Solano — Supervised Visitation / Supervised Exchange Order

Source: https://solano.courts.ca.gov/system/files/form/order-supervised-visitation-or-exchange-rev-1-29-26.pdf

5020-FL

Superior Court of California, County of Solano 600 Union Avenue PO Caller 5000 Fairfield, CA 94533

Petitioner: Respondent: Claimant:

Case Number:

ORDER FOR SUPERVISED VISITATION OR EXCHANGE
NEXT COURT DATE:

1. Pursuant to Family Code sections 3100 and 3200, the court finds that the best interest of the child(ren) requires
that visitations and/or exchanges be supervised until further order of the court. Evidence has been presented
in support of a request that the contact of Petitioner Respondent Claimant with the child(ren)
should be supervised based upon allegations of:
Domestic Violence Sexual Abuse Drug/Alcohol Abuse
Physical Abuse Neglect Mental Illness
Emotional Abuse Risk of Abduction Failure to Comply with Custody Orders
Other:

THE COURT ORDERS: 2. CHILD(REN) TO BE SUPERVISED Name: Birthdate: Age: Sex:

Additional children listed on Attachment 2 The court has appointed minor’s counsel:

3. TYPE OF SUPERVISION
Provider Type: Professional (see page 2) Non-Professional (see page 3)
Service Type: Supervised Visitation Supervised Exchange Therapeutic Visitation
Service Method: In person Videoconference (e.g. Zoom, Facetime, etc.)
Language: English Other: _____________________________________________________

4. DURATION AND FREQUENCY
Supervised visitation/exchange shall occur with the above-named child(ren) on the following schedule:
_______ times per ___________________ for up to _________________________ per visit
According to the facility’s or supervisor’s availability and the parties’ schedules.
Other:
The court reserves jurisdiction to modify and/or set days and times in the event the parties are unable to agree.

Order for Supervised Visitation or Exchange

5020-FL Rev. 1-29-26 Page 1 of 3

5. PROFESSIONAL SUPERVISION PROVIDERS Name Address Phone Number Email/Website Safe 4 Us Solano 604 Empire Street (707) 784-7229 Safe4Us@solanofamilyjustice.org (Solano Family Justice Center) Fairfield, CA 94533 Visitation Care Center 1201 Marshall Road (707) 564-8312 www.vacavillevisitationcare.org North Vacaville, CA 95687 Timon Supervised Visits 1031 Jefferson Street (707) 234-7011 www.timonsvp.com Provider Napa, CA 94559 Eagle Eye Supervised Office location closed. (925) 305-6146 www.eagleeyesupervisedvisitation.com Visitation Operating for off-site visits only. a. PAYMENT RESPONSIBILITY: Petitioner 100% 50% Other: Respondent 100% 50% Other: Claimant 100% 50% Other: The court reserves jurisdiction to reallocate or reapportion any costs. b. The custodial party and the supervised party shall each contact the provider within _____ calendar days of notice of this order to initiate intake. c. The supervised person’s failure to initiate intake within 30 calendar days of notice of this order shall cause this order to be suspended pending further court hearing. d. The supervised person’s failure to either maintain contact with the provider or to utilize supervised visitation or exchange for a period greater than ______ calendar days shall cause this order to become suspended pending further hearing. e. The provider shall be permitted access to the family law file of the above case for the sole purpose of obtaining information pertinent to scheduling appropriate visitation. f. A person’s failure to comply with the provider’s policies and procedures is a basis for the provider to suspend or terminate visitation or exchange services pending further court hearing. g. If the provider makes a mandated report to Child Welfare Services, the provider shall promptly notify the court, the parties or their attorneys, and minor’s counsel. h. Dates and times of exchanges may be modified by MUTUAL AGREEMENT of the parties and with consent and availability of the provider. i. The provider shall provide the court, the litigants, and minor’s counsel (if appointed) with a report of attendance, compliance with facility procedures, and/or assessment of supervised visitation/exchange. The reports shall be submitted with a Declaration of Supervised Visitation Provider (Judicial Council form FL-324(P)). j. Additional Orders: (1) Any person transporting child(ren) by vehicle to and from visitations or exchanges must have a valid driver’s license, car insurance, valid registration and appropriate safety restraints, including an age-appropriate car seat or booster seat as necessary. (2) Gifts: Supervised person may bring gifts only per the provider’s policy may NOT bring gifts. (3) Food: Supervised person may bring food only per the provider’s policy may NOT bring food. (4) Photos: Supervised person may take photos or give the child photos only per the provider’s policy may NOT take photos or give the child photos. (5) Third parties: Third parties are allowed at visits: ____________________________________________ Third parties are NOT allowed at visits. (6) Other: Order for Supervised Visitation or Exchange

5020-FL Rev.1-29-26 Page 2 of 3

6. NON-PROFESSIONAL SUPERVISOR(S)

   Name Address Phone Number Email
   1.

   2.

   3.

   a. Each non-professional supervisor shall complete and file with the court a Declaration of Supervised Visitation
   Provider (Non-Professional) (Judicial Council form FL-324(NP)). THIS FORM MUST BE FILED WITH THE
   COURT BEFORE ANY VISITS OR EXCHANGES BEGIN.
   b. Dates and times of exchanges may be modified by MUTUAL AGREEMENT of the parties and with consent and
   availability of the non-professional supervisor.
   c. Visits or exchanges shall take place at the following location(s):

   d. Additional Orders:
   (1) Any person transporting child(ren) by vehicle to and from visitations or exchanges must have a valid
   driver’s license, car insurance, valid registration and appropriate safety restraints, including an age-
   appropriate car seat or booster seat as necessary.
   (2) Gifts: Supervised person may bring gifts.
   Supervised person may bring gifts only for the child’s birthday or other special occasions
   (e.g. Christmas).
   Supervised person may not bring gifts.
   (3) Food: Supervised person may bring food.
   Supervised person may not bring food.
   (4) Photos: Supervised person may take photos or give the child photos.
   Supervised person may not take photos or give the child photos.
   (5) Third parties: These third parties are allowed at visits: _________________________________________
   Third parties are NOT allowed at visits.
   (6) Other:

7. OTHER ORDERS

   It is so ordered.

Dated: _________________________________________________
Judicial Officer

Order for Supervised Visitation or Exchange

5020-FL Rev. 1-29-26 Page 3 of 3