Vn233 Form PDF Details

Navigating the complexities of managing a conservatorship in Ventura County, California, requires thorough understanding and rigorous compliance with the local court's mandates, especially as laid out in the VN233 form. This form, a critical component for anyone appointed as a conservator of a person or estate, serves as a comprehensive report detailing the care plan and status updates for the conservatee. It covers a wide range of essentials, from the conservatee's current living situation and care needs to their financial affairs, including monthly income and expenses, details on property, and whether they benefit from trusts or Medi-Cal. Additionally, it delves into the physical and medical condition of the conservatee, specifying the level of care needed, the involvement of other health providers, and an outline of the conservatee's participation in various activities. Crucially, the form mandates the conservator to provide plans for any anticipated changes, address potential property sales, and ensure a holistic approach to the conservatee's wellbeing, including plans for emergency situations and regular updates to the care plan. This document not only holds the conservator accountable but also ensures that the conservator acts in the best interest of the conservatee, adhering to the responsibilities and legal duties expected by the Ventura Superior Court.

QuestionAnswer
Form NameVn233 Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesvn233, superior ventura conservatorship, conservatorship forms for ventura couty, ca ventura conservatorship

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ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address)

Telephone Number

E-MAIL ADDRESS

ATTORNEY FOR (Name):

SUPERIOR COURT OF CALIFORNIA, COUNTY OF VENTURA

Juvenile Courthouse

4353 Vineyard Ave

Oxnard, CA 93036

IN THE MATTER OF:

CONSERVATORSHIP

CARE PLAN

STATUS REPORT

Ventura Superior Court Local Rule 10.02.I & J

CONFIDENTIAL

VN233

FOR COURT USE ONLY

CASE NUMBER:

_____________________________, the conservator of the person/estate of

____________________________________ hereby submits the

conservator’s Care Plan

compliance with Ventura Superior Court Local Rules.

 

1. Conservatee’s current residence:*

 

Status Report in

a.Address:

b.Type of facility (i.e. own home, skilled nursing, hospital, etc.) :

c.How long has the conservatee been in the present residence?

d.Do you anticipate making any changes in the conservatee’s residence in the next year?

No Yes (explain)

e.What is the plan to return the conservatee to his/her personal residence if not now living at home?

f.If there are no plans to return the conservatee to his/her personal residence in the foreseeable future, explain the limitations or restrictions for not doing so?

2. Current level of care (mark all that apply):

requires total care

requires assistance with care

able to do own care

uses a wheelchair/walker

ambulatory

urinary/bowel incontinence

Details:

 

has feeding tube has catheter

If residing in a facility or group home, attach copy of the facility’s care plan:

If client of a regional center, identify regional center and social worker and telephone number as well as a complete copy of the most recent individual program planning (IPP) report:

* Please note that the Probate Investigator’s Office, and Conservatee’s Counsel, must be notified of any change of address.

Mandatory Form

CONSERVATORSHIP CARE PLAN/STATUS REPORT

Page 1 of 3

VN233 (07/19)

 

 

CONSERVATORSHIP OF (Name):

CONSERVATEE

Case number:

3.Conservatee’s physical and medical condition: a. Please list health problems:

b. Are any other health providers involved?

No

Yes

 

 

visiting nurse

 

 

social worker

 

 

podiatrist

 

 

dentist

 

 

counselor

 

 

physical therapist

 

 

speech therapist

 

 

other (specify):

 

c. Medications:

 

 

 

 

 

d. Activities conservatee is involved in?

 

 

 

 

 

4.How often do you expect to visit the conservatee?

5.Are there plans to give the conservator a rest?

. Does the family visit?

 

.

respite care

 

adult day care

 

other care takers

In Home Support Services (IHSS)

 

 

Names & relationships of relief caregivers:

6.Conservatee’s Estimated Monthly Income (complete even if a conservatorship of the person only):

7.Conservatee’s Estimated Monthly Expenses (complete even if a conservatorship of the person only):

a. LIVING EXPENSES

 

 

 

 

 

 

 

Rent/Mortgage

$

 

Utilities

$

 

 

Nursing/Care Home

$

 

In-Home Care

$

 

 

Food

$

 

Clothing

$

 

 

Medical/Dental

$

 

Medications

$

 

 

Transportation

$

 

Entertainment

$

 

 

 

 

 

Other (specify)

$

 

 

 

 

Total Estimated Monthly Expenses

$

 

 

b. OTHER EXPENSES

 

 

 

 

 

 

 

TAXES

 

Current

 

Estimated Amount

Income Tax

$

 

$

 

 

 

 

Property

$

 

$

 

 

 

 

Payroll

$

 

$

 

 

 

 

c. INSURANCE

 

 

 

 

 

 

 

 

 

Current

 

Estimated Amount

Homeowner

$

 

$

 

 

 

 

Renters

$

 

$

 

 

 

 

Automobile

$

 

$

 

 

 

 

Worker’s Comp

$

 

$

 

 

 

 

Health

$

 

$

 

 

 

 

Life

$

 

$

 

 

 

 

8. What are the contents of any safe deposit boxes?

Mandatory Form

CONSERVATORSHIP CARE PLAN/STATUS REPORT

Page 2 of 3

VN233 (07/19)

 

 

CONSERVATORSHIP OF (Name):

CONSERVATEE

Case number:

9. Does the conservatee receive Medi-Cal benefits?

No

Yes $

 

share of cost

10. Do you expect to sell any of the conservatee’s real or personal property in the next year? No Yes

If yes, what will be sold and explain reason why:

11. Does the conservatee own a home in which (s)he does not live in?

No

Yes

If yes, is it rented?

No

If not rented, explain why:

Yes Amount of rent: $

12.If the Conservatee’s monthly expenses are greater than his/her income explain how the shortfall will be met:

13.Does the conservatee have a trust or is (s)he a beneficiary of a trust and entitled to receive income from the trust? If so, please provide an attachment with the name of the trust, the name(s) of the trustee(s) and their contact information, and if applicable court case number for the trust:

14.Do you anticipate any unusual activities related to the management of the conservatee’s estate during the next year? No Yes (explain): _______________________________________________________

15.Are there any special problems or needs raised by the Court Investigation, the Court, or other interested? If yes, how have you addressed them:

The undersigned conservator will:

a. Inventory all assets in which the conservatee has any interest. b. Submit accurate, complete, and timely accountings.

c. Carry out all mandatory usual and general duties of a conservator.

d. Maintain periodic contact with the conservatee’s physician and other health care providers, if appointed conservator of the person.

e. Maintain periodic contact with the conservatee’s family and friends, if applicable.

f. Be available to the conservatee on a 24 hour basis for emergencies, or arrange for such coverage by a qualified agent.

g. Maintain accurate records related to the estate.

h. Maintain all estate assets in a separate identifiable manner.

i. Maintain estate cash assets in interest-bearing accounts, except as necessary for every day administration. j. Maintain an adequate surety bond as required by law.

k. Update care plan as needed.

l. Refer to the “Conservator’s Handbook.”

I declare under penalty if perjury under the laws of the State of California that the foregoing is true and correct, and that I have retained a copy for my record.

___________________________

_________________________________

Dated

Signature of Conservator

 

_________________________________

 

Type or Print Name

File the original Conservatorship Care Plan Status Report with the court and mail a copy to the Probate Investigations Office at: 800 S.

Victoria Ave, Ventura, CA 93009 and Public Defender’s Office at: 800 S. Victoria Ave. Suite 207, Ventura, CA 93009.

Mandatory Form

CONSERVATORSHIP CARE PLAN/STATUS REPORT

Page 3 of 3

VN233 (07/19)

 

 

 

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This form will need specific information to be filled out, hence be sure you take your time to type in exactly what is requested:

1. The vn233 pdf necessitates certain information to be entered. Make certain the next blank fields are complete:

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2. Once your current task is complete, take the next step – fill out all of these fields - a Address, b Type of facility ie own home, c How long has the conservatee, d Do you anticipate making any, Yes explain, e What is the plan to return the, f If there are no plans to return, limitations or restrictions for, Current level of care mark all, requires total care able to do own, requires assistance with care uses, has feeding tube has catheter, and Details with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

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3. The following part is focused on If residing in a facility or group, If client of a regional center, Please note that the Probate, Mandatory Form VN, CONSERVATORSHIP CARE PLANSTATUS, and Page of - fill out all of these blank fields.

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4. This next section requires some additional information. Ensure you complete all the necessary fields - CONSERVATORSHIP OF Name, CONSERVATEE, Case number, Conservatees physical and medical, a Please list health problems, b Are any other health providers, Yes, visiting nurse podiatrist, social worker dentist physical, c Medications, d Activities conservatee is, How often do you expect to visit, Does the family visit, Are there plans to give the, and respite care In Home Support - to proceed further in your process!

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5. This form must be completed within this section. Further you will see a comprehensive list of form fields that need accurate details for your document submission to be complete: Names relationships of relief, Conservatees Estimated Monthly, Conservatees Estimated Monthly, a LIVING EXPENSES, RentMortgage NursingCare Home Food, b OTHER EXPENSES, TAXES, Income Tax Property Payroll, Utilities InHome Care Clothing, Medications, Entertainment Other specify, Total Estimated Monthly Expenses, Current, and Estimated Amount.

Filling in section 5 of jury service ventura courts ca

People who work with this form frequently make errors while filling out RentMortgage NursingCare Home Food in this section. Make sure you revise what you enter right here.

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