DJJ Form ADSD-006 "Protective Action Response Performance Evaluation - State Operated Facility/Contracted Detention/ and Law Enforcement Operated Facility Staff" - Florida

What Is DJJ Form ADSD-006?

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 June 1, 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-006 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-006 "Protective Action Response Performance Evaluation - State Operated Facility/Contracted Detention/ and Law Enforcement Operated Facility Staff" - Florida

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ADSD-006
Attempt 1
Attempt 2
Attempt 3
FLORIDA DEPARTMENT OF JUVENILE JUSTICE
Protective Action Response Performance Evaluation –
State Operated Facility/Contracted
Detention/ and Law Enforcement
Operated Facility staff
First
M.I.
Last
Last 5 digits SSN:
-
Facility Name:
Telephone: (
)
Work Address:
City:
Zip:
Region (Circle one):
North
Central
South
Circuit:
County:
Training Location:
Date of Evaluation:
/
/
(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 – State Operated Facility/Contracted Detention/
and Law Enforcement Operated Facility Staff (6/01/2006
)
Page 1 of 4
ADSD-006
Attempt 1
Attempt 2
Attempt 3
FLORIDA DEPARTMENT OF JUVENILE JUSTICE
Protective Action Response Performance Evaluation –
State Operated Facility/Contracted
Detention/ and Law Enforcement
Operated Facility staff
First
M.I.
Last
Last 5 digits SSN:
-
Facility Name:
Telephone: (
)
Work Address:
City:
Zip:
Region (Circle one):
North
Central
South
Circuit:
County:
Training Location:
Date of Evaluation:
/
/
(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 – State Operated Facility/Contracted Detention/
and Law Enforcement Operated Facility Staff (6/01/2006
)
Page 1 of 4
ADSD-006
Participant’s Name: ________________________________________________
Attempt 1
Attempt 2
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 – This shall be evaluated.
28. (a) Straight Arm Escort: Extended
(b) Straight Arm Escort: Close
CONTROL TECHNIQUES – Staff selects 4, one of which must be Ground Control.
29. Ground Control
30. Baskethold
31. Wrap-Around
32. Arm Bar
33. Arm Control
34. Team Arm Control
PAR Performance Evaluation – State Operated Facility/Contracted Detention/
and Law Enforcement Operated Facility Staff (6/01/2006)
Page 2 of 4
ADSD-006
Participant’s Name: ________________________________________________
Attempt 1
Attempt 2
Attempt 3
Demo 1
Demo 2
Remedial
TECHNIQUES
COMMENTS
S/U
S/U
S/U
TAKEDOWNS – Staff selects 3.
35. Straight Arm to a Takedown
36. Baskethold to a Takedown
37. Arm Bar to a Takedown
38. Immediate Team Takedown
SEARCHES – This shall be evaluated.
39. Person Search
MECHANICAL RESTRAINTS – This shall be evaluated..
40. (a) Standing Front Handcuffing
(b) Standing Front Uncuffing
MECHANICAL RESTRAINTS – Staff selects 1 rear handcuffing and uncuffing technique.
41. (a) Standing Rear Handcuffing
(b) Standing Rear Uncuffing
42. Prone Handcuffing
MECHANICAL RESTRAINTS – Staff selects 1 leg cuffing and uncuffing technique.
43. (a) Leg Cuffing (Kneeling Position)
(b) Leg Uncuffing (Kneeling Position)
44. (a) Leg Cuffing (Hands on Wall)
(b) Leg Uncuffing (Hands on Wall)
PAR Performance Evaluation – State Operated Facility/Contracted Detention/
and Law Enforcement Operated Facility Staff (6/01/2006)
Page 3 of 4
ADSD-006
Participant’s Name: ________________________________________________
Attempt 1
Attempt 2
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. _____
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 – State Operated Facility/Contracted Detention/
and Law Enforcement Operated Facility Staff (6/01/2006)
Page 4 of 4