Form TJJD-AID-005 "Internal Investigation Report Form" - Texas

What Is Form TJJD-AID-005?

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

Form Details:

  • Released on August 1, 2014;
  • The latest edition provided by the Texas Juvenile Justice Department;
  • 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 fillable version of Form TJJD-AID-005 by clicking the link below or browse more documents and templates provided by the Texas Juvenile Justice Department.

ADVERTISEMENT
ADVERTISEMENT

Download Form TJJD-AID-005 "Internal Investigation Report Form" - Texas

Download PDF

Fill PDF online

Rate (4.5 / 5) 26 votes
T
EXAS
Internal Investigation Report Form
J
UVENILE
J
USTICE
Administrative Investigations Division
D
EPARTMENT
In accordance with Texas Administrative Code Section 358.800, an Internal Investigation Report (IIR) shall be completed
at the conclusion of all internal investigations resulting from alleged abuse, neglect, exploitation or death of a juvenile.
GENERAL INFORMATION
TJJD Case Number:
County Case ID#:
County:
Department / Program / Facility:
Date of Alleged Incident:
Alleged Victim(s):
Alleged Perpetrator(s):
#1:
#2:
#3:
#4:
Alleged Perpetrator’s Current Mailing Address
First Person of Knowledge:
(including address, city, state and zip code):
Date Allegation Reported to First Person of Knowledge:
Perpetrator #1:
Perpetrator #2:
Perpetrator #3:
Date Allegation Reported to TJJD:
Perpetrator #4:
LAW ENFORCEMENT INFORMATION
Name of Law Enforcement Agency:
Date Reported to Law Enforcement:
Law Enforcement Report Number:
DEPARTMENT / PROGRAM / FACILITY EMPLOYMENT SEPARATION
In accordance with Texas Administrative Code Section 358.720, if during the internal investigation the
Subject of Investigation resigns or is terminated from employment, the TJJD shall be notified
no later than the second business day after the resignation or termination:
Type:
Date TJJD Notified:
Name of Individual Who Notified TJJD:
Date of Resignation /
Termination:
Perpetrator #1:
Resignation
Termination
Type:
Date of Resignation /
Date TJJD Notified:
Name of Individual Who Notified TJJD:
Termination:
Perpetrator #2:
Resignation
Termination
Type:
Date of Resignation /
Date TJJD Notified:
Name of Individual Who Notified TJJD:
Termination:
Perpetrator #3:
Resignation
Termination
Type:
Date of Resignation /
Date TJJD Notified:
Name of Individual Who Notified TJJD:
Termination:
Perpetrator #4:
Resignation
Termination
TJJD-AID-005 (8/14)
Page 1 of 3
T
EXAS
Internal Investigation Report Form
J
UVENILE
J
USTICE
Administrative Investigations Division
D
EPARTMENT
In accordance with Texas Administrative Code Section 358.800, an Internal Investigation Report (IIR) shall be completed
at the conclusion of all internal investigations resulting from alleged abuse, neglect, exploitation or death of a juvenile.
GENERAL INFORMATION
TJJD Case Number:
County Case ID#:
County:
Department / Program / Facility:
Date of Alleged Incident:
Alleged Victim(s):
Alleged Perpetrator(s):
#1:
#2:
#3:
#4:
Alleged Perpetrator’s Current Mailing Address
First Person of Knowledge:
(including address, city, state and zip code):
Date Allegation Reported to First Person of Knowledge:
Perpetrator #1:
Perpetrator #2:
Perpetrator #3:
Date Allegation Reported to TJJD:
Perpetrator #4:
LAW ENFORCEMENT INFORMATION
Name of Law Enforcement Agency:
Date Reported to Law Enforcement:
Law Enforcement Report Number:
DEPARTMENT / PROGRAM / FACILITY EMPLOYMENT SEPARATION
In accordance with Texas Administrative Code Section 358.720, if during the internal investigation the
Subject of Investigation resigns or is terminated from employment, the TJJD shall be notified
no later than the second business day after the resignation or termination:
Type:
Date TJJD Notified:
Name of Individual Who Notified TJJD:
Date of Resignation /
Termination:
Perpetrator #1:
Resignation
Termination
Type:
Date of Resignation /
Date TJJD Notified:
Name of Individual Who Notified TJJD:
Termination:
Perpetrator #2:
Resignation
Termination
Type:
Date of Resignation /
Date TJJD Notified:
Name of Individual Who Notified TJJD:
Termination:
Perpetrator #3:
Resignation
Termination
Type:
Date of Resignation /
Date TJJD Notified:
Name of Individual Who Notified TJJD:
Termination:
Perpetrator #4:
Resignation
Termination
TJJD-AID-005 (8/14)
Page 1 of 3
WITNESSES
In accordance with Texas Administrative Code Section 358.740, diligent efforts shall be made to obtain
written or electronically recorded oral statements from all persons with direct knowledge of the alleged incident.
If more space is needed for additional witnesses, please include in the "Additional Information" section on Page 2.
Please provide a list of all persons who provided a written and/or oral statement.
Name:
Title:
Type:
Oral
Written
Name:
Title:
Type:
Oral
Written
Name:
Title:
Type:
Oral
Written
Name:
Title:
Type:
Oral
Written
Name:
Title:
Type:
Oral
Written
Name:
Title:
Type:
Oral
Written
Name:
Title:
Type:
Oral
Written
Name:
Title:
Type:
Oral
Written
Name:
Title:
Type:
Oral
Written
Name:
Title:
Type:
Oral
Written
Name:
Title:
Type:
Oral
Written
INTERNAL INVESTIGATION REPORT
In accordance with Texas Administrative Code Section 358.820, the Internal Investigation Report (IIR) shall include the following.
Date Internal Investigation Initiated:
Date Internal Investigation Completed:
Date Alleged Victim’s Parent/Guardian was
Notified of Allegation:
Summary of Original Allegation:
Relevant Policy and Procedure Related to the Alleged Incident: (Please also note any changes to policies and procedures that occurred as a
result of this incident.)
Summary of Steps Taken During the Internal Investigation:
Written Summary of All Oral Interviews Conducted:
List of All Evidence Collected During the Internal Investigation (i.e. audio and/or video recordings, polygraph examinations, etc.):
Relevant Findings of the Investigation that Support the Disposition (i.e., an analysis of the evidence):
Additional Information:
Assigned Disposition:
Founded
Unfounded
Inconclusive
Perpetrator #1 Administrative Disciplinary Action / Corrective Measures Taken to Date:
Termination
Suspension
Retrained
Returned to Duty
None
Perpetrator #2 Administrative Disciplinary Action / Corrective Measures Taken to Date:
Termination
Suspension
Retrained
Returned to Duty
None
Perpetrator #3 Administrative Disciplinary Action / Corrective Measures Taken to Date:
Termination
Suspension
Retrained
Returned to Duty
None
Perpetrator #4 Administrative Disciplinary Action / Corrective Measures Taken to Date:
Termination
Suspension
Retrained
Returned to Duty
None
Names of All Persons Who Assisted in Conducting the Internal Investigation:
TJJD-AID-005 (8/14)
Page 2 of 3
PARENT / GUARDIAN INFORMATION
Name of Parent or Guardian:
Current Mailing Address (including address, city, state and zip code):
ADDITIONAL INFORMATION
Please include any additional information you think is pertinent to this investigation that has not already been detailed. This includes any
additional witnesses that you were unable to list on Page 1:
COMPLETED BY
Printed Name of Person Who Completed the
Date Completed:
Signature:
Internal Investigation Report:
In accordance with Texas Administrative Code Section 358.840, please submit the Internal Investigation Report and copies of the
following documents to the TJJD within five calendar days following its completion.
Written statements;
Relevant medical documentation, if the release is authorized by law;
Training records, if applicable; and
Any other documentation used to reach the disposition of the internal investigation
* Please note that although some of the contents of this form are required by administrative rule, the form has been provided for your convenience and its use
is not mandatory.
TJJD-AID-005 (8/14)
Page 3 of 3
Page of 3