If the noncustodial party fails to arrive at the appointed time and fails to notify the custodial party that he or she will
be late, then the custodial party need wait for only minutes before considering the
visitation (parenting time) canceled.
(specify number):
a.
b.
c.
If the noncustodial party is unable to exercise visitation (parenting time) on a given occasion, he or she must notify
the custodial party (specify):
If the children are ill and unable to participate in the scheduled visitation (parenting time), the custodial party must
give the noncustodial party (specify):
A doctor's excuse.
at the earliest possible opportunity.
Other
as much notice as possible.
(specify):
Other
(specify):
In the event any party requires child care for
hours or more
while the children are in his or her custody, the other party or parties must be given first opportunity, with as much prior
notice as possible, to care for the children before other arrangements are made. Unless specifically agreed or ordered by the
court, this order does not include regular child care needed when a party is working.
Each party must notify the other
days before any
planned change in residence of the children. The notification must state, to the extent known, the planned address of the
children, including the county and state of the new residence. The notification must be sent by certified mail, return receipt
requested.
ADDITIONAL PROVISIONS—PHYSICAL CUSTODY ATTACHMENT
TO Petition
Response
Stipulation and Order for Custody and/or Visitation of Children
Findings and Order After Hearing or Judgment
Responsive Declaration to Request for Order
Request for Order
telephone/message number at
address for a.
b.
The parties may not use such information for the purpose of harassing, annoying, or disturbing the peace of the other or
invading the other's privacy. No residence or work address is needed if a party has an address with the State of
California's Safe at Home confidential address program.
residence workmailing
home the children's schoolswork
e-mail
cell phone
must notify all parties within (specify number):
days of any change in his or her
1. Notification of parties' current address.
2.
(specify number):
Notification of proposed move of child.
3.
a.
b.
The children must not be left alone without age-appropriate supervision.
The parties must let each other know the name, address, and phone number of the children's regular child-care
providers.
Child care.
4.
(specify number):
Right of first option of child care.
5. Canceled visitation (parenting time).
children at reasonable times, for reasonable durations.
a.
b.
c.
The children may have telephone access to the parties
and the parties may have telephone access to the
No party or any other third party may listen to, monitor, or interfere with the calls.
The custodial parent must make the child available for the following scheduled telephone contact
(specify child's
telephone contact with each party):
6.
Phone contact between parties and children.
ADDITIONAL PROVISIONS—PHYSICAL CUSTODY ATTACHMENT
Family Code, §§ 3003, 3024, 3083
www.courts.ca.gov
Form Approved for Optional Use
Judicial Council of California
FL-341(D) [Rev. July 1, 2016]
Page 1 of 2
The additional provisions to physical custody apply to (specify parties):
Petitioner
Respondent Other Parent/Party
Petitioner Respondent Other Parent/Party
Other (specify):
Custody Order—Juvenile—Final Judgment
FL-341(D)
CASE NUMBER:
PETITIONER:
RESPONDENT:
OTHER PARENT/PARTY:
(specify name):
a.
b.
The children will have no contact with
The children must not be left alone in the presence of (specify name):
14. Children's clothing and belongings.
Third-party contact.
may not consume
alcoholic beverages, narcotics, or restricted dangerous drugs (except by prescription) within hours
before or during periods of time with the children
10.
(specify number):
Alcohol or substance abuse. The petitioner respondent
and may not permit any third party to do so in the presence of the
other parent/party
No use of children as messengers. The parties will communicate directly with each other on matters concerning the
children and may not use the children as messengers between them.
children.
11.
No exposure to cigarette or medical marijuana smoke. The parties will not expose the children to secondhand cigarette
or medical marijuana smoke.
No interference with schedule of any party without that party's consent. The parties will not schedule activities for the
children during the other party's scheduled visitation (parenting time) without the other party's prior agreement.
12.
13.
a.
b.
Each party will maintain clothing for the children so that the children do not have to make the exchanges with
additional clothing.
The children will be returned to the other party with the clothing and other belongings they had when they arrived.
15.
Log book. The parties will maintain a "log book" and make sure that the book is sent with the children between their
homes. Using businesslike notes (no personal comments), parties will record information related to the health, education,
and welfare issues that arise during the time the children are with them.
16.
Terms and conditions of order may be changed. The terms and conditions of this order may be added to or changed as
the needs of the children and parties change. Such changes will be in writing, dated and signed by the parties; each party
will retain a copy. If the parties want a change to be a court order, it must be filed with the court in the form of a court
document.
17. Other (specify):
ADDITIONAL PROVISIONS—PHYSICAL CUSTODY ATTACHMENT
FL-341(D) [Rev. July 1, 2016]
Page 2 of 2
7.
No negative comments. The parties will not make or allow others to make negative comments about each other or about
their past or present relationships, family, or friends within hearing distance of the children.
Discussion of court proceedings with children. Other than age-appropriate discussion of the parenting plan and the
children's role in mediation or other court proceedings, the parties will not discuss with the children any court proceedings
relating to custody or visitation (parenting time).
9.
8.
FL-341(D)
CASE NUMBER:
PETITIONER:
OTHER PARENT/PARTY:
RESPONDENT:
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