FILED
2025 MAY 12 11:28 AM
KING COUNTY
SUPERIOR COURT CLERK
E-FILED
CASE #: 25-2-11308-6 SEA

Superior Court of Washington, County of King
No. 25-2-11308-6
Matthew W Ralidak
Petitioner

6/12/1986
Date of Birth

Vs
Veronika E. Goodnight
Respondent

2/15/1982
Date of Birth

Sealed Cover Sheet- Confidential:
[ ] Sealed Financial Source Documents
(SEALFN)
[X] Sealed Personal Health Care Records
(SEALPHC)
[ ] Sealed Confidential Report (SEALRPT)
Court Clerk: This is a Restricted Access
Document. Do not file in a ublic access file.

Sealed Cover Sheet - Confidential
Important! Use this cover sheet as page 1 of a separate filing. Check documentls below. Write "Confidential" at
least one inch from the top of the first page of each attached document. For use only in family law, guardianship,
and protection order cases.

[X]
[

Health Care Records (SEALPHC)
Medical/Psychological Report (SEALRPT)

]

[ ]

Court Visitor/Guardian ad Litem Report (SEALRPT)

[ ]

Social Security Representative Payee Report (SEALRPT)

Submitted by:
► /s/ Mathew Ralidak
Signature

Mathew Ralidak

Print Name

[ JWSBA [ JCPG#

Privacy Notice! All parties, court staff, and authorized volunteers may have access to these documents.

GR22
(07/2023)
All Civil 040

Sealed Cover Sheet - Confidential
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Billing Name:

Elora Goodnight-Ralidak

Name

Elora Goodnight-Ralidak

Pronouns

She/Her

Gender

Female

Client ID:

153056

DOB:

Employee Name: Anjali DSouza , LMHCA , MA , MHP Date/Time - Duration: 4/23/2025 4:00 PM to 4:00 PM - 0
Service Type:

Special Occurrence

Supervisor/Manager yes
Supervisor/Manager: Program Supervisor Linda Lasz
Date and Time: 04/22/2025 at 3:00 PM
Supervisor was: Consulted (document recommendations)
Consulted with Linda Lasz and was advised to make a CPS report and continue to reach out to client's mother.
Law Enforcement (includes making a police report) yes
Law enforcement: Will fax to Carnation PD
Law enforcement was: Notified
CPS or APS yes
CPS/APS: CPS intake line, intake number: 5688548, spoke with Paul De La Cuasta
Date and Time: 04/24/2025 at 2:00 PM
CPS/APS was: : Notified

ACTION PLAN
Please indicate which actions have been taken, and which are planned for the future.
Review risk issues in the near future (specify when) yes
Clinician will continue to be in contact with client's parents to assess for ongoing risk.
Other actions yes
Therapist will continue working with client in therapy to address safety issues.
Employee Signature

Supervisor Signature

4/24/2025 2 58 PM
Anjali DSouza 2827
LMHCA , MA , MHP

4/24/2025 4 30 PM
Linda Lasz 2877
MHP, MS, LMFT, CMHS

Supervisor's Signature
Approved by LLASZ on 4/24/2025
Linda Lasz, 2877, MHP , MS , LMFT , CMHS

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