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A. A report on the guardianship of the person of an incapacitated or partially incapacitated person shall set forth:

1. The name and place of abode of the ward and the name and address of the guardian or limited guardian;

2. Any significant change in the capacity of the ward to meet the essential requirements for his physical health or safety;

3. The services being provided to the ward and the relationship of those services to the individual guardianship plan;

4. Any significant actions taken by the guardian or limited guardian or guardian during the reporting period;

5. Any significant problems relating to the guardianship which have arisen during the reporting period;

6. The reasons, if any, why the appointment should be continued; and

7. The reasons, if any, why no less restrictive alternative will permit the incapacitated or partially incapacitated person to meet the essential requirements for his physical health or safety.

B. The report shall be substantially in the following form:

Report on the Guardianship of the Person

I, _________________________, the (Guardian/Limited Guardian of the person)

(Name)

for ________________________, an (incapacitated/partially incapacitated) person hereby submit this (annual, court-ordered) Guardianship Report.

(Name)

1. The present place of abode of the ward is:

__________

__________

2. The type of home or facility in which the ward lives is __________ and the name of the person in charge of the home or facility is __________

3. My present street address and telephone number is:

__________

4. During the last year, I have seen the ward __________ times. I otherwise or also have become or remained familiar with the needs and care of the ward as follows:

__________

The nature of my visits to the ward have been:

__________

5. The following services are currently being provided to the ward:

__________

6. These services (are, are not) provided for in the current Guardianship Plan. The reason they are not shown in the current Guardianship Plan is:

__________

7. The ward was last seen by a physician on: ____________________ The purpose of the visit was: ___________________________________

8. I (have, have not) observed any major change in the ward’s physical or mental condition during the last year. (If so,) these are my observations:

__________

__________

9. I (have, have not) taken any significant action for or on behalf of the ward since the last time I submitted a Guardianship Report.

(If so,) I took the following actions:

__________

10. There (have, have not) been any significant problems relating to the ward or to my guardianship of the ward since the last time I submitted a Guardianship Report or, if this is an initial report, since the issuance of my letters. (If so,) I have observed these problems:

__________

11. It is my opinion that the guardianship (should, should not) be continued. (If so,) the basis for my belief is as follows:

__________

12. I believe the ward (would, would not) be able to manage essential requirements for physical health and safety with fewer restrictions on the ward’s ability to act for himself or herself.

(If so,) the basis for my belief is as follows:

__________

13. My opinion of the present care being provided to the ward is as follows:

__________

14. The place of abode of the ward (has, has not) changed since the last guardianship report. (If so,) the place of abode of the ward was changed for the following reasons:

__________

I hereby swear that the answers set forth above are true and correct to the best knowledge and belief of the undersigned, subject to the penalties of making a false affidavit or declaration.

Date: __________

___________________________

(Signature of Guardian or Limited Guardian)

Telephone: _________________________

C. Whenever there are changes or proposed changes to the guardianship plan, an individual guardianship plan, substantially in the same form as provided in 16 ONC § 6-159, shall be submitted with the guardianship report and shall show any such changes or proposed changes in the guardianship plan since last submitted to and approved by the Court.

D. Attached to the report shall be:

1. An accounting of any monies received by the guardian or limited guardian on behalf of the ward;

2. Any expenditures made by the limited guardian or guardian on behalf of the ward;

3. Any compensation requested by the guardian or limited guardian; and

4. Copies of any appropriate medical records, evaluations, or other similar documentation pertinent to the reporting period. ONCA 13-34, eff. Apr. 19, 2013.