Fillable ANNUAL REPORT OF GUARDIAN OF THE PERSON (Denton County, Texas)

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ANNUAL REPORT OF GUARDIAN OF THE PERSON (Denton County, Texas)

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Revised 3/2020 Page 1 of 5
Once completed please mail back to
Attn: Probate Court 1450 E. McKinney Suite 2412 Denton, Texas 76209
CAUSE NO.: ___________________
IN RE: GUARDIANSHIP
§
IN THE PROBATE COURT
§
OF THE PERSON OF
§
OF
§
____________________________
§
DENTON COUNTY, TEXAS
Please answer each question as completely as possible. All questions must be answered, use n/a if question does not apply.
Incomplete reports will delay the issuance of Letters of Guardianship.
ANNUAL REPORT OF GUARDIAN OF THE PERSON
Now comes _________________, Guardian of ___________________, Ward (hereinafter referred
to as “Protected Person”) in the above entitled and numbered cause, and files this report covering the time
period of ______________through ____________ concerning the Protected Person’s physical well-being,
location, and condition pursuant to Section 1163.101 of the Texas Estates Code.
1. Protected Person’s name: ___________________________________________________
2. Protected Person’s date of birth and age: ______________________________________
3. Protected Person’s address: _________________________________________________
4. Protected Person’s phone number: __________________________________________
5. Guardian's name: ________________________________________________________
6. Guardian’s address: _____________________________________________________
_____________________________________________________
7. Guardian’s phone number: ________________________________________________
8. Guardian’s email address: _________________________________________________
9. Guardian’s relationship to Protected Person: __________________________________
10. Check the type of residence in which the Protected Person lives:
Guardian’s home
Protected Person’s own home
Denton State Supported Living Center
Nursing home (Name of facility): ________________________________________
Group home (Company Operated by): _____________________________________
Other (Adult foster-care, etc.) ___________________________________________
11. How long has the Protected Person resided at his/her current residence?
______________________
Revised 3/2020 Page 2 of 5
Once completed please mail back to
Attn: Probate Court 1450 E. McKinney Suite 2412 Denton, Texas 76209
12. Has the Protected Person’s residence changed in the last twelve months? Yes No
If yes, please provide the date of change and the reason for the change:
_______________________________________________________________________
13. As the Guardian do you believe the Protected Person is content with his/her living arrangements?
Yes No
If no, please explain: _____________________________________________________
_______________________________________________________________________
14. As the Guardian do you believe the Protected Person has any unmet needs?
No Yes
If yes, please explain:
_______________________________________________________________________
15. As the Guardian I rate the Protected Person’s living conditions as:
Excellent Average Below Average
If below average, please explain: ___________________________________________
_______________________________________________________________________
As the Guardian I have taken the following steps to improve the living conditions:
_______________________________________________________________________
_______________________________________________________________________
16. As the Guardian I rate the Protected Person’s day to day care as:
Excellent Average Below Average
If below average, please explain: ___________________________________________
_______________________________________________________________________
As the Guardian I have taken the following steps to improve the day to day care:
_______________________________________________________________________
_______________________________________________________________________
17. The Protected Person’s primary physician is: __________________________________
18. Check the appropriate box if the Protected Person has been seen by any of the following health care
providers within the last year:
Psychiatrist: Name __________________ Treated for: ______________________
Psychologist: Name _________________ Treated for: ______________________
Dentist: Name _____________________ Treated for: ______________________
Other: Name _______________________ Treated for: ______________________
19. During the past year the Protected Person’s physical health has:
remained the same
improved
Revised 3/2020 Page 3 of 5
Once completed please mail back to
Attn: Probate Court 1450 E. McKinney Suite 2412 Denton, Texas 76209
deteriorated
If improved or deteriorated, please explain: ____________________________________
_______________________________________________________________________
20. During the past year the Protected Person’s mental health has:
remained the same
improved
deteriorated
If improved or deteriorated, please explain: ____________________________________
_______________________________________________________________________
21. Does the Protected Person have an estate? (SSI benefits are not an estate)?
No Yes
If yes, are you the Guardian of the Protected Person’s estate? Yes No
If yes, have you filed your Annual Account? Yes No
22. Do you receive money for acting as the Protected Person’s Guardian? Yes NO
Source of funds:________________________________
23. Do you or the Protected Person receive any funds for the Protected Person’s care? Please identify
all that apply.
SSI: Amount: ______________ SS Survivor Benefits: Amount: _______________
SSDI: Amount: _____________ Trust Account: Amount:_______________
VA: Amount: _______________ Other: Amount: _________________
24. Are you the representative payee and/or the person that handles the Protected Person’s funds?
Yes No
If No, please state who the rep. payee is: ___________________________________
25. If you handle funds for the Protected Person’s care, in what kind of account are the funds
maintained?
Separate designated account: Yes No
Joint account with Protected Person: Yes No
Other: Please identify: ___________________________________________________
26. When the Guardianship was granted I posted a:
personal surety bond cash bond corporate bond
If a corporate bond was posted have you paid the premium for the next reporting period?
Yes No
27. As the Guardian I believe my Guardianship powers should:
remain the same
be increased
be decreased
If increased or decreased is selected please explain: _____________________________
_______________________________________________________________________
Revised 3/2020 Page 4 of 5
Once completed please mail back to
Attn: Probate Court 1450 E. McKinney Suite 2412 Denton, Texas 76209
28. The Denton County Probate Court has a standing requirement for Guardians to have face-to-face
visits in the Protected Person’s residence a minimum of four times per year spread throughout the
year. As the Guardian have you met this requirement?
Yes No If no, please explain why you have not visited:_____________________
_______________________________________________________________________
Yes, I reside with the Protected Person or I visit weekly every other week
monthly
Please list the dates of visits if different from the choices above: __________________
_______________________________________________________________________
29. During the past year the Protected Person has participated in the following activities:
Recreational: (list activities) ____________________________________________
Educational: (list activities) _____________________________________________
Social: (list activities) _________________________________________________
Occupational: (list activities) ___________________________________________
Limited ability to participate but enjoys: (list activities) ______________________
_______________________________________________________________________
30. Does the Protected Person receive any community services and/or resources (i.e. Denton County
MHMR Waiver Programs, STAR+ Waiver, Private/ Insurance Pay)?
Yes No: If yes, please provide a case manager name and contact number: __
_____________________________________________________________________________
31. Texas Estates Code §1151.351 requires Guardians each year on annual renewal of the Guardianship
to explain the rights delineated in the “Ward’s Bill of Rights” in the Protected Person’s native
language, or preferred mode of communication, and in a manner accessible to the Protected Person.
In addition to explaining those rights, the Court requires Guardians each year to provide a copy of
the Bill of Rights to the Protected Person. Have you, as Guardian, explained the rights delineated in
the Bill of Rights and provided the Protected Person a copy of the Bill of Rights?
Yes No
32. In 2017, the Texas Legislature enacted a new law requiring all guardianships to be registered
with the Judicial Branch Certification Commission (JBCC). Effective June 1, 2018, each
guardianship in Texas must be registered.
Have you registered your guardianship?
a.
Yes
b.
No Explain why:_________________________________
Revised 3/2020 Page 5 of 5
Once completed please mail back to
Attn: Probate Court 1450 E. McKinney Suite 2412 Denton, Texas 76209
33. Please use this space to share any other information that you would like the Court to know about the
Protected Person and/or your role as Guardian, including any new medical issues or concerns, and
whether you the Guardian have filed an Application for Emergency Detention of the Protected
Person and if applicable, the number of times and dates of the applications):
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
UNSWORN DECLARATION
I ______________________________, Guardian of the Person for _____________________ in Denton
County, Texas declare under penalty of perjury that the foregoing is true and correct.
Executed on the____ day of __________, 20____.
(date) (month)
___________________________
Signature of Declarant/Guardian
____________________________
Printed Name of Declarant/Guardian
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ANNUAL REPORT OF GUARDIAN OF THE PERSON (Denton County, Texas)

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Completed 13 February 2021

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