problems with others, concentration, eating, bedtime and sleeping routine, discipline, history of abuse, related therapy or medication.)

 

F.    Self-care skills (answer relative to age)

(Provide details about matters such as toilet training, brushing of teeth and hair, dressing, bathing.)

 

G.   Language development

 

(9 to 17 months)

(Provide details about matters such as cooing noises, reaction to stimulation, babbling.)

 

(18 to 24 months)

(Provide details about matters such as vocabulary, imitation of sounds, sentences.)

 

       (2 to 3 years)

(Provide details, such as repeating words and simple sentences produced by adults, speaks a lot about own actions, uses correct pronunciation for age, has basic understanding.)

 

(3 to 4 years)

(Provide details, such as sentences contain many words with plural endings, greater variety of emotions reflected in speech, easily repeats songs, expresses feelings, recognizes colours, etc.)

 

H.   Motor development

 

       (Birth to 8 months)

(Provide details, such as kicks, lifts and turns head, waves arms, lifts chin when lying on stomach, shakes objects when held, rolls from back to stomach, stands with help, crawls, picks up small objects, etc.)

 

       (9-17 months)

(Provide details, such as stands holding onto furniture, sits up easily, pulls up to stand, walks a few steps, stands alone.)

 

       (18-24 months)

(Provide details, such as runs awkwardly, pulls/pushes toys, throws a ball, holds glass in one hand, scribbles, walks up and down stairs, builds towers of 6-7 blocks, turns book pages singly.)

 

       (2-3 years)

(Provide details, such as places marks on paper, uses scribbles (vertical and circular) to cover all or part of a page, tries to make the basic shapes (triangles, circles, squares), scribbles to make designs, uses circles with circles, can jump down from a low chair or a step, can pedal a tricycle.)

 

       (3-4 years)

(Provide details, such as rides tricycle, hops with both feet, runs smoothly, buttons and unbuttons, catches a ball, walks up and down stairs with one foot on each step, scribbles to make designs.)

 

Child’s Comprehensive Plan of Care

(Six Years and Over)

 

Office:                                         Date of meeting:

 

Child:                                         File #:

 

Child’s D.O.B                            Worker:

 

Child’s NS Health #:                 Case ID:

 

Child’s care status:                   V7_____ V8_____ TCC____ PCC_____

 

Date of coming into care:

 

Names of birth parents:

 

Present placement:                    Date:

 

Placement history: (Attach printout showing placement history.)

 

Date of the last plan of care meeting:

 

Case summary:

What is the plan for the child over the course of the next 12 months?

What are the long-term goals for the child?

 

A.   Health

(Provide details about matters such as date of last medical exam, last dental exam, eye exam, acute or chronic health issues, diet, medications, immunizations, smoking, drugs, sexuality, etc.)

 

B.    Education

(Provide details about matters such as schools attended, grade, resource, tutoring, educational assessment, performance, attitude, homework, other activities, etc.)

 

C.   Identity

(Provide details about matters such as understanding of reasons he/she is in care, information on birth family, life book, religion, culture, self-esteem, goals.)

 

D.   Family/social relationships

(Provide details about matters such as number of placements, success of placements, respite, affection, access to birth family, confidence, friends, etc.)

 

E.    Social presentation (answer relative to age and development)

(Provide details about matters such as personal hygiene, clothing, communication, etc.)

 

F.    Emotional/behavioural development

(Provide details about matters such as defiant or disruptive behaviours in school or at home, shy, over-friendly, suspicious of others, getting into fights, demanding, impatient, angry, trouble with concentration, impulse control, worry, sleep and eating, discipline, therapy, medication, physical or sexual abuse, legal issues.)

 

G.   Self-care skills (answer relative to age and development)

(Provide details, such as does he/she have the skills to live independently, e.g. able to cook, clean, do laundry, shop for food and household items, personal care items, make his/her own personal appointments, etc.)

Form X replaced: O.I.C. 2004-339, N.S. Reg. 198/2004.

 

 ________________________________________________________________ 

Form XI – Child Abuse Register

C.A.R.#                     

 

Name of Perpetrator:  

D.O.B.                                                   MSI #                                                                         

SI#                                                    Driver License Master #                                                 

Finger Print Service #                                                        

 

Place of Residence at the time of Abuse/Offence:                                                                    

                                                                                                                                                   

Sex:                  

 

Type of Abuse:                                                                                                                          

 

Matter Recorded Pursuant to:

 

      Finding in Need of Protective Services ((63(2)(a) of the Children and Family Services Act))

 

      Finding of Abuse ((63(2)(c) of the Children and Family Services Act))

 

      Criminal Conviction((63(2)(b) of the Children and Family Services Act))

 

      Section 104 of the Act (Registration under former Children’s Services Act):

                                                                                                                                                  

 

Perpetrator is a Young Offender: □ Yes       □ No

 

Date Matter Recorded:                                                                                                              

 

Form XII – Report to the Child Abuse Register

 

Nova Scotia

Department of Community Services

Family and Children’s Services Division

 

(Pursuant to the Children and Family Services Regulations the Court is required to report any Family Court finding or criminal conviction in which the VICTIM of the abuse/offence is UNDER THE AGE OF 16 YEARS at the time of the abuse/offence.)

 

                                                                                                                                                

SURNAME OF OFFENDER/ABUSER                          FIRST NAME MIDDLE NAME(S)

 

ALIASES, NICKNAMES (if known)                                                                                                                              

 

PREVIOUS SURNAMES                                                                                                                                                

 

CURRENT MAILING ADDRESS                                                                                                                                   

 

DATE OF BIRTH                                       SEX □ Male □ Female OCCUPATION                                             

 

S.I. # M.S.I. # DRIVER’S LICENSE MASTER #                              

 

F.P.S. #(FINGER PRINT SECTION #) LOCAL POLICE FILE #                                             

 

TYPE OF ABUSE: □ Physical □ Sexual □ Emotional

 

                                                                                                                                                                                           

SURNAME OF CHILD / VICTIM                                  FIRST NAME                                         MIDDLE NAME(S)

 

DATE OF BIRTH                                       SEX □ Male □ Female

 

RELATIONSHIP OF ABUSER / OFFENDER TO CHILD (Please check • Below):

 

□ FATHER

    □ Natural / Biological

    □ Adoptive

    □ Stepfather

 

□ MOTHER

    □ Natural / Biological

    □ Adoptive

    □ Stepmother

 

□ FOSTER FATHER

 


□ FOSTER MOTHER

 

□ GRANDFATHER

    □ Paternal

    □ Maternal


□ GRANDMOTHER

    □ Paternal

    □ Maternal

 

□ BROTHER

 

□ SISTER

 

□ RELATIVE (Please Specify)

                                                         

 

□ BABYSITTER

 

□ SCHOOL PERSONNEL (Please Specify)

                                       

 


□ DAYCARE WORKER

 

□ NEIGHBOR

 

□ STRANGER

 

□ FAMILY FRIEND

 

□ VOLUNTEER (Please Specify Organization)

 

 

□ CHILD-CARE WORKER

 

□ OTHER (Please Specify)

                                             

 


 


 

PLACE OF OFFENCE/ABUSE DATE OF OFFENCE/ABUSE                                    

 

INVESTIGATING POLICE AGENCY Signature of Investigating Officer                               

 

INVESTIGATING CHILDREN’S SERVICES AGENCY Signature of Child Protection Worker         

 

C O U R T I N F O R M A T I O N

 

COURT TYPE COURT LOCATION COURT FILE NO.(S)                           

 

DATE OF FINDING / CONVICTION                                                                                                                            

 

PRESIDING JUDGE / JUSTICE                                                                                                                                     

 

SENTENCE UPON CRIMINAL CONVICTION (where applicable)                                                                             

 

DETAILS OF COURT FINDING / CONVICTION: (please check • below)

 

□ Finding under s.22(2)(a) Children and Family Services Act

□ Finding under s.22(2)(c) Children and Family Services Act

□ Finding under s.63(3) Children and Family Services Act

□ Criminal Conviction (check • below for particular offence(s))

       □ 151              Sexual Interference

       □ 152              Invitation to sexual touching

       □ 153              Sexual exploitation

       □ 155              Incest

       □ 159              Anal intercourse

       □ 160(3)          Bestiality in the presence of or by a child

       □ 170              Parent or guardian procuring sexual activity

       □ 171              Householder permitting sexual activity

       □ 172              Corrupting children

       □ 173(2)          Indecent exposure

       □ 212(1)(h)     Aiding, abetting or compelling a person to engage in prostitution

       □ 212(1)(j)      Living on the avails of prostitution

       □ 215(1)(a)     Failure to provide necessaries

       □ 218              Abandoning child


□ 220     Causing death by criminal negligence

□ 221     Causing bodily harm by criminal negligence

□ 235     Murder

□ 236     Manslaughter

□ 239     Attempted murder

□ 244     Causing bodily harm with intent

□ 266     Assault

□ 267     Assault with weapon or causing bodily harm

□ 268     Aggravated assault

□ 269     Unlawfully causing bodily harm

□ 271     Sexual assault

□ 272     Sexual assault with a weapon, threats to a third party or causing bodily harm

□ 273     Aggravated sexual assault

□ 279     Kidnapping

□ other (offence repealed)                                                        

   Please specify:                                                                       


 

A COPY OF ANY WRITTEN DECISION OR ORDER MUST BE FILED WITH THIS REPORT

 

Finding / Conviction CERTIFIED at _______________ this _____ day of ____________________, 19 ____.

 

___________________________________________

Prothonotary/Clerk/Family Court Officer

 


 

 

APPEAL RESULTS:

 

□ Conviction / Finding Appealed     □ Conviction / Finding Upheld (date)

□ Conviction / Finding Overturned (date)

 

 

CERTIFIED at __________________ this ____ day of ________________, 19___.

 

                                                                                                                                                                                

Registrar

* SEE REVERSE SIDE FOR ADDRESS & CIRCULATION PROCEDURES

 

Address and Circulation

[Reverse Side of Form]

 

Filing process

 

Original, Duplicate # 1 and Duplicate # 2

To be filed with the Court at the same time as the criminal information is filed with the Court OR in the case of an agency application or proceeding under the Children and Family Services Act at the same time the application forms/documentation are filed with the Court.

 

Duplicate # 2

            Court’s file copy

 

Circulation process

 

Original (initial report to the Child Abuse Register)

Where a conviction is entered or a finding is made, the original copy filed with the Court SHALL be completed and certified by the Court Clerk/Family Court Officer and forwarded to the CHILD ABUSE REGISTER, DEPARTMENT OF COMMUNITY SERVICES, FAMILY AND CHILDREN’S SERVICES DIVISION, P.O. BOX 696, HALIFAX, NOVA SCOTIA, B3J 2T7.

 

Duplicate # 1 (Appeal Copy)

Where a matter is appealed, Duplicate # 1 SHALL be completed and certified by the Court Clerk/Family Court Officer upon disposition and forwarded to the CHILD ABUSE REGISTER, DEPARTMENT OF COMMUNITY SERVICES, FAMILY AND CHILDREN’S SERVICES DIVISION, P.O. BOX 696, HALIFAX, NOVA SCOTIA, B3J 2T7.

 

Duplicate # 2

            Court’s final file copy.

 

Form XII – Report to the Child Abuse Register replaced: O.I.C. 93-633, N.S. Reg. 104/93.

 

 ________________________________________________________________ 

Form XIII repealed: O.I.C. 2008-203, N.S. Reg. 251/2008.

 

Form XIV – Notice of Registration

pursuant to subsection (1) of Section 64 and subsection (4) of Section 104

of the Children and Family Services Act

 

TO: ___________________________________________

ADDRESS:

 

You are hereby notified that your name has been entered in the Child Abuse Register. A copy of the Registration which appears in the Child Abuse Register is attached.

 

This is to advise you that you may apply to the Family Court at any time to have your name removed from the Child Abuse Register.

 

Dated the _____ day of ____________, 19___.

 

                                                                                                                                                      

                                                                                Signature of Supervisor, Child Abuse Register

 

 ________________________________________________________________ 

Form XV – Agreement for Voluntary Care for the Purpose of Adoption

 

THIS AGREEMENT is made in triplicate this _____ day of ___________, 19___,

 

BETWEEN              _______________________, __________________ (occupation)

of ______________, in the County of _________________,

Province of _____________________

 

and

The Children’s Aid Society of _________________ The Family and Children’s Services of _______________ an agency approved by the Minister of Community Services as a child-placing agency pursuant to clause (i) of subsection (1) of Section 3 of the Children and Family Services Act, being Chapter 5 of the Statutes of Nova Scotia, 1990, hereinafter referred to as the “Agency.”

 

The parties hereto agree as follows:

 

1.   I, ____________, hereby give up my male/female child _______________ who was born at the ____________ Hospital, in ____________, in the County of ____________ Province of ____________ day of ____________ 19___, to the Agency for the purpose of being adopted under the provisions of the Children and Family Services Act.

 

2.   I, ____________, hereby freely surrender my child, understanding that if the child is adopted I will be deprived permanently of my parental rights with respect to the child.

 

3.   This agreement is to remain in effect for one year from the date it is signed unless during that time the child is placed for adoption and in that case the agreement shall continue in full force and effect until an adoption order is made or until the application to Court for Adoption is dismissed, discontinued or unduly delayed.

 

4.   If the child is placed in a home for the purpose of adoption and a Notice of Proposed Adoption is given by or on behalf of the adopting parents to the Minister of Community Services, I, ________ ______ cannot terminate this agreement. However, if the child has not been placed for adoption, or, a Notice of Proposed Adoption has not been received by the Minister, I may terminate the agreement at any time by giving notice to the Agency pursuant to subsection (4) of Section 68 of the Children and Family Services Act.

 

5.   If the Agency is unable to place the child for adoption while this Agreement is in effect, then, upon termination of this agreement, the Agency shall return the child to ____________________ except where the child is taken into care as permitted by and in accordance with Section 33 of the Children and Family Services Act.

 

IN WITNESS WHEREOF the parties hereto have executed this agreement the day and year first above written.

 

SIGNED, SEALED AND DELIVERED

in the presence of

 

                                                                        

Signature of Witness                                      Signature of Parent

                                                                        

Signature of Witness                                      Signature of person authorized by Agency to sign Agreements on behalf of Agency

 

 ________________________________________________________________ 

Form XVI – Secure Treatment Certificate

 

 

Regarding ___________________________________, born _________________________

                                             (name of child)                                (dd/mm/yyyy)

 

This certificate is issued on behalf on the Minister under Section 55 of the Children and Family Services Act.

 

This certificate is authority for a peace officer or agent to apprehend and convey or return the child to a secure treatment facility (Section 59 of the Act).

 

This certificate authorizes any person to confine the child in a secure treatment facility from _______________________________ to ___________________.

   (date of issuance of certificate)               (date)

 

(Not to exceed 5 days, which is defined in subsection 35A(2) of the Children and Family Services Regulations as 5 weekdays, not including the day of issuance, Saturday, a holiday or any other day when the applicable justice centre is closed for business.)

 

The secure treatment facility the child will be placed in is

 

[ ] Wood Street Center, 225 Wood Street, Truro, Nova Scotia

[ ] (insert other)

 

The reason for this certificate is that I have reasonable and probable grounds to believe that the child is suffering from an emotional or behavioral disorder, it is necessary to confine the child in order to remedy or alleviate the disorder, and the child refuses or is unable to consent to treatment.

 

DATED at ___________, Nova Scotia, ________________, 20___.

 

Signed on behalf of the Minister of Community Services by:

 

(signature)

 

(name)

 

(job title)

 

Notice

Hearing

A hearing must take place no later than 5 days from the date of this certificate. The hearing will take place at:

                                    Family Court

                                    540 Prince Street

                                    Truro, Nova Scotia,

 

and will be heard on: _____________ (date) at __________ (time), or as soon after that time as it may be heard.

 

The Minister or the agency will be at the hearing to satisfy the court that the conditions of Section 55 of the Children and Family Services Act have been met. The court will also decide whether to issue a secure-treatment order, if one has been applied for under Section 56 of the Act. (You should be served with a copy of any such application.)

 

Right to representation

You have the right to be represented by counsel at the hearing. You must arrange for representation yourself. A lawyer is available through the office of Nova Scotia Legal Aid, located at:

                                    Suite 102, 523 Prince Street

                                    Truro, NS B2N 1E8

                                    Phone: (902) 893-5920

Form XVI added: O.I.C. 2003-513, N.S. Reg. 208/2003; amended: O.I.C. 2004-197, N.S. Reg. 145/2004.