Agreement for Service

This Agreement for Service must be completed in full before services can be considered.

Please read each section carefully and complete all required fields.

Client Information

Orientation Acknowledgment

Guidelines and Orientation

Orientation is required. Before services begin, each party must separately complete the required intake and orientation process and provide current custody, visitation, and protective orders and any requested health or safety information.

Each parent or guardian must participate in good faith, communicate promptly and respectfully, participate reasonably in scheduling, follow arrival and departure procedures, arrange transportation assigned to them, and make reasonable efforts to support safe, consistent, child-focused visitation. Children must not manage scheduling, communicate between adults, choose whether a scheduled visit occurs, or carry responsibility for the visitation process.

Visits may be community-based or in-home when appropriate and approved in advance. Subject to the court order, the Monitor determines whether a proposed location or activity can be safely and appropriately supervised.

The Monitor is a neutral third party. The child and visiting parent must remain within the Monitor's sight and hearing throughout all supervised contact, and all conversations must be audible to the Monitor.

Appropriate parent-child interaction, including ordinary care, comfort, conversation, play, meals, and age-appropriate activities, is encouraged when safely appropriate. The Monitor may provide neutral prompts, encouragement, transition support, clarification, or redirection while preserving the parent's role.

A child will not be forced to provide affection, engage in physical contact, discuss a subject, or participate in a particular activity. If the child becomes significantly or acutely distressed, the Monitor may pause, modify, interrupt, reschedule, or terminate the service.

Before signing, a client may ask questions or request a verbal explanation, interpreter, or reasonable communication support needed to understand this Agreement.

This Agreement incorporates the Supervised Visitation Guidelines and Fee Schedule effective August 30, 2026:

https://calaverascountysupervisedvisitation.com/Supervised_Visitation_Guidelines_and_Fees.pdf

The applicable court order controls if it conflicts with this Agreement or the Guidelines. A case-specific change is not effective unless it is consistent with the court order and confirmed by the Monitor in writing.

Current service rates are:

• Parent orientation: $45 per parent.

• Supportive supervised visitation: $100 per hour, with a two-hour minimum.

• Supervised exchange: $50 per 15-minute increment.

• Written visit summary or report: $65 per report.

• Consultation and case coordination: $50 per hour, billed in 15-minute increments.

• Travel, virtual services, and court-related services: confirmed in writing when applicable.

Accepted payment methods are Square invoice, Venmo at @Julie.Alonso, and Zelle at (925) 594-1274.

Square invoices are generally sent on Monday for services occurring that week or promptly when a service is arranged after Monday. Full payment must be received no later than 48 hours before the scheduled start unless the Monitor approves another written arrangement.

Payment does not independently confirm a visit or exchange. A service is not confirmed until the Monitor provides written confirmation of the approved date, time, location, and applicable arrangements.

Cancellation notice must be received at least 48 hours before the scheduled start. Late cancellations and missed services remain subject to the full scheduled fee. The cancelling party is responsible unless the court order, this Agreement, or a written payment arrangement provides otherwise.

Staggered arrival and departure procedures may be used. Each participant must follow their assigned arrival, drop-off, pickup, waiting, parking, and departure instructions. Participants must not arrive earlier than instructed, remain beyond their assigned time, wait for, approach, observe, follow, photograph, record, or communicate directly with another parent unless authorized.

If a required participant has not arrived and has not contacted the Monitor within 15 minutes of the assigned time, the service is cancelled, the scheduled fee remains due, and prepaid fees are not refunded.

If a delayed participant contacts the Monitor and the Monitor determines that the service can proceed safely and practically, it will still end at the originally scheduled time. Lateness does not extend the service or reduce the fee.

When the Monitor cancels because of the Monitor's own illness, emergency, or unavailability, the paying party may choose a refund of the prepaid service fee or a credit toward a rescheduled service.

Privacy, Records, Reports, and Mandated Reporting

Communications and records arising from supervised visitation and exchange services are not protected by a legal privilege of confidentiality.

The Monitor will maintain case information confidentially whenever reasonably possible but may disclose information when authorized or required by law, court order, subpoena, written authorization, court-related process, Child Protective Services, law enforcement, or mandated-reporting obligations.

The Monitor is a mandated reporter and must report suspected child abuse as required by law.

Reports are not automatic. They ordinarily require a written request and advance payment and are limited to factual observations and direct statements. The Monitor does not provide custody recommendations, diagnoses, therapy, evaluations, investigative conclusions, legal opinions, or recommendations concerning future visitation.

Standard report turnaround is five to seven business days unless a court order, legal requirement, or written agreement provides otherwise.

When a report is ordered or requested, the original and copies will be distributed as required by California Standard 5.20, the court order, and applicable law, regardless of which person requested or paid for the report.

Protected identifying information—including addresses, telephone numbers, workplaces, and schools—will be withheld or removed from released documents as required by law.

Safety, Conduct, and Child Protection

All participants must follow the court order, this Agreement, the Guidelines, written confirmations, and Monitor directions. Services must remain child-focused.

Smoking, vaping, tobacco or nicotine use, weapons, alcohol, marijuana, illegal substances, impairment, threats, intimidation, harassment, and violence are prohibited during services.

Participants must not:

• Discuss litigation, custody, support, or possible court outcomes with the child.
• Make negative or derogatory comments about a parent, caregiver, family member, guardian, sibling, attorney, court, or Monitor.
• Question the child about another parent, caregiver, or household.
• Use the child or Monitor to gather information.
• Use the child or Monitor to transmit messages, legal papers, documents, money, personal belongings, or other property.
• Coach the child about what to say, remember, do, or report.
• Promise custody changes, reunification, changes in living arrangements, or future court outcomes.
• Pressure the child for affection, physical contact, conversation, information, or reassurance.
• Whisper, pass notes, use hidden messages or signals, or attempt to communicate outside the Monitor's sight or hearing.
• Spank, hit, use corporal punishment, threaten physical punishment, or engage in emotional, verbal, physical, or sexual abuse.
• Threaten, intimidate, harass, follow, confront, photograph, or record another participant or the Monitor.
• Attend while impaired by alcohol, marijuana, illegal substances, or misused medication.
• Engage in conduct that interferes with continuous supervision.

Court documents, service of process, and other legal-paper exchanges may not occur during a visit or supervised exchange unless expressly authorized in advance.

Gifts and significant items must be shown to the Monitor before they are given to the child. Significant changes to the child's appearance require court authorization or advance written approval.

When allegations of sexual abuse, court restrictions, or case-specific safety concerns are involved, stricter conditions may prohibit or limit gifts, money, cards, photographs, recordings, physical contact, bathroom assistance, whispering, signals, particular activities, or use of a particular location.

Visitors may participate only when permitted by the court order or approved in writing by both parents and the Monitor before the service. Surprise or unapproved visitors are not permitted.

Transportation during a visit is permitted only when authorized by the court order or written agreement, accepted by the Monitor, and approved in writing in advance. All applicable driver, vehicle, licensing, insurance, child-seat, route, and supervision requirements must be satisfied.

Parents must promptly notify the Monitor about illness, contagious conditions, allergies, medications, chronic health conditions, or other health or safety concerns relevant to the service.

A participant should not attend when experiencing a contagious condition or symptoms that may materially affect the health or safety of the child, other participants, or the Monitor. The Monitor may modify, cancel, or reschedule a service when proceeding would be unsafe or inappropriate.

Required medication and instructions must be provided to the responsible adult and disclosed to the Monitor when relevant to the child's health or safety. The Monitor does not independently administer medication unless specifically agreed upon in writing and legally permitted.

Phone use must not interfere with supervision or child-focused interaction. Photographs may be permitted when appropriate and approved by the Monitor. Unauthorized photography, audio recording, video recording, or livestreaming is prohibited.

The Monitor remains neutral and may provide clarification, support, or redirection when a concern can be corrected safely.

The Monitor may decline to begin, pause, relocate, modify, interrupt, reschedule, suspend, or terminate a service when requirements are incomplete, rules are violated, the child becomes acutely distressed, continuous supervision cannot be maintained, or the safety of the child, an adult, or the Monitor is at risk.

Serious conduct or circumstances may require immediate intervention without prior warning. Nothing in this Agreement requires the Monitor to continue a service when immediate interruption, suspension, or termination is appropriate.

Repeated violations, threats, harassment, nonpayment, inability to maintain safe supervision, or serious or continuing noncompliance may result in suspension or termination of services.

All interruptions and terminations will be recorded in the case file, and the parties will be advised of the reason. When services are temporarily suspended or terminated, the Monitor will state the reasons in writing and distribute the written statement to the parties and other recipients as required by California Standard 5.20, the court order, and applicable law.

Complete this acknowledgment only when supervised virtual visitation will be provided.

I acknowledge that I received the Monitor's written Virtual-Visitation Policies and Procedures before virtual supervision began. I understand that virtual visitation requires audiovisual communication and is not an exchange service. I agree to follow the confirmed platform, privacy, location, equipment, supervision, recording, and child-safety procedures.

Policy link: https://calaverascountysupervisedvisitation.com/Virtual_Visitation_Policies_and_Procedures.pdf

By signing below, I acknowledge that I have read and understand this Agreement for Service and that I received or was given access to the Supervised Visitation Guidelines and Fee Schedule effective August 30, 2026. I have completed, or will complete before services begin, the required orientation and agree to follow applicable court orders, this Agreement, the Guidelines, written confirmations, Monitor directions, and provider policies. I understand that submitting this Agreement, completing orientation, or making payment does not guarantee that services or a particular visit or exchange will be accepted, scheduled, or confirmed. Concerns or complaints may be submitted directly to the Monitor in writing and will be reviewed without changing the Monitor's neutral role. A complaint does not alter or suspend a court order.