17.1 Juvenile Custody Report - Oregon (Page 2 of 3) in pdf

17.1 JUVENILE CUSTODY REPORT

Pursuant to Section 223(a) (14) States must have an adequate system of monitoring for compliance with the four core requirements. Facilities must collect data on juveniles held

and must report the data to the state. In addition, the state must conduct regular on-site visits to monitor all adult jails and lockups to verify the reported data.

17.1.1 – FACILIY IDENTIFICATION

AGENCY/DEPARTMENT:

_______________________________________________________________________________________________________

(Parent Institution)

_______________________________________________________________________________________________________

AGENCY ADDRESS:

FACILITY NAME:

______________________________________________________________________________

(If different than above)

FACILITY ADDRESS:

______________________________________________________________________________

(If different than above)

17.1.2 – CONTACT INFORMATION

AGENCY HEAD:

First:__________________ Last:____________________________ ________________Title:__________________________

(Parent Institution)

Phone: (_______)_________-_______________Email:_________________________________________________________

AGENCY CONTACT:

REPORTER NAME:

First:____________ Last:_________________________ Title: _________________________

(If different than above)

REPORTER CONTACT:

Phone: (_____)______-_

__ __Email:__________________________________________

(If different than above)

17.1.3 – SUMMARY REPORT

Today’s Date: _____/_____/______

Is a full six month period covered in this report?

__ Yes __ No

If so, please indicate from: _____/_____/______ to: _____/_____/______

During the period requested was the facility for which you are reporting used for the temporary confinement of any youth?

__ Yes __ No

If yes, please provide the summary of the total youth documented in facility custody for the period requested:

____________

If any, provide the number of status offenders securely confined for this period, enter zero if none:

____________

If any, provide the total number of youth held in facility custody over six hours, enter zero if none:

____________

If any, provide the number of youth who sustained contact with adult offenders while in facility custody:

____________

17.1 Juvenile Custody Report - Oregon Page 2

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