SAFE SUPERVISED VISITATION PROGRAM AGREEMENT TO PARTICIPATE
The mission of the SAFE Supervised Visitation Program (SVP) is to provide a safe and stress-free environment for
children to visit with their non-custodial parents when allegations have been made or it has been determined that
visits in an unsupervised setting could place the child or custodial party at risk of physical or emotional harm.
¨ Please initial beside each section and sign the last page of the document. ¨
THE REGISTRATION PROCESS
1. ________ NO VISITS are scheduled until the completion of the registration process by both parties. Parties will
be notified, via mail, of the date visits are scheduled to begin. If there are no immediate openings at the chosen
facility, the parties are encouraged to start visitation where space allows and transfer when space is available at
the location closest to the home of the child.
2. ________A non-refundable registration fee of $50.00 will be assessed to each party, at time of initial
registration and annually thereafter, unless a court order is provided that specifically addresses SAFE Program
fees. In the event the Custodial Party is not a biological parent, or if they have had a Protective Order in effect
within the past three years, all registration fees will be assessed to the visiting party. (a $10.00 late fee will be
assessed monthly till entire fee paid) (Example: If a 2-year Protective Order was obtained 2/2002, the non-
custodial party would be responsible for all annual registration fees until 2/2007 – 3 years after the Protective
Order expires.)
3. ________If a visiting party is currently on probation, a copy of probation conditions must be provided to the
SVP office before visits will be scheduled.
4. ________ NO CONTACT PROVISION: Harris County bail bonds prohibit contact with victims or witnesses in a
criminal case. If the District Attorneys office confirms a child may be testifying as a witness in a case against the
visiting party or their spouse, visits will be denied unless special provisions are recommended by the District
Attorney’s office, or Judge presiding over the case.
5. ________ The SVP has the right to deny services to a family if a party’s participation poses a clear and present
danger to him/herself or others. (Determination at discretion of Executive Director of the Victim Assistance Centre
& the SAFE Program Director).
6. ________ Participants and guests are subject to rules and regulations established by SAFE. SAFE is not a
party to the lawsuit. If the SVP is unable to provide services in accordance with the Court Order, it is the
participant’s responsibility to request the court to modify the Order in the absence of a mutual agreement.
THE POLICIES AND GUIDELINES
1. ________ Visitation schedules will be established within the boundaries and limitation of the SVP, with an
attempt to meet the needs of the participants. The standard visit schedule is every other Saturday for four (4)
hours. (Visits at the Ft. Bend County and Montgomery County visitation sites are scheduled for the 1st, 3rd and
5th Saturdays of each month.)
2. ________The visitation location will be established by the SVP office staff, considering the convenience of the
child and the availability of the facility.
3. ________ Visits are scheduled for the visiting party ONLY. Guests must be relatives, named in the court order
and approved by the SAFE Programs Director. The number of guests may be limited due to space availability. All
guests are required to follow the same rules as visiting party regarding conversation, cell phones, photos, etc.
Failure to comply will result in termination of visiting privileges. No guest approval will be considered the day
of the visit. All guest names should be submitted for approval during registration. No guest will be allowed
without payment of the guest fee at the visit.
4. ________ CUSTODIAL PARTY ARRIVAL/DEPARTURE TIMES: The custodial party or their designee is
required to arrive no earlier than the scheduled time the visit is to begin. The custodial party is not allowed on
the premises prior to the time the visit is scheduled to end. If the custodial party arrives earlier than the
designated time of drop-off or pick-up, they will be asked to leave the premises and necessary action will be
taken. A $10.00 late fee will be assessed if the child is not picked up within 15 minutes after the end of the visit.
An additional $10.00 will be charged each additional 15-minute period thereafter.
5. ________ VISITING PARTY ARRIVAL/DEPARTURE TIMES: The visiting party is required to arrive 15 - 30
minutes prior to the scheduled time of the visit and will be allowed to leave approximately 10 minutes after all of the
children have left the premises and the facility has been cleaned. If the visiting party is not present at the
time the child arrives, and has not called to advise they are running late, the child will be signed in and
out and leave the premises (the custodial party will not be able to leave the child). If the visiting party is
being dropped off or picked up by another individual, the designated individual is required to comply with the same
provisions set forth for the visiting party.
6. ________ Staggered arrival and departure times are established for the protection of all parties. There is to
be NO CONTACT between the parties. This includes physical and visible contact. Therefore, if either party is
observed attempting to “see” the other party, necessary action will be taken.
7. ________ Gifts for the child(ren) are allowed, but should be moderate and reasonable in number and size.
Gifts must be taken home with the child(ren) after a visit. Interactive toys or activities brought back and forth to the
visits by the visiting party are encouraged. No money is to be given to the child(ren) unless prior approval is
received from the SVP. The SVP is not responsible for any lost or damaged items brought to the visit.
8. ________ Food: Parents are encouraged to bring store-bought, unopened snacks and/or drinks to be shared
by all. Light snacks are provided at each facility site.
9. ________ NO live animals of any kind will be allowed without supervisor approval.
10. ________ Children will not be allowed to talk on the phone unless approved by the Location Supervisor. If a
child is observed on the phone, or it has been determined that a child was talking on the phone during a visit
immediate termination and possible termination of future visits will occur. Visiting parents & guests are not allowed
to talk on a cell phone during visitation.
11. ________ The Location Supervisors observe and document all periods of visitation. SAFE records, including
visit reports, are released by subpoena ONLY. A business records affidavit certifies records are accurate. A fee
of $1.00/page is assessed to the party requesting copies.
12. ________ If a child discloses any form of abuse or if any physical signs of abuse are observed, by law, a call
to Child Protective Services (CPS) will be made.
13. ________ Playpens, blankets, diapers, change of clothes, and other child/infant items are the responsibility of
the visiting party when the child is an infant or is very young.
14. ________ Parties are responsible for informing the SAFE Program office staff of any changes in address or
phone numbers immediately.
15. ________ Photographic and video recordings may occur during the visitation. If the custodial party does not
agree to photographs they must fill out an additional form and SAFE staff will review and advise of decision. All
parties must restrict their recording/photo taking to their children.
16. ________ A monthly fee of $60.00 will be assessed to the visiting party, unless otherwise ordered by the
court. The fee will be due at the first visit of each month and must be paid in cash. (Receipts will be
given.) A $10.00 late fee will be assessed for EACH visit after the first visit until the fee is paid. A visiting party
wishing to apply for reduced fees must meet certain financial guidelines and must provide all required information
prior to consideration of any fee reduction. Reduction of fees, if any, applies only to the visit fee. There is no
reduction in registration fees, guest fees nor no-show fees. Failure to pay fees may result in the
termination of services or suspension of visits. (Fees subject to change without notice, depending on available
program income.)
17.________ This agreement provides a release to discuss the child(ren), with therapist involved in the case, (see"
other rules" section, #3). If a treating counselor identifies problems resulting from visitation, SAFE may: 1.) amend
visit guidelines or scheduling, or 2.) suspend visits pending a court review.
PARTICIPATION BEHAVIOR
1. ________ No party will be allowed visitation if his/her behavior compromises a safe and stress-free
environment. Threatening, aggressive or argumentative behavior with children, staff and/or other participants of
any nature will cause immediate termination of the visit or future visits, and may result in the filing of a court and/or
police report. All parties must conduct themselves in a manner that clearly demonstrates that the well being of the
child(ren) is the highest priority. No weapons are allowed in the visit facility and any observed weapons will be
confiscated.
2. ________ Parties are expected to take care of and be responsible for their children during visits. Parties are
expected to set limits and discipline appropriately when needed without the use of physical discipline. Children
should not be allowed to interfere with other participant’s visits, harm other people or property, or engage in other
inappropriate behaviors.
3. ________Visits are held in a group setting, making it impossible to hear all conversations, however
interrogation of the child(ren), derogatory comments about the opposing party, promises made that may not be
able to be kept, discussion regarding the litigation and/or the court, unsupervised visits or living arrangements, or
any other statements that the staff may interpret as negative and inappropriate will not be tolerated. Allegations
of inappropriate conversations will be investigated thoroughly. Violation of this policy may result in: 1.)
suspension of 1 or more visits; 2.) reprimand letter with copies provided to attorneys and the court; 3.) termination
of all visits pending court review; 4)private one-on-one supervised visits for 2-hour period at a local restaurant for
a cost of $75.00 per visit, with the visiting party paying all meal expenses.
4. ________Supervised visits provide the opportunity for the parties to interact with children in a positive and
enjoyable environment. Conversations should be natural and directed by the child’s interest, not the adults’. If
your child has a question regarding the family situation, please notify a supervisor and they will assist in
addressing any questions the child may have.
5. ________ The staff will not discuss a party’s case, concerns or complaints during the visits. Only questions
relating to the well-being of the child during the particular visit will be allowed. Any other questions or information
must be directed to the office during SAFE Program business hours.
6. _________ If drug or alcohol use prior to a visit is suspected the visit will be immediately terminated. SAFE
has the right and will require any party suspected of consuming drugs or alcohol prior to a visit to submit to a drug
screening test either by hair or blood sample within 24 hours. This policy applies if it is suspected that a child or
party picking up a child has cinsumed or used drugs or alcohol prior to arriving at the SAFE Program location.
Failure to comply with the request for a drug test may result in termination of visits.
7. _________ Under no circumstances will a child be released to a custodial party if the use of drugs or alcohol is
suspected. The party will be required to arrange for someone to come to the visit site to pick up the child and the
party. The Party will be responsible for having someone pick up the vehicle, or return later to get the vehicle. If
the party refuses to follow these requirements, law enforcement will be called. All attorneys involved in the case
will be notified.
8. _________ The visits occur in a group setting with supervisors and security present at all times. All visiting
party/child conversations cannot be monitored. Parties must be able to be seen at all times. No parent may
accompany a child to the restroom without a supervisor.
9. ________ No party will be allowed to leave the premises or return to their car once they have signed in without
approval from the location supervisor.
10. ________ Notes, gifts, etc. for the other party will not be allowed to be passed through the child(ren). All such
information or items should be conveyed through supervisor, with staff approval.
11. ________ No clothing with inappropriate language, symbols, and/or pictures will be allowed. Clothing must be
tasteful and appropriate for a supervised visit with your child(ren). (Nothing low-cut, too short, and/or tight).
12. ________Staff has the right to determine appropriate and inappropriate behaviors and conversations
between parties and the children or in front of any child. Continued infractions may result in the suspension of one
or more visits, or visit termination pending a court hearing.
CANCELLATION AND NO-SHOW POLICY
1. ________Proper Cancellation of a visit can be made 24 hours a day, 7 days a week by calling the main
office number (713) 755-5625. Visit cancellations should be made by 12 noon the Friday prior to a visit. Calls
after noon will result in a late cancellation fee of $40.00. In the case of an emergency, parties are
responsible for contacting their location supervisor before 7:30am on the day of the schedule visit. It is the
parties responsibility to know how to reach their location supervisor, however, parties can always leave a message
on the main number. Site supervisors will check those messages.
2. ________ A late cancellation fee of $40.00 will be assessed to a party failing to give proper cancellation
notification. “Proper” notification will be determined at the discretion of the SAFE Program staff. Fees are due at
or before next scheduled visit. "Proper" cancellation notification will be determined at the discretion of the SAFE
Program staff.
3. ________ SVP staff do not give permission for a visit to be missed. The reason for a missed visit is
documented and make-up visits may be arranged with the agreement of both parties. (SVP recommends
providing proof for the reason the visit was cancelled for the protection of both parties, (ex. Dr's note, sports
schedule, etc.)
4. ________ No Show Fees: A “no-show” is defined as ‘late arrival, no arrival, or improper cancellation notice
for a visit. A no-show fee of $40.00 will be assessed to each party responsible for improper notification. Fees are
due at or before next scheduled visit.
5. ________ If the parties mutually agree on the cancellation of a visit, notification must be given to SVP by
each party. Failure to give notice will result in a no-show fee assessed to the parties failing to provide
notification.
6. ________ Visit Termination for No-Shows: When the visiting party acquires TWO (2) consecutive no-shows
or establishes a pattern of irregular participation, the SAFE Program Director will suspend visits, and may require
a review by the court for reinstatement. If the custodial parent acquires TWO (2) consecutive no-shows notice to
the courts and/or attorneys will be given.
7. ________ The Location Supervisor’s pager and/or cell number should be used in emergency situations ONLY,
such as running late to a visit or sudden illness. All other cancellations are to be made to the office by noon on
the Friday before the scheduled visit in order to avoid a late cancellation fee and to allow staff sufficient time to
notify the other party. Consideration and respect should be given to the location supervisor’s time.
8. ________ If a family will no longer be utilizing the services of the SAFE Program, we request you notify the
office. The SAFE Program is not a party to the suit, therefore the court does not notify the Program of hearings or
changes in visitation arrangements. A no-show fee will be assessed to both parties until proper notification of
termination is provided to the office.
OTHER RULES
1. _________ All conditions of this Agreement to Participate are subject to modification by the Victim Assistance
Centre, Inc., with or without notice to the parties.
2. _________ I have read and received a copy of these rules. My signature below indicates that I understand
these rules and agree to follow these rules.
3. _________ I understand that the information gathered during my supervised visitations may be released to
attorneys, therapists, the court, or other pertinent agency involved with my case.
4. _________ I further understand the SAFE Program is not a party to the suit and are not ordered to provide
services, and reserve the right to terminate services for violations of the policies and procedures set forth by the
SAFE Program.
5. _________ I hereby give consent for my child(ren) to participate in this program and all activities and I release
the Victim Assistance Centre and facility assigned, officers, employees, and volunteers against any claim or liability
arising out of my child’s participation in the SAFE Family Programs. I further release the Victim Assistance Centre,
the facility assigned, officers, employees, and volunteers against any claim or liability arising out of my participation
in the SAFE Family Programs.
6. _________ I understand rules are subject to change at the discretion of the SAFE program or to accommodate
special circumstances or court orders.
7. _________I understand fees may be adjusted based on program funding changes.
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Signature (CP/ NCP) Date
__________________________________ ___________________________
Witness Date
SVP Agreement