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Cause Number: ______________________________
Full Name of Respondent: ___________________
Safety Plan Rules
If any of these Rules conflict with the Orders of Release, these Rules shall control.
I. Supervisors
Persons who are allowed to provide supervision of the Respondent are ________
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______________________________________ and those persons who are pre-
approved by the probation officer or the Court.
These persons shall be referred to as “Approved Supervisors”.
“Supervision” means in the immediate presence of the Respondent (for instance, if
the Respondent is outside a home, the Approved Supervisor is not allowed to
“supervise” from inside the home), with a direct line of sight over the Respondent,
and paying attention to the activities of the Respondent.
II. Curfew
To the Respondent: Be at and inside your residence everyday at all hours unless: (a) you
are with an Approved Supervisor, (b) working, or (c) participating in parent-approved and
officially sanctioned and supervised school/religious/civic/social activity. When you are
engaging in activities allowed by items (b) and (c) above, you must be in compliance with all
the terms of this Safety Plan and with the Orders of Release. If you intend to spend the night
away from your residence, you must obtain prior permission from the probation officer or the
Court.
III. Contact with alleged victim/alleged victim’s family
Respondent shall:
_________ Have no contact with the alleged victim(s).
_________ Have no contact with the alleged victim’s/victims’ family.
_________ Have no unsupervised contact with the alleged victim(s). Only Approved
Supervisors may monitor contact between the Respondent and the alleged victim.
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IV. Contact with persons under a certain age
Respondent shall have no contact with children under ___ years of age, “the
Prohibited Age”, unless the Respondent is being supervised by an Approved
Supervisor.
If the Respondent rides a school bus with children younger than the Prohibited Age,
Respondent’s parent(s)/guardian(s)/custodian(s) must inform the bus driver of
Respondent’s restrictions for contact with such children and Respondent must sit
within the bus driver’s line of sight, as determined by the bus driver. Provide written
proof to Respondent’s Probation Officer that you have complied with this Order.
See Item V regarding contact with other children while Respondent is at school.
No person under the age of 17 who is not related to the Respondent by blood or
marriage may spend the night at Respondent’s residence.
V. Notification to School
The Court cannot require a school district to separate the Respondent from children, including
children under the Prohibited Age. Within three (3) days of the date of this Order and each time
you enroll in school thereafter, Respondent’s parent(s)/guardian(s)/ custodian(s) must inform
Respondent’s school principal about Respondent’s restrictions for contact with children under
the Prohibited Age and the reason for the restrictions. This notification is to be made at the time
of the enrollment. Proof of such notification must be given to the Respondent’s Probation
Officer.
VI. Use of Internet and Social Media
Respondent shall have no unsupervised use of the Internet (through any device including but not
limited to a computer, I pad, cellular phone, etc.) or of any social media outlet (including but not
limited to Facebook, My Space, Twitter, etc.). If the Respondent’s school requires use of the
Internet for scholastic purposes while Respondent is in class, each teacher who requires such
internet use must be made aware of Respondent’s internet use restrictions, the requirement that
the use be supervised, and the reasons therefore. For purposes of this Rule only, the teacher shall
be considered a “supervisor” of Respondent.
VII. Inappropriate Material
To the Respondent: Do not access, possess, or view sexually stimulating or sexually oriented
material or attempt to do the same. You shall not play or view others playing “M” (mature) rated
or “A” (adult) rated video games.
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To the Approved Supervisors: Do not allow Respondent to access, possess, or view sexually
stimulating or sexually oriented material or have the ability to attempt to do the same. For
example, do not allow Respondent to possess a cell phone or gaming device with internet access.
A complete list of examples would be nearly endless. Do not allow Respondent to play or view
others playing “M” (mature) rated or “A” (adult) rated video games.
VIII. Door Alarms
A door alarm must be installed on Respondent’s bedroom door. Except in the event of an
emergency or unless a prior exception to this Order is granted by the Court or the Probation
Officer, Respondent shall be inside and remain inside his/her bedroom during the hours of
______ p.m. and _____ a.m. each day. The door alarm on Respondent’s door shall be armed
during those hours each day.
IX. During the time these Orders are in effect, do not visit a public pool or public park
unless you obtain prior permission of the Probation Officer or the Court.
X. Other
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