DJJ Form ADSD-007 "Protective Action Response Performance Evaluation - Contracted Facility Staff" - Florida

What Is DJJ Form ADSD-007?

This is a legal form that was released by the Florida Department of Juvenile Justice - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 11, 2006;
  • The latest edition provided by the Florida Department of Juvenile Justice;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of DJJ Form ADSD-007 by clicking the link below or browse more documents and templates provided by the Florida Department of Juvenile Justice.

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Download DJJ Form ADSD-007 "Protective Action Response Performance Evaluation - Contracted Facility Staff" - Florida

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ADSD-007
q Attempt 1 q Attempt 2 q Attempt 3
FLORIDA DEPARTMENT OF JUVENILE JUSTICE
Protective Action Response Performance Evaluation – Contracted Facility Staff
-- PLEASE, NO ABBREVIATIONS. --
First
M.I.
Last
Last 5 digits SSN: __-______
Company Name:
Telephone: (
)
Facility Name:
Work Address:
City:
Zip:
Reg.: North Central South
Circuit:
County:
Training Location:
Date of Evaluation:
/
/
q
(Check, if applicable.) This participant is on Medical Status.
NOTE: Verbal direction must be used for all techniques except Reactionary Gap, Danger Zone, and Interview Stance.
Demo 1
Demo 2
Remedial
TECHNIQUES
COMMENTS
S/U
S/U
S/U
STANCE & BODY MOVEMENT – All are evaluated.
1. Reactionary Gap
2. Danger Zone
3. Interview Stance
4. Ready Stance
5. Approach (Using 45-Degree Angle)
COUNTERMOVES – Blocks – All are evaluated.
6. High Block
7. Mid-Range – Straight Arm Blows
8. Mid-Range – Roundhouse Blows
9. Low Block – “X” Block
10. Low Block – Leg Raise
COUNTERMOVES – Evasive – All are evaluated.
11. Evasive Sidestep
12. Evasive Sidestep w/ Redirection
COUNTERMOVES – Releases – All are evaluated.
13. One Wrist / Forearm Grab Release
14. Two Wrist / Forearm Grab Release
15. Rear Two Hand Release
16. Two Hands Together Grab Release
17. Front Choke Backstroke Release
18. Front Choke Wrist Release
19. Rear Bear Hug Release
20. Front Bear Hug Release
PAR Performance Evaluation – Contracted Facility Staff (Revised 12/11/2006)
Page 1 of 4
ADSD-007
q Attempt 1 q Attempt 2 q Attempt 3
FLORIDA DEPARTMENT OF JUVENILE JUSTICE
Protective Action Response Performance Evaluation – Contracted Facility Staff
-- PLEASE, NO ABBREVIATIONS. --
First
M.I.
Last
Last 5 digits SSN: __-______
Company Name:
Telephone: (
)
Facility Name:
Work Address:
City:
Zip:
Reg.: North Central South
Circuit:
County:
Training Location:
Date of Evaluation:
/
/
q
(Check, if applicable.) This participant is on Medical Status.
NOTE: Verbal direction must be used for all techniques except Reactionary Gap, Danger Zone, and Interview Stance.
Demo 1
Demo 2
Remedial
TECHNIQUES
COMMENTS
S/U
S/U
S/U
STANCE & BODY MOVEMENT – All are evaluated.
1. Reactionary Gap
2. Danger Zone
3. Interview Stance
4. Ready Stance
5. Approach (Using 45-Degree Angle)
COUNTERMOVES – Blocks – All are evaluated.
6. High Block
7. Mid-Range – Straight Arm Blows
8. Mid-Range – Roundhouse Blows
9. Low Block – “X” Block
10. Low Block – Leg Raise
COUNTERMOVES – Evasive – All are evaluated.
11. Evasive Sidestep
12. Evasive Sidestep w/ Redirection
COUNTERMOVES – Releases – All are evaluated.
13. One Wrist / Forearm Grab Release
14. Two Wrist / Forearm Grab Release
15. Rear Two Hand Release
16. Two Hands Together Grab Release
17. Front Choke Backstroke Release
18. Front Choke Wrist Release
19. Rear Bear Hug Release
20. Front Bear Hug Release
PAR Performance Evaluation – Contracted Facility Staff (Revised 12/11/2006)
Page 1 of 4
ADSD-007
Participant’s Name: ________________________________________________ q Attempt 1 q Attempt 2 q Attempt 3
Demo 1
Demo 2
Remedial
TECHNIQUES
COMMENTS
S/U
S/U
S/U
COUNTERMOVES – Escapes – All are evaluated.
21. Bite Escape
22. Headlock Escape
23. Full Nelson Escape
24. Double Arm Lock Escape
25. Front Hairpull Escape
26. Rear Hairpull Escape
COUNTERMOVES – Defense
27. Ground Defense
TOUCH – Staff selects 1.
28. (a) Straight Arm Escort: Extended
(b) Straight Arm Escort: Close
29. Supportive Hold: Stage 1
CONTROL TECHNIQUES – Staff selects 4, one of which must be Ground Control.
30. Ground Control
31. Baskethold
32. Arm Bar
33. Arm Control
34. Team Arm Control
35. Wrap-Around
36. Supportive Hold Control: Stage 2
37. Supportive Hold Control: Stage 3
PAR Performance Evaluation – Contracted Facility Staff (Revised 12/11/2006)
Page 2 of 4
ADSD-007
Participant’s Name: ________________________________________________ q Attempt 1 q Attempt 2 q Attempt 3
Demo 1
Demo 2
Remedial
TECHNIQUES
COMMENTS
S/U
S/U
S/U
TAKEDOWNS – Staff selects 3.
38. Straight Arm to a Takedown
39. Baskethold to a Takedown
40. Arm Bar to a Takedown
41. Wrap-Around:
Team Tak edown
42. Supportive Hold Takedown: Stage 4
43. Supportive Hold Takedown: Stage 5
44. Immediate Team Takedown
SEARCHES – This shall be evaluated.
45. Person Search
MECHANICAL RESTRAINTS – Staff selects 1 front handcuffing and uncuffing technique.
46. (a) Standing Front Handcuffing
(b) Standing Front Uncuffing
47. (a) Waist Chain (Application)
(b) Waist Chain (Removal)
48. (a) Restraint Belt (Application)
(b) Restraint Belt (Removal)
MECHANICAL RESTRAINTS – Staff selects 1 rear handcuffing and uncuffing technique.
49. (a) Standing Rear Handcuffing
(b) Standing Rear Uncuffing
50. Prone Handcuffing
MECHANICAL RESTRAINTS – Staff selects 1 leg cuffing and uncuffing technique.
51. (a) Leg Cuffing (Kneeling Position)
(b) Leg Uncuffing (Kneeling Position)
52. (a) Leg Cuffing (Hands on Wall)
(b) Leg Uncuffing (Hands on Wall)
PAR Performance Evaluation – Contracted Facility Staff (Revised 12/11/2006)
Page 3 of 4
ADSD-007
Participant’s Name: ________________________________________________ q Attempt 1 q Attempt 2 q Attempt 3
Comments (attach additional pages, if necessary):
§
Specify the number of unsatisfactory techniques in the “Demo 2” column. _____
§
Specify the number of unsatisfactory techniques in the “Remedial” column. _____
q
q
§
Upon conclusion of this evaluation session, the participant: PASSED?
? ? ?
FAILED
1.
2.
nd
Evaluator’s Printed Name & Initials
2
Evaluator’s Printed Name & Initials, If Necessary
3.
4.
rd
th
3
Evaluator’s Printed Name & Initials, If Necessary
4
Evaluator’s Printed Name & Initials, If Necessary
This evaluation has been reviewed and discussed.
Participant’s Signature
PAR Performance Evaluation – Contracted Facility Staff (Revised 12/11/2006)
Page 4 of 4