STATISTICAL                                                                                                                                              FORM

 
On June 28, 1940, a complaint was filed by the County Attorney
charging the mother with disorderly conduct and drinking
excessively.  It also charged that the children were dependent
and neglected.  July 5, 1940, the mother of Larry & Jimmie
appeared in Juvenile Court with them, and admitted that they were
dependent and neglected and that she was unable to care for them.
It was therefor ordered and adjudged that they be placed in the
care, custody and control of the Iowa Children's Home Society at
Des Moines, Iowa.  The children were placed there and are there
at this time.  In the past the mother was permitted to visit them
in their foster homes, but from time to time she would visit
these homes when she was intoxicated and it became necessary to
withdraw this privilege.  Later the mother married Edward
Leifheit and took up residence in Rock Island, Illinois.  They
live over a tavern, the mother works at Woolworth's' and buys her
meals in a cafe.  Her present husband has been an inmate at the
Reformatory in Anamosa, Iowa, and her brother-in-law has been
arrested on a charge of burglary.  Their  adjustment in the
foster homes have been quite unfavorable.  Dr. Habenicht states
"that both these children are badly in need of long time
routinized training such as is given in an institution.  It has
been a long and difficult task to correct these children--when
they entered their foster homes they were completely untrained in
habits of cleanliness and eating habits."  Due to the several
factors involved, it has been ordered by the Juvenile Court that
they be placed in the Soldiers Orphanage at Davenport, Iowa.
 

          Classification:    Normal or average
 
         Qualitative:  Vocabulary and memory somewhat below average, reasoning above.
            All round average performance.                           
 
 
   III. Educational Status:
 
       3rd Grade
 
 
   IV. Physical Status:
 
        49 in. 54-1/2 lbs.  Nutrition normal.
        Wassermann & Kline negative 1-29-42.  Mantoux Negative 2-4-42 
 
        Other laboratory findings negative                                           .
 
    Clinical findings: Tonsils hypertrophic. T. & A. ordered.

       Other Clinical findings - normal.
                T&A 2-10-42      [Tonsils removed  on 2-10-42]
 
   V. Appearance:
 
       Medium blonde hair, gray eyes, fair skin, average size and build. Very
   nice looking boy.                                                     
 
 
   VI. Remarks:
 
       (Same as for Jimmie)
    
 
 
  VII. Placement Recommendations:
 
       (Same as for Jimmie)
 

 
   PLACED                                                                       RETURNED        REASON FOR RETURN                                      REMARKS
 
   2-10-43  To Ross H. Potter   1-6-44   Foster mother passed away.      
 

 1.  Applicants for children are expected to be kind-hearted, and respected citizens.  They must be of such financial circumstances and sustain such social relations as to give a child good advantages.
 
 2.  The child is sent on 60 day's trial, at the end of which time if it is to be removed, it must be at the expense of the applicant, and 30 days' notice must be given unless otherwise agreed upon.
 
 3.  In no case shall a child be given away to a third party.
 
 4.  After 60 days trial period if the child is not to be adopted or it is placed at wages, a contract shall be given as provided by law.
 
 5.  This application must be filled out with ink, signed by both husband and wife.
 
 6.  In order to protect the interest of the children in our charge, it is necessary in all cases to make careful inquiries, and to have an agreement duly executed and approved before delivering the child.  We signify our concurrence therein by making application on reverse of this sheet. [COVER PAGE]

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APPLICATION   PLEASE WRITE PLAINLY IN INK IN YOUR OWN HANDWRITING  
 
Date: October 17, 1942
Husband's Name  Ross H Potter   Age 58  Nationality German & English
Wife's Name  Pearl M Potter     Age  50 Nationality Scotch & Irish 
City  Sioux City, Iowa    Street  50th & N. Rustin County Woodbury
If your home is in the country and you have R.F.D. give No. of route.
If you have a telephone give number 9338
What is the nearest railway station?  How far and in what direction do you live from it?  4 miles north
Do you own your own home, or real estate? Yes - 15 acres 2 houses improvements $3000
      (Describe property and give approximate value)
What is your business or occupation? Farmer
Members of your family ( State age and sex)  Wife 50 years - Father-in-law 73            
Do you keep a hired  man?    No    Do you keep a hired girl?  No
Do you take in boarders, temporary or permanent?    No
Are there invalids or aged persons in your family?    Yes    73 age   Mrs. Potter's father
                                                                                                     (State age and condition)
Church membership - Husband     Presbyterial  Church    Wife    Presbyterial   Church
If not members, what church do you attend?   Same
Name and address of your pastor  Rev. Scott G. Porter-122 South Leonard, Sioux City, Ia.
How far from school?    I Mile by bus   How far from church?   1 mile
Will you pay the expense of sending the child to you?  Yes
What is your object in taking the child?For companionship & as heir to anything we may have.
Do you wish to  (1)  Adopt,  (2)  employ at wages, or (3) take child on contract?
(See conditions on other side) (1) Adopt
Have you ever taken a child from any other Institution or Society? No    
Do you want a boy or a girl?   boy    Age 8 to 11  (Give largest limit possible)
 
         Give the name and address of a minister, a banker, a physician, and two other responsible persons who know you and to whom we can write for recommendations:
Name Rev. Scott G. Porter  Address   122 South Leonard, Sioux City, Ia.      
Name Dr., Fred Vernon  Address   Jewell, Iowa
Name Geo. Magoun - Lawyer Address   2030 Douglas, Sioux City, Ia 
Name Mr. R. C. Lawrenson  Address   107 North Helen, Sioux City, Ia.
Name Mr. Wm Richard  Address   2012 West 25th St., Sioux City, Ia.

            We hereby agree to receive such a child as we have described, and to give it good advantages and companionship.  If, of school age and not employed at wages the child shall have school privileges as provided by law.  We promise to provide for it's well being, physical, mental and moral, in all respects as our own child; and we further agree that we will report in writing when requested to do so, to the Board of Control on Blanks furnished by the Board of Control.
            If at any time in the judgment of the Board of Control it should be for the best interest of the child, we will promptly return the child to the care of the state at our expense.

                                                                                     Signed   Ross H Potter    Husband
                                                                                     Signed   Pear; M Potter              Wife

(SEE CONDITIONS ON OTHER SIDE)

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          Picture of home.                                                                                 Picture of applicants.

 
I.    IDENTIFYING INFORMATION
 Husband's name Ross H. Potter   Age  58   Descent  German & English
 Wife's name (also ,maiden name) Pearl M. Erby  Age  50    Descent  Scotch - Irish
 Address--Town  Sioux City          County   Woodbury

 Full directions for reaching home from nearest town if in rural area.
 
 
  West in Leeds to Rustin Street, North to 50th ST.
 Third house from corner of 50th.
 
 
  [NOTE by the author: This house was the third house west of  Rustin on the north side of  50th street. ]
 
 

[Stamped] Approved Dec 10, 1942 Board of Control By R. T. Pullen  

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BOARD OF CONTROL OF STATE INSTITUTIONS Children's Division   Report of Visitor's Investigation of a Prospective Foster Home (To be attached to original application)  
Applicant's names   Potter, Ross H. & Pearl Irby            White  White
Address  50th & No.Rustin,Sioux City County  Woodbury      Colored                 
Home visit by    Mrs. Fred B. Wolf    on   10-9-42
Occupation   Farmer    Telephone   9338
 
        I. Visitor's impression of home and surrounding neighborhood--
 
    This is a small five room house in the hills northwest of
 Leeds, a suburb of Sioux City. It is comfortably but modestly  furnished.  The yard has little grass in it and there is little  that is attractive about the place, but the Potters have not lived here long and are gradually cleaning it up and improving  it.  Other homes in the neighborhood are much like it.
       II. Type of child Not a superior Child     Catholic                                  Free 
            Sex  Male      Age 8 to 11             Protestant Protestant  Wage
                                                                                          Jewish                         Adoptive Adoptive

      III. Visitor's impression of interior of home (furnishings, comfort and conveniences, Cleanliness and order evidence of culture and refinement)
 

    The home is clean and neat.  It is comfortably and modestly  furnished.  It is not modern.  There are many evidences of effort
to make the house homelike, plants in the windows, handwork about the rooms, pictures on the walls.  Newspapers and a  few magazines speak of natural culture and refinement.
 
       IV. The Family (Give the names of those actually interviewed, with your impression of the personality,  disposition, intelligence and culture of each)
 
     Agent interviewed both Mr. and Mrs. Potter.  Both seem kindly  and understanding, and of even disposition.  They are friendly and have a sense of humor.  Neither has much education but they are not crude.
    Both are of average intelligence and are courteous.
    Mrs. Potter's father who lives with them is said to be a kindly old man.  In the winter he spends much of his time doing needle work
 
        V. What experience have they, especially the wife, had, or preparation made for bringing up a child?   Do they show any evidence of familiarity with or interest in modern methods of child care and  training?
 
    Mrs. Potter's experience is confined to helping with the
children at home when she was younger.  They often have children
of relatives and friends there to visit.
[Continued on next page]

  State Juvenile Records - Section Three