CJ-10A/5 Annual Summary on Inmates in Private and Multi-Jursdicti

OMB No. 1121-0094 Approval Expires ##/##/201#

DEATHS IN CUSTODY—2015
ANNUAL SUMMARY ON INMATES IN
PRIVATE AND MULTIJURISDICTIONAL JAILS

Form CJ-10A/5

U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT:
RTI INTERNATIONAL

FORM COMPLETED BY—
Name

Title

Official
Address

Telephone

City

FAX

State

Zip

Email

Instructions for completion and submission
FOR EACH ITEM—
 If the answer to a question is “none” or “zero,” write “0” in the space provided.
 When exact numeric answers are not available, provide estimates and mark ( X ) in the checkbox beside each number that is
estimated. For example 1,234 
Please submit your completed form(s) within 30 days of receipt. You may submit information in one of these ways:
ONLINE: Complete this form online at: https://bjsdcrp.rti.org
EMAIL: [email protected]
FAX (TOLL-FREE): 1-866-800-9179

MAIL: RTI International, Attn: Data Capture
Project Number: 0213149.001.200.207.400
5265 Capital Boulevard
Raleigh, NC 27690-1652

If you need assistance, contact Matt Bensen of RTI International toll-free at 1-800-344-1387 or [email protected].

What to include and exclude in this data collection
INCLUDE—
 Confinement facilities—including detention centers, jails, and other correctional facilities—intended for adults but sometimes holding
juveniles, that are either privately owned and operated or administered by two or more governments (or a board composed of
representatives from two or more governments).
 All jails and city/county correctional centers that hold inmates beyond arraignment. Report data on all inmates, including those held in
separate holding or lockup areas within your facilities.
 Special jail facilities (e.g., medical/treatment/release centers, halfway houses, and work farms).
 Temporary holding or lockup facilities if they are part of your combined function.
 Inmates held for other jurisdictions, including federal authorities, state prison authorities, and other local jail jurisdictions.
EXCLUDE—
X Facilities that are exclusively used as temporary holding or lockup facilities, where inmates are generally held for less than 72 hours
and not held beyond arraignment.

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 1 hour and 15 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.

«AGENCY ID»

Section I — INMATE DEATHS
1.

3.

Between January 1, 2015, and December 31, 2015, how
many persons died while under the supervision of this
facility?

On December 31, 2015, how many persons under the
supervision of your jail were—
a. CONFINED in this facility?
INCLUDE—
 Persons on transfer to treatment facilities but who
remain under your jurisdiction
 Persons held for other jurisdictions
 Persons in community-based programs (e.g., work
release, day release, or drug/alcohol treatment) who
return to jail at night
 Persons out to court while under your jurisdiction.

INCLUDE deaths of ALL persons—
 CONFINED in this facility
 UNDER THE SUPERVISION of this facility, but out to
court or in a special facility (e.g., hospital, hospice, or
nursing home; treatment facility; residential community
center; residential work release or house arrest
program; or release center)
 WHILE IN TRANSIT to or from this facility while under
your supervision.

EXCLUDE—
X Persons under your jurisdiction who are boarded
elsewhere
X Inmates who are AWOL, escaped, or on long-term
transfer to other jurisdictions
X Persons in community-based programs run by this
facility (e.g., electronic monitoring, house arrest,
community service, day reporting, or work
programs) who do NOT return to jail at night.

EXCLUDE—
X Deaths of persons in the process of arrest by your
agency if they have not yet been booked into this
facility. Arrest-related deaths should be reported using a
CJ-11A form.
Number of inmate deaths
a. Males ...............................................................
b.

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

INCLUDE—
 Persons in community-based programs run by this
facility (e.g., electronic monitoring, house arrest,
community service, day reporting, or work
programs) who do NOT return to jail at night.

REMINDER: IF THIS FACILITY HAD ONE OR MORE
DEATHS IN CALENDAR YEAR 2015, please ensure that
you have completed a 2015 CJ-9/CJ-10 (individual death
report) form for each death reported. If you need additional
CJ-9/CJ-10 forms, please go to the DCRP website
(https://bjsdcrp.rti.org), call 1-800-344-1387, or send an
email to [email protected].

EXCLUDE—
X Persons on pretrial release who are not in a
community-based program run by this facility
X Persons under the supervision of probation, parole,
or other agencies
X Inmates on weekend programs that allow offenders
to serve their sentences of confinement only on
weekends (e.g., Friday–Sunday)
X Inmates participating in community-based programs
(e.g., work release, day release, or drug/alcohol
treatment) who return to jail at night.

Section II — SUPERVISED POPULATION
2.

On June 30, 2015, how many persons under the
supervision of your jail were CONFINED in this facility?
INCLUDE—
 Persons on transfer to treatment facilities but who
remain under your jurisdiction
 Persons held for other jurisdictions
 Persons in community-based programs (e.g., work
release, day release, or drug/alcohol treatment) who
return to jail at night
 Persons out to court while under your jurisdiction.
EXCLUDE—
X Persons under your jurisdiction who are boarded
elsewhere
X Inmates who are AWOL, escaped, or on long-term
transfer to other jurisdictions
X Persons in community-based programs run by this
facility (e.g., electronic monitoring, house arrest,
community service, day reporting, or work
programs) who do NOT return to jail at night.

Under jail supervision, but NOT CONFINED?

c.
4.

TOTAL (Sum of items 3a and 3b) ..............

On the weekend prior to December 31, 2015, did this
facility have a weekend program?
Weekend programs allow offenders to serve their sentences
of confinement only on weekends (e.g., Friday–Sunday).

5.

1

Yes – How many inmates
participated? .........................

2

No

Of all the persons CONFINED in this facility on December
31, 2015 (as reported in item 3a), how many were not U.S.
citizens?
Non-U.S. citizens

When exact numeric answers are not available, provide
estimates and mark ( X ) in the checkbox beside each number
that is estimated. For example 1,234 
Page 2

Section III — INMATE COUNTS AND MOVEMENTS OF
THE CONFINED POPULATION
6.

10. On December 31, 2015, how many persons CONFINED in
this facility were—

On December 31, 2015, how many persons CONFINED in
this facility were—
11
a. Adult males (age 18 or older) .....................

a. White, not of Hispanic origin ........................
b. Black or African American,
not of Hispanic origin ....................................

b. Adult females (age 18 or older) ..................

c. Hispanic or Latino ......................................
d. American Indian or Alaska Native,
not of Hispanic origin ....................................

c. Males age 17 or younger ...........................
d. Females age 17 or younger.......................

e. Asian, not of Hispanic origin ........................
f. Native Hawaiian or other Pacific
Islander, not of Hispanic origin ...................

e. TOTAL (Sum of items 6a through
6d should equal item 3a) .............................
7.

g. Two or more races, not of Hispanic origin ..
h. Additional categories in your
information system – Specify

Of all the persons age 17 or younger CONFINED in this
facility on December 31, 2015 (sum of 6c and 6d), how
many were tried or awaiting trial in adult court?
Number of persons age 17
or younger held as adults ......................

8.

i. Not known ...................................................
j. TOTAL (Sum of items 10a to 10i
should equal item 3a) ..................................

Of all persons CONFINED in this facility on
December 31, 2015, how many were—



For persons with more than one status, report the status
associated with the most serious offense.
For convicted inmates, include probation and parole
violators with no new sentence.

11. On December 31, 2015, how many persons CONFINED in
this facility were held for—
Count persons with multiple holds only once with priority
being federal, state, tribal, and local.


INCLUDE contractual, temporary, courtesy, or ad hoc
holds for other agencies.
a. Federal authorities

a. Convicted ..................................................
b. Unconvicted ...............................................

1. U.S. Marshals Service ....................
c. TOTAL (Sum of items 8a and 8b
should equal item 3a) .................................
9.

2. Federal Bureau of Prisons ............
3. U.S. Immigration and Customs
Enforcement (ICE)..........................

On December 31, 2015, how many persons CONFINED in
this facility, regardless of conviction status, had an
offense type of—

4. Bureau of Indian Affairs (BIA) .......
X EXCLUDE inmates being housed for tribal
governments in item 11c below.
5. Other – Specify

For persons with more than one offense, report the most
serious type of offense.
a. Felony ........................................................

b. State prison authorities

b. Misdemeanor .............................................

1. For your state .................................
c. Other – Specify

2. For other states ..............................
c. American Indian or Alaska Native tribal governments
X EXCLUDE inmates being housed for the BIA in
item 11a4.

d. TOTAL (Sum of items 9a to 9c
should equal item 3a) .................................

d. Other local jail jurisdictions
X EXCLUDE inmates being housed for your own
jurisdiction (i.e., your own county/city inmates).
X EXCLUDE inmates being housed for tribal
governments in item 11c.
1. Within your state ............................

When exact numeric answers are not available, provide
estimates and mark ( X ) in the checkbox beside each number
that is estimated. For example 1,234 

2. Outside your state .........................
e. TOTAL (Sum of items 11a to 11d) ...............
Page 3

12. a. During the 31-day period from December 1 to
December 31, 2015, on what day did this facility hold
the greatest number of inmates?

15. How many persons under the supervision of your jail
were—
a. ADMITTED to this facility during 2015?

Peak population should be equal to or greater than the
confined inmate population reported in item 3a.
December

, 2015

b. How many persons were CONFINED on that day?
Number that day

EXCLUDE—
X Returns from escape, work release, medical
appointments/treatment facilities, furloughs,
bail/bond releases, and court appearances.

13. Between January 1, 2015, and December 31, 2015, what
was the average daily population of this facility?








INCLUDE—
 Persons officially booked into and housed in this
facility by formal legal document and by the authority
of the courts or some other official agency
 Repeat offenders booked on new charges
 Persons serving a weekend sentence coming into
the facility for the first time.

INCLUDE inmates who participated in weekend
programs that allow offenders to serve their sentences
of confinement only on weekends (e.g., Friday–Sunday).
To calculate the average daily population, add the
number of persons for each day during the period
January 1, 2015, through December 31, 2015, and
divide the result by 365.
If daily counts are not available, estimate the average
daily population by adding the number of persons held
on the same day of each month and divide the result by
12.
If average daily population cannot be calculated as
directed above, then estimate the typical number of
persons held in this facility each day.
Average daily population
a. Males....................................................

New admissions
1. Males ....................................................
2. Females ................................................
3. TOTAL (Sum of items 15a1 and 15a2)
b. DISCHARGED from this facility during 2015?
INCLUDE—
 Persons released after a period of confinement
(e.g., sentence completion, bail/bond releases, other
pretrial releases, transfers to other jurisdictions, or
deaths)
 Persons completing their weekend sentence leaving
the facility for the last time.
EXCLUDE—
X Temporary discharges (e.g., work releases, medical
appointments/treatment, out to courts, furloughs,
day reporters, or transfers to other facilities within
your jurisdiction).

b. Females ...............................................
c. TOTAL (Sum of items 13a and 13b) ....

Final discharges
14. On December 31, 2015, what was the total rated capacity
of this facility, excluding separate temporary holding
areas?



1. Males ....................................................
2. Females ................................................

Rated capacity is the maximum number of beds or
inmates assigned by a rating official to a facility.
If rated capacity is not available, estimate by using the
design capacity and mark the checkbox.

3. TOTAL (Sum of items 15b1 and 15b2)

Rated capacity

When exact numeric answers are not available, provide
estimates and mark ( X ) in the checkbox beside each number
that is estimated. For example 1,234 
Page 4

Section IV — POPULATION SUPERVISED IN THE
COMMUNITY
If item 3b equals 0 (zero), SKIP to item 17.
16. On December 31, 2015, how many persons under the
supervision of this facility who were NOT CONFINED
participated in—
X

EXCLUDE inmates on weekend programs.

a. Electronic monitoring ................................
b. Home detention without
electronic monitoring ................................

Section V —STAFFING
17. On December 31, 2015, how many staff employed in this
facility were—
Count each employee only once. Classify employees with
multiple functions by the function performed most frequently.
 INCLUDE payroll staff, nonpayroll staff on the payroll of
other government agencies (e.g., health department,
school district, or court), and unpaid interns.
X EXCLUDE staff paid through contractual agreements
and community volunteers.
a. Correctional officers
(Deputies, monitors, and other custody
staff who spend more than 50% of their
time with the incarcerated population.)

c. Community service ....................................
d. Day reporting .............................................

1. Males .................................................

e. Other pretrial supervision .........................

2. Females ..............................................

f. Other alternative work programs .............
X EXCLUDE inmates participating in
work release programs who return to
jail at night.

b. All other staff
(Administrators, clerical and maintenance
staff, educational staff, professional and
technical staff, and other staff – unspecified
who spend more than 50% of their time in
the facility.)

g. Alcohol/drug treatment programs ............
X EXCLUDE inmates participating in
alcohol/drug treatment programs
who are confined in jail.

1. Males ..................................................

h. Other programs outside of
jail facilities – Specify

2. Females ..............................................
i. TOTAL (Sum of items 16a to 16h
should equal item 3b) ..................................

c. TOTAL (Sum of items 17a and 17b) ............

When exact numeric answers are not available, provide
estimates and mark ( X ) in the checkbox beside each number
that is estimated. For example 1,234 
Page 5