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    3 555. Faxe d c onfirm atio n she e t re ce ive d ind ic ating "T ransm issio n O K" m eaning the fax w assent .

    Case Name: I Case ID:Pow e ll, Jo shua . 1513430Case Note Category: CPS

    Case Note ID:34658905 I Note Finalized [ 8 JDate Occurred: 08/26/2010Date Entered: 08/26/2010 0 3: 13 PM

    Case Note Type: Con tac tTime Occurred: 03 : 11 PMNote Entered by: SLAUGHTER, roLIE

    Related Participants and Collaterals:Jo sh ua S . P ow e llC ha rle s J. P owe llB rad en T. Po we ll

    A ctivity : C o ntac t - L aw E nfo rc e me ntPhone T im e : 03:11 PM TCM : NoA ctivity : C on tac t - L aw E nfo rc e me ntPhone T im e: 03 : 11 PM TCM : N oA c tiv ity : C o ntac t - L aw E nf orc em e ntT ime : 03:11 PM TCM : No

    Related Intakes:08/20/2010 5:1 9 PM 23 0141 2

    ACTIVITIE;SPartic ip ant: B rad e n T. Powe ll Lo c atio n: ByP art ic ip an t: C ha rle s J. P owe ll L oc atio n: B yP artic ip ant: Jo shua S. Po we ll Lo catio n: B y Pho ne

    CONTACTSNARRATIVE

    C ase N o te 1 o f 1Ent e r e d : 0 3: 1 3 PMR ec eive d vo ic em ail fro m Sgt . B obro wski a t the W e st V alle y Po lic e in U tah 'J'Calle d him back. H e re ce ive d a c o py o f in take 102301412 ye ste rd ay. H e wante d to kno w ifCAw as go ing to m ake c ontac t w ith the Po we ll fam ily in any w ay. In take sup erviso r info rm ed thatCA was no t go ing to be c o ntac t ing the fam ily . H e re p lie d , "go od ", H e re que ste d that ifCA d oe sp lan to m ake c o ntac t w ith the fam ily at any tim e to p le ase c o ntac t him o r the LE age ncy p rio r tom aking c ontac t w ith the fam ily , 'In take sup erviso r to ld him that th is w ould be p lac ed in a c aseno t e .

    Ente re d By: JULIE SLAUGHTER D ate Ente re d :' 08/26/2010 Time

    Case Name: I Case ID: Case Note ID: . I Note Finalized I Z lPow e ll , J o sh ua . 1513430 34708091Case Note Category: CPS Case Note Type: Con tac tDate Occurred: 091 09 / 2 0 1 0 Time Occurred: 02:51 PMDate Entered: 09 /09 /2010 02:53 PM Note Entered by: S LAUGHTER, JU LIERelated Participants and Collaterals: Related Intakes:Jo sh ua S . P ow e ll 08/20/2010 5: 19 PM 230 1412Cha rle s J. P owe llB rad en T. Po we ll

    . Page 2 of 386201202 PRR 000002264 .

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    IACTIVITIESActivity: Contact - Law Enforcement Participant: Braden T. Powell Location: ByPhone Time: 02:51 PM TCM:NoActivity: Contact - Law Enforcement Participant: Charles J. Powell Location: ByPhone Time: 02:51 PM TCM:NoActivity: Contact - Law Enforcement Participant: Joshua S. Powell Location: By Phone

    Time: 02:51 PM TCM:NoCONTACTSNARRATIVE

    Case Note 1 of 1 Entered By: JULIE SLAUGHTER Date Entered: 09/09/2010 TimeEntered: 02:53 PMDetective Maxwell from West Valley Police in Utah called to indicate that they have followedup and interviewed the staff from the YMCA. At this point they are not following up on thisreported concern an y further. Detective Maxwell wanted to let DCFS know that from lawenforcement perspective, it is okay to follow up on any concerns related to this family asappropriate.

    Case Name: I CaseID: Case Note ID: I Note Finalized I ' 8 JPowell, Joshua 1513430 35294343Case Note Category: Intake Case Note Type: ContactDate Occurred: 02/18/2011 Time Occurred: 06:00 PMDate Entered: 0211812011 06:08 PM Note Entered by: MONAHAN, MARYRelated Participants and CollateraIs: Rela ted Intakes:Braden T. Powell

    ACTIVITIESActivity: Contact - Collateral Participant: Braden T. Powell Location: Law EnforcementTime: 06:00 PM TCM:No

    CONTACTSNARRATIVE

    Case Note 1 of 1 Entered By: MARY MONAHAN Date Entered : 02/18/2011 TimeEntered: '06:08 P MDeputy Aloisio.Pierce County Sheriff Badge number #387,went to the home to check on the.children. The children were safe,Braden was there. Family was not happy police were contactedaccording to Deputy.

    Case Name: I Case ID: Case Note ID: '1 Note Finalized I ' 8 JPowell, Joshua 1513430 35335697Case Note Category: CPS Case NoteType: Contact .

    Page 3 of 386201202 PRR 000002265

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    Date Occurred: 03/0112011 Time Occurred: 04:10 PMDate Entered: 03/03/2011 03:59 PM Note Entered by: SEBASTIAN, MISTYRelated Participants and Collaterals: Related Intakes:Joshua S. Powell 02/18/2011 4:36 PM 2405663

    ACTIVITIESActivity: Contact - Law Enforcement Participant: Joshua S. Powell Location: Children'sAdministration Office Time: 04: 10 PM TCM:No

    CONTACTSNARRATIVE

    Case Note 1of 1 Entered By: MISTY SEBASTIAN Date Entered: 03/03/2011 TimeEntered: 03:59 PMPer e-mail from Det. Sgt. Teresa Berg, Pierce County Sheriff Department, this referral has beenassigned to Det. Sanders.

    Case Name: I Case ID: Case Note ID: I Note Finalized [g ]Powell, Joshua 1513430 35745826Case Note Category: CPS Case Note Type: ContactDate Occurred: 06/28/2011 Time Occurred: 03:48 PMDate Entered: 06/28/2011 03:55 PM Note-Entered by: SLAUGHTER, JULIERelated Participants and Collaterals: Related Intakes:Joshua S. Powell 06/13/2011 8:11 AM 2457783Charles J. PowellBraden T. Powell

    t

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    PCV VISIT REPORT FORMAmended ReportEXHIBITEPIERCE EAST

    - VISIT REPORT FORMUnsupervised D I Monitored.D I Supervised xDTransporter/Supervisor: Elizabeth Griffin-HallSocial Worker Name: Forest JacobsonReferring Office: Pierce EastFamily Name: Powell Case # 1513430Father: Joshua Powell Children: Charles PowellBraden PowellDate: Time: Location of Visit: FeRN23 October 2011 U:30- Pick-up Location: Caregiver's Home2:30 Drop-off Location: Caregiver's HomeObservation/Question: Yes No N/A1. Parent was on time for visit?

    xD 0 Dxplain: Dad was waiting for us in the parking lot at 11202. Parent stayed for entire visit? xD D 0xplain: Dad used every minute of the visit time3. Parent planned age-appropriate snacks? Explain: Dad made homemade pizzawith pepperoni, Canadian bacon, two cheeses, tomatoes, mushrooms, olives,g"''''-'U pepper, red pepper. He washed, sliced and diced the vegetables with good xD 0 Dk .;he brought from home. Dad gave both boys two glasses of orange juice.4. Parent planned age-appropriate activities? xD D 0xplain: Dad brought in a large pumpkin to carve and games from home5. Parent participated in the following activities during the visit:Playing: xD 0 DGames: Electronics Snap Kit and already constructed magnetic game (from prior xD xD 0week)Singing: D xD 0Reading: Dad read game instructions and showed the boys exactly how to set up xD D 0complex electricity game with lightsCooking/Eating: Dad had children eat at the kitchen table. He sat the food on

    xD 0 0paper platesHomework: 0 xD 0Child Care: (e.g. change diapers, combing hair; etc.) The boys each went to the xD 0 0bathroom once by themselvesOther: 0 0 06. i-arent greeted child at beginning of visit? xD D 0xplain how: Dad said, "1 love you, Charlie and Braden" and picked them up7. Parent set age appropriate limits with child, managed the child's behavior? xD 201~PRF 000 0Explain: For the most part the boys were well behaved. Late into the visit Dad 001

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    sed counting to 3 to get Braden to share with Charlie.

    8. Parent showed signs of affection consistent with family culture? i.e. Eyecontact, tone of voice, smiles, hugs, holding, listening, and positive feedback?F 'ain: Dad is very attentive to the boys and listens carefully to their words andiii",...s . He smiles, laughs and holds them

    x D

    x D9. Parent asked child questions about child's school, how they are adjusting?Explain: Dad asked Charlie ifhe went to school every day. Charlie said no. Dadasked why not. Charlie said he did not know

    x D1 0. If visit was in home, was the home child safe and childproof for age of child?Explain: Visi t was at-FCRN o

    D

    11. Child on time for visit?Explain: Children arrived at 1120 x D12. Child greeted parent?Explain: The boys were eager to see Dad and jumped up into his arms x D13. Child showed signs of affection consistent with family culture? i.e, Eyecontact, tone of voice, smiles, hugs, holding, listening?Explain: The boys are attentive to Dad and listen carefully to his directions.They maintain engagement with Dad thru eye contact, touching, standing close orconversations14. Child shared experiences with parent?Explain: See below15. Parent helped child say good-bye at end of visit? (i.e. helped clean up, saidgood-bye, walked child to the car, etc.)F 'ain: Dad helped buckle the boys into their car seat, He said extendedgL.v..tbyes, which lasted for 14 minutes.Supervisor had to intervene to maintain child safety?Explain:

    D D

    Comments:

    o D

    1120 - Arrived in parking lot with boys. Dad waiting in his van with two big boxes of stuff already unloaded onthesteps to the entrance. The boys were happy to see Dad. Charlie had a wilted purple rose in a paper cup. Heshowed it to Dad and said, 'purple was mommy's favorite color'. Josh, said, no she loved all colors. Charlie putthe rose on the counter top next to the table where he was sitting.1130 - Dad brought in a fresh pumpkin approx 10 inches wide and 8 inches tall with a diameter of about 32 inches.He also unpacked a wood project for the boys to do during the visit.1135 ~ Everything unpacked and boys restless. Dad asks to go outside. We walked to the far back of the propertywhere the boys knew they could find apples on the ground.1140- Social worker. Forest Jacobson arrived to observe visit. Boys asked for a photo to take back to grandparents.Josh asked which grandparents. Charlie said, 'where they live". Dad said 'no, he had nothing at all to give tothose people'.1145 - Back inside and ready to carve pumpkin. Dad carved out the top and removed the seeds for roasting. Hesaid he and mom used to grow their own pumpkins and mom made yummy pumpkin pies. He said that he had aparrot at home and someday the boys 'could come see it'.1157 ~ Dad rinsed; dried and salted the seeds and put them on a cookie shake to roast in the oven. He had boysstand back from oven door. Braden said that their grandparents were good Mormons, Dad scowled and said tor, rnber their church and not grandparent's church. He said some day he would take them back to his funchurch.1208...:.Dad took the seeds out of the oven and put them on the stove top to cool. Dad let Charlie and Braden drawa face on the pumpkin and then he continued carving until the face was complete. Charlie asked if he could drawears and Dad said yes but did not carve them out. Braden said he wanted to go Trick or Treati~1witJl'FIDallbo Dadsaid that he wanted to do that too. He said that the people at the house they were staying woulJl~er~brate

    o xDo oo oD DDD o

    xD o Dx D

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    alloween with them.1222 - Dad washed and sliced a variety of fresh vegetables including tomatoes. red & green peppers and putogether a home made pizza using prepared pizza sauce, pepperoni Canadian bacon, mozzarella and cheddarcheeses. '1 /':1 7 - Dad and the boys put the toppings on the pizza and the pizza into the oven.T - Dad said that normally they would grind their own wheat for the crust but there was not enough time ortools to grind it today and unwrapped a pizza crust from the store. While the pizza was cooking the boys ate theroasted seeds.1247 - Dad washed and sliced a star fruit. Everybody tried it. They boys said it tasted good but they did not wantmore.1256 - Dad got out the magnetic roller coaster that was constructed during the prior visit. The game stretched outapproximately 2 feet by 3 feet. Dad set up the batteries after the boys used the battery tester to make sure each oneworked. The game had music and flashed lights as each marble progressed thru the chambers. The game was abig hit and Braden danced with joy he was so excited.1: 1 0 - Dad said that they could build a new configuration but the boys wanted to keep playing with roller coaster.1:23 - Dad said, 'that's it. time to eat the pizza and put away the game in the big cardboard box he brought it in.I :25 - Dad sat the boys at the table with the freshly carved pumpkin .. Charlie and Braden were across from eachther and Dad sat next to Braden. They were each served a slice of pizza. Both boys nibbled and ate a few bites.

    Braden said, 'I love you Daddy and Dad said,

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    Family Preservation ServicesMonthly Status Report----------~--------.----'"-----,--,---.---,----~foday's Date: December 30~2011Agency: Strickland &SeferianCASocial Worker: Charles PowellConsumer: Forrest JacobsonDate of Referral: October 15,2011Dates of contact with social workerCurrent Service Time Period: 11/30/11 to 12/31/11

    Therapist: Paula Lynn~StrickiandPhone Number: _CA Case #: 1513430Date of Tennination:12/5/11 12112/2011 lU26/11

    Dates of direct face-to-face contact Number of Hourswithfamlly_

    December 5, 2011 15 hoursDecember 12,2011 15 hoursDecember 19, 2011 1.5 hoursDecember 26, 2011 1.5 hours

    Paperwork 2 h ou rs

    Total # hours of direct face-to-face 6 hourscontacts with family

    GOAL: Strengthen parenting/Safety skillsPROGRESS: (EXPLAIN ANY USE OF CONCRETE FUNDS AS IT PERTAINS TO THIS GOAL)During this reporting period I have continued working with Charles and Judy Cox inregards to their two grandchiCharles and Braden Powell. The children were placed with their maternal grandparents and the goal of this intervis to assist with grandparentS/children with adjustment issues regarding their placement with their grandparents.Assisting the grandparent's address some of the emotionaIlbehavioral issues these children are displaying is a primfocus of this intervention. Inaddition, helping Charlie deal with what I believe to be anxiety/depression symptombeen another focus of my work with the family.The children are clearly adjusting to the grandparents and I continue to see progress and movement in the relationetween the children and their grandparents as well as improvement in the children's behavior. These children winitially angry with the grandparents due to beliefs that the grandparents had done "bad things" to their mom and

    "Mormon's do bad things to families", In addition Charlie made it clear to me ifhe liked his grandparents he thohe "would have to stay longer", These feelings appear to have reduced significantly and now I see kids that have201202 PRR 000002235

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    bo nd ed and are aff e ct io nate to the ir grand pare nts.I ave se en the grand pare n ts se t s tro nge r lim its and be gin to fe e l c o mfo rtable p are nt ing the ir grand child re n. Ihink

    . w e re in it ially re luc tan t to se t lim its fo r fe ar that the kid s would d islike them e ven m o re give n the y alre ad y had a lo tle gat ive fe elings to ward s the grand pare nts. The se kid s are lis t e n ing m uc h be tt e r and start ing to show mo re jo y andh ap p in e ss r esid in g with the grand pare nts. B rad en is ve ry lo ving and af fe c tio nate w he n I visit no w ve rse s alw ayswanting to hit and ac t o u t. H e is c ommunic ating be t te r and altho ugh he is ac tive , he is a hap p y and fun c hild to bearound .Charlie is c ommunic ating mo re and se em s much m o re at e ase . In itially whe n his m o the r's nam e up in c onve rsat io nw ould c o ve r his e ars and run to the o the r ro om sc re am ing. N ow he is ac t ive ly talk ing abo ut 'h is mom and c an d iscf e e ling sad that she is m issing and ho p e s she c an f ind he r w ay hom e sinc e he says she is "lo st". H e is d e aling w ithgrie f and lo ss and that is a p o sit ive ste p to re d uc e what I se e as d e p re ssio n and anxie ty . C harlie is le ss ro bo tic in hiin te rac tio ns and se em s much m o re re laxe d and jo yful and c an have a no rmal c o nve rsatio n at t im e s. So c ial skillsc o n tinue to be an issue that the grand pare n ts are wo rking o n w ith Charlie . H e lp ing him le arn ap pro priate so cial skimp o rtan t fo r his ability to ge t alo ng w ith o the rs and p re ve n t so c ial p ro blem s at sc ho o l. G rand p a is taking him outsto re s to he lp him p rac t ic e ap p ro p ria te so c ial skills . Fo r e xamp le , he would walk up to st range r having a c o nve rsatiand stand and simp ly stare at them . G rand p a is in te rve ning and giving him f e ed bac k w he n he d oe s the se be havio rs.ad dit io n, Charlie struggle s to m ake d ec isio ns so w orking w ith him o n d ec isio n-m aking has be e n ano the r fo c us o f ow ork w ith C harlie .The grand p are n ts c o ntinue to e xp re ss c o nc e rn about ac t ing o ut whe n the kid s re turn hom e from visits w ith the ir d are p o rt that the re ad justm e nt p e rio d is sho rte r. They w ill usually te st bo und arie s and af te r c le ar e xp e c ta t io ns aree xp re sse d . the y re turn to the ir o rig inal be havio ral base line . I have e xp laine d to the grand pare n ts that th is is typ ic alkid s af te r se e ing p are n ts sinc e the y are up se t and o r sad .

    w ill c o n t inue p ro vid ing fam ily p re se rvat io n se rvic e s to the grand pare n ts w ith a fo c us o n ad justm ent issue s alo ngm y co nt inue d wo rk w ith Charlie and he lp ing him le arn to e xp re ss fe elings and d eve lo p be tt e r c op ing skills .

    (Revised 12128 / 1 1 ) 201202 PRR 000002236

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    The fo llo wing are so me quo te s fro m the bo ys sinc e the y have be en staying w ith o ur fam ily , no to ne o f the se quo te s w as bro ught o n by a c onve rsa tio n abo ut anything re la te d to re lig io n, the yw ere rand o m q uo te s;22 Se p 11- te n m inute s af te r I p ic ke d the m up fro m R oc ky I was having a d isc ussio n w ithCharlie abo ut Sushi and o ut o f no whe re he said II d o yo u know what I hate I hate Je sus. H e ism ad e up and fake I"I said w e ll w e lo ve Je sus at o ur ho use why d o yo u think Je sus i s f ake?"be c ause m y d ad to ld m e Je sus is fake and he hate s H im to o l II23 Se p 11 - Charlie starte d ta lking abo ut th e p olic e c o ming to his ho use and ho w p eo ple w eret rying to s te al him . H e said II the M orm ons are trying to s te al m e."25 Se p 11- C harlie said II the c hurch is trying to harass m e, no o ne e lse , just m e".25 Se p 1 1- C harlie 'li the c hurc h te lls lie s to e ve ryo ne ."So me quo te s w ere bro ught up in d isc ussio ns that w ere abo ut c hurc h o r ho lid ays;26 Se p 11- w e w ere talking abo ut C hristm as and H allo we e n and Brad en said II G od is bad , thep olic e ,are bad but G od is re ally bad ." C harlie said "B rad en yo u sho uld sto p talk ing be cause the ybe lie ve so me th ing d if fe re nt and w e sho uld re sp ec t tha t , the y go to a go od c hurc h, it 's no t bad . II26 Se p 11- a lit t le lat e r in the c onve rsa tio n C harlie said II d o yo u know that G o d gave the churc hto a m an in U tah and he is . try ing to ge t m e , U tah is in the d ese rt and he wants to take m e to thed ese rt . That is why w e m ove d he re , 11

    T he y also h ad an ot he r c o nv ersa tio n with C aro le e o n Sund ay abo ut the ir m othe r, 1 w as no t th e rebut C aro le e w as quit e surp rise d and she le ft K are n a vo ic e m ail abo ut it .H op e that is he lp ful,f o st e r p a re n t

    Case Name: I CaseID: Case Note ID: I Note Finalized l 2 JPow e ll, Jo shua 1513430 36095291Case Note Category: CFWS Case Note Type: Lega lDate Occurred: 09/27/2011 Time Occurred: 1 2:4 5 PMDate Entered: 10/10/2011 0 9:47 A M Note Entered by: R OSEN BERG , C HERY L, R .Related Participants and Collaterals: Related Intakes:C ha rle s J. P ow e ll 03/0212010 8:23 A M 220 161 4B rad e n T . Po we ll 08/20/2010 5:1 9 P M 2 30 141 2

    02118/2011 4:3 6 P M 240 566306/13/2011 8:1 1 A M 245778309/22/2011 1 1:53 A M 2 50 5483

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    CHILDREN'S ADMINISTRATIONGAIN55

    . ' ~ rs io n (GVER): GSS -annua I2 . 0 ,1 .Copyr ighted @ 2005 by: Che st nu t H e alt h S y st emsClient Refused to Answer QuestionsClient Unable to Answer Questions

    RACE/ETHNIC ITYL IENT D ATE OF BIR TH

    CITY STATE ZIP CODEL IE NT ADDRESSS OC IA L WO RK ER T EL EP HO NE NUM BE RO CIA L W OR KE R'S N AM E

    (CPS)Family Voluntary ServicesFamily Reconciliation Services (FRS)Child and Family Welfare ServicesChild Health & Education Track

    6, Client currently receiving serviceo Mental Healtho Chemical DependencyDCa-occurring

    5. Client referred for assessmentD Mental Healtho Chemical Dependencyo Co-occurringClient not referred

    7,

    o0

    you spend a lot of time either getting alcohol or drugs, using alcohol or drugs, or feeling theeffects of alcohol or d ?

    c. you keep using alcohol or drugs even though it was causing social problems, leading to fights,oru into trouble with other Ie? .d. your use of alcohol or drugs cause you to give up, reduce or have problems at importantactivities ~t home or social events?e. you have withdrawal problems from alcohol or drugs like shaking hands, throwing up; havingtrouble sitt ing still or sleeping, or use any alcohol or drugs to stop being sick or void withdrawal~~ .

    I understand that a copy of this form may become part of a referral for services,~ IGNATURE