Department of Children’s Services



|[pic] |Tennessee Department of Children’s Services |

| |Rules of Probation/Aftercare |

|Type of Supervision | Probation Aftercare |

|Youth: |      |Date: |      |

The court has placed you under the supervision of a Department of Children’s Services (DCS) Family Service Worker (FSW) until the court and the Department of Children’s Services formally close your case. If you violate any of the following rules a Child and Family Team Meeting (CFTM) will be held to discuss next steps that could include, additional services, therapy, classes, or a formal violation filed with the court.

The contact information is listed below for your assigned DCS FSW and Contract Provider Worker:

|FSW’s: |Name: |Telephone Number: |Email Address: |Emergency (24 Hour) Number: |

| |      |      |      |      |

|In-home Worker’s: | | | | |

| |Name: |Telephone Number: |Email Address: |Other: |

| |      |      |      |      |

You Will Follow these Rules:

1. Report to your FSW at any time you are told to report, and follow the instructions given to you. You will stay in contact with your FSW as instructed and you are responsible for keeping all scheduled appointments.

2. You will obey all laws and court orders. You will report all arrests and citations to your FSW within 24 hours.

1. Do not possess alcohol, illegal drugs or drug paraphernalia or associate with persons who abuse drugs or alcohol.

2. Do not possess or use guns, ammunition, knives and/or other weapons. If you have a valid Tennessee Hunting License it is your responsibility to present a copy to your Judge and get written permission from the court, for continued approval of this privilege.

3. You will follow all safety rules of the home. You will get permission from your parent/caretaker before leaving home and make sure they know where you are at all times. You will be home by your curfew and will not stay out past your curfew unless supervised by your parent or an adult approved by the FSW. Curfew times not set by the court will be determined by the Child and Family Team with parental involvement.

|Your curfew is: |Start Time:       End Time:       |Start Time:       End Time:       |

| |Weekdays: Sunday through Thursday |Weekends: Friday through Saturday |

6. You are required to obey school rules and report any suspensions, truancy issues or behavior problems to your FSW immediately.

7. You will immediately notify your FSW of any change of address, phone number or if you change schools within 24 hours.

8. If you are suspected of using any illegal substance you may be drug screened or drug tested by your FSW. If you test positive for drugs you may face court action.

|You are not to associate with the following people: |      |

|You are not to be at the following places: |      |

| You are not to possess and/or use the following: |      |

9. You will complete       hours of community service work. Your work assignment must be approved by your FSW.

10. You will follow the conditions of your Family Permanency Plan.

11. You will not leave the State of Tennessee for more than 24 hours without prior permission from your FSWs.

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|Youth’s Signature | |Judge’s Signature |

|Parent/Guardian’s Signature | |Family Service Worker |

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