Child Welfare Services Request for Records

Request for Records

Rachel Pena, LCSW | Social Services Director || Nicholas Ready, CWS | Program Manager
Records Request Instructions

NOTE: Only individuals identified in 827 are entitled to receive copies of juvenile records. Such individuals include: the minor who is the subject of the proceeding; the parent or guardian of a minor who is subject of the proceeding; the parent or guardian involved in a criminal or juvenile proceedings involving the minor; and the attorney for the parent, guardian or minor provided the attorney is actively participating in the family, probate, criminal or juvenile proceeding involving the minor.

For the Parents of Minors:

1. Fill out the CWS Records Request Form with as much information as possible, then sign the form. Please be advised that incomplete or inaccurate information may delay the processing of your request. Please be as detailed as possible when filling out the specific time periods, as “All” will not be accepted.

2. Once completed, please upload a photo of a valid ID.

3. You will only receive one copy of records requested.

4. The Custodian of Records will notify you when your request is ready for pick-up.

5. Be prepared to show a valid photo ID such as a Driver’s License, State issued Identification Card, Passport, or Military ID when claiming your copies.

6. Records request typically take four to six weeks to fill.

7. For questions, please contact the Custodian of Records at (530) 273-4291.

For Attorneys or outside Agencies:

Please contact the Custodian of Records at (530) 273-4291.
Date:

MonthDayYear
Date
Person making request:*

First NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:*
Please enter a valid phone number.
Alternate Phone Number:
Please enter a valid phone number.
Email:*
example@example.com
Relationship to child(ren):*

FatherMotherOther
If relationship is "Other", please explain:
Name of Child: * Date of Birth: *
Name of Child: Date of Birth:
Name of Child: Date of Birth:
Name of Child: Date of Birth:
Name of Child: Date of Birth:
Name of Child: Date of Birth:
Name of Child: Date of Birth:
Name of Child: Date of Birth:
Name of Child: Date of Birth:
Name of Child: Date of Birth:
Specific date or timeframe of dates of the records being requested:
Start Date:*

MonthDayYear
Date
End Date:*

MonthDayYear
Date
Please upload a photo of your ID:*

Cancelof
Signature*

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Child Welfare Services | 988 McCourtney Road, Grass Valley, CA 95949

Phone: 530-273-4291 | Fax: 530-273-6941
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