CJ-15 JRFC Collection

Juvenile Facility Census Program (JFCP)

2026 JRFC Form Draft CJ-15

OMB: 1121-0381

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1121-0381 can be found here:

2025-04-28 - No material or nonsubstantive change to a currently approved collection

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U.S. DEPARTMENT OF COMMERCE U.S. CENSUS BUREAU
ACTING AS A COLLECTING AGENT FOR U.S. DEPARTMENT OF JUSTICE OFFICE OF JUVENILE JUSTICE AND DELINQUENCY PREVENTION

2026 Juvenile Residential Facility Census

This questionnaire asks about services, staff, and persons
assigned beds in this facility on Wednesday, March 25, 2026.
Instructions:
1. A juvenile residential facility is a place
where young persons who have committed
offenses may be housed overnight as
direct result of those offenses. A facility
has living/sleeping units, such as wings,
floors, dorms, barracks, or cottages on one
campus or in one building.
2. Any buildings with living/sleeping units that
are not on the same campus should be
considered separate facilities and should
submit a separate questionnaire. Please
request additional questionnaires using the
contact information below.

You may find it helpful to use this form to gather
the requested information. We ask that you submit
your response online BY APRIL 30, 2026:

https://respond.census.gov/jrfc
If you cannot submit your information online,
please mail or fax your information to following:
U.S. Census Bureau
PO Box 5000
Jeffersonville, IN 47199-5000
GOVS/JRFC
Fax: 1–888–262–3974

If you have any questions, contact the U.S. Census Bureau: 1–800–352–7229 | [email protected]
FACILITY NAME

PERSON COMPLETING THIS QUESTIONNAIRE
Name

E-mail address

Title
Street Address or P.O. Box
Apt, Suite, or Unit (Optional)
City

FORM CJ-15 (03-15-2026)

Telephone
State

ZIP Code

Area code

Number

Extension

OMB No. XXXX-XXXX: Approval Expires [TBD]

MAILING ADDRESS OF FACILITY
Street Address or P.O. Box

Apt, Suite, or Unit (Optional)

City

State

ZIP Code

PHYSICAL ADDRESS OF FACILITY
Physical address is the same as mailing address

Street Address (DO NOT provide P.O. Box)
Apt, Suite, or Unit (Optional)

City

State

ZIP Code

Section 1 – GENERAL FACILITY INFORMATION
1a. Is this facility part of a larger agency?
Yes
02
No ➔ Go to NOTE A
What is the name of this agency?
01

1b.

NOTE
B

4a.
Questions 2 and 3 ask who OWNS
NOTE
this
facility. Later you will be asked
A
who OPERATES this facility.

2a. Who OWNS this facility?

Mark (X) only one.
a private non-profit agency
a for profit agency
02
a government agency ➔
03

for-profit agency that OPERATES this facility?

Go to Question 3

Go to

➔ Question

2b. What is the name of the private non-profit or

for-profit agency that OWNS this facility?

Go to
➔ NOTE
B
3.

Page 2

Go to Question 5

4b. What is the name of the private non-profit or

Mark (X) only one.
a private non-profit agency
a for profit agency
02
a government agency ➔

Who OPERATES this facility?

Questions 4 and 5 ask who OPERATES
this facility (either directly or under
contract with).

What is the level of the government agency
that OWNS this facility?
Mark (X) all that apply.
A Native American Tribal Government
01
Federal
02
State
03
County
04
Municipal (includes Washington, DC)
05
Other – Specify
06

What is the level of the government agency
that OPERATES this facility?
Mark (X) all that apply.
01

A Native American Tribal Government

Federal

State

County

Municipal (includes Washington, DC)

Other – Specify

FORM CJ-15 (03-15-2026)

Section 1 – GENERAL FACILITY INFORMATION - Continued
6. What type of residential facility is the

INSTRUCTIONS

one listed on the front cover?
Mark (X) all that apply.

Detention center: A short-term facility that
provides temporary care in a physically restricting
environment for young persons in custody pending
court disposition and, often, for young persons who
are adjudicated delinquent and awaiting disposition
or placement elsewhere, or are awaiting transfer to
another jurisdiction. In some jurisdictions, detention
centers may also hold young persons committed for
short periods of time as part of their disposition
(e.g., weekend detention).
Long-term secure facility: A specialized type
of facility that provides strict confinement and longterm treatment generally for post-adjudication
committed young persons placed for delinquency or
status offenses. Includes training schools, juvenile
correctional facilities, youth development centers.
Reception or diagnostic center: A short-term
facility that screens young persons committed by
the courts and assigns them to appropriate
correctional facilities.
Group home/Halfway house: These facilities are
generally non-secure and typically intended for post
adjudication commitments in which young persons
are allowed extensive contact with the community,
such as attending school or holding a job.
Residential treatment center: A facility that
focuses on providing some type of individually
planned treatment program for young persons
(substance use, sex offender, mental health, etc.) in
conjunction with residential care. Such facilities
generally require specific licensing by the state that
may require that treatment provided is Medicaidreimbursable.
Ranch, forestry camp, wilderness or marine
program or farm: These are long-term generally

non-secure residential facilities often located in a
relatively remote area. The young persons
participate in a structured program that emphasizes
outdoor work, including conservation and related
activities.
Runaway and homeless shelter: A short-term
facility that provides temporary care in a physically
unrestricted environment. It can also provide
longer-term care under a juvenile court disposition
order.
Other type of shelter: This includes emergency
non-secure shelters where young persons are
housed short-term until another placement can be
found.

The following items ask you to use your records
to provide counts of persons who had assigned
beds in this facility at the end of the day on
Wednesday, March 25, 2026. This date has
been chosen carefully to give a standardized count
of persons in facilities like yours across the
country. You will be asked to classify this facility
population into two age groups:
1. those persons under age 21;
and
2. those persons age 21 and
older.
You will then be asked to classify each
person UNDER THE AGE OF 21 into just
one of the two following categories:
1. those here because they have been
charged with or court-adjudicated for an
offense. An offense is any behavior that is
illegal in your state for underage persons
alone or for both underage persons and
adults.
2. those here for reasons other than offenses.

7a. According to your records, at the

end of the day on Wednesday, March
25, 2026, did ANY persons have
assigned beds in this facility?

Include persons who were temporarily away, but
had assigned beds on March 25. Do NOT include
staff
01
Yes
02

No ➔

Go to Question 7c

7b. According to your records, at the end of
the day on March 25, 2026, how many
persons had assigned beds in this facility?
Persons

➔ Go to Question 8

7c. Specify why there were not ANY persons
assigned beds in this facility on
Wednesday, March 25, 2026:
01

Facility permanently closed
Date of Closure:
(MM/DD/YYYY)

Facility temporarily closed

Other - Specify

Other: This includes independent living programs

and anything that cannot be classified above.
Specify

FORM CJ-15 (03-15-2026)

INSTRUCTIONS
If you did NOT have ANY persons assigned beds
in this facility on Wednesday, March 25, 2026
STOP HERE and submit this form.
Page 3

Section 1 – GENERAL FACILITY INFORMATION - Continued
8. What was the TOTAL NUMBER OF

STANDARD BEDS in this facility on the
night of Wednesday, March 25, 2026?

11a. At the end of the day on Wednesday,
March 25, 2026 did ANY persons
UNDER AGE 21 have assigned beds
in this facility?
Include persons being tried as adults in criminal
court. Do NOT include staff.

Do NOT include staff beds.
• A single bed is one standard bed
• A double bunk bed is two standard beds
Total number of standard beds

9a. On the night of Wednesday, March 25,
2026, were there ANY OCCUPIED
MAKESHIFT BEDS in this facility?
Makeshift beds are:
• Roll-out mats
• Fold-out cots
• Roll-away beds
• Pull-out mattresses
• Sofas
• Any other beds that are put away or
moved during non-sleeping hours
01
Yes
02

No ➔ Go to Question 10

assigned beds at the end of the day on
Wednesday, March 25, 2026 were AGE
21 or older?
Include persons who were temporarily away, but had
assigned beds on Wednesday, March 25, 2026. Do
NOT include staff. Please write "0" if there are NO
persons age 21 or older.

Persons age 21 or older

➔ Go to Question 11c

Include persons who were temporarily away but
had assigned beds on March 25. Do NOT include
staff.

Persons under age 21

Go to

➔ NOTE C

11c. Specify why there were not ANY persons
UNDER 21 assigned beds in this facility
on Wednesday, March 25, 2026:
Mark (X) all that apply.
01

Adult only facility

No persons under age 21 were placed in
this facility

Other - Specify

Occupied makeshift beds

10. How many of the persons who had

Yes

11b. According to your records, at the end of the
day on Wednesday, March 25, 2026 how
many persons under age 21 had assigned
beds in this facility?

9b. How many makeshift beds were occupied
that night?

As a check, the sum of question 10 (persons
NOTE 21 and older) and 11b (persons under age 21) should
c
equal the sum reported in question 7b
(number of persons assigned beds in the facility).

INSTRUCTIONS
1. If you DID NOT have ANY persons
UNDER AGE 21 assigned beds in this
facility on Wednesday, March 25, 2026,
STOP HERE and submit this form..
2. If you DID HAVE persons UNDER
AGE 21 assigned beds in this facility on
Wednesday, March 25, 2026,
CONTINUE BELOW.

FORM CJ-15 (03-15-2026)

Page 4

Section 1 – GENERAL FACILITY INFORMATION - Continued
12a. At the end of the day on Wednesday,

March, 25, 2026, did ANY of the persons UNDER
AGE 21 have assigned beds in this facility
SPECIFICALLY BECAUSE they were CHARGED
WITH OR COURT-ADJUDICATED FOR AN OFFENSE?

An offense is any behavior that is illegal in your state for
underage persons alone or for both underage persons
and adults.
INCLUDE in your count persons UNDER AGE 21 here
BECAUSE they were CHARGED WITH OR COURTADJUDICATED FOR:

12c. Specify why there were not ANY persons
UNDER AGE 21 assigned beds in this
facility on Wednesday, March 25, 2026
SPECIFICALLY BECAUSE they were
CHARGED WITH OR COURT-ADJUDICATED
FOR AN OFFENSE:
Mark (X) all that apply.
01
02

● ANY offense that is illegal for both adults and underage
persons.

● AN offense that is ILLEGAL IN YOUR STATE for

underage persons but not for adults. Examples are
running away, truancy, incorrigibility, curfew violation,
and underage liquor violations. Count persons with
these behaviors here ONLY IF THE BEHAVIORS ARE
ILLEGAL IN YOUR STATE. This includes those CHINS
(Children in Need of Services) and PINS
(Persons in Need of Services) who are here BECAUSE
of an offense.

● ANY offense being adjudicated in juvenile or criminal
court, including a probation or parole violation.

Do NOT INCLUDE here:
● Persons under age 21 who have committed one or more
offenses in the past, BUT HAVE ASSIGNED BEDS ON
MARCH 25 FOR REASONS OTHER THAN OFFENSES.

No persons under age 21 were placed in
this facility for an offense
This facility is no longer under contract to
hold persons under age 21 for offense
reasons
Other - Specify

13a. At the end of the day on Wednesday,

March, 25, 2026, did ANY of the persons
UNDER AGE 21 have assigned beds in
this facility FOR REASONS OTHER THAN
OFFENSES? Do NOT include staff.
INCLUDE here:
● Persons under age 21 assigned beds here for NONOFFENSE REASONS, such as neglect, abuse,
dependency, abandonment, mental health problems,
substance use problems, or another non-offense
reason

● Persons under 21 assigned beds here BECAUSE OF
REASONS OTHER THAN OFFENSES, such as neglect,
abuse, dependency, abandonment, mental health
problems, substance use problems. These persons will
be counted in questions 13a and 13b.

● Persons under age 21 who have committed one or
more offenses in the past, BUT ARE ASSIGNED
BEDS HERE ON MARCH 25, 2026 FOR REASONS
OTHER THAN THESE OFFENSES

● Persons under 21 who have run away, been truant or
incorrigible, or violated curfew, IF THESE BEHAVIORS
ARE NOT CONSIDERED ILLEGAL IN YOUR STATE.
These young persons will be counted in questions 13a
and 13b.

● Persons under age 21 who have run away, been
truant or incorrigible, or violated curfew, IF THESE
BEHAVIORS ARE NOT CONSIDERED ILLEGAL IN
YOUR STATE.

● Those persons who are PINS (Persons in Need of
Services) or CHINS (Children in Need of Services) who
have assigned beds because of REASONS OTHER
THAN OFFENSES. These persons will be counted in
questions 13a and 13b.
01

Yes

No ➔

Go to Question 12c

12b. According to your records for the end of the
day on Wednesday, March, 25, 2026, HOW
MANY PERSONS UNDER AGE 21 had
assigned beds in the facility SPECIFICALLY
BECAUSE they were CHARGED WITH OR
COURT-ADJUDICATED FOR AN OFFENSE, as
defined in question 12a?

● Persons assigned beds here due to voluntary or nonoffense related admissions.

Do NOT INCLUDE here:
● Persons assigned beds here BECAUSE THEY WERE
CHARGED WITH OR COURT-ADJUDICATED FOR
AN OFFENSE. These persons are counted in
questions 12a and 12b.
01

Yes

No ➔

Go to NOTE D

Include persons who were temporarily away
but had assigned beds on March 25. Do NOT
include staff.
Persons under age 21
here because they
Go to
were charged with or
➔ Question
court-adjudicated for
13a
an offense
FORM CJ-15 (03-15-2026)

Page 4

Section 1 – GENERAL FACILITY INFORMATION - Continued
13b. According to your records for the end of the

day on Wednesday, March, 25, 2026, HOW MANY
PERSONS UNDER AGE 21 had assigned beds in this
facility FOR REASONS OTHER THAN OFFENSES, AS
DEFINED IN 13a?
Include persons who were temporarily away but had
assigned beds on March 25. Do NOT include staff.
Persons under age 21 here
because of non-offense reasons

As a check, the sum of questions
NOTE 12b (persons under 21 with offense) and 13b
D
(persons under 21 with non-offense) should
equal 11b (total persons under age 21).

14c. (If part of a set schedule) When are young
persons in this facility locked into their
sleeping rooms by staff?
Mark (X) all that apply.
01
02
03
04

15. Does this facility have any of the following
features intended to secure or confine
young persons within specific areas?
Mark (X) all that apply.

INSTRUCTIONS
1. If you DID NOT have ANY persons UNDER AGE 21
assigned beds in this facility on Wednesday, March
25, 2026, SPECIFICALLY BECAUSE they were
CHARGED WITH OR COURT-ADJUDICATED FOR
AN OFFENSE, STOP HERE and submit this form.
2. If you DID HAVE persons UNDER AGE 21 assigned
beds in this facility on Wednesday, March 25, 2026,
SPECIFICALLY BECAUSE they were CHARGED
WITH OR COURT-ADJUDICATED FOR AN
OFFENSE CONTINUE BELOW.

14a. Are ANY young persons in this facility locked
into their sleeping rooms by staff at ANY
time to confine them?
01

Yes

No ➔

Go to Question 15

14b. (If yes) In what situations are young persons
in this facility locked into their sleeping rooms?
Mark (X) all that apply.

Page 5

When they are out of control

When they are suicidal

For medical reasons other than suicide

During shift changes

Whenever they are in their sleeping rooms

As part of a set schedule

Other - Specify

All of the time
During the day for 2 hours or less
During the day for more than 2 hours
At night

03
04

Doors for secure day rooms that are locked by staff
to confine young persons within specific areas or
rooms
Wing, floor, corridor, or other internal security doors
that are locked by staff to confine young persons
within specific areas
Outside doors that are locked by staff to confine
young persons within specific buildings
External gates in fences or walls WITHOUT
razor wire that are locked by staff to
confine young persons

External gates in fences or walls WITH razor wire
that are locked by staff to confine young persons

Other – Specify

The facility has NONE of the above features.

16a. Are outside doors to any buildings with
living/sleeping units in this facility ever
locked?
01

Yes

No ➔

Go to Question 17a

16b. Why are outside doors to buildings with living/
sleeping units in this facility locked?
Mark (X) all that apply.
01

To keep intruders out

To keep young persons inside this facility

16c. When are outside doors to buildings with
living/sleeping units in this facility locked?
Mark (X) all that apply.

All of the time

During the day for 2 hours or less

During the day for more than 2

hours At night

Other – Specify

FORM CJ-15 (03-15-2026)

Section 1 – GENERAL FACILITY INFORMATION - Continued
18. Which of the following training requirements
are front-line supervision staff and direct
care staff required to take before working
with young persons?
Mark (X) all that apply.

17a. Does this facility provide ON-SITE
RESIDENTIAL TREATMENT
01

Yes

➔ Go to Question 18

17b.What kind of treatment is
provided INSIDE this facility?

Mark (X) all that apply.
01
Mental health treatment

Substance use treatment

Sex offender treatment

Treatment for arsonists

Treatment specifically for violent offenders

Behavioral modification or therapy

Trauma treatment

Anger management

Other – Specify

06
07
08
09
10
11

Behavioral health interventions and resources
Conflict de-escalation training and communication
with young persons
Cross-gender supervision
Defensive tactics and restraint techniques
Gang identification, prevention, and management
LGBTQ+ responsiveness
Managing young persons with mental health
problems
Professional Conduct and Ethics
Staff boundaries
Trauma informed care
Other - Specify

19a. Does this facility provide any of the following activities or services for the young persons in
this facility through either the facility's own staff or by bringing in external providers?
Mark (X) all that apply.
Provided by the
facility's staff
(1)

Provided by
bringing in
external providers
(2)

This facility
does not
provide this
(3)

a. Artistic opportunities (e.g., music, painting, drama)

b. Formal mentoring program

c. Recreation (e.g., team sports, playing games)

d. Reentry planning

e. Religious/Spiritual/Faith Based

f. Wellness (e.g, yoga, meditation)

g. Workforce development or vocational training

19b. Are there any other activities or services not listed above that are provided for
young persons in this facility? Please list any other activities or services provided.

FORM CJ-15 (03-15-2026)

Page 6

Section 1 – GENERAL FACILITY INFORMATION - Continued
20. Which of the following best describes
the physical layout of this facility?
Mark (X) only one.
This facility is 01
02
03
04

a part of one building
all of one building
more than one building at a single site or on
one campus
Other – Specify

22a. Are there any other juvenile residential facilities
located within the same building or on the same
campus as the facility being reported on here?
01

Yes

Go to Section 2

22b. How many OTHER juvenile residential facilities are
located within the same building or on the same
campus as the facility being reported on here?
Juvenile residential facilities

21. Are there any other buildings with

living/sleeping units that are associated with this
facility that are not next to this facility building or
on the same campus?

➔

22c.Does the facility being reported on here share
any of the following with the other facilities
located in the same building or on the same
campus?
Mark (X) all that apply.

INSTRUCTIONS
Please use the contact information on Page 1 to request
additional questionnaires for each building with living/
sleeping units associated with this facility that is not at
the site of this facility building or campus.

01
02
03
04
05
06
07
08
09
10
11

The same agency affiliation
The same mailing address
The same on-site administrators
One or more staff directly caring for the young persons
One or more security staff
The same school rooms
The same infirmary
The same food services
The same dining room
The same laundry services
None of the above services are shared

FORM CJ-15 (03-15-2026)

Page 7

Section 2 – MENTAL HEALTH SERVICES
1a. For each of the following behavioral/mental health providers, please indicate if young persons have
access to these providers as paid facility employees, contract staff, or are available as needed in
the community.
Mark (X) all that apply.

Available as
paid facility
employees
(1)

Available as
contract staff
(2)

Available as
needed in the
community
(3)

Not available
(4)

a. Psychiatrists (MDs or DOs)

b. Licensed clinical psychologists (PhDs)

c. Licensed clinical social worker or licensed

mental health clinicians (e.g., persons
with a master's degree in social work)

1b. Do young persons have access to any other behavioral/mental health providers not listed above?
Please list any other behavioral/mental health providers.

2a. After arrival in this facility, are ANY young

persons asked questions or administered a
form which asks questions to determine risk
for suicide?

01
02

Yes
No ➔ Go to Question 7 on page 9

2b. What best describes the process through

which young persons are asked questions or
administered a form which asks questions to
determine risk of suicide?

Mark (X) all that apply.
01
One or more questions about suicide
incorporated into the medical history or
intake process
A form or questions designed by this facility
02
to assess suicide risk
A form or questions designed by a county
03
or state juvenile justice system to assess
suicide risk
MAYSI- Full Form
04
MAYSI- Suicide/depression module
05
C-SSRS
06
Other – Specify
07

INSTRUCTIONS
Mental health professionals are limited in this census to:
● psychiatrists
● psychologists with at least a Master’s degree in
PSYCHOLOGY
● social workers with at least a Master’s in
SOCIAL WORK (MSW, LCSW)
Counselors in this census are:
● persons with a Master’s degree in a field other than
psychology or social work
● persons whose highest degree is a Bachelor’s in any field

3. Who asks questions or administers a form
which asks questions to determine risk of
suicide?

Mark (X) all that apply.
01

Counselors/intake workers who have NOT been
trained by mental health professionals

Counselors/intake workers who have been
trained by mental health professionals
A mental health professional

Some other person – Specify

4. When are young persons FIRST asked

questions or administered a form which asks
questions to determine risk of suicide?
Mark (X) all that apply.
Within less than 24 hours after arrival
02
Between 24 hours and less than 7 days
after arrival
Seven or more days after arrival
03
Other – Specify
04
01

FORM CJ-15 (03-15-2026)

Page 8

Section 2 – MENTAL HEALTH SERVICES - Continued
5. Which young persons are asked questions

or administered a form which asks questions
to determine risk of suicide?
Mark (X) all that apply.

02
03
04
05
06

ALL young persons are asked questions or
administered a form which asks questions to
determine suicide risk ➔
Go to Question 6a
Young persons who come directly from home,
rather than from another facility
Young persons who display or communicate
suicide risk
Young persons known to have prior suicide
attempts
Young persons for whom no mental health care
record is available
Other young persons not listed above – Specify

NOTE
E

The following questions ask about
preventative measures taken once a
young person is identified to be at risk for
suicide. Please include all levels of
suicide risk used by this facility, if any,
when answering these questions.

8a. Are young persons who are determined to

be at risk for suicide ever placed in a
sleeping room or observation room that is
locked or under staff security?

01
02

Yes
No ➔

Go to Question 9

8b. Which of the following best describes what

happens in the sleeping room or observation
room that is locked or under staff security?

Mark (X) all that apply.
01
Camera observation

6a. Are ANY young persons re-asked questions
or re-administered a form which asks
questions to determine risk for suicide?
01
02

Yes
No ➔

Go to Question 7

15 minute staff checks

5 minute staff checks

Line of site supervision (direct or through glass)

Staff assigned to doorway or in sleeping room/
One-on-one supervision/Arms length supervision

Other – Specify

6b. Which best describes the conditions under

which young persons are re-asked questions
or re-administered a form that asks questions
to determine suicide risk?
Mark (X) all that apply.
As necessary on a case-by-case basis
01
02

Systematically, based on length of stay, facility
events, or negative life events (for example,
after each court appearance, every time the
young person re-enters the facility, after a
death in the family)
Other – Specify

7. Does this facility assign different levels of
risk to young persons based on their
perceived risk of suicide?
01

Yes

FORM CJ-15 (03-15-2026)

9. Are any of the following preventative

measures taken when a young person is
determined to be at risk for suicide?

Mark (X) all that apply.
01

No preventative measures are taken when a young
person is determined to be at risk for suicide

One-on-one supervision/Arms length supervision

Line-of-sight supervision

Special clothing to identify young persons as at risk
for suicide

Special clothing designed to prevent suicide attempts

Restraints used to prevent suicide attempts

Removal of personal items that may be used to
attempt suicide

Removal from the general population

Other – Specify

Page 9

Section 2 – MENTAL HEALTH SERVICES - Continued

NOTE
F

Questions 10 through 15 ask about mental
health services provided at a location either
INSIDE or OUTSIDE this facility. INSIDE
refers to any location on the facility grounds.
OUTSIDE refers to any location in the
community or off facility grounds.

10. Do young persons assigned beds receive mental
health services other than a suicide evaluation
either INSIDE or OUTSIDE this facility?
Mental health services include:
• evaluations and appraisals conducted by
mental health professionals to diagnose or to
identify mental health needs
• ongoing mental health therapy
• ongoing counseling
01
02
03
04

Yes, provided both INSIDE and OUTSIDE
this facility
Yes, provided INSIDE this facility
Yes, provided OUTSIDE this facility
No, this facility does not provide mental health
services ➔ Go to Question 13a on page 11

11a. Is ongoing COUNSELING for mental health

problems provided INSIDE or OUTSIDE this
facility by a COUNSELOR?
Counselors are limited to:
● persons with a Master’s degree in a field
other than psychology or social work
● persons whose highest degree is a Bachelor’s
in any field.
01
Yes, INSIDE and OUTSIDE this facility
Yes, INSIDE this facility
02
Yes, OUTSIDE this facility
03
04 ● No, ongoing counseling

12b.When are young persons evaluated or
appraised by a MENTAL HEALTH
PROFESSIONAL?
Mark (X) all that apply.
01

Within less than 24 hours

Between 24 hours and less than 7 days
after arrival

Seven or more days after arrival

Other – Specify

12c. Which young persons are evaluated or
appraised by a MENTAL HEALTH PROFESSIONAL?
Mark (X) all that apply.
01

ALL young persons are evaluated or appraised
by a MENTAL HEALTH PROFESSIONAL?

Young persons who come directly from home,
rather than from another facility

mental health problems are provided by a
COUNSELOR?

Young persons who are ordered by the court to
get an evaluation

Mark (X) all that apply.
Individual counseling
01

Young persons whom staff identify as needing
an evaluation

Young persons known to have mental health
problems

Young persons for whom no mental health
record is available

Other young persons not listed above – Specify

is not provided ➔ Go to Question 12a

11b. Which forms of ongoing COUNSELING for

Page 10

12a.Are ANY young persons evaluated or appraised
by a MENTAL HEALTH PROFESSIONAL at a
location INSIDE or OUTSIDE this facility?
Evaluations and appraisals are conducted by
mental health professionals to diagnose or to
identify mental health needs.
Mental health professionals are limited to:
• psychiatrists
• psychologists with at least a Master’s
degree in PSYCHOLOGY
• social workers with at least a Master’s
degree in SOCIAL WORK (MSW, LCSW)
01
Yes, INSIDE and OUTSIDE this facility
02
Yes, INSIDE this facility
03
Yes, OUTSIDE this facility
No ➔ Go to Question 15a on page 11
04

Group counseling

Family counseling

Other – Specify

FORM CJ-15 (03-15-2026)

Section 2 – MENTAL HEALTH SERVICES - Continued
13a. Is ongoing THERAPY for mental health

problems provided to young persons by a
MENTAL HEALTH PROFESSIONAL INSIDE or
OUTSIDE this facility?
Mental health professionals are limited to:
• psychiatrists
• psychologists with at least a Master’s degree in
PSYCHOLOGY
• social workers with at least a Master’s degree
in SOCIAL WORK (MSW, LCSW)
01
02
03

Yes, INSIDE and OUTSIDE this facility
Yes, INSIDE this facility
Yes, OUTSIDE this facility
No, ongoing THERAPY is
not provided ➔ Go to Question 14a

13b. Which forms of ongoing THERAPY for mental
health problems are provided by MENTAL
HEALTH PROFESSIONALS?

15a. Upon a young person’s departure from this

facility, is information regarding their mental
health status, services and/or needs
communicated to the young person's new
placement or residence?
01

Yes

Individual therapy

Group therapy

Family therapy

Other – Specify

Go to Section 3 on page 12

15b. For which young persons is this information
shared?

Mark (X) all that apply.
01

All young persons that depart from
the facility ➔
Go to Section 3 on page 12

Young persons being placed in other juvenile
justice facilities, including halfway houses, shelters
or other transition homes

Young persons returning to the community under
juvenile justice supervision through probation,
parole, or aftercare

Young persons returning to the community (their
homes, independent living, foster care, or another
type of guardian’s care) without further juvenile
justice supervision
Young persons being placed in adult criminal justice
facilities (prisons, jails)

Mark (X) all that apply.
01

➔

05
06

Young persons going to another living or placement
situation – Please explain

14a. Are there one or more special living/sleeping

unit(s) in this facility reserved just for young
persons with mental health problems that are
separate from other living/sleeping units?

Yes

No ➔

Go to Question 15a

14b. What are the differences between special

living/sleeping units reserved just for young
persons with mental health problems and
the other living/sleeping units?

Mark (X) all that apply.
01
average length of stay

physical security and/or monitoring of
young persons
number of staff per young persons

type of treatment program

05
06
07

characteristics of young persons
specialized criteria for staff selection
specialized curriculum of treatment for
the residents of these units

Other – Specify

No differences between units

FORM CJ-15 (03-15-2026)

Page 11

Section 3 – EDUCATIONAL SERVICES
1. After arrival in this facility, are ANY young

persons evaluated to determine their educational
grade levels and their educational needs at a
location either INSIDE or OUTSIDE this facility?

Yes

No ➔

NOTE
G

Go to Question 5a

2. After arrival in this facility, when are young
persons evaluated to determine their
educational grade level?
Mark (X) all that apply.

Questions 5 through 7 ask about
educational services provided either
INSIDE and/or OUTSIDE this facility.
INSIDE this facility refers to any location on
the facility grounds. OUTSIDE this facility
refers to any location in the community or off
facility grounds.

5a. Do ANY young persons assigned beds here

attend school or receive teacher instruction at
a location either INSIDE or OUTSIDE this
facility?
Mark (X) only one.
01
Yes, provided both INSIDE and OUTSIDE
this facility

Within less than 24 hours after arrival

Between 24 hours and less than 7 days
after arrival

Seven or more days after arrival

Yes, provided INSIDE this facility

Other – Specify

Yes, provided OUTSIDE this facility

3. Which of the following methods are used to
evaluate young persons to determine their
educational grade levels and their
educational needs?

No, educational services are not provided
to young persons while assigned beds
here ➔ Go to Section 4 on page 14

5b. Which young persons attend school or receive
teacher instruction?

Review of previous academic records

Mark (X) all that apply.
01
ALL young persons are required to
attend school or receive teacher
instruction ➔
Go to Question 6

Interview with an education specialist

Administration of one or more written
or computerized tests

Those young persons who have not completed
high school or their GED

Interview with an intake or
admissions counselor

Those young persons with special needs for
remedial education

Interview with guidance counselor

Those young persons who have been in the facility
long enough to receive educational services

Other – Specify

Those young persons who are required by the
state to attend school because of their age

Those young persons assigned beds in special
living/sleeping units –Specify unit type

Mark (X) all that apply.

4. Which young persons are evaluated to

determine their educational grade levels and
their educational needs?
Mark (X) all that apply.
01

Other young persons not listed
above – Specify

ALL young persons are
evaluated ➔ Go to Question 5a

Young persons who come directly from home,
rather than from another facility

Young persons whom the staff identify as
needing an assessment

Young persons for whom no educational record
is available

Young persons with known educational problems

Other young persons not listed above – Specify

FORM CJ-15 (03-15-2026)

Page 12

Section 3 – EDUCATIONAL SERVICES – Continued
6. Which of the following educational services

are provided to young persons assigned beds
here at a location either INSIDE or OUTSIDE this
facility?
Mark (X) all that apply.
01
Elementary-level education
02

Middle school-level education

High school-level education

Special education

GED preparation

GED testing

Post-high school education or post-high
school correspondence courses

Vocational/technical education

Life skills training

Other – Specify

7a. Upon a young person’s departure from this
facility, is information regarding their
educational status, services and/or
needs communicated to the young
person's new placement or residence?
01

Yes

➔

Go to Section 4 on page 14

7b. For which young persons is this information
shared?
Mark (X) all that apply.
01

All young persons that depart from
the facility ➔ Go to Section 4 on page 14

Young persons being placed in other juvenile
justice facilities, including halfway houses,
shelters or other transition homes

Young persons returning to the community under
juvenile justice supervision through probation,
parole, or aftercare

Young persons returning to the community (their
homes, independent living, foster care, or
another type of guardian’s care) without further
juvenile justice supervision
Young persons being placed in adult criminal
justice facilities (prisons, jails)

05
06

Page 13

Young persons going to another living or
placement situation – Please explain

FORM CJ-15 (03-15-2026)

Section 4 – SUBSTANCE USE SERVICES
1a. After arrival in this facility, are ANY young

2. When are young persons FIRST evaluated to

determine whether they have substance use
problems?

persons evaluated to determine whether
they have substance use problems?

Substance use problems include problems with
drugs and/or alcohol.
01

Yes

No ➔

Mark (X) all that apply.

Go to Question 4a

1b. Which of the following methods are used
to evaluate persons after arrival in this
facility to determine whether they have
substance use problems?
Mark (X) all that apply.
01
Visual observation

Within less than 24 hours after arrival

Between 24 hours and less than 7 days
after arrival

Seven or more days after arrival

Other – Specify

3a. Are ALL young persons evaluated after

Standardized self-report instruments, such as
the SASSI, JASI, ACDI, ASI

Self-report check list inventory which asks
about substance use

A staff-administered series of questions
which asks about substance use

None of these methods are used

Other – Specify

arrival in this facility to determine whether
they have substance use problems?

Yes ➔

Go to Question 4a

3b. After arrival in this facility, which young

persons are evaluated for substance use
problems?
Mark (X) all that apply.
01

Young persons charged with or adjudicated for a
drug or alcohol-related offense

Young persons identified by the court or a
probation officer as potentially having substance
use problems

Young persons identified by facility staff as
potentially having substance use problems

Other young persons not listed above – Specify

4a. Are ANY young persons required to provide urine FOR DRUG ANALYSIS after arrival IN
THIS FACILITY?

Yes

No ➔ Go to NOTE H on page 15

4b. Which statements below describe the circumstances under which young persons are required to
provide urine INSIDE this facility FOR DRUG ANALYSIS? Mark (X) all that apply.

PERSONS
PROVIDING URINE
SAMPLE
a. Young persons who are suspected
of recent drug or alcohol use
b. Young persons with substance
use problems
c. ALL young persons assigned beds
here
Page 14

After initial
arrival in this
facility
(1)

CIRCUMSTANCES OF TESTING
Each time young
When drug use
At randomly
persons reenter
is suspected or
scheduled times
the facility during
drug is present
their stay
(2)

(3)

(4)

At the request of
the court or
probation officer
(5)

FORM CJ-15 (03-15-2026)

Section 4 – SUBSTANCE USE SERVICES – Continued

NOTE
H

Questions 5 through 9 ask about substance
use services provided at a location either
INSIDE or OUTSIDE this facility. INSIDE
refers to any location on the facility grounds.
OUTSIDE refers to any location in the
community or off facility grounds.

INSTRUCTIONS
Substance use services include:
● developing a substance use treatment
plan
● assigning a case manager to oversee
substance use treatment
● assigning young persons to special
living units just for those with substance
use problems
● ongoing substance use therapy or
counseling
● substance use education
Substance use treatment professionals
are limited in this census to:
● CERTIFIED substance use or
addictions counselors
● psychiatrists
● psychologists with at least a
Master’s degree in PSYCHOLOGY
● social workers with at least a
Master’s degree in SOCIAL WORK
(MSW, LCSW)
Counselors who are NOT substance use
treatment professionals are limited to:
● persons with a Master’s degree in a
field other than psychology or social
work
● persons whose highest degree is a
Bachelor’s in any field

5. Do ANY young persons assigned beds here

receive substance use services INSIDE or
OUTSIDE this facility other than urinalysis or a
substance use screening?

Yes, provided both INSIDE and OUTSIDE this facility

Yes, provided INSIDE this facility

Yes, provided OUTSIDE this facility

No, this facility does not provide substance use
services ➔ Go to Section 5 on page 17

6. Which of the following SUBSTANCE USE

services are provided INSIDE or OUTSIDE this
facility?

Mark (X) all that apply.
01

Substance use education

Assignment of a case manager to oversee
substance use treatment

Development of a treatment plan to specifically
address substance use problems

Special living units in which all young persons
have substance use offenses and/or problems

None of these services are offered

7. Which of the following self-led, self-help
groups are provided INSIDE or OUTSIDE
this facility?

Mark (X) all that apply.
01

Alcoholics Anonymous or other related groups

Narcotics Anonymous or other related groups

Other – Specify

No self-led, self-help groups are provided

8a. Is ongoing COUNSELING for substance

use problems provided to young persons
INSIDE or OUTSIDE this facility by a
COUNSELOR who is NOT a substance use
treatment professional?

Counselors who are NOT substance use
treatment professionals are:
● persons with a Master’s degree in a field other
than psychology or social work
● persons whose highest degree is a Bachelor’s in any
field
01

Yes, provided both INSIDE and OUTSIDE this facility

Yes, provided INSIDE this facility

03
04

Yes, provided OUTSIDE this facility
No, ongoing COUNSELING for substance use problems
is not provided ➔ Go to Question 9a on page 16

8b. Which forms of ongoing COUNSELING for

substance use problems are provided
INSIDE or OUTSIDE this facility to young
persons by a COUNSELOR who is NOT a
substance use treatment professional?
Mark (X) all that apply.
Individual counseling

FORM CJ-15 (03-15-2026)

Group counseling

Family counseling

None of these are provided

Page 15

Section 4 – SUBSTANCE USE SERVICES – Continued
9a. Is ongoing THERAPY for substance use

problems provided to young persons INSIDE
or OUTSIDE this facility by a SUBSTANCE
USE TREATMENT PROFESSIONAL?

Substance use treatment professionals are
limited to:

01
02
03
04

● CERTIFIED substance use/addictions
counselors
● psychiatrists
● psychologists with at least a Master’s degree
in psychology
● social workers with a Master’s degree in
SOCIAL WORK (MSW, LCSW)
Yes, provided both INSIDE and OUTSIDE this facility
● Yes, provided INSIDE this facility
Yes, provided OUTSIDE this facility
No, ongoing THERAPY for substance use problems is
not provided ➔ Go to Section 5 on page 17

9b. Which forms of ongoing THERAPY for

substance use problems are provided
INSIDE or OUTSIDE this facility to young
persons by a SUBSTANCE USE
TREATMENT PROFESSIONAL?
Mark (X) all that apply.
Individual therapy

Page 16

Group therapy

Family therapy

None of these are provided

10a. Upon a young person’s departure from this
facility, is information regarding their
substance use status, services and/or
needs communicated to the young
person's new placement or residence?

Yes

No ➔

Go to Section 5 on page 17

10b. For which young persons is this information
shared?

Mark (X) all that apply.
01

All young persons that depart from
the facility➔ Go to Section 5 on page 17

Young persons being placed in other
juvenile justice facilities, including halfway
houses, shelters or other transition homes
Young persons returning to the community
under juvenile justice supervision through
probation, parole, or aftercare

05
06

Young persons returning to the community
(their homes, independent living, foster care,
or another type of guardian’s care) without
further juvenile justice supervision
Young persons being placed in adult criminal
justice facilities (prisons, jails)
Young persons going to another living or
placement situation – Please explain

FORM CJ-15 (03-15-2026)

Section 5 – MEDICAL SERVICES
INSTRUCTIONS
Questions 1 through 7 ask about the availability of medical services at locations either INSIDE and/or OUTSIDE
this facility.
INSIDE this facility refers to any location on the facility grounds.
OUTSIDE this facility refers to any location in the community or off facility grounds.

1. For each of the following medical providers, please indicate if this facility has access to these providers

as paid facility employees, contract staff, available as needed in the community, or if the medical providers
are not available.
Mark (X) all that apply.

Available as
paid facility
employee
(1)

Available as
paid contract
staff
(2)

Available as
needed in the
community
(3)

Not available
(4)

d. Licensed practical nurses (LPNs) or
licensed vocational nurses (LVNs)

e. Certified nursing assistants, nursing
assistants, medication technicians or
medication aides

a. Physicians (MDs or DOs)
b. Nurse practitioners (NPs) or physician
assistants (PAs)
c. Registered nurses (RNs)

f. Licensed social workers or persons with a
bachelor's or master's degree in social work

2. Do ANY young persons assigned beds here receive the following examinations by a physician (MD or DO),
nurse practitioner (NP), or physician assistant (PA), at a location either INSIDE or OUTSIDE of this facility?
Yes, provided
INSIDE and
OUTSIDE this
facility
(1)

Yes, provided
only INSIDE
this facility
(2)

Yes, provided
only OUTSIDE
this facility
(3)

No, not
provided
(4)

a. Physical Examination

b. Dental Examination

c. Vision Examination

d. Hearing Examination

Page 17

FORM CJ-15 (03-15-2026)

Section 5 – MEDICAL SERVICES - Continued
3. When a medical provider orders vaccinations
for ANY young persons assigned beds here, can
the young persons receive the vaccinations at a
location either INSIDE or OUTSIDE of this
facility?
Yes, provided INSIDE and OUTSIDE this facility
Yes, provided INSIDE this facility
Yes, provided OUTSIDE this facility
No, vaccinations are not provided

01
02
03
04

4. Do medical providers INSIDE or OUTSIDE
this facility prescribe psychotropic
medication for young persons?
01
02
03
04

Yes, prescribed INSIDE and OUTSIDE this facility
Yes, prescribed INSIDE this facility
Yes, prescribed OUTSIDE this facility
No, psychotropic medications are not prescribed

5. Do medical providers INSIDE or OUTSIDE
this facility monitor psychotropic
medication for young persons?
Yes, monitored INSIDE and OUTSIDE this facility
Yes, monitored INSIDE this facility
Yes, monitored OUTSIDE this facility
No, psychotropic medications are not monitored

01
02
03
04

7a. Were ANY young persons assigned beds in
this facility known by facility staff to be
pregnant between March 1, 2025 and February
28, 2026?
01
02

Yes
No ➔

Go to Section 6 on page 19

7b. How many young persons assigned beds
in this facility were pregnant between
March 1, 2025 and February 28, 2026?
Number of pregnant young persons

7c. Did ANY young persons assigned beds in this
facility who were pregnant between March 1,
2025 and February 28, 2026 receive prenatal
care by a physician (MD or DO), nurse
practitioner (NP), or physician assistant (PA)
at a location either INSIDE or OUTSIDE of this
facility?
01
02
03
04

Yes, provided INSIDE and OUTSIDE this facility
Yes, provided INSIDE this facility
Yes, provided OUTSIDE this facility
No, prenatal care was not provided

6. Do ANY female young persons assigned beds
here receive a gynecological examination by a
physician(MD or DO), nurse practitioner (NP), or
physician assistant (PA) at a location either
INSIDE or OUTSIDE of this facility?
A gynecological examination involves the medical
provider gathering a medical history regarding
reproductive health and sexual behavior and conducting
a pelvic and breast exam.
01
02
03
04
05

Page 18

Yes, provided INSIDE and OUTSIDE this facility
Yes, provided INSIDE this facility
Yes, provided OUTSIDE this facility
No, gynecological examinations are not provided
No, this facility does not house female young
persons

FORM CJ-15 (03-15-2026)

Section 6 – THE PRIOR MONTH
INSTRUCTIONS

The following items ask you to answer questions
about different events that may have occurred at this
facility over a 28-day period.

3. During the month of February 2026, were
ANY of the young persons assigned beds here
restrained by facility staff with a mechanical
restraint?
Mechanical restraints include handcuffs, leg cuffs, waist
bands, leather straps, restraining chairs, strait jackets
or other mechanical devices

The 28-day REFERENCE PERIOD for this section
covers the time between the beginning of the day,

February 1, 2026 and the end of the day on
February 28, 2026.

If the facility staff ONLY used mechanical restraints
during transportation to and from this facility answer
NO.
01

1. During the month of February 2026, were there

ANY UNAUTHORIZED DEPARTURES of any young
persons who were assigned beds at this facility?

An "unauthorized departure" includes any incident in
which a young person leaves without staff permission or
approval for more than 10 minutes from:
● The physical security perimeter of the facility
● The mandatory supervision of a staff member when

Yes
No

During the month of February 2026 were ANY of the
young persons assigned beds here locked for more
than four hours alone in an isolation, seclusion, or
sleeping room to regain control of their unruly
behavior?

01 ●

Yes

Answer NO if:
● Young persons were locked in their sleeping rooms
as part of the facility routine
OR
● Young persons were locked in their rooms ONLY
for purposes of quarantine, suicide watch, facility
wide lockdown, or self-requested seclusion

there is no physical security

● The mandatory supervision of transportation staff
● Any other approved area

2a. During the month of February 2026, were

Yes
No

ANY young persons assigned beds at this
facility transported to a hospital emergency
room by facility staff, transportation staff,
or by an ambulance?
01
02

Yes
No ➔

Go to Question 3

2b. For what reason(s) were the young persons
transported to a hospital emergency room
DURING THIS 28 DAY PERIOD in February?
Mark (X) all that apply.
01
02
03

05
06
07
08
09

Sports-related injury
Work or chore-related injury
An injury that resulted from interpersonal conflict
between one or more young persons, not
including a sports-related injury
An injury that resulted from interpersonal conflict
between a young person and a non-resident
(including staff, visitors, or persons from the
community).
Illness
Pregnancy complications
Labor and delivery
Suicide attempt
A non-emergency injury or illness that occurred
when no physical health professional was
available at the facility or on call
A non-emergency injury or illness that
occurred when no doctor’s appointment could
be obtained in the community
Other – Specify

FORM CJ-15 (03-15-2026)

Page 19

Section 7 – THE PAST YEAR
INSTRUCTIONS
Questions 1 through 3 ask about deaths of young persons at locations either INSIDE and/or OUTSIDE this
facility during the period between March 1, 2025 and February 28, 2026.
INSIDE this facility refers to any location on the facility grounds.
OUTSIDE this facility refers to any location in the community or off facility grounds.

1. During the YEAR between March 1, 2025 and February 28, 2026, did ANY young persons die
while assigned a bed at this facility at a location either INSIDE or OUTSIDE of this facility?
01
02

Yes
No ➔

Go to page 21

2. How many young persons died while assigned beds at this facility during the year between
March 1, 2025 and February 28, 2026?
Person(s)

3. What was the cause of death, location of death, age, sex, gender identity, race, date of admission to the
facility, and date of death for each young person who died while assigned a bed at this facility?
a. Cause of death
1 – Illness/natural causes
2 – Injury suffered prior to
placement here
3 – Suicide
4 – Homicide or manslaughter
by another resident
5 – Homicide or manslaughter
by non-resident(s)
6 – Accidental death
7 – Other – Specify in box ➔

Young person 1
(1)

Young person 2
(2)

Young person 3
(3)

Code

b. Location of death

1 – Inside this facility
2 – Outside this facility

c. Age at death (in years)
d. Sex assigned at birth
1 – Male
2 – Female
e. Gender identity
1 – Male
2 – Female
3 – Transgender
4 – Nonbinary
5 – Other – Specify in box

➔

f. Race

1 – White, not Hispanic origin
2 – Black or African American,

not of Hispanic origin

3 – Hispanic or Latino
4 – American Indian/

Alaskan Native

5 – Asian
6 – Native Hawaiian or other

Pacific Islander
7 - Middle Eastern or North
African
8 – Other – Specify in box

➔

g. Date of admission to
facility (mm/dd/yyyy)
h. Date of death
(mm/dd/yyyy)
Page 20

FORM CJ-15 (03-15-2026)

COMMENTS
Thank you for completing this questionnaire. If you would like to give us any comments
on this form, please write them on this page or attach another sheet.

NOTE
I

Please make a copy of this questionnaire for your records so that if we need to contact you
about a response, you will be able to refer to your copy.
If you are unable to submit online, please mail the completed form to U.S. Census Bureau
P.O. Box 5000
Jeffersonville, IN 47199–5000
ERD/JRFC
or FAX toll free to: 1–888–262–3974.

Comments

FORM CJ-15 (03-15-2026)

Page 21

DEFINITIONS OF TERMS
Campus: A self-contained environment that includes
multiple structures or areas dedicated to different aspects
of the juveniles' daily lives.

On-site Residential Treatment: Structured,
therapeutic services provided on the grounds of a
residential facility, either by facility staff or contracted staff.

CHINS [Children in Need of Services]: Persons
under age 21 in need of services for a reason other than
an offense, such as neglect, abuse, dependency,
abandonment, etc.

Operator: An agency that operates a facility is
responsible for the day-to-day management,
administration, and provision of services within that facility.
They oversee staffing, programming, security, and services
provided within physical space. The agency may operate a
facility on behalf of the owning agency, under a contract or
agreement, or they may be the same entity that owns the
facility.

Court-adjudicated: Refers to a youth who has been
determined by a court to have committed the delinquent
act for which they were charged.
Counselors: Individuals with a master’s degree in a field
other than psychology or social work, or persons whose
highest degree is a Bachelor’s in any field.
Educational Instruction: The structured teaching
and learning activities provided to residents. These
activities are designed to meet the educational needs of
juveniles, helping them achieve academic goals, develop
essential skills, or prepare for reintegration into traditional
educational settings or the workforce.
Evaluations / Appraisals: Any form of assessment
conducted by [specialized field] professionals to diagnose
or to identify a young person’s needs.
Facility: A place that has living/sleeping units such as
wings, floors, dorms, barracks, or cottages on one
campus or in one building.
Gender identity: A person's core internal
understanding of who they are, regardless of sex
assigned at birth.

Owner: An agency that owns a facility is the legal entity
or organization that has legal rights to the property, assets,
and physical infrastructure. They have title and financial
responsibility for the facility and the land where the facility
is situated. The owner may directly operate the facility or
contract with another agency for operations on their behalf.
They may also lease or allocate the facility to another
agency.
PINS [Persons in Need of Services]:
Residential Facility: A facility that houses persons
overnight.
Services “Inside” a Facility: A service provided at
any location on the facility grounds.
Services “Outside” a Facility: A service provided at
any location in the community or off facility grounds.
Sex assigned at birth: The sex assigned to a child at
birth, most often based on the child's external anatomy.

Juveniles: Persons younger than 21.

Standard Beds: A regular, fixed bed that is permanently
set up for use and does not need to be assembled,
unfolded, or moved for sleeping purposes. These include,
but are not limited to, traditional fixed-frame beds, bunk
beds, or any bed that remains in place regardless of the
time of day.

Juvenile Offenders: Persons under the age 21 that
commit an act that is illegal, in the specific state, if
committed by either underage persons only or if
committed by either underage persons or adults.

Status Offense: An offense that is illegal in a state for
underage persons but not for adults. Examples include
running away, truancy, incorrigibility, curfew violation, and
underage liquor violations.

Makeshift Beds: Alternative beds including roll-out
mats, fold-out cots, roll-away beds, pull-out mattresses,
sofas, and any other beds that are put away or moved
during non-sleeping hours.

Substance Use Services: Include developing a
substance use treatment plan, assigning a case manager
to oversee substance use treatment, assigning young
persons to special living units for those with substance use
problems, ongoing substance use therapy or counseling,
and substance use education.

Gynecological Exam: Involves the medical provider
gathering a medical history regarding reproductive health
and sexual behavior and conducting a pelvic and breast
exam.

Medical Providers: Licensed physicians (such as MDs
or DOs), registered nurses (RNs), nurse practitioners
(NPs), and physician assistants (PAs) who are authorized
to practice by the State and performing within the scope
of their practice as defined by State law. - orAn individual with a medical degree who is authorized to
practice by the state and is performing within the scope of
their practice as defined by state law, such as physicians
(MDs or DOs), registered nurses (RNs), nurse
practitioners (NPs), etc.
Mental Health Professionals: Individuals that are
Psychiatrists or Psychologists with at least a master’s
degree in psychology, and Social Workers with at least a
Master’s in social work (MSW, LCSW).
Mental Health Services: Includes evaluations and
appraisals conducted by mental health professionals to
diagnose or to identify mental health needs, as well as
ongoing mental health therapy and ongoing counseling.
FORM CJ-15 (03-15-2026)

Substance Use Treatment Professionals:
Individuals that are certified substance use or addiction
counselors, psychiatrists, or psychologists, with at least a
master’s degree in psychology, as well as social workers
with at least a Master’s degree in social work (MSW,
LCSW).
Therapy: Treatment of physical, mental, or behavioral
disorders or disease.
Treatment: Intervention designed to manage illness,
injury, disease or disorders.
Unauthorized Departures: Incidents in which a young
person leaves without staff permission or approval for
more than 10 minutes from the following: the physical
security perimeter of the facility, the mandatory supervision
of a staff member when there is no physical security; the
mandatory supervision of transportation staff, or any other
approved area.
Page 22

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File Modified	2024-09-26
File Created	2022-04-15