NSYC-3 Facility Survey

NSYC-3 Facility Survey

FORM APPROVED
OMB No.: XX
EXPIRATION DATE: XX

National Survey of Youth in Custody
Facility Questionnaire

Facility name:

[Name of Facility]

NSYC researchers are scheduled to visit your facility on .
This questionnaire asks about staffing and youth in this facility as of
, the Wednesday before the NSYC visit.

Person Completing this Questionnaire
Name

Email Address

Title
Facility Name

Telephone
Area code

Number

Area code

Number

Facility Address – Number/street/PO Box number

Fax Number
City

State

ZIP Code

2

Extension

FACILITY STATISTICS
1.

Please use your most recent payroll records to provide the number and gender of staff members working
at this facility as of Wednesday, . Include full and part-time payroll and non-payroll staff.
Examples of non-payroll staff: staff provided by outside agencies such as teachers provided by schools,
social workers provided by health and human services agencies, and staff paid under contractual
agreements/grants. (NSYC-2, modified)
For each category, please provide the number of staff members working at this facility as of Wednesday,
.
Include each staff person in only one category. If a staff member serves in more than one capacity,
categorize the person based on his or her primary role.
[Programming Note: Respondent fills in Total column, then system performs an edit check. Prompt
respondent if Male+Female don't match total.]
SEX
TOTAL
Male
Female
a. Frontline supervision staff, direct care staff, and
correctional officers

______

______

______

b. Program staff (e.g., instructors, teachers, librarians,
education assistants and other program staff)

______

______

______

c. Medical or health care staff (e.g., certified
counselors, doctors, dentists, psychologists,
psychiatrists, social workers, nurses, and medical
assistants)

______

______

______

d. Administrative staff (e.g., wardens, superintendents,
assistants, office clerical, and others in
administrative positions)

______

______

______

e. Support staff (e.g., cafeteria workers, maintenance,
ground crew, drivers, religious staff)

______

______

______

f. Volunteers

______

______

______

[TOTALS TO BE GENERATED
AUTOMATICALLY]
TOTAL STAFF
2.

______

______

Excluding volunteers, how many paid staff have been hired or have left this facility in the past 12
months? Include ONLY full and part-time payroll staff. (NEW)
a. Paid staff who have been hired ______
b. Paid staff who have left ______

3.

______

Compared to 12 months ago, has the current number of paid staff at this facility… (NEW)
increased
decreased
stayed the same
3

4.

As of Wednesday, , how many vacant or unfilled positions existed within this facility? (NEW)
_____________
Vacant positions (include partial FTEs)
[Programming note: Use a single decimal so that it’s possible to enter a number less than zero (#.#).]

4a.

Indicate how many vacant or unfilled positions exist currently for each category. Include full and parttime payroll and non-payroll staff. (Include partial FTEs.) (NEW)
[Programming note: check that the total from a-g below matches the total entered for #4 and use a single
decimal so that it’s possible to enter a number less than zero (#.#).]
a. Frontline supervision staff, direct care staff, and correctional officers ______
b. Program staff (e.g., instructors, teachers, librarians, education assistants and other program staff)
______
c. Medical or health care staff (e.g., certified counselors, doctors, dentists, psychologists, psychiatrists,
social workers, nurses, and medical assistants) ______
d. Administrative staff (e.g., wardens, superintendents, assistants, office clerical, and others in
administrative positions) ______
e. Support staff (e.g., cafeteria workers, maintenance, ground crew, drivers, religious, etc.) ______
f.

Volunteers ______

g. Unknown ______
5.

Please use your most recent payroll records to provide counts of frontline supervision staff, direct care
staff, and correctional officers at this facility as of Wednesday, . If exact counts are not available,
please provide estimates and check this box . (NEW)
a. White, not of Hispanic origin ______
b. Black or African American, not of Hispanic origin ______
c. Hispanic or Latino ______
d. American Indian or Alaska Native, not of Hispanic origin ______
e. Asian, not of Hispanic origin ______
f.

Native Hawaiian or Other Pacific Islander, not of Hispanic origin ______

g. Two or more races, not of Hispanic origin ______
h. Additional categories in your information system
Other (Please specify): _________________________________ ______

6.

i.

Not known ______

j.

TOTAL ______ (Sum of items 5a to 5j)

Please use your most recent payroll records to provide counts of frontline supervision staff, direct care
staff, and correctional officers by age working at this facility as of Wednesday, . If exact counts
are not available, please provide estimates and check this box . (NEW)
a. 29 or younger ______
b. 30-39 ______
c. 40-49 ______
d. 50 or older ______

4

7.

Please use your most recent payroll records to provide counts of frontline supervision staff, direct care
staff, and correctional officers by length of service working at this facility as of Wednesday, . If
exact counts are not available, please provide estimates and check this box . (NSYC-2, modified)
a. Less than 1 year ______
b. 1-2 years ______
c. 3-4 years ______
d. 5-9 years ______
e. 10 or more years ______

PERSONNEL SCREENING
Personnel screening involves procedures that go beyond asking someone to self-disclose information.
Examples of screening include checking police records and records of other public agencies.
Please consider only frontline supervision staff, direct care staff, and correctional officers when
answering the following questions:
8.

When screening potential new hires for frontline supervision staff, direct care staff, and correctional
officers positions, does this facility utilize the following sources? (NSYC-2, modified)
Yes

No

a. Criminal record/history check
b. Test for current drug use
c. Child abuse/sex offender registry check
d. Domestic violence/civil protective order check
9.

How often are periodic checks conducted for frontline supervision staff, direct care staff, correctional
officer staff positions? Mark one for each row. (NEW)

Once a
year or
more
a. Criminal record/history check
b. Test for current drug use
c. Child abuse/sex offender registry check
d. Domestic violence/civil protective order check

5

Less than
once a
year

Only in
response
to an
incident

Never

STAFF TRAINING
The next questions ask about staff training programs.
Examples of training programs include supervised on-the-job instruction, classroom training, distance learning,
self-directed learning, workshops, lectures, group discussions, demonstrations, role play, and other methods
of group and individual interaction.
Please consider only frontline supervision staff, direct care staff, and correctional officers when answering the
following questions:
10.

What topics are covered during required training programs for new hires and refresher training for
current frontline supervision staff, direct care staff, and correctional officers? (NEW)
Mark all that apply. Please consider training for new hires and current employees separately.
Refresher
training for
Not
current
currently
Employee Training Topics
New hires
employees
offered
a. Cross-gender supervision
b. LGBT responsiveness
c. Managing mentally disordered youth
d. Staff boundaries
e. Conflict de-escalation training and communication
with youth
f. Gang management, identification, and prevention

11.

What is the required number of training hours on PREA-related topics that new frontline supervision
staff, direct care staff, and correctional officers must complete either pre-service and/or during their first
year of employment? (NEW)
______________
None
Hours

12.

What is the required timeframe for new frontline supervision staff, direct care staff, and correctional
officers to complete all PREA-related trainings? (NEW)
Pre-service (prior to starting position)
Within first 24 hours of starting position
After first 24 hours but within first week (7 days) of starting position
After first week but within first month (30 days) of starting position
After first month but within first six months (180 days) of starting position
After first six months but within first year (365 days) of starting position
Other (Please specify):
_______________________________________________________________________
__
_______________________________________________________________________
__

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FACILITY CHARACTERISTICS
13.

Does this facility have any of the following features intended to confine youth within specific areas?
(NEW)
Yes
No
a. Doors for secure day rooms that are locked by staff to confine youth
within specific areas
b. Wing, floor, corridor, or other internal security doors that are locked
by staff to confine youth within specific areas
c. Outside doors that are locked by staff to confine youth within specific
buildings
d. External gates in fences or walls WITHOUT razor wire that are
locked by staff to confine youth
e. External gates in fences or walls WITH razor wire that are locked to
confine youth
f. Other (Please specify): ____________________________________
_______________________________________________________

14.

Are outside doors to any buildings with living/sleeping units in this facility ever locked? (NEW)
Yes
No (go to 16)

15.

Why are outside doors to buildings with living/sleeping units in this facility locked? (NEW)
Yes
a.

To keep intruders out

b.

To keep youth inside this facility

No

16.

As of Wednesday, , how many youth were assigned beds in this facility? Include standard and
makeshift beds. Makeshift beds are roll-out mats, fold-out cots, roll-away beds, pull-out mattresses,
sofas, or any other beds that are put away or moved during non-sleeping hours. (NSYC-2, modified)
______________
Youth

17.

On Wednesday, , how many of each type of bed were assigned and how many were not
assigned? (NSYC-2)
Assigned
Not assigned
a.

Standard beds

______

______

b.

Makeshift beds

______

______

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18.

How many adjudicated youth were held in this facility on Wednesday, ? Adjudication is the court
process that determines if the juvenile committed the act for which he or she is charged. The term
"adjudicated" is analogous to "convicted" and indicates that the court concluded the juvenile committed
the act. (NSYC-2)
______________
Adjudicated youth

19.

During the past 12 months, how many adjudicated youth were admitted to this facility? (NEW)
______________
Admitted youth

20.

During the past 12 months, how many adjudicated youth were released from this facility? (NSYC-2,
modified)
______________
Released youth

YOUTH ASSESSMENT AND SCREENING
21.

Does your facility conduct or receive results of youth assessments or screening for the following types
of issues? (NEW)
Yes
a. Risk for suicide
b. Substance abuse
c. Mental health issues
d. Physical disabilities
e. Level of emotional and cognitive development
f.

Prior sexual victimization

g. Prior sexual exploitation/trafficking
h. History of trauma (e.g., victimization, abuse by parents,
witnessing violence)
i.

Prior predatory sexual behavior

j.

Prior non-sexual abusiveness or violence to others

k. Gang membership or affiliation
l.

LGBT identification

8

No

m. Gender non-conforming identification or appearance or
manner
22.

Are any of the results from these assessments/screenings used to make decisions about any of the
following aspects of the youths’ stay at this facility? Check all that apply. (NEW)
[Programming note: Only include the response options checked “yes” in previous question in the table
below]
Mental
Other
health
programs
Housing
treatment/
or
assignments counseling services
a. Risk for suicide
b. Substance abuse
c. Mental health issues
d. Physical disabilities
e. Level of emotional and cognitive development
f. Prior sexual victimization
g. Prior sexual exploitation/trafficking
h. History of trauma (e.g., victimization, abuse by parents,
witnessing violence)
i. Prior predatory sexual behavior
j. Prior non-sexual abusiveness or violence to others
k. Gang membership or affiliation
l. LGBT identification
m. Gender non-conforming identification or appearance or
manner

23.

Does this facility currently house any transgender youth? (NEW)
Yes
No

9

TREATMENT AND SERVICES
24.

During the past 12 months, has this facility housed youth with any of the following limitations? (NEW)
Yes

No

a. Limited English proficiency
b. Deaf or hard of hearing
c. Blind or limited vision
d. Learning disabilities (e.g., dyslexia, language processing
disorder)
e. Intellectual/developmental disabilities
f. Other physical, mental, or medical disabilities that cause
impairment to youth functioning
25.

Does this facility allow youth to access legal assistance (e.g., lawyers, law students, paralegals)? (NEW)
No
Yes, but only pre-adjudication
Yes, but only post-adjudication
Yes, both pre- and post-adjudication

10

EDUCATIONAL SERVICES
26.

When youth arrive at this facility, do staff assess educational background and needs in any of the
following ways? (NEW)
Yes

No

a. Staff obtain educational records from youth’s prior school in the
community
b. Staff obtain Individual Education Program (IEP) and 504 plans
(if applicable)
c. Staff administer a brief educational assessment and/or obtain
results of an assessment conducted at a prior facility placement
27.

What types of educational programs and services does this facility offer to youth? (NEW)
Yes

No

a. Curricula required by the state for graduation from high school
b. Special education
c. GED or High School Equivalency Diploma preparation
d. GED or High School Equivalency Diploma testing
e. College coursework
f. Job or vocational training
RESTRICTIVE HOUSING
28.

During the past 12 months, did this facility hold any youth in a separate room, other than their own room,
without contact with other youth? Exclude youth held for medical purposes. (NEW)
Yes
No

29.

[If Yes to item 28]: How many of these youth were held in locked rooms without being allowed contact
with other youth on Wednesday, ? (NEW)
______________
Youth

30.

During the past 12 months, did this facility confine youth to their rooms for breaking facility rules? (NEW)
Yes
No

31.

[If Yes to item 30]: How many youth were confined to their rooms for breaking facility rules on
Wednesday, ? (NEW)
______________
Youth

11

GRIEVANCE PROCESS
32.

Which of these ways can a youth use to report a complaint against a staff member in this facility? (NEW)
Yes
No
a. Make a report or talk to a different staff member or administrator
b. Report by phone or hotline
c. Talk to someone outside the facility
d. Talk to someone who visits from outside the facility
e. Report some other way

33.

If a youth wanted to report a complaint against a staff member, is there a process by which they could
do so anonymously? (NEW)
Yes
No

YOUTH EDUCATION ON PREA
34.

How are youth typically given information that sexual activity is not allowed in this facility? (NEW)
Yes
No
a. Facility staff
b. Posters/signs
c. Brochure/flier/pamphlet
d. Handbook with facility rules
e. Video
f. Other (Please specify):
______________________________________

COMMENTS
35.

Please provide any additional suggestions, explanations, or comments.

12