San Luis Obispo — PR027

Source: https://www.slo.courts.ca.gov/documents/san-luis-obispo/PR027_Regional_Center_Report.pdf

ATTORNEY OR PARTY WITHOUT ATTORNEY (NAME, STATE BAR NUMBER AND ADDRESS) FOR COURT USE ONLY

TELEPHONE NUMBER: FAX NO. (Optional):

EMAIL ADDRESS (Optional):

ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN LUIS OBISPO

STREET ADDRESS: 1035 Palm Street, Room 385 MAILING ADDRESS: Same as above CITY AND ZIP CODE: San Luis Obispo, CA 93408 BRANCH NAME: San Luis Obispo Division

LIMITED CONSERVATORSHIP OF: CASE NUMBER:

Date: Time: Dept:

CONFIDENTIAL

REGIONAL CENTER REPORT-Probate Code §1827.5

*In the case of a Limited Conservatorship Petition, pursuant to Probate Code §1827.5, the Regional Center shall assess the limited conservatee at the Regional Center and submit a written report of its findings and recommendations to the Court.

Petitioner: Submit this form to the Regional Center at least thirty (30) days before your hearing date.

Regional Center: This form must be filed and mailed at least five (5) days prior to the hearing date noted above on the parties listed in Probate Code §1827.5.

[PETITIONER- COMPLETE FOLLOWING]:

1. A Petition has been filed to establish a limited conservatorship over the proposed limited

conservatee (name)_______________________________. The Petition has been filed

by (name)_____________________________________ (relationship to conservatee)

___________________________________________________________________.

Form Adopted for Optional Use CONFIDENTIAL REGIONAL CENTER REPORT Probate Code § 1827.5San Luis Obispo Superior Court Local Form PR027 Rev. 1/1/16

LIMITED CONSERVATORSHIP OF: CASE NUMBER

[REGIONAL CENTER COMPLETE FOLLOWING]:

2. Describe the “specific areas, nature and degree of disability of the proposed

limited conservatee” below. Probate Code §1827.5(c).

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

__________________________________________________________________.

3. Based on the information provided to the Regional Center: (mark either box a or

b).

a. The Petitioner is included in one of the following categories (mark

applicable box).

i. Is NOT a provider of board and care, treatment, habilitation, or

other services to developmentally disabled persons, or is a spouse or

employee of a provider; OR

ii. Is the natural parent of the proposed limited conservatee; OR

iii. Is a public entity.

b. The Petitioner is not included in one of the categories under 3.a. i-iii.

(Complete item 3.c).

c. If the Petitioner is not one of categories under item 3.a, the Regional Center’s

report must include a recommendation concerning the Petitioner’s suitability

as a limited conservator. (Probate Code §§1461.4(b), 1827.5(c)) (if

applicable, please provide recommendation below or on attachment 3.c.).

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

__________________________________________________________________.

Form Adopted for Optional Use CONFIDENTIAL REGIONAL CENTER REPORT Probate Code § 1827.5San Luis Obispo Superior Court Local Form PR027 Rev. 1/1/16

LIMITED CONSERVATORSHIP OF: CASE NUMBER

4. The proposed limited conservatorship is:

Recommended for approval. Not recommended for approval.

Other (please explain below or on attachment 4):

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

__________________________________________________________________.

5. The powers requested by the Petitioner are:

Recommended for approval. Not recommended for approval.

Other (please explain below or on attachment 5):

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

__________________________________________________________________.

6. Other Comments (please explain below or on attachment 6).

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

_________________________________________________________________.

I declare under penalty of perjury under the laws of the State of California, that the
foregoing is true and correct.

Date: ______________________________________
(Signature )

_______________________________________
(Title)

Form Adopted for Optional Use CONFIDENTIAL REGIONAL CENTER REPORT Probate Code § 1827.5San Luis Obispo Superior Court Local Form PR027 Rev. 1/1/16