SSV-5 SSV State Juvenile Systems Summary Form

OMB No. 1121-0292: Approval Expires 02/28/2011
U.S. DEPARTMENT OF JUSTICE

SSV-5

FORM
(4-8-2010)

BUREAU OF JUSTICE STATISTICS

SURVEY OF SEXUAL VIOLENCE, 2009
— State Juvenile Systems
Summary Form

AND ACTING AS COLLECTION AGENT

U.S. DEPT. OF COMMERCE
Economics and Statistics Administration

U.S. CENSUS BUREAU

DATA SUPPLIED BY

TELEPHONE
E-MAIL
ADDRESS

City

Number and street or P.O. Box/Route Number
Area code

Number

FAX
NUMBER

State

▼

OFFICIAL
ADDRESS

Title

▼▼▼

Name

Area Code

ZIP Code
Number

(Please correct any error in name, mailing address, and ZIP Code)

What facilities are included in this data collection?
All State-operated juvenile residential placement facilities
used to house juveniles and youthful offenders, regardless of
age or reason for placement.
• INCLUDE State-operated juvenile residential facilities
such as: detention centers, training schools, long-term
secure facilities; reception or diagnostic centers; group
homes or halfway houses; boot camps; ranches; forestry
camps, wilderness or marine programs, or farms;
runaway or homeless shelters; and residential treatment
centers for juveniles.
• EXCLUDE privately operated facilities and
facilities operated or administered by local
governments. (These facilities will be
contacted directly for data on sexual
violence.)
What persons and incidents are included in this
data collection?
Juveniles and youthful offenders, regardless of age or reason
for placement, under your custody between January 1, 2009,
and December 31, 2009.
• INCLUDE incidents involving juveniles or youthful
offenders under the authority, custody, or care of your
confinement or community-based facilities or staff.
• EXCLUDE incidents involving juveniles or
youthful offenders not held in facilities
operated by your State juvenile system.

Reporting instructions:
•
•
•
•
•

Please complete the entire SSV-5 Form.
If the answer to a question is "not available" or "unknown,"
write "DK" (do not know) in the space provided.
If the answer to a question is "not applicable," write "NA"
in the space provided.
If the answer to a question is "none" or "zero," mark the
box ( X ) provided.
When exact numeric answers are not available, provide
estimates and mark ( X ) the box beside each figure.

Substantiated incidents of sexual violence:
• Please complete an Incident Form (Juvenile, SSV-IJ)
for each substantiated incident of sexual violence.
Returning forms:
• If you need assistance, please call Greta Clark at the
U.S. Census Bureau toll-free at 1–800–253–2078 or
email [email protected]
• Please return your completed questionnaire
and substantiated incident forms by
October 1, 2010.
• If you prefer, you may also return these forms
by mail or fax.
• MAIL TO: U.S. Census Bureau, P.O. Box 5000,
Jeffersonville, IN 47199-5000
• FAX (TOLL FREE): 1–888–891–2099

Burden Statement
Under the Paperwork Reduction Act, we cannot ask you to respond to a collection of information unless it displays a currently valid OMB
control number. The burden of this collection is estimated to average 60 minutes per response, including reviewing instructions, searching
existing data sources, gathering necessary data, and completing and reviewing this form. Send comments regarding this burden estimate or
any aspect of this survey, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street,
NW, Washington, DC 20531. Do not send your completed form to this address.

2. On December 31, 2009, how many persons
held in the facilities reported in Item 1 were —

DEFINITIONS
JUVENILES and YOUTHFUL OFFENDERS:
• Any person under the jurisdiction of your State’s juvenile
system or youthful offender authority, regardless of age
or reason for placement.

a. Males . . . . . . . . . . . . . . . . . .

FACILITIES:

b. Females . . . . . . . . . . . . . . . .

INCLUDE all State-operated facilities used to house juveniles
or youthful offenders charged with or court-adjudicated for:
c. TOTAL (Sum of Items 2a to 2b) .

• Any offense that is illegal for both adults and juveniles;

• Count persons held in the facilities reported in Item 1
regardless of age or reason for placement. Include
persons who were temporarily away but had assigned
beds on December 31, 2009.

OR
• An offense that is ILLEGAL in your State for juveniles,
but not for adults (running away, truancy, incorrigibility,
curfew violations, and liquor violations).

3. On December 31, 2009, how many persons
held in the facilities reported in Item 1 were —

EXCLUDE State-operated facilities used ONLY to house
juveniles for:
• Non-criminal purposes (neglect, abuse, abandonment, or
dependency);

a. Age 17 or younger . . . . . . . .

OR
b. Age 18 to 20

• Being Persons in Need of Services (PINS) or Children in
Need of Services (CHINS) who have assigned beds for
reasons other than offenses.

............

c. Age 21 or older

d. TOTAL (Sum of Items 3a to 3c
should equal Item 2c) . . . . . . . .

Section I – GENERAL INFORMATION

• Count all persons held in the facilities reported in Item 1
regardless of age or reason for placement. Include
persons who were temporarily away but had assigned
beds on December 31, 2009.

1. On December 31, 2009, how many facilities
operated by your State held juveniles or
youthful offenders CHARGED WITH or
COURT-ADJUDICATED FOR AN OFFENSE?

Number of facilities

..........

4. Between January 1, 2009, and December 31, 2009,
how many persons were admitted to or discharged
from the facilities reported in Item 1?

• Count all juvenile residential facilities where young
persons who have committed offenses may be
housed overnight.

a. TOTAL number admitted . . .

• Count each facility with a separate physical location
only once. Do not count separate living/sleeping units,
wings, floors, dorms, barracks, or cottages within a
single facility.

b. TOTAL number discharged .
• Include all persons admitted into your State-operated
juvenile residential facilities by a formal legal document,
by the authority of the courts, or by some other official
agency.
• Include all persons discharged from your
State-operated juvenile residential facilities after a
period of confinement including sentence completion,
pretrial releases, transfers to adult jurisdictions or to
other States, and deaths.
• Exclude admissions and discharges resulting from
returns from escape, administrative transfers to other
juvenile facilities operated by your State, or temporary
release including work/school release, medical
appointments, other treatment facilities, or court
appearances.

FORM SSV-5 (4-8-2010)

Page 2

Section II – YOUTH–ON–YOUTH SEXUAL VIOLENCE
DEFINITIONS OF SEXUAL VIOLENCE

5. Does your State juvenile system record
allegations of youth-on-youth NONCONSENSUAL
SEXUAL ACTS?
01

The definition of "rape" as required under the Prison Rape
Elimination Act of 2003 will be operationalized by
disaggregating sexual assault into two categories of
youth-on-youth SEXUAL VIOLENCE. These categories
reflect uniform definitions formulated by the National Center
for Injury Prevention and Control, in "Sexual Violence
Surveillance: Uniform Definitions and Recommended Data
Elements," Centers for Disease Control and Prevention. The
categories of youth-on-youth SEXUAL VIOLENCE are:

Yes ➔ a. Do you record all reported
occurrences, or only
substantiated ones?
01
02

All
Substantiated only

b. Do you record attempted
nonconsensual sexual acts or
only completed ones?

NONCONSENSUAL SEXUAL ACTS:
01

Contact of any person without his or her consent, or of a
person who is unable to consent or refuse;

02

AND
• Contact between the penis and the vagina or the penis
and the anus including penetration, however slight;
OR

02

No

Both attempted and completed
Completed only

➔ Please provide the definition used by your
State juvenile system for youth-on-youth
NONCONSENSUAL SEXUAL ACTS in the
space below. Use that definition to complete
Items 6 and 7.

• Contact between the mouth and the penis, vagina, or
anus;
OR
• Penetration of the anal or genital opening of another
person by a hand, finger, or other object.
ABUSIVE SEXUAL CONTACTS:
6. Between January 1, 2009, and December 31, 2009,
how many allegations of youth-on-youth
NONCONSENSUAL SEXUAL ACTS were reported?

Contact of any person without his or her consent, or of a
person who is unable to consent or refuse;
AND
• Intentional touching, either directly or through the
clothing, of the genitalia, anus, groin, breast, inner thigh,
or buttocks of any person.

Number reported

None

• If an allegation involved multiple victimizations, count
only once.

• Exclude incidents in which the intent of the sexual
contact is to harm or debilitate rather than sexually
exploit.

7. Of the allegations reported in Item 6, how
many were — (Please contact the agency or office
responsible for investigating allegations of sexual
violence in order to fully complete this form.)

None

a. Substantiated . . . . . . .

• The event was investigated and determined to have
occurred.
b. Unsubstantiated

None

....

• Evidence was insufficient to make a final determination
that the event occurred.
None

c. Unfounded . . . . . . . . .

• The event was determined NOT to have occurred.
d. Investigation ongoing

.

None

• A final determination has not yet been made as to
whether the event occurred.
e. TOTAL (Sum of Items
7a through 7d) . . . . . . . . .

FORM SSV-5 (4-8-2010)

Page 3

None

Section III – STAFF SEXUAL MISCONDUCT
AND HARASSMENT

8. Does your State juvenile system record
allegations of youth-on-youth ABUSIVE SEXUAL
CONTACTS? (See definitions on page 3.)

DEFINITION OF STAFF SEXUAL MISCONDUCT
01

02

Yes

No

➔ Can these be counted separately

The definition of STAFF SEXUAL MISCONDUCT is based on
"Training for Investigators of Staff Sexual Misconduct,"
prepared by the National Institute of Corrections. STAFF
SEXUAL MISCONDUCT includes any behavior or act of a
sexual nature directed toward a juvenile or youthful offender
by an employee, volunteer, contractor, official visitor, or other
agency representative (exclude youth family, friends, or other
visitors). Sexual relationships of a romantic nature between
staff and youth are included in this definition.

from allegations of
NONCONSENSUAL SEXUAL ACTS?
01

Yes

02

No

➔ Skip to Item 11.

➔ Please provide an explanation in the space
below and then skip to Item 11.

Consensual or nonconsensual sexual acts including:
• Intentional touching of the genitalia, anus, groin, breast,
inner thigh, or buttocks with the intent to abuse, arouse,
or gratify sexual desire;
OR
• Completed, attempted, threatened, or requested sexual
acts;
OR
• Occurrences of indecent exposure, invasion of privacy,
or staff voyeurism for sexual gratification.
DEFINITION OF STAFF SEXUAL HARASSMENT
9. Between January 1, 2009, and
December 31, 2009, how many allegations
of youth-on-youth ABUSIVE SEXUAL
CONTACTS were reported?

The definition of STAFF SEXUAL HARASSMENT was also
developed by the National Institute of Corrections. STAFF
SEXUAL HARASSMENT includes repeated verbal statements
or comments of a sexual nature to a juvenile or youthful
offender by an employee, volunteer, contractor, official visitor,
or other agency representative (exclude youth family, friends,
or other visitors).

Number reported
None
• If an allegation involved multiple victims, count only
once.

• Demeaning references to gender or derogatory
comments about body or clothing;
OR

10. Of the allegations reported in Item 9, how
many were — (Please contact the agency or
office responsible for investigating allegations of
sexual violence in order to fully complete this form.)

a. Substantiated

c. Unfounded

FORM SSV-5 (4-8-2010)

02

None

.........

e. TOTAL (Sum of Items
10a through 10d) . . . . . . .

01

Yes

None

....

d. Investigation ongoing

11. Does your State juvenile system record
allegations of STAFF SEXUAL MISCONDUCT?

None

......

b. Unsubstantiated

• Repeated profane or obscene language or gestures.

.

No

➔ Do you record all reported

occurrences, or only substantiated
ones?
01

All

02

Substantiated only

➔ Please provide an explanation in the space
below and then skip to Item 14.

None

None

Page 4

12. Between January 1, 2009, and
December 31, 2009, how many allegations
of STAFF SEXUAL MISCONDUCT were
reported?
Number reported

16. Of the allegations reported in Item 15, how
many were — (Please contact the agency or
office responsible for investigating allegations of
sexual violence in order to fully complete this form.)

None

• If an allegation involved multiple victims, count only
once.
13. Of the allegations reported in Item 12, how
many were — (Please contact the agency or
office responsible for investigating allegations of
sexual violence in order to fully complete this form.)

a. Substantiated . . . . . . .

b. Unsubstantiated . . . . .

None

None

d. Investigation ongoing .

None

02

Yes

No

02

No

c. Unfounded . . . . . . . . . .

None

d. Investigation ongoing .

None

e. TOTAL (Sum of Items 16a
through 16d) . . . . . . . . . .

None

01

Yes

02

No

18. Did any of the allegations reported in items 6,9,
12, or 15 occur in a facility operated or
administered by local governments?

separately from allegations of
STAFF SEXUAL MISCONDUCT?
Yes

None

17. Did any of the allegations reported in items 6, 9,
12, or 15 occur in a privately operated facility?

➔ Can these allegations be counted
01

b. Unsubstantiated . . . . .

Section IV – PRIVATE AND LOCAL ALLEGATIONS

None

14. Does your State juvenile system record
allegations of STAFF SEXUAL HARASSMENT ?
(See definitions on page 4.)
01

None

None

c. Unfounded . . . . . . . . . .

e. TOTAL (Sum of Items
13a through 13d) . . . . . . .

a. Substantiated . . . . . . .

01

Yes

02

No
Section V – TOTAL OF SUBSTANTIATED
INCIDENTS OF SEXUAL VIOLENCE

➔ Skip to Item 17.

➔ Please provide an explanation in the space
below and then skip to Item 17.

19. What is the total number of substantiated
incidents reported in Items 7a, 10a, 13a,
and 16a?
Total substantiated
incidents . . . . . . . . . . . . .

None

➔ Please complete an Incident Form (Juvenile,
SSV-IJ) for each substantiated incident of
sexual violence.

15. Between January 1, 2009, and
December 31, 2009, how many allegations of
STAFF SEXUAL HARASSMENT were reported?

Number reported

NOTES

None

• If an allegation involved multiple victims, or staff count
only once.
FORM SSV-5 (4-8-2010)

Page 5