"Florida Prevention Assessment Tool" - Florida

Florida Prevention Assessment Tool is a legal document that was released by the Florida Department of Juvenile Justice - a government authority operating within Florida.

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  • Released on October 30, 2014;
  • The latest edition currently provided by the Florida Department of Juvenile Justice;
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Florida Prevention Assessment Tool 1.0
Youth’s Name:
Date:
DOMAIN 1: Record of Referrals Resulting in Diversion, Adjudication Withheld, Adjudication, or Deferred Prosecution
Domain 1 Definitions: Referrals, rather than offenses (charges), are used to assess the persistence of re-offending by the Youth.
Referrals should be included in Domain 1 if either (1) they have a qualifying disposition or (2) they have no qualifying disposition, but
are less than 1,100 days old from the date of the referral. This includes the current and prior matters. Qualifying dispositions include:
any diversion, adjudication withheld, or adjudication.
o
Over 16
The age of the youth at the time of their first offense or contact with the
1.
Age at first offense:
o
16
Department that resulted in charges being filed by law enforcement.
o
15
o
13 to 14
o
Under 13
o
None
Felony and misdemeanor referrals: Items 2 and 3 are mutually exclusive and should add to the total number of referrals as defined
in “Domain 1 Definitions,” (see above).
o
None or one
2.
Misdemeanor referrals: Total number of referrals for which the most serious offense was a non-traffic
o
Two
misdemeanor that resulted in diversion, adjudication withheld, adjudication,deferred prosecution or referral to
o
Three or four
adult court (regardless of whether successfully completed).
o
Five or more
o
None
3.
Felony referrals: Total number of referrals for which the most serious offense was a felony offense that
o
One
resulted in diversion, adjudication withheld, adjudication,deferred prosecution or referral to adult court
o
(regardless of whether successfully completed).
Two
o
Three or more
Against-person or weapon referrals: Items 4, 5, and 6 are mutually exclusive and should add to the total number of referrals that
involve an against-person or weapon offense, including sex offenses that resulted in diversion, adjudication withheld, adjudication,
deferred prosecution or referral to adult court (regardless of whether successfully completed).
o
None
4.
Weapon referrals: Total number of referrals for which the most serious offense was a firearm/weapon
o
One or more
charge or a weapon enhancement finding.
o
None
5.
Against-person misdemeanor referrals: Total number of referrals for which the most serious offense was
o
an against-person misdemeanor – a misdemeanor involving threats, force, or physical harm to another
One
o
person or sexual misconduct (assault, coercion, harassment, intimidation, etc.).
Two or more
o
None
6.
Against-person felony referrals: Total number of referrals for which the most serious offense was an
o
One or two
against-person felony involving force or physical harm to another person including sexual misconduct as
o
Three or more
defined as a felony.
Sex offense referrals: Items 7 and 8 are mutually exclusive and should add to the total number of referrals, as defined in “Domain 1
Definitions,” (see above) that involve a sex offense or sexual misconduct.
o
None
7.
Sexual misconduct misdemeanor referrals: Total number of referrals for which the most serious offense
o
One
was a sexual misconduct misdemeanor, including obscene phone calls, indecent exposure, obscenity,
o
pornography, or public indecency, or misdemeanors with sexual motivation.
Two or more
o
None
8.
Felony sex offense referrals: Total number of referrals for which the most serious offense was a sex
o
One
offense involving sexual motivation including carnal knowledge, child molestation, communication with youth
o
for immoral purposes, incest, indecent exposure, indecent liberties, promoting pornography, rape/sodemy,
Two or more
sexual misconduct, or voyeurism.
o
None
9.
Confinements in secure detention where youth was held for at least 48 hours: Number of times the
o
One
youth was held for at least 48 hours physically in a detention facility.
o
Two
o
Three or more
o
None
10. Commitment orders where youth served at least one day in a residential commitment program: Total
o
One
number of commitment orders for which the youth was placed for at least a 24 hour period of time in a DJJ
o
Two or more
residential facility
o
None
11. Escapes: Total number of attempted or actual escapes that resulted in adjudication.
o
One
o
Two or more
o
None
12. Warrants for failure-to-appear in court or absconding supervision: Total number of failure to appear in
o
One
court or absconding from supervision circumstances that resulted in a warrant being issued. Do not include
o
Two or more
warrants for non-criminal matters like traffic infractions or citations.
DOMAIN 2: Demographics
Gender is auto-populated from JJIS.
Current age is auto-populated from JJIS.
October 30, 2014
1
Florida Prevention Assessment Tool 1.0
Youth’s Name:
Date:
DOMAIN 1: Record of Referrals Resulting in Diversion, Adjudication Withheld, Adjudication, or Deferred Prosecution
Domain 1 Definitions: Referrals, rather than offenses (charges), are used to assess the persistence of re-offending by the Youth.
Referrals should be included in Domain 1 if either (1) they have a qualifying disposition or (2) they have no qualifying disposition, but
are less than 1,100 days old from the date of the referral. This includes the current and prior matters. Qualifying dispositions include:
any diversion, adjudication withheld, or adjudication.
o
Over 16
The age of the youth at the time of their first offense or contact with the
1.
Age at first offense:
o
16
Department that resulted in charges being filed by law enforcement.
o
15
o
13 to 14
o
Under 13
o
None
Felony and misdemeanor referrals: Items 2 and 3 are mutually exclusive and should add to the total number of referrals as defined
in “Domain 1 Definitions,” (see above).
o
None or one
2.
Misdemeanor referrals: Total number of referrals for which the most serious offense was a non-traffic
o
Two
misdemeanor that resulted in diversion, adjudication withheld, adjudication,deferred prosecution or referral to
o
Three or four
adult court (regardless of whether successfully completed).
o
Five or more
o
None
3.
Felony referrals: Total number of referrals for which the most serious offense was a felony offense that
o
One
resulted in diversion, adjudication withheld, adjudication,deferred prosecution or referral to adult court
o
(regardless of whether successfully completed).
Two
o
Three or more
Against-person or weapon referrals: Items 4, 5, and 6 are mutually exclusive and should add to the total number of referrals that
involve an against-person or weapon offense, including sex offenses that resulted in diversion, adjudication withheld, adjudication,
deferred prosecution or referral to adult court (regardless of whether successfully completed).
o
None
4.
Weapon referrals: Total number of referrals for which the most serious offense was a firearm/weapon
o
One or more
charge or a weapon enhancement finding.
o
None
5.
Against-person misdemeanor referrals: Total number of referrals for which the most serious offense was
o
an against-person misdemeanor – a misdemeanor involving threats, force, or physical harm to another
One
o
person or sexual misconduct (assault, coercion, harassment, intimidation, etc.).
Two or more
o
None
6.
Against-person felony referrals: Total number of referrals for which the most serious offense was an
o
One or two
against-person felony involving force or physical harm to another person including sexual misconduct as
o
Three or more
defined as a felony.
Sex offense referrals: Items 7 and 8 are mutually exclusive and should add to the total number of referrals, as defined in “Domain 1
Definitions,” (see above) that involve a sex offense or sexual misconduct.
o
None
7.
Sexual misconduct misdemeanor referrals: Total number of referrals for which the most serious offense
o
One
was a sexual misconduct misdemeanor, including obscene phone calls, indecent exposure, obscenity,
o
pornography, or public indecency, or misdemeanors with sexual motivation.
Two or more
o
None
8.
Felony sex offense referrals: Total number of referrals for which the most serious offense was a sex
o
One
offense involving sexual motivation including carnal knowledge, child molestation, communication with youth
o
for immoral purposes, incest, indecent exposure, indecent liberties, promoting pornography, rape/sodemy,
Two or more
sexual misconduct, or voyeurism.
o
None
9.
Confinements in secure detention where youth was held for at least 48 hours: Number of times the
o
One
youth was held for at least 48 hours physically in a detention facility.
o
Two
o
Three or more
o
None
10. Commitment orders where youth served at least one day in a residential commitment program: Total
o
One
number of commitment orders for which the youth was placed for at least a 24 hour period of time in a DJJ
o
Two or more
residential facility
o
None
11. Escapes: Total number of attempted or actual escapes that resulted in adjudication.
o
One
o
Two or more
o
None
12. Warrants for failure-to-appear in court or absconding supervision: Total number of failure to appear in
o
One
court or absconding from supervision circumstances that resulted in a warrant being issued. Do not include
o
Two or more
warrants for non-criminal matters like traffic infractions or citations.
DOMAIN 2: Demographics
Gender is auto-populated from JJIS.
Current age is auto-populated from JJIS.
October 30, 2014
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Florida Prevention Assessment Tool 1.0
For Initial Assessments, current means behaviors during the last 6 months.
For Final Assessments, current means behaviors during the last 4 weeks or if a program of less than 4 weeks, current
means during the length of the program.
DOMAIN 3: School
 No special education need
 Behavioral
1.
Youth is a special education student or has a formal
 Learning
 ADHD/ADD
diagnosis of a special education need: (Check all that
 Intellectual Disability
apply.)
Youth’s current school enrollment status, regardless
o Graduated/GED
o Suspended
2.
o Enrolled full-time
o Dropped out
of attendance: If the youth is in home school as a result
o Enrolled part-time
o Expelled
of being expelled or dropping out, check expelled or
dropped out. Otherwise check enrolled if in home school.
Youth’s conduct in the most recent term: Fighting or
o Recognition for good behavior
3.
o No problems with school conduct
threatening students; threatening teachers/staff; overly
o Problems reported by teachers
disruptive behavior; drug/alcohol use; crimes like theft or
o Parents notified of problems at school
vandalism; lying, cheating, dishonesty.
o Calls to police
o No expel/suspend
o 2 or 3
4.
Number of expulsions and suspensions in the most
o 1 expel/suspend
o More than 3
recent term:
Youth’s attendance in the most recent term: Some
o Good attendance; few excused absences
5.
o No unexcused absences
partial-day unexcused absences mean missing one or
o Some partial-day unexcused absences
more classes; some full-day unexcused absences mean
o Some full-day unexcused absences
missing complete day; habitual truant means missing at
o Habitual truant
least one class 15 times or more during one grading
period.
Youth’s academic performance in the most recent
o Honor student (mostly As)
6.
o Above 3.0 (mostly As and Bs)
term:
o 2.0 to 3.0 (mostly Bs and Cs, no Fs)
o 1.0 to 2.0 (mostly Cs and Ds, some Fs)
o Below 1.0 (some Ds and mostly Fs)
DOMAIN 4: Use of Free Time
 None
1.
Types of structured recreational activities in which
 Community/cultural group
youth is currently interested: (Check all that apply.)
 Hobby group or club
 Athletics
 Religious group/church
 Volunteer organization
 Other organization
 None
2.
Types of structured recreational activities in which
 Community/cultural group
youth is currently participating: (Check all that apply.)
 Hobby group or club
 Athletics
 Religious group/church
 Volunteer organization
 Other organization
DOMAIN 5: Employment
o Too young for employment consideration
1.
Current employment status:
o Not currently employed
o Employment is currently going well
o Having problems with current employment
o Too young for employment consideration
2.
Understanding of what is required to maintain a job:
o Lacks knowledge of what it takes to maintain a job
such as being punctual, reliable, appropriately dressed,
o Has knowledge of abilities to maintain a job
courteous, diligent, getting along with management and co-
o Has demonstrated ability to maintain a job
workers.
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Florida Prevention Assessment Tool 1.0
DOMAIN 6: Relationships
o No positive adult relationships
1.
Current positive adult relationships: Adults who can
o 1 positive adult relationship
provide support and model pro-social behavior, such as
o 2 positive adult relationships
extended family member, teacher, religious leader, club
o 3 or more positive adults relationships
member, community person.
 No consistent friends or companions
2.
Current friends/companions youth actually spends
 Pro-social friends
time with: (Check all that apply.)
 Anti-social friends
 Gang member/associate
o Does not admire, emulate anti-social peers
3.
Currently admires/emulates anti-social peers:
o Somewhat admires, emulates anti-social peers
o Admires, emulates anti-social peers
o Does not associate with anti-social peers
4.
Current resistance to anti-social peer influence:
o Usually resists going along with anti-social peers
o Rarely resists goes along with anti-social peers
o Leads anti-social peers
DOMAIN 7: Family/Living Arrangement
 No one with history of being in jail/prison
1.
Jail/imprisonment history of persons who are currently
 Mother/female caretaker
involved in the household: (Check all that apply.)
 Father/male caretaker
 Older sibling
 Younger sibling
 Other member
 No problem history of parents in household
2.
Problem history of parents currently involved in the
 Parental alcohol problem history
household: (Check all that apply.)
 Parental drug problem history
 Parental physical health problem history
 Parental mental health problem history
 Parental employment problem history
 No siblings currently in household
3.
Problem history of siblings currently involved in the
 No problem history of siblings in household
household: (Check all that apply.)
 Sibling alcohol problem history
 Sibling drug problem history
 Sibling physical health problem history
 Sibling mental health problem history
 Sibling employment problem history
o Stable living situation
Youth’s current living situation:
4.
o Transient living situation
o Shelter
o Homeless
o
Never ran away
5.
Youth has run away from home: Include times youth did
o
Has run away once
not voluntarily return within 24 hours, and include incidents
o
Has run away two to three times
not reported by or to law enforcement.
o
Has run away four to five times
o
Has run away over five times
o
Current runaway
o
Never been kicked out
6.
Youth has been kicked out of the home:
o
Has been kicked out once
o
Has been kicked out two to three times
o
Has been kicked out four to five times
o
Has been kicked out over five times
o
Is currently kicked out of home
o Some conflict that is well managed
7.
Level of conflict between parents, between youth and
o Verbal intimidation, yelling, heated arguments
parents, among siblings:
o Threats of physical abuse
o Domestic violence: physical/sexual abuse
o Consistent supervision
8.
Parental supervision: Parents know who the youth is
o Sporadic supervision
with, when the youth will return, where the youth is going,
o Inadequate supervision
and what the youth is doing.
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Florida Prevention Assessment Tool 1.0
o Youth usually obeys and follows rules
9.
Parental authority and control:
o Youth sometimes obeys and follows rules
o Youth consistently disobeys and/or is hostile
DOMAIN 8: Alcohol and Drugs
 No past use of alcohol ever
Youth’s alcohol use: (Check all that apply.)
1.
 Past alcohol use
 Not currently using alcohol
 Currently using alcohol
 Alcohol causes family conflict
 Alcohol disrupts education
 Alcohol causes health problems
 Alcohol interferes with keeping pro-social friends
 Alcohol contributes to criminal behavior
 Youth needs increasing amounts of alcohol to achieve
same level of intoxication or high
 Youth experiences withdrawal problems
 No past use of drugs ever
Youth’s drug use: (Check all that apply.)
2.
 Past drug use
 Not currently using drugs
 Currently using drugs
 Drugs causes family conflict
 Drugs disrupts education
 Drugs causes health problems
 Drugs interferes with keeping pro-social friends
 Drugs contributes to criminal behavior
 Youth needs increasing amounts of drugs to achieve same
level of intoxication or high
 Youth experiences withdrawal problems
 No current substance use
3.
Types of drugs currently used: (Check all that apply.)
 Tobacco
 Marijuana/hashish
 Amphetamines (meth/uppers/speed/ecstacy)
 Cocaine (crack/rock)
 Cocaine (coke)
 Heroin
 Inhalants
 Barbiturates (Tuinal/Seconal/downers)
 Tranquilizers/sedatives
(Valium/Libnum/Dalmane/Ketamine)
 Hallucinogens (LSD/Acid/Mushrooms/GHB)
 Phencyclidine (PCP/Angel Dust)
 Other opiates (Codeine/ Oxycontin)
 OTCs (cough syrup/Sudafed)
 Other drugs (Specify________)
o Alcohol/drug treatment never previously warranted
4.
Prior participation in drug/alcohol treatment program:
o Never previously participated in needed treatment
o Previously participated in treatment program once
o Previously participated several times in treatment
o Alcohol/drug treatment not warranted
5.
Current drug/alcohol treatment program participation:
o Not currently attending needed treatment program
o Currently attending treatment program
o Successfully completed current treatment program
o Unsuccessfully completed current treatment program
DOMAIN 9: Mental Health
 Not a victim of violence/physical abuse
1.
History of violence/physical abuse: (Check all that
 Victim of violence/physical abuse at home
apply.)
 Victim of violence/ abuse in a foster/group home
 Victimized by family member
 Victimized by someone outside the family
 Attacked with a weapon
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Florida Prevention Assessment Tool 1.0
 Not a victim of sexual abuse/rape
2.
History of being a victim of sexual abuse/rape: (Check
 Sexually abused/raped by family member
all that apply.)
 Sexually abused/raped by someone outside the family
o Not a victim of neglect
3.
History of being a victim of neglect:
o Victim of neglect
o Has never had thoughts about suicide
4.
History of suicidal ideation: Include any previous
thoughts, threats, plans and attempts even if youth
o Has had serious thoughts about suicide
indicates they were manipulative or there was no intent.
o Has made a plan to commit suicide. If yes, describe
_______________________
o Has attempted to commit suicide. If yes, describe
______________________
 No suicide risks
5.
Current suicidal risks: (Check all that apply.)
 Feels life is not worth living—no hope for future
 Knows someone well who has committed suicide. If yes,
who and when _______________________
 Engages in self-mutilating behavior
o No current mental health problem
6.
Mental health problems currently interfere in working
o Mental health problem(s) do not interfere in work with youth
with the Youth:
o Mental health problem(s) interfere in work with youth
DOMAIN 10: Attitudes/Behaviors
o Uses self-control; usually thinks before acting
1. Impulsive; acts before thinking:
o Some self-control; sometimes thinks before acting
o Impulsive; often acts before thinking
o Highly Impulsive; usually acts before thinking
o Believes he or she can avoid/stop anti-social behavior
2. Belief in control over anti-social behavior:
o Somewhat believes anti-social behavior is controllable
o Believes his or her anti-social behavior is out of their
control
o Has empathy for victim(s)
3. Empathy, remorse, sympathy, or feelings for the
o Has some empathy for victim(s)
victim(s) of criminal behavior:
o Does not have empathy for victim(s)
o Respects most authority figures
4. Respect for authority figures:
o Does not respect, resents some authority figures
o Resents most authority figures
o Defies or is hostile toward most authority figures
o Abides by conventions/values
5. Attitude toward responsible law abiding behavior:
o Believes conventions/values sometimes apply to him or her
o Does not believe conventions/values apply to him or
her
o Resents or is hostile toward responsible behavior
o Accepts responsibility for anti-social behavior
6. Accepts responsibility for anti-social behavior:
o Minimizes, denies, justifies, excuses, or blames others
o Accepts anti-social behavior as okay
o Proud of anti-social behavior
DOMAIN 11: Aggression
o Primarily positive view of the actions and intentions of
1.
Hostile interpretation of the actions and intentions of
others in a common non-confrontational setting:
others
o Primarily negative view of the actions and intentions of
others
o Primarily hostile view of the actions and intentions of
others
o Believes physical aggression is never appropriate
2.
Belief in fighting and physical aggression to resolve a
o Believes physical aggression is rarely appropriate
disagreement or conflict:
o Believes physical aggression is sometimes appropriate
o Believes physical aggression is often appropriate
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