SSV-6 SSV Locally or Privately-Operated Juvenile Facilities Su

OMB No. 1121-0292: Approval Expires 02/28/2011
U.S. DEPARTMENT OF JUSTICE

SSV-6

FORM
(4-8-2010)

SURVEY OF SEXUAL VIOLENCE, 2009
— Locally or Privately-Operated Juvenile Facilities

BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT

U.S. DEPT. OF COMMERCE
Economics and Statistics Administration

Summary Form

U.S. CENSUS BUREAU

DATA SUPPLIED BY

TELEPHONE
E-MAIL
ADDRESS

City

Number and street or P.O. Box/Route Number
Area code

Number

FAX
NUMBER

State

▼

OFFICIAL
ADDRESS

Title

▼▼▼

Name

Area Code

ZIP Code
Number

(Please correct any error in name, mailing address, and ZIP Code)

What facilities are included in this data collection?
All juvenile residential placement facilities operated or
administered by a local government and all privately owned or
operated facilities that are used to house juveniles and
youthful offenders, regardless of age or reason for placement.
• INCLUDE locally-operated juvenile residential facilities;
privately owned or operated juvenile residential facilities;
detention centers, training schools, long-term secure
facilities; reception or diagnostic centers; group homes or
halfway houses; boot camps; ranches; forestry camps,
wilderness or marine programs, or farms; runaway or
homeless shelters; and residential treatment centers for
juveniles.
• EXCLUDE State operated juvenile residential
facilities. (These facilities will be contacted
directly for data on sexual violence.)
What persons and incidents are included in this
data collection?
Juveniles and youthful offenders, regardless of age or
reason for placement, under your custody between
January 1, 2009, and December 31, 2009.
• INCLUDE incidents involving juveniles or youthful
offenders under the authority, custody, or care of your
confinement or community-based facilities or staff.
• EXCLUDE incidents involving juveniles or
youthful offenders held in facilities operated
by your State juvenile system.

Reporting instructions:
•
•
•
•
•

Please complete the entire SSV-6 Form.
If the answer to a question is "not available" or "unknown,"
write "DK" (do not know) in the space provided.
If the answer to a question is "not applicable," write "NA"
in the space provided.
If the answer to a question is "none" or "zero," mark the
box ( x ) provided.
When exact numeric answers are not available, provide
estimates and mark ( x ) the box beside each figure.

Substantiated incidents of sexual violence:
• Please complete an Incident Form (Juvenile, SSV-IJ)
for each substantiated incident of sexual violence.
Returning forms:
• If you need assistance, please call Greta Clark at the
U.S. Census Bureau toll–free at 1–800–253–2078,
or e-mail govs.ssv@census.gov
• Please return your completed questionnaire
and substantiated incident forms by
October 1, 2010.
• If you prefer, you may also return these forms
by mail or fax.
• MAIL TO: U.S. Census Bureau, P.O. Box 5000,
Jeffersonville, IN 47199-5000
• FAX (TOLL FREE): 1–888–891–2099

Burden Statement
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMB
control number. The burden of this collection is estimated to average 60 minutes per response, including reviewing instructions, searching
existing data sources, gathering necessary data, and completing and reviewing this form. Send comments regarding this burden estimate or
any aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street,
NW, Washington, DC 20531. Do not send your completed form to this address.

DEFINITIONS

3. On December 31, 2009, how many persons
held in this facility were —

JUVENILES and YOUTHFUL OFFENDERS:
• Any person under the custody or care of a juvenile
residential facility owned or operated by a local
government or private agency.

a. Males . . . . . . . . . . . . . . . . . .

FACILITIES:

b. Females . . . . . . . . . . . . . . . .

INCLUDE all juvenile residential placement facilities operated
or administered by a local government and all privately owned
or operated facilities that are used to house juveniles and
youthful offenders charged with or court-adjudicated for:

c. TOTAL(Sum of Items 3a to 3b) .

• Any offense that is illegal for both adults and juveniles;

• Count persons held in the facility regardless of age or
reason for placement. Include persons who were
temporarily away but had assigned beds on
December 31, 2009.

OR
• An offense that is ILLEGAL in your State for juveniles,
but not for adults (running away, truancy, incorrigibility,
curfew violations, and liquor violations).

4. On December 31, 2009, how many persons
held in this facility were —

EXCLUDE all State-operated facilities and locally or
privately-operated facilities used ONLY to house juveniles for:
• Non-criminal behavior (neglect, abuse, abandonment, or
dependency);

a. Age 17 or younger . . . . . . . .

OR
b. Age 18 to 20

• Being Persons in Need of Services (PINS) or Children in
Need of Services (CHINS) who have assigned beds for
reasons other than offenses.

............

c. Age 21 or older

..........

Section I – GENERAL INFORMATION
d. TOTAL (Sum of Items 4a to 4c
should equal Item 3c) . . . . . . . .

1. Is this facility owned by a —
01

Private agency

02

Native American Tribal Government

03

State

04

County

05

Local or municipal government

06

Other – Specify

• Count all persons held in the facility regardless of age
or reason for placement. Include persons who were
temporarily away but had assigned beds on
December 31, 2009.
5. Between January 1, 2009, and
December 31, 2009, how many persons were
admitted to or discharged from this facility?

a. TOTAL number admitted . . .
2. Is this facility operated by a —
01

Private agency

02

Native American Tribal Government

03

State

04

County

05

Local or municipal government

06

Other – Specify

b. TOTAL number discharged .
• Include all persons admitted to this facility by a formal
legal document, by the authority of the courts, or by
some other official agency.
• Include all persons discharged from this facility after a
period of confinement including sentence completion,
pretrial releases, transfers to adult jurisdictions or to
other States, and deaths.
• Exclude admissions and discharges resulting from
returns from escape, administrative transfers to other
juvenile facilities, or temporary release including
work/school release, medical appointments, other
treatment facilities, or court appearances.

FORM SSV-6 (4-8-2010)

Page 2

Section II – YOUTH-ON-YOUTH SEXUAL VIOLENCE

6. Does your facility record allegations of
youth-on-youth NONCONSENSUAL SEXUAL
ACTS?

DEFINITIONS OF SEXUAL VIOLENCE

01

The definition of "rape" as required under the Prison Rape
Elimination Act of 2003 will be operationalized by
disaggregating sexual assault into two categories of
youth-on-youth SEXUAL VIOLENCE. These categories
reflect uniform definitions formulated by the National Center
for Injury Prevention and Control, in "Sexual Violence
Surveillance: Uniform Definitions and Recommended Data
Elements," Centers for Disease Control and Prevention. The
categories of youth-on-youth SEXUAL VIOLENCE are:

Yes ➔ a. Do you record all reported
occurrences, or only
substantiated ones?
01
02

All
Substantiated only

b. Do you record attempted
NONCONSENSUAL SEXUAL ACTS
or only completed ones?

NONCONSENSUAL SEXUAL ACTS:

01
02

Contact of any person without his or her consent, or of a
person who is unable to consent or refuse;
02

AND

No

Both attempted and completed
Completed only

➔ Please provide the definition used by your
facility for youth-on-youth NONCONSENSUAL
SEXUAL ACTS in the space below. Use that
definition to complete Items 7 and 8.

• Contact between the penis and the vagina or the penis
and the anus including penetration, however slight;
OR
• Contact between the mouth and the penis, vagina, or
anus;
OR
• Penetration of the anal or genital opening of another
person by a hand, finger, or other object.

7. Between January 1, 2009, and December 31, 2009,
how many allegations of youth-on-youth
NONCONSENSUAL SEXUAL ACTS were reported?

ABUSIVE SEXUAL CONTACTS:
Contact of any person without his or her consent, or of a
person who is unable to consent or refuse;

Number reported

AND

• If an allegation involved multiple victims, count only
once.

• Intentional touching, either directly or through the
clothing, of the genitalia, anus, groin, breast, inner thigh,
or buttocks of any person.
• Exclude incidents in which the intent of the sexual
contact is to harm or debilitate rather than sexually
exploit.

None

8. Of the allegations reported in Item 7, how many
were — (Please contact the agency or office responsible
for investigating allegations of sexual violence in order to
fully complete this form.)

None

a. Substantiated . . . . . . .

• The event was investigated and determined to have
occurred.
b. Unsubstantiated

None

....

• Evidence was insufficient to make a final
determination that the event occurred.
c. Unfounded

None

.........

• The event was determined NOT to have occurred.
d. Investigation ongoing

.

None

• A final determination has not yet been made as to
whether the event occurred.
e. TOTAL (Sum of Items
8a through 8d) . . . . . . . . .

FORM SSV-6 (4-8-2010)

Page 3

None

Section III – STAFF SEXUAL MISCONDUCT
AND HARASSMENT

9. Does your facility record allegations of
youth-on-youth ABUSIVE SEXUAL CONTACTS?
(See definitions on page 3.)
01

02

Yes

No

DEFINITION OF STAFF SEXUAL MISCONDUCT

➔ Can these be counted separately

from allegations of
NONCONSENSUAL SEXUAL ACTS?
01

Yes

02

No

The definition of STAFF SEXUAL MISCONDUCT is based on
"Training for Investigators of Staff Sexual Misconduct,"
prepared by the National Institute of Corrections. STAFF
SEXUAL MISCONDUCT includes any behavior or act of a
sexual nature directed toward a juvenile or youthful offender
by an employee, volunteer, contractor, office visitor, or other
agency representative (exclude youth family, friends, or other
visitors). Sexual relationships of a romantic nature between
staff and youth are included in this definition.

➔ Skip to Item 12.

➔ Please provide an explanation in the space
below and then skip to Item 12.

Consensual or nonconsensual sexual acts including:
• Intentional touching of the genitalia, anus, groin, breast,
inner thigh, or buttocks with the intent to abuse, arouse,
or gratify sexual desire;
OR
• Completed, attempted, threatened, or requested sexual
acts;
OR
• Occurrences of indecent exposure, invasion of privacy,
or staff voyeurism for sexual gratification.

10. Between January 1, 2009, and December 31,
2009, how many allegations of youth-on-youth
ABUSIVE SEXUAL CONTACTS were reported?

DEFINITION OF STAFF SEXUAL HARASSMENT
Number reported

None

The definition of STAFF SEXUAL HARASSMENT was also
developed by the National Institute of Corrections. STAFF
SEXUAL HARASSMENT includes repeated verbal statements
or comments of a sexual nature to a juvenile or youthful
offender by an employee, volunteer, contractor, office visitor, or
other agency representative (exclude youth family, friends, or
other visitors).

• If an allegation involved multiple victimizations, count
only once.
11. Of the allegations reported in Item 10, how
many were — (Please contact the agency or
office responsible for investigating allegations of
sexual violence in order to fully complete this form.)

• Demeaning references to gender or derogatory
comments about body or clothing;
OR

a. Substantiated . . . . . . .

None

b. Unsubstantiated . . . . .

None

c. Unfounded . . . . . . . . . .

None

d. Investigation ongoing . .

None

• Repeated profane or obscene language or gestures.
12. Does your facility record allegations of STAFF
SEXUAL MISCONDUCT?
01

02

e. TOTAL (Sum of Items
11a through 11d) . . . . . . .

FORM SSV-6 (4-8-2010)

Yes

No

➔ Do you record all reported

occurrences, or only substantiated
ones?
01

All

02

Substantiated only

➔ Please provide an explanation in the space
below and then skip to Item 15.

None

Page 4

13. Between January 1, 2009, and
December 31, 2009, how many allegations
of STAFF SEXUAL MISCONDUCT were
reported?
Number reported

17. Of the allegations reported in Item 16, how
many were — (Please contact the agency or
office responsible for investigating allegations of
sexual violence in order to fully complete this form.)

None

• If an allegation involved multiple victims, count only
once.
14. Of the allegations reported in Item 13, how
many were — (Please contact the agency or
office responsible for investigating allegations of
sexual violence in order to fully complete this form.)

a. Substantiated . . . . . . .

b. Unsubstantiated . . . . .

c. Unfounded . . . . . . . . . .

a. Substantiated . . . . . . .

None

b. Unsubstantiated . . . . .

None

c. Unfounded . . . . . . . . . .

None

d. Investigation ongoing .

None

e. TOTAL (Sum of Items 17a
through 17d) . . . . . . . . . .

None

None

None

None
Section IV – TOTAL OF SUBSTANTIATED
INCIDENTS OF SEXUAL VIOLENCE

d. Investigation ongoing .

e. TOTAL (Sum of Items
14a through 14d) . . . . . . .

None
18. What is the total number of substantiated
incidents reported in Items 8a, 11a, 14a,
and 17a?
None

15. Does your facility record allegations of STAFF
SEXUAL HARASSMENT ? (See definitions on page 4.)
01

02

Yes

No

SSV-IJ) for each substantiated incident of
sexual violence.

separately from allegations of
STAFF SEXUAL MISCONDUCT?
Yes

02

No

➔ Skip to Item 18.

NOTES

➔ Please provide an explanation in the space
below and then skip to Item 18.

16. Between January 1, 2009, and
December 31, 2009, how many allegations of
STAFF SEXUAL HARASSMENT were reported?

Number reported

None

• If an allegation involved multiple victims or staff, count
only once.

FORM SSV-6 (4-8-2010)

None

➔ Please complete an Incident Form (Juvenile,

➔ Can these allegations be counted
01

Total substantiated
incidents . . . . . . . . . . . . .

Page 5