Download:
pdf |
pdfOMB No. 1121-0292: Approval Expires XXXXXX
U.S. DEPARTMENT OF JUSTICE
SSV-2
FORM
(3-5-2014)
BUREAU OF JUSTICE STATISTICS
SURVEY OF SEXUAL VICTIMIZATION, 2013
State Prison Systems
Summary Form
AND ACTING AS COLLECTION AGENT
U.S. DEPT. OF COMMERCE
Economics and Statistics Administration
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 State-operated confinement facilities that are intended for
adults but sometimes hold juveniles.
• INCLUDE prisons, penitentiaries, and correctional
institutions; boot camps; community correction facilities;
halfway houses; prison farms; reception, diagnostic, and
classification centers; road camps; forestry and
conservation camps; vocational training facilities; prison
hospitals; and drug and alcohol treatment facilities for
prisoners.
• INCLUDE State-operated local detention facilities in
Alaska, Connecticut, Delaware, Hawaii, Rhode Island,
and Vermont.
• EXCLUDE privately operated facilities and
facilities operated and administered by local
governments. (These facilities will be
contacted directly for data on sexual
victimization.)
• EXCLUDE facilities that hold only juveniles. (These
facilities will be contacted directly for data on sexual
victimization.)
What inmates and incidents are included in this
data collection?
Inmates under your custody between January 1, 2013, and
December 31, 2013.
• INCLUDE incidents involving inmates under the
authority, custody, or care of your confinement or
community-based facilities or staff.
Reporting instructions:
•
•
Please complete the entire SSV-2 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.
Substantiated incidents of sexual violence:
• Please complete an Incident Form (Adult, SSV-IA)
for each substantiated incident of sexual victimization.
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 July 1, 2014.
• You may complete these forms online (see
enclosed instructions.) Or if you prefer, you may
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
• EXCLUDE incidents involving inmates held in
local jails and facilities in other jurisdictions.
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.
Section I – INMATE–ON–INMATE SEXUAL VICTIMIZATION 1. Does your State prison system record
allegations of inmate-on-inmate
NONCONSENSUAL SEXUAL ACTS?
DEFINITIONS
Yes ➔ a. Do you record all reported
01
occurrences, or only substantiated
The survey utilizes the definition of “sexual abuse” as
ones?
provided by 28 C.F.R. §115.6 in the National Standards to
Prevent, Detect, and Respond to Prison Rape (under the
01
All
Prison Rape Elimination Act of 2003). For purposes of SSV,
sexual abuse is disaggregated into three categories of
02
Substantiated only
inmate-on-inmate sexual victimization. These categories are:
b. Do you record attempted
NONCONSENSUAL SEXUAL ACTS
or only completed ones?
NONCONSENSUAL SEXUAL ACTS
Sexual contact of any person without his or her consent,
or of a person who is unable to consent or refuse;
AND
• Contact between the penis and the vulva or the penis
and the anus including penetration, however slight;
02
No
01
Both attempted and completed
02
Completed only
➔ Please provide the definition used by your
State prison system for inmate-on-inmate
NONCONSENSUAL SEXUAL ACTS in the
space below. Use that definition to complete
Items 2 and 3.
OR
• Contact between the mouth and the penis, vulva, or
anus;
OR
• Penetration of the anal or genital opening of another
person, however slight, by a hand, finger, object, or
other instrument.
ABUSIVE SEXUAL CONTACTS
2. Between January 1, 2013, and December 31, 2013,
how many allegations of inmate-on-inmate
NONCONSENSUAL SEXUAL ACTS were reported?
Sexual contact of any person without his or her consent,
or of a person who is unable to consent or refuse;
Number reported . . . . . .
None
• If an allegation involved multiple victimizations,
count only once.
AND
• 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 contact was incidental to
a physical altercation.
• Exclude any allegations that were reported as
consensual.
3. Of the allegations reported in Item 2, how
many were — (Please contact the agency or office
responsible for investigating allegations of sexual
victimization in order to fully complete this form.)
SEXUAL HARASSMENT
Repeated and unwanted sexual advances, requests for
sexual favors, or verbal comments, gestures, or actions
of a derogatory or offensive sexual nature by one inmate
directed toward another.
a. Substantiated
None
......
• The event was investigated and determined to
have occurred, based on the preponderance of
evidence (28 C.F.R. §115.72).
b. Unsubstantiated
None
....
• The investigation concluded that evidence was
insufficient to determine whether or not the event
occurred.
None
c. Unfounded . . . . . . . . .
• The investigation determined that the event did NOT
occur.
d. Investigation ongoing
.
None
• Evidence is still being gathered, processed or evaluated,
and a final determination has not yet been made.
e. TOTAL (Sum of Items
3a through 3d) . . . . . . . .
None
• The total should equal the number reported in Item 2.
FORM SSV-2 (3-5-2014)
Page 2
7. Does your State prison system record
allegations of inmate-on-inmate SEXUAL
HARASSMENT? (See definitions on page 2.)
4. Does your State prison system record
allegations of inmate-on-inmate ABUSIVE
SEXUAL CONTACT? (See definitions on page 2.)
01
Yes
➔ Can these be counted separately from
01
Yes
allegations of NONCONSENSUAL
SEXUAL ACTS?
01
02
02
No
Yes
No ➔ Skip to Item 7.
➔ Please provide an explanation in the space
02
below and then skip to Item 7.
No
➔ Do you record all reported
allegations or only substantiated
ones?
01
All
02
Substantiated only
➔ Please provide an explanation in the space
below and then skip to Item 10.
5. Between January 1, 2013, and December 31, 2013,
how many allegations of inmate-on-inmate
ABUSIVE SEXUAL CONTACT were reported?
8. Between January 1, 2013, and December 31, 2013,
how many allegations of inmate-on-inmate
SEXUAL HARASSMENT were reported?
Number reported . . . . . .
None
• If an allegation involved multiple victimizations,
count only once.
Number reported . . . . . .
None
• If an allegation involved multiple victims or
multiple inmate perpetrators, count only once.
• Exclude any allegations that were reported as
consensual.
• Exclude any allegations that were reported as
consensual.
6. Of the allegations reported in Item 5, how
many were — (Please contact the agency or office
responsible for investigating allegations of sexual
victimization in order to fully complete this form.)
9. Of the allegations reported in Item 8, how
many were — (Please contact the agency or office
responsible for investigating allegations of sexual
victimization in order to fully complete this form.)
None
a. Substantiated . . . . . . .
None
a. Substantiated
b. Unsubstantiated . . . . .
None
b. Unsubstantiated
....
None
c. Unfounded
.........
None
c. Unfounded . . . . . . . . .
None
d. Investigation ongoing .
None
d. Investigation ongoing
e. TOTAL (Sum of Items
6a through 6d) . . . . . . . . .
None
e. TOTAL (Sum of Items
9a through 9d) . . . . . . . .
.
None
None
• The total should equal the number reported in
Item 8.
• The total should equal the number reported in
Item 5.
FORM SSV-2 (3-5-2014)
......
Page 3
SECTION II – STAFF-ON-INMATE SEXUAL
ABUSE
10. Does your State prison system record
allegations of STAFF SEXUAL
MISCONDUCT?
DEFINITIONS
The survey utilizes the definition of “sexual abuse” by a staff
member, contractor or volunteer as provided by 28 C.F.R.
§115.6 in the National Standards to Prevent, Detect, and
Respond to Prison Rape (under the Prison Rape Elimination
Act of 2003). For purposes of SSV, sexual abuse is
disaggregated into two categories of staff-on-inmate sexual
abuse. These categories are:
01
STAFF SEXUAL MISCONDUCT
02
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 13.
Any behavior or act of a sexual nature directed toward an
inmate by an employee, volunteer, contractor, official visitor or
other agency representative (exclude family, friends or other
visitors.) Sexual relationships of a romantic nature between
staff and inmates are included in this definition.
Consensual or nonconsensual sexual acts including:
• Intentional touching of the genitalia, anus, groin, breast,
inner thigh, or buttocks that is unrelated to official duties or
with the intent to abuse, arouse, or gratify sexual desire;
OR
• Completed, attempted, threatened, or requested sexual acts;
11. Between January 1, 2013, and
December 31, 2013, how many allegations of
STAFF SEXUAL MISCONDUCT were reported?
OR
Number reported . . . . . . .
None
• If an allegation involved multiple victims or staff,
count only once.
• Occurrences of indecent exposure, invasion of privacy,
or staff voyeurism for reasons unrelated to official duties
or for sexual gratification.
STAFF SEXUAL HARASSMENT
Repeated verbal statements, comments or gestures of a sexual
nature to an inmate by an employee, volunteer, contractor,
official visitor, or other agency representative (exclude family,
friends, or other visitors).
12. Of the allegations reported in Item 11, how
many were — (Please contact the agency or office
responsible for investigating allegations of sexual
victimization in order to fully complete this form.)
• Demeaning references to gender or derogatory
comments about body or clothing; sexually suggestive;
a. Substantiated . . . . . . .
None
OR
b. Unsubstantiated . . . . .
None
c. Unfounded . . . . . . . . . .
None
d. Investigation ongoing .
None
e. TOTAL (Sum of Items
12a through 12d) . . . . . . .
None
• Repeated profane or obscene language or gestures.
• The total should equal the number reported in
Item 11.
FORM SSV-2 (3-5-2014)
Page 4
13. Does your State prison system record
allegations of STAFF SEXUAL HARASSMENT?
(See definitions on page 4.)
01
Yes
➔ Can these allegations be counted
Section III – PRIVATE AND LOCAL ALLEGATIONS
separately from allegations of STAFF
SEXUAL MISCONDUCT?
02
No
01
Yes
02
No
➔ Skip to Item 16.
➔ Please provide an explanation in the space
16. Did any of the allegations reported in items 2,
5, 8, 11, or 14 occur in a privately operated
facility?
01
Yes
02
No
17. Did any of the allegations reported in items 2,
5, 8, 11, or 14 occur in a facility operated and
administered by local governments?
below and then skip to Item 16.
01
Yes
02
No
Section IV – TOTAL SUBSTANTIATED
INCIDENTS OF SEXUAL VICTIMIZATION
18. What is the total number of substantiated
incidents reported in Items 3a, 6a, 9a, 12a, and
15a?
Total substantiated
incidents . . . . . . . . . . . .
14. Between January 1, 2013, and
December 31, 2013, how many allegations
of STAFF SEXUAL HARASSMENT were
reported?
➔
15. Of the allegations reported in Item 14, how
many were — (Please contact the agency or office
responsible for investigating allegations of sexual
victimization in order to fully complete this form.)
......
None
b. Unsubstantiated . . . .
None
c. Unfounded . . . . . . . . .
None
d. Investigation ongoing .
None
e. TOTAL (Sum of Items
15a through 15d) . . . . . .
None
a. Substantiated
• The total should equal the number reported in
Item 14.
FORM SSV-2 (3-5-2014)
Please complete an Incident Form (Adult,
SSV-IA) for each substantiated incident of
sexual victimization.
NOTES
Number reported . . . . . .
None
• If an allegation involved multiple victims or staff,
count only once.
Page 5
None
File Type | application/pdf |
File Title | ssv2p01.g |
File Modified | 2014-03-05 |
File Created | 2014-03-05 |