Form CJ-43B 2012 Census of State and Federal Adult Correctional Faci

CJ-43B

OMB No. 1121-0147: Approval Expires XX/XX/XXXX

CJ-43B

FORM
(2-1-2012)

U.S. DEPARTMENT OF JUSTICE

2012 CENSUS OF STATE AND FEDERAL
ADULT CORRECTIONAL FACILITIES —
INDIVIDUAL FACILITY INFORMATION

BUREAU OF JUSTICE STATISTICS
AND ACTING AS COLLECTION AGENT

U.S. DEPARTMENT OF COMMERCE
ECONOMICS AND STATISTICS ADMINISTRATION

U.S. CENSUS BUREAU

DATA SUPPLIED BY:
Name

E-MAIL
ADDRESS

Number and street or P.O. box/Route number City
Area code Number

State

Extension FAX
NUMBER

䊴

TELEPHONE

䊴
䊴
䊴

OFFICIAL
ADDRESS

Title
Zip Code

Area Code Number

INSTRUCTIONS FOR COMPLETION
Complete questions 1-10 for each individual facility in operation on June 30, 2012.
Reporting methods:
• INTERACTIVE ONLINE LISTING: You will be asked to answer the facility level questions.
• UPLOAD PREPARED SPREADSHEET: Downloading the spreadsheet will allow you to view your listing AND answer the
Individual Facility Information (CJ-43B) questions at the same time. Once completed and saved, the spreadsheet can be uploaded.
• UPLOAD DATA FILE(S): You may submit data in any format that is convenient to your information system. Include the
information requested in items 1-10 of the CJ-43B for each individual facility. When uploading the completed datafile, please
include a file layout and codebook that will allow us to read the data included.
• MAIL/FAX: Complete paper form. Make copies of the CJ-43B as needed.
Facility Number

out of

1. Facility name and address
Please provide a street address where the facility is located.
Facility Name

Address 1

Address 2

City

State

Zip Code

Burden statement
We estimate that your reporting burden will average 15 minutes per response, including the time needed to review instructions, search
existing data sources, gather and maintain the data needed, and complete and review the collection of information. The approval of
this data collection expires xx/xx/xxxx. We cannot ask you to respond to a collection unless it displays a currently valid OMB control
number. Send comments regarding this burden or any other aspect of this collection of information, including suggestions for reducing
this burden, to the Director, Bureau of Justice Statistics, Washington, DC 20531 and to the Office of Management and Budget,
OMB No. 1121-0147, Washington, DC 20503.

FORM CJ-43B (2-1-2012)

PRISON FACILITY REPORT

6. Who operates this facility?
Mark ( X ) only ONE box.

2. Designated facility contact
Please provide information for the person at this facility
who could assist in providing information about this facility.

01
02
03
04

Name

05

Federal authority
State authority
Local authority
Joint state and local authority
Private contractor — For what jurisdictions does
this facility currently hold inmates?

Title
Phone

(

)

–

ext.

E-mail
3. Is this facility authorized to house —
Mark ( X ) only ONE box.
01
02
03

7. On September 30, 2011, how many inmates
confined in this facility were —
• Include all inmates held in this facility for State
or Federal authorities, regardless of jurisdiction.

Males only
Females only
Both males and females

4. What is the physical security level of this facility?
Mark ( X ) the ONE box that best describes the physical
security of this facility.
Super maximum, maximum, close, or high — is
characterized by walls or double-fence perimeters, armed
towers and/or armed patrols. Cell housing is isolated in one
of two ways: within a cell block so that a prisoner escaping
from a cell is confined within the building; or by double
security from the perimeter by bars, steel doors, or other
hardware. All entry or exit is via trap gate or sally port.

a. Males

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

b. Females

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

8. Is this facility administratively-linked to any
other facilities?
• Facilities that share budgets or administrators are
considered to be administratively linked.
01

Medium — is characterized by a single or double fenced
perimeter with armed coverage by towers or patrols.
Housing units are cells, rooms, or dormitories. Dormitories
are living units designed or modified to accommodate 12 or
more persons. All entry or exit is via trap gate or sally port.

02

No
Yes — What are the names of the facilities?

Minimum or low — is characterized by a fenced or "posted"
perimeter. Cell housing units are rooms or dormitories.
Normal entry and exit are under visual surveillance.
01
02
03
04
05
06

Super maximum
Maximum/close/high
Medium
Minimum/low
Administrative (e.g. Federal medical facilities)
Other — Specify

9. Are there any planned changes to the use of this
facility in the next year?
01
02

5. What percentage of inmates in this facility are
regularly permitted to leave the facility
unaccompanied (for work release, study release,
rehabilitation, etc.)?
Mark ( X ) only ONE box.
01
02
03

50% or more of the inmates
Less than 50% of the inmates
None

No
Yes — a. Describe planned changes.

— b. On what date are planned changes
expected to take effect?
Month
Year
Don’t Know
10. Are there plans to close this facility in the
next year?
01
02

No
Yes — On what date is the planned closure
expected to occur?
Month
Year
Don’t Know

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