SSV5 form BJS markup

OMB No. 1121-0292: Approval Expires 07/31/2027
U.S. DEPARTMENT OF JUSTICE

SSV-5

FORM
(11-01-2024)

BUREAU OF JUSTICE STATISTICS

SURVEY OF SEXUAL VICTIMIZATION: 2023
State Juvenile Systems
Summary Form

AND ACTING AS COLLECTION AGENT

U.S. DEPT. OF COMMERCE
U.S. CENSUS BUREAU

DATA SUPPLIED BY

TELEPHONE
E-MAIL
ADDRESS

City

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

Number

FAX
NUMBER

State

▼

OFFICIAL
ADDRESS

Title

▼▼▼

Name

Area Code

ZIP Code
Number

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

What facilities are included in this data collection?
All State-operated juvenile residential placement facilities
used to house juveniles and youthful offenders, regardless of
age or reason for placement.
● INCLUDE State-operated juvenile residential facilities
such as: detention centers, training schools, long-term
secure facilities; reception or diagnostic centers; group
homes or halfway houses; boot camps; ranches; forestry
camps, wilderness or marine programs, or farms;
runaway or homeless shelters; and residential treatment
centers for juveniles.
● EXCLUDE privately operated facilities and
facilities operated or administered by local
governments. (These facilities will be
contacted directly for data on sexual
victimization.)
What persons and incidents are included in this
data collection?
Juveniles and youthful offenders, regardless of age or reason
for placement, under your custody between January 1, 2023,
and December 31, 2023.
● INCLUDE incidents involving juveniles or youthful
offenders under the authority, custody, or care of your
confinement or community-based facilities or staff.
● EXCLUDE incidents involving juveniles or
youthful offenders not held in facilities
operated by your State juvenile system.

Reporting instructions:
●
●

Please complete the entire SSV-5 Form.
If the answer to a question is "not available" or "unknown,"
write "DK" (do not know) in the space provided.
● If the answer to a question is "not applicable," write "NA"
in the space provided.
● Section I: when exact numeric answers are not available,
provide estimates and mark X inside the box beside each
figure.
● Sections II, III, and V: if the answer to a question is
"none" or "zero," write "0" on the line.
Substantiated incidents of sexual victimizaton:
● Please complete an Incident Form (Juvenile, SSV-IJ)
for each substantiated incident of sexual victimization.
Returning forms:
● If you need assistance, please call the U.S. Census
Bureau toll-free at 1–800–253–2078 or email
[email protected]
● Please return your completed summary and
substantiated incident forms by December 20,
2024.
● You may complete these forms online at:
https://ssv.census.gov/
● MAIL TO: U.S. Census Bureau, P.O. Box 5000,
Jeffersonville, IN 47199-5000
● FAX (TOLL FREE): 1–888–262–3974

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

2. On December 31, 2023, how many persons
held in the facilities reported in Item 1 were —

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

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

FACILITIES

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

INCLUDE all State-operated facilities used to house juveniles
or youthful offenders charged with or court-adjudicated for:

c. TOTAL (Sum of Items 2a and
2b) . . . . . . . . . . . . . . . . . . .

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

● Count persons held in the facilities reported in Item 1
regardless of age or reason for placement. Include
persons who were temporarily away but had assigned
beds on December 31, 2023.

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

3. On December 31, 2023, how many persons
held in the facilities reported in Item 1 were —

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

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

OR
b. Age 18 to 20 . . . . . . . . . . . . .

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

c. Age 21 or older . . . . . . . . . .
d. TOTAL (Sum of Items 3a
through 3c should equal Item
2c) . . . . . . . . . . . . . . . . . . . .

Section I – GENERAL INFORMATION
1. On December 31, 2023, how many facilities
operated by your State held juveniles or
youthful offenders CHARGED WITH or
COURT-ADJUDICATED FOR AN OFFENSE?

Number of facilities

....

● Count all persons held in the facilities reported in Item 1
regardless of age or reason for placement. Include
persons who were temporarily away but had assigned
beds on December 31, 2023.
4. Between January 1, 2023, and December 31, 2023,
how many persons were admitted to or discharged
from the facilities reported in Item 1?

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

a. TOTAL number admitted . . .

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

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

FORM SSV-5 (11-01-2024)

Page 2

Section II – YOUTH–ON–YOUTH SEXUAL VICTIMIZATION 5. Does your State juvenile system record

allegations of youth-on-youth SEXUAL ABUSE?

DEFINITIONS

01

This survey utilizes the PREA standard definitions for types
of sexual victimization. These categories are:

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

SEXUAL ABUSE

02

Sexual abuse of a youth, detainee, or resident by
another youth, detainee, or resident includes any of the
following acts, if the victim does not consent, is coerced
into such act by overt or implied threats of violence, or is
unable to consent or refuse:

02

No

All
Substantiated only

➔ Please provide an explanation as to why

your agency does not record youth-on-youth
SEXUAL ABUSE allegations, in the space
below, and skip to item 8.

(1) Contact between the penis and the vulva or the penis
and the anus, including penetration, however slight;
(2) Contact between the mouth and the penis, vulva, or
anus;
(3) Penetration of the anal or genital opening of another
person, however slight, by a hand, finger, object, or
other instrument; and

6. Between January 1, 2023, and December 31, 2023,
how many allegations of youth-on-youth SEXUAL
ABUSE were reported?

(4) Any other intentional touching, either directly or through
the clothing, of the genitalia, anus, groin, breast, inner
thigh, or the buttocks of another person, excluding
contact incidental to a physical altercation.

Number reported . . . . . . .
● If the allegation involved multiple victims and/or
perpetrators, count only once. If an allegation included
repeated abuse with the same victim/s and perpetrator/s
involved, count only once.

SEXUAL HARASSMENT
Repeated and unwelcome sexual advances, requests for
sexual favors, or verbal comments, gestures, or actions
of a derogatory or offensive sexual nature by one youth,
detainee, or resident directed toward another.

● Exclude any allegations that were reported as
consensual.
7. Of the allegations reported in Item 6, how
many were — (Please contact the agency or office
responsible for investigating allegations of sexual
victimization in order to fully complete this form.)
a. Substantiated . . . . . . . .
● The event was investigated and determined to have
occurred, based on a preponderance of the evidence
(28 C.F.R. §115.72).
b. Unsubstantiated . . . . . .
● The investigation concluded that evidence was
insufficient to determine whether or not the event
occured.
c. Unfounded . . . . . . . . . .
● The investigation determined that the event did NOT
occur.
d. Investigation ongoing . .
● Evidence is still being gathered, processed or evaluated,
and a final determination has not yet been made.
e. TOTAL (Sum of Items
7a through 7d) . . . . . . .
● The total should equal the number reported in
Item 6.

FORM SSV-5 (11-01-2024)

Page 3

8. Does your State juvenile system record
allegations of youth-on-youth SEXUAL
HARASSMENT? (See definitions on page 3.)
01

Yes

➔ Do you record all reported

allegations or only substantiated
ones?
01
All
02

02

No

Substantiated only

➔ Please provide an explanation as to why

your agency does not record youth-on-youth
SEXUAL HARASSMENT allegations, in
the space below, and skip to Section III.

9. Between January 1, 2023, and
December 31, 2023, how many allegations of
youth-on-youth SEXUAL HARASSMENT were
reported?
Number reported . . . . . . .
● If the allegation involved multiple victims and/or
perpetrators, count only once. If an allegation
included repeated harassment with the same
victim/s and perpetrator/s involved, count only
once.
● Exclude any allegations that were reported as
consensual.
10. Of the allegations reported in Item 9, how
many were — (Please contact the agency or office
responsible for investigating allegations of sexual
victimization in order to fully complete this form.)

a. Substantiated . . . . . .

b. Unsubstantiated . . . .

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

d. Investigation ongoing .
e. TOTAL (Sum of Items
10a through 10d) . . . . .
● The total should equal the number reported in
Item 9.
FORM SSV-5 (11-01-2024)

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Section IV – PRIVATE AND LOCAL ALLEGATIONS
14. Does your State juvenile system record
allegations of STAFF SEXUAL HARASSMENT?
(See definitions on page 5.)
01

02

Yes

No

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

➔ Can these allegations be counted
separately from allegations of
STAFF SEXUAL ABUSE?
01

Yes

02

No

01

Yes

02

No

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

➔ Skip to Item 17.

➔ Please provide an explanation as to why

your agency does not record STAFF
SEXUAL HARASSMENT allegations, in
the space below, and skip to Item 17.

01

Yes

02

No

Section V – TOTAL SUBSTANTIATED
INCIDENTS OF SEXUAL VICTIMIZATION
19. What is the total number of substantiated
incidents reported in Items 7a, 10a, 13a,
and 16a?
Total substantiated
incidents . . . . . . . . . . . . .

➔ Please complete a Substantiated Incident Form
(Juvenile, SSV-IJ) for each substantiated
incident of sexual victimization.

15. Between January 1, 2023, and
December 31, 2023, how many allegations of
STAFF SEXUAL HARASSMENT were reported?

NOTES

Number reported . . . . . . .
● If the allegation involved multiple victims and/or
perpetrators, count only once. If an allegation included
repeated harassment with the same victim/s and
perpetrator/s involved, count only once.
16. Of the allegations reported in Item 15, how
many were — (Please contact the agency or
office responsible for investigating allegations of
sexual victimization in order to fully complete this
form.)
a. Substantiated . . . . . . .

b. Unsubstantiated . . . . .

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

d. Investigation ongoing .
e. TOTAL (Sum of Items
16a through 16d) . . . . .
● The total should equal the number reported in
Item 15.

FORM SSV-5 (11-01-2024)

Page 6