"Prea Sexual Abuse Incident Review Form (115.386)" - Florida

Prea Sexual Abuse Incident Review Form (115.386) is a legal document that was released by the Florida Department of Juvenile Justice - a government authority operating within Florida.

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FLORIDA DEPARTMENT OF JUVENILE JUSTICE
Rick Scott, Governor
Christina K. Daly, Secretary
PREA Sexual Abuse Incident Review (115.386)
Date:
CCC Incident Number:
Program Name:
Date incident reported: ______________
Date investigation concluded: _________
 Substantiated
 Unsubstantiated
Finding(s):
 Founded
 Information Only
(Check One Above)
Review Team Members:
Name
Title
Program Administrator
PREA Facility Compliance
Manager
Facility Mental Health
representative
Line Supervisor
Statewide PREA
Coordinator
DJJ Regional
Representative
Other
Other
Review of Incident Summary: See attached
2737 Centerview Drive
Tallahassee, Florida 32399-3100
(850) 488-1850
http://www.djj.state.fl.us
The mission of the Department of Juvenile Justice is to increase public safety by reducing juvenile delinquency through effective
prevention, intervention, and treatment services that strengthen families and turn around the lives of troubled youth.
FLORIDA DEPARTMENT OF JUVENILE JUSTICE
Rick Scott, Governor
Christina K. Daly, Secretary
PREA Sexual Abuse Incident Review (115.386)
Date:
CCC Incident Number:
Program Name:
Date incident reported: ______________
Date investigation concluded: _________
 Substantiated
 Unsubstantiated
Finding(s):
 Founded
 Information Only
(Check One Above)
Review Team Members:
Name
Title
Program Administrator
PREA Facility Compliance
Manager
Facility Mental Health
representative
Line Supervisor
Statewide PREA
Coordinator
DJJ Regional
Representative
Other
Other
Review of Incident Summary: See attached
2737 Centerview Drive
Tallahassee, Florida 32399-3100
(850) 488-1850
http://www.djj.state.fl.us
The mission of the Department of Juvenile Justice is to increase public safety by reducing juvenile delinquency through effective
prevention, intervention, and treatment services that strengthen families and turn around the lives of troubled youth.
PREA Sexual Abuse Incident Review (115.386)
Date:
Consideration of the following information:
1. Does allegation indicate a need to change policy or practice to better detect or
Yes  No 
respond to sexual abuse?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
2. Was incident motivated by race, ethnicity, gender identity (lesbian, gay,
bisexual) or perceived gender identity, gang affiliation, or was motivated by
Yes  No 
other group dynamics at the facility?
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
3. Examination of area where incident occurred:
a. Physical barriers observed?
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
Yes  No 
b. Video monitoring of area available?
4. Adequacy of staffing levels in that area:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
5. Assessment of monitoring technology to be deployed or augmented to
supplement supervision by staff:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Yes  No 
6. Has victim been notified of investigation outcome:
Action taken by facility after this incident:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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