Form CJ-17L Census of Juveniles on Probation

National Juvenile Probation Census Project

2009CJP_9-5-09

National Juvenile Probation Census Project

OMB: 1121-0291

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1121-0291 can be found here:

2012-11-05 - Reinstatement with change of a previously approved collection

Document [pdf]

Download: pdf | pdf

OFFICE OF JUVENILE JUSTICE AND DELINQUENCY PREVENTION

CENSUS OF JUVENILES ON PROBATION

GEORGE MASON UNIVERSITY
ACTING AS COLLECTING AGENT FOR
Office of Juvenile Justice and Delinquency Prevention

U.S. DEPARTMENT OF JUSTICE

This two-part form asks for population counts and individual-level information for all
young persons on juvenile probation on October 21, 2009.
Please complete the questionnaire before November 21, 2009. The following methods of reporting are available to
you:
• web entry via the online survey on the CJP web portal (requires registration)
• pre-formatted EXCEL document downloaded from the CJP web portal
• securely uploading CSV text, Excel or XML data file using formatting guide the CJP web portal
• mailing this completed questionnaire to George Mason University in the enclosed envelope
• faxing all pages to George Mason University at (703) 993-8316, Attention: CJP Census.
For details about any of these options as well as the census itself, please see page 2 of this questionnaire or visit
the CJP web portal at ojjdp.gmu.edu.
If you have questions about completing the form or need technical assistance, please call Kimberly MehlmanOrozco at (571) 230-9667 or email [email protected].

PERSON COMPLETING THIS FORM
BOX A

Name

Title

Mailing address

City

State

ZIP Code

E-mail address

Telephone number with area code

Extension

ORGANIZATION FOR WHICH YOU ARE REPORTING
BOX B

FORM

Organization

CJ-17L (Rev. 9-5-2009)

OMB No. 1121-0291: Approval Expires XX/XX/XXXX

REPORTING OPTIONS

1. Section I of this form collects total population counts. Section II collects individuallevel information. Both sections request this information for young persons on
probation supervision on October 21, 2009.
2. The following methods of reporting are available to you:
Method

Features

Online
web-based form

• Access at ojjdp.gmu.edu on or after October 21 (requires brief
one-time registration if not already registered)
• Easy-to-use interface
• Eliminates all manual coding for offenses, race or status
• Password-protected so only you can access your records
• Records entered into secure database—no need to save
• All records encrypted for maximum security
• Dropdown menus for quick and accurate entry
• Pop-up tooltips for entry guidance
• Complete survey in multiple sessions picking up where you left off
• Modify entries
• View, print and export your records to Excel

Excel
spreadsheet

• Download templates for Excel 2003 or 2007 from
ojjdp.gmu.edu. Upload completed spreadsheet securely via web
site (most secure) or email to [email protected]

Uploaded
data file

• Upload formatted CSV, Excel or XML file using fields and formatting instructions on the web site.
• Technical assistance available by phone & email

Paper
questionnaire

• Fill in this paper questionnaire by hand and mail or fax

3. If you choose to submit this paper questionnaire, please mail to:

Administration of Justice Department
George Mason University
10900 University Blvd., MS 4F4
Manassas, VA 20110
ATTN: CJP Census
or fax to (703) 993-8316, Attention: CJP Census

For further information on web and electronic submissions, call
Kimberly Mehlman-Orozco at (571) 230-9667 or email to [email protected].

4. Be sure to keep copies for your records of the data you submit.
5. Thank you. You will have access through the CJP portal web site at ojjdp.gmu.edu
to a number of resources, including a wide range of pre-configured charting options
to present the data you submit in applications of your choosing.

Page 2

FORM CJ-17L (Rev. 9-5-2009)

Section I — SUMMARY OF JUVENILE PROBATION COUNTS
IMPORTANT INSTRUCTIONS
Please complete this questionnaire for the juvenile probation organization
that you identified in Box B on the front page.
Note that definitions for all text in light blue are provided on page 18 of this form.
1a. Does this office provide OR oversee the provision of FORMAL court ordered juvenile
probation supervision?
❏ Yes
❏ No STOP HERE AND MAIL THIS FORM
1b. According to your records, on Wednesday, October 21, 2009, how many juveniles were
on FORMAL court ordered juvenile probation supervision through this office and any
probation office(s) that this office oversees? Please note instructions carefully.
DO NOT include in your count juveniles who were, on Wednesday, October 21, 2009:
• on PAROLE
• on INFORMAL non-court ordered probation
• in a RESIDENTIAL FACILITY even if those juveniles were on court ordered probation
(data are collected on this population in a separate census).
INCLUDE in your count juveniles who were, on
Wednesday, October 21, 2009, on AFTERCARE.
Total count of

juveniles on FORMAL court ordered probation

2a. Does this office provide OR oversee the provision of INFORMAL non-court ordered
juvenile probation supervision?
❏ Yes
❏ No — SKIP TO QUESTION 3
2b. On Wednesday, October 21, 2009, how many juveniles were on INFORMAL non-court
ordered probation supervision through this office?
Total count of

juveniles on INFORMAL probation

3. What best describes the geographic area served by this office and any offices that this
office oversees? Please mark (X) only ONE geographic area and provide the name(s) of the area
served.
Area type
Name(s) of area(s)

❏ An entire state
❏ Most of a state
❏ A single county
❏ Multiple counties
❏ A single municipality
❏ Multiple municipalities
❏ Other type of area

FORM CJ-17L (Rev. 9-5-2009)

(Name of state)
(Describe area)
(Name of county)
(Name of counties)
(Name of municipality)
(Name of municipalities)
(Name of area)

Page 3

NOTE: IF MORE THAN 120 PERSONS MEET THE REQUIREMENTS OF THIS SURVEY

Section II - PERSON LEVEL DATA
Please COMPLETE a LINE on the table below for EACH
person who on Wednesday, October 21, 2009, was on
FORMAL court ordered juvenile probation supervision
(including juveniles on aftercare).

What
is this
person’s
sex?
Enter the
code on the
line.

What is this
person’s
date of
birth?

Line Number

1.
Enter an identifying
number or first name and
last initial for all juveniles
meeting ALL requirements
above. Use an identifier
that will allow YOU to
reidentify each person
6 months from now, if a
callback is needed.

M – Male
F – Female

4.
What is this person’s race?
Enter the code on the line.
1 – White, not of Hispanic origin
2 – Black or African American, not of
Hispanic origin
3 – Hispanic or Latino (i.e., Mexican,
Puerto Rican, Cuban, Central or
South American, or other Spanish
culture or origin)
4 – American Indian or Alaska Native
5 – Asian, not of Hispanic origin
6 – Native Hawaiian or other Pacific
Islander, not of Hispanic origin
7 – Two or more races, not of Hispanic
origin — Specify

➧

5.
On Wednesday, October 21, 2009,
in which county and state did
this person reside? Please print the
full county name. State name may be
abbreviated.
If county and/or state are not known, enter
code 99 in the appropriate box(es) below.
If this person resides in an independent
city which is located outside of any
“county” area, list the independent city
name in the “County” box.

9 – Unknown

Code

Mo. Day Yr.

Code

Specify Other Only

County

State

Line Number

START HERE

Page 4

IF MORE PERSONS MEET THE REQUIREMENTS OF THIS SURVEY

FORM CJ-17L (Rev. 9-5-2009)

PHOTOCOPY PAGES 16 AND 17 TO MAKE MORE BLANK FORMS

Section II - PERSON LEVEL DATA
Do NOT include in your count juveniles who were:
A. On PAROLE,
B. On INFORMAL non-court ordered probation, or
C. In a RESIDENTIAL FACILITY even if those juveniles were on formal court ordered probation.

In which county and state did this person
commit the most serious offense he or she was
adjudicated for or charged with that resulted
in placement on formal court ordered juvenile
probation supervision? Please print the full county
name. State name may be abbreviated.

What is the most serious offense
this person was adjudicated for
or charged with that resulted in
placement on formal court ordered
juvenile probation supervision?
Enter the code for the most serious
offense resulting in court order to formal
juvenile probation supervision.

If county and/or state are not known, enter code 99 in
the appropriate box(es) below.

State

Code

Specify Other Only

Line Number

1 – Formal Probation Supervision
2 – Other Form of Probation Supervision
— Specify

See offense codes on pages 19
and 20.

If this offense was committed in an independent city
which is located outside of any “county” area, list the
independent city name in the “County” box.

County

8.
On Wednesday, October 21, 2009,
what was this person’s court ordered
probation status?

FORM CJ-17L (Rev. 9-5-2009)

CONTINUE ON NEXT PAGE

Page 5

3.
What is this
person’s
date of
birth?

M – Male
F – Female

9 – Unknown

Code

Mo. Day Yr.

Code

Specify Other Only

County

State

Line Number

2.
What
is this
person’s
sex?
Enter the
code on the
line.

Line Number

Page 6

FORM CJ-17L (Rev. 9-5-2009)

If county and/or state are not known, enter code 99 in
the appropriate box(es) below.

Line Number

If this offense was committed in an independent city
which is located outside of any “county” area, list the
independent city name in the “County” box.

County

State

8.
On Wednesday, October 21, 2009,
what was this person’s court ordered
probation status?
1 – Formal Probation Supervision
2 – Other Form of Probation Supervision
— Specify

See offense codes on pages 19
and 20.

Code

Specify Other Only

Line Number

6.
In which county and state did this person
commit the most serious offense he or she was
adjudicated for or charged with that resulted
in placement on formal court ordered juvenile
probation supervision? Please print the full county
name. State name may be abbreviated.

FORM CJ-17L (Rev. 9-5-2009)

Page 7

3.
What is this
person’s
date of
birth?

M – Male
F – Female

9 – Unknown

Code

Mo. Day Yr.

Code

Specify Other Only

County

State

Line Number

2.
What
is this
person’s
sex?
Enter the
code on the
line.

Line Number

Page 8

FORM CJ-17L (Rev. 9-5-2009)

If county and/or state are not known, enter code 99 in
the appropriate box(es) below.

Line Number

If this offense was committed in an independent city
which is located outside of any “county” area, list the
independent city name in the “County” box.

County

State

8.
On Wednesday, October 21, 2009,
what was this person’s court ordered
probation status?
1 – Formal Probation Supervision
2 – Other Form of Probation Supervision
— Specify

See offense codes on pages 19
and 20.

Code

Specify Other Only

Line Number

FORM CJ-17L (Rev. 9-5-2009)

Page 9

3.
What is this
person’s
date of
birth?

M – Male
F – Female

9 – Unknown

Code

Mo. Day Yr.

Code

Specify Other Only

County

State

Line Number

2.
What
is this
person’s
sex?
Enter the
code on the
line.

Line Number

Page 10

FORM CJ-17L (Rev. 9-5-2009)

If county and/or state are not known, enter code 99 in
the appropriate box(es) below.

Line Number

If this offense was committed in an independent city
which is located outside of any “county” area, list the
independent city name in the “County” box.

County

State

8.
On Wednesday, October 21, 2009,
what was this person’s court ordered
probation status?
1 – Formal Probation Supervision
2 – Other Form of Probation Supervision
— Specify

See offense codes on pages 19
and 20.

Code

Specify Other Only

Line Number

FORM CJ-17L (Rev. 9-5-2009)

Page 11

3.
What is this
person’s
date of
birth?

M – Male
F – Female

9 – Unknown

Code

Mo. Day Yr.

Code

Specify Other Only

County

State

Line Number

2.
What
is this
person’s
sex?
Enter the
code on the
line.

Line Number

Page 12

FORM CJ-17L (Rev. 9-5-2009)

If county and/or state are not known, enter code 99 in
the appropriate box(es) below.

Line Number

If this offense was committed in an independent city
which is located outside of any “county” area, list the
independent city name in the “County” box.

County

State

8.
On Wednesday, October 21, 2009,
what was this person’s court ordered
probation status?
1 – Formal Probation Supervision
2 – Other Form of Probation Supervision
— Specify

See offense codes on pages 19
and 20.

Code

Specify Other Only

Line Number

FORM CJ-17L (Rev. 9-5-2009)

Page 13

3.
What is this
person’s
date of
birth?

M – Male
F – Female

9 – Unknown

Code

Mo. Day Yr.

Code

Specify Other Only

County

State

Line Number

2.
What
is this
person’s
sex?
Enter the
code on the
line.

Line Number

100

101

102

Page 14

FORM CJ-17L (Rev. 9-5-2009)

If county and/or state are not known, enter code 99 in
the appropriate box(es) below.

Line Number

If this offense was committed in an independent city
which is located outside of any “county” area, list the
independent city name in the “County” box.

County

State

8.
On Wednesday, October 21, 2009,
what was this person’s court ordered
probation status?
1 – Formal Probation Supervision
2 – Other Form of Probation Supervision
— Specify

See offense codes on pages 19
and 20.

Code

Specify Other Only

Line Number

100

101

102

FORM CJ-17L (Rev. 9-5-2009)

Page 15

3.
What is this
person’s
date of
birth?

Page 16

M – Male
F – Female

9 – Unknown

Code

Mo. Day Yr.

Code

Specify Other Only

County

State

Line Number

2.
What
is this
person’s
sex?
Enter the
code on the
line.

Line Number

FORM CJ-17L (Rev. 9-5-2009)

If county and/or state are not known, enter code 99 in
the appropriate box(es) below.

Line Number

If this offense was committed in an independent city
which is located outside of any “county” area, list the
independent city name in the “County” box.

County

FORM CJ-17L (Rev. 9-5-2009)

State

8.
On Wednesday, October 21, 2009,
what was this person’s court ordered
probation status?
1 – Formal Probation Supervision
2 – Other Form of Probation Supervision
— Specify

See offense codes on pages 19
and 20.

Code

Specify Other Only

Line Number

Page 17

The Federal Government uses the following definitions for the various racial categories.
White – A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Black or African American – A person having origins in any of the black racial groups of Africa.
Hispanic or Latino – A person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin, regardless of race.
American Indian or Alaskan Native – A person having origins in any of the original peoples of North
America and South America (including Central America) and who maintains tribal affiliations or community
attachment.
Asian – A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian
subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
Native Hawaiian or other Pacific Islander – A person having origins in any of the original peoples of
Hawaii, Guam, Samoa or other Pacific Islands.
Two or more races, not of Hispanic origin – Refers to combinations of two or more of the following race
categories: White, Black or African American, American Indian/Alaska Native, Asian, Native Hawaiian or
other Pacific Islander. In cases or Hispanic origin, regardless of race(s), mark “Hispanic or Latino.”

DEFINITIONS OF TERMS
Formal – Formal court ordered probation supervision is the supervision of persons adjudicated for one or
more delinquent or status offenses.
Informal – Informal juvenile probation supervision is the supervision of persons who have reached an
agreement with this probation office and, usually, the juveniles’ parents or guardians. This non-court ordered
agreement stipulates the conditions of compliance.
Parole – Supervision of juveniles who are released following commitment to a state institution.
Residential Facility – A residential facility is any state, local, tribal, or privately-run facility that houses one
or more juveniles who are charged with or adjudicated for a delinquent or status offense. Examples of facilities include but are not limited to: detention centers, boot camps, residential treatment centers, and training
schools.
Aftercare – Aftercare is a continuation of formal court ordered probation supervision following release
from a local or privately-run facility. It may include treatment and/or reintegration plans. It excludes parole,
post-probation supervision, and other understandings of aftercare.

Thank you for completing this questionnaire. Please make copies for your own records of this completed
questionnaire, so that if we need to call you about an answer, you will be able to refer to your copies.
Please mail the completed form in the enclosed envelope to:

Administration of Justice Department
George Mason University
10900 University Blvd., MS 4F4
Manassas, VA 20110
ATTN: CJP Census
Page 18

FORM CJ-17L (Rev. 9-5-2009)

OFFENSE CODE CARD
Census of Juveniles on Probation
This card presents a list of offenses divided into two main categories: (1) offenses for both underage
persons and for adults, and (2) possible offenses for underage persons only. Information on this card
may make it easier for you to classify juveniles on formal court-ordered probation because of an offense.
In Section II, question 6, you are again referred to this card. There, you are asked to match each young
person’s offense to the category and type of offense on this card, note the two-digit code number, and
write that number in Section II, question 6, on the line for that person. Please record the most serious
offense for which this juvenile is on formal court-ordered probation as of October 21, 2009.
Attempted offenses should be coded as if they were actual offenses, except for attempted murder
which should be coded as 20 (assault, aggravated).
Definitions of the offenses are provided on the back of this card.

OFFENSES FOR BOTH UNDERAGE PERSONS AND ADULTS
OFFENSES AGAINST PROPERTY
10 Arson
11 Auto theft, unauthorized use of auto, joyriding
12 Burglary, breaking and entering, household larceny
13 Theft, non-household larceny
14 Property damage, vandalism
19 Other property offense
OFFENSES AGAINST PERSONS
20 Assault, aggravated
21 Assault, simple
22 Kidnapping
23 Murder, manslaughter, negligent homicide
24 Violent sexual assault including forcible rape
25 Robbery
29 Other person offense

DRUG-RELATED OFFENSES
30 Drugs or narcotics, trafficking
31 Drugs or narcotics, possession
39 Other drug-related offense
OFFENSES AGAINST THE PUBLIC ORDER
40 Alcohol or drugs, driving under influence of
41 Obstruction of justice
42 Non-violent sex offense, statutory rape
43 Weapons-related offenses
49 Other public order offense
PROBATION OR PAROLE VIOLATION
50 Probation or parole violation, violation of valid court
order

POSSIBLE OFFENSES FOR UNDERAGE PERSONS ONLY
The behaviors identified below are considered offenses in this census ONLY IF THEY ARE ILLEGAL in your
state for underage persons:
60 Curfew violation
61 Incorrigible, ungovernable
62 Running away

63 Truancy
64 Alcohol: underage use, possession or consumption
69 Other offense illegal for underage persons only

UNKNOWN OFFENSES
97
98
99
00

Unknown offense for both underage persons and adults
Unknown offense for underage persons only
Unknown offense
Other

FORM CJ-17L (Rev. 9-5-2009)

Page 19

DEFINITIONS OF OFFENSES
Alcohol or drugs, driving under influence of — Driving or operating a motor vehicle while under the influence of alcohol, a drug
or controlled substance. Code 40.
Alcohol: underage use, possession or consumption — Possession, use, or consumption of alcohol by a minor. Code 64.
Arson — Actual or attempted intentional damaging or destroying of property by fire or explosion, without the owner’s consent.
Code 10.
Assault, aggravated — An actual, attempted, or threatened
physical attack on a person that 1) involves the use of a weapon
or 2) causes serious physical harm. Include attempted murder.
Code 20. For assaults with less than serious harm and without use
of a weapon - See Assault, simple.
Assault, simple — An actual, attempted, or threatened physical
attack on a person that causes less than serious physical harm
and without a weapon. Include non-physical attacks causing the
fear of an attack. Code 21.
Auto theft, unauthorized use of auto, joyriding — Actual or
attempted unauthorized taking or use of a motor vehicle, intending to deprive the owner of it temporarily or permanently. Include
joyriding and grand theft auto. Code 11.
Burglary, breaking and entering, household larceny — Actual
or attempted unlawful entry of a building, structure, or vehicle with
intent to commit larceny or another crime. Code 12.
Curfew violation — Violation of an ordinance forbidding persons
below a certain age from being in public places during set hours.
Code 60.
Drugs or narcotics, possession — Actual or attempted purchase, possession or use of any illegal drug or substance, excluding alcohol. Code 31.
Drugs or narcotics, trafficking — Actual or attempted making,
selling, or distributing of a controlled or illegal drug or substance.
Code 30.
Incorrigible, ungovernable — Being beyond the control of parents, guardians, or custodians. Code only if this is considered an
offense in your state. Code 61.
Kidnapping — Actual or attempted unlawful transportation or
confinement of a person without his/her consent (or, if a minor,
consent of a guardian). Code 22.
Murder, manslaughter, negligent homicide — Causing the
death of a person without legal justification. Code 23. For attempted murder/manslaughter - See Assault, aggravated.
Non-violent sex offense, statutory rape — Actual or attempted
offenses with a sexual element, without violence. Include consensual sex with an underaged person, prostitution, solicitation,
indecent exposure, pornography, and obscenity. Code 42. For
sexual abuse by a minor against another minor - See Violent sexual
assault.
Obstruction of justice — Any act that intentionally impedes
the enforcement of a law or court order. Examples: Escape from
confinement, contempt of court, perjury, failing to report a crime,
nonviolently resisting arrest, and bribery. Code 41. See Probation/
parole violation.
Page 20

Other drug-related offense — Select this option if the drug offense is not specifically listed on the offense code card or definitions. Examples include: possession of drug paraphernalia, visiting
a place where drugs are found, etc. Code 39.
Other offense that is illegal for underage persons only —
Select this option if the offense is not illegal for adults and is not
specifically listed on the offense code card or definitions. Examples
include: underage smoking, unruliness in school, etc. Code 69.
Other person offense — Select this option if the person offense is
not specifically listed in the definitions. Examples include: harassment, coercion, reckless endangerment, etc. Code 29.
Other property offense — Select this option if the property offense is not specifically listed in the definitions. Examples include:
trespassing, selling stolen property, possession of burglar’s tools,
fraud, etc. Code 19.
Other public order offense — Select this option if the public
order offense is not specifically listed in the definitions. Examples
include: cruelty to animals, disorderly conduct, traffic offenses, etc.
Code 49.
Probation or parole violation, violation of valid court order
— Acts that disobey or go against the conditions of probation
or parole. Examples: failure to participate in a specific program,
failure to appear for drug tests or meetings, and failure to pay
restitution. Code 50.
Property damage, vandalism — Actual or attempted damaging
or destroying of property of a person or public property. Code 14.
For destroying or damaging by fire or explosion - See Arson.
Robbery — Actual or attempted unlawful taking of property in the
direct possession of a person by force or threat of force. Include
purse snatching with force and carjacking. Code 25. For purse
snatching without force - See Theft/non-household larceny.
Running away — Leaving the custody and home of parents or
guardians without permission and failing to return within a reasonable length of time. Select only if this is considered an offense in
the state in which it occurred. Code 62. For running away from a
facility - See Obstruction of justice.
Theft, non-household larceny — Actual or attempted taking of
property (other than an auto) from a person without force or deceit. Include shoplifting, pickpocketing, and purse snatching without force. Code 13. For purse snatching with force, see Robbery.
For theft using deceit, see Other property offense. For household
larceny, see Burglary, breaking and entering, household larceny.
Truancy — Violation of a compulsory school attendance law. Select only if this is considered an offense in your state. Code 63.
Violent sexual assault including forcible rape — Actual or
attempted sexual intercourse or sexual assaults against a person
against her/his will by force or threat of force. Includes incest, sodomy, and sexual abuse by a minor against another minor. Code 24.
See also Non-violent sex offense, statutory rape.
Weapons-related offenses — Actual or attempted illegal sale,
distribution, manufacture, alteration, transportation, possession,
or use of a deadly or dangerous weapon or accessory. Code 43.

FORM CJ-17L (Rev. 9-5-2009)

File Type	application/pdf
File Title	2009 CJP Questionnaire
Subject	Hard copy to be sent to respondents
Author	Jack Chirieleison
File Modified	2009-09-28
File Created	2009-09-04