Dd Form 2951 - Initial Report Of Suspected Child Sexual Abuse In Dod Operated Or Sponsored Out-Of-Home Care Activities Page 4
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48. Probable Victims (Continued).
15. Years at Installation. Enter the number of years the
care provider currently has been at the installation.
d. Sponsor's Service. Enter the Service of the sponsor of
each child who has been identified as a probable victim. If a
16. Current Position Within Activity. Enter the care
child who has been identified as a probable victim is not a
provider's position title within the out-of-home care activity,
military dependent, enter "Unaffiliated".
such as program assistant, youth development specialist,
sports coach, teacher, etc.
9. Potential Victims in Other Out-of-Home Care Programs?
If there is reason to believe that the care provider who is the
17. Employment Status. Mark whether the care provider is
subject of the investigation has had significant opportunities
an employee, contractor or contract employee, or volunteer.
for access to other children in other DoD operated or
sponsored out-of-home care activities at the installation,
18. Current Position(s) in Other Out-of-Home Care
mark "Yes". If there is reason to believe that the subject has
Activities on Installation. List all other employed, contract, or
not had significant opportunities for access to other children
or youth in other DoD operated or sponsored out-of-home
volunteer positions the care provider currently has in
care activities at the installation, mark "No".
out-of-home care activities on the installation.
10. Total Estimated Potential Victims. Estimate the number
19. Previous Position(s) in Out-of-Home Care Activities on
of children or youth who may be victims, including those
Installation. List all other employed, contract, or volunteer
already identified as probable victims, because the care
positions the care provider previously had in out-of-home
provider had significant opportunities for access to them in
care activities on the installation.
DoD operated or sponsored out-of-home care activities at
the installation.
20. Previous Position(s) in Out-of-Home Care Activities at
Other Installation(s). List all other employed, contract, or
11. Estimated Age Range of Potential Victims. Based on
volunteer positions the care provider previously had in
the DoD operated or sponsored out-of-home care activities
out-of-home care activities on other military installations and
at the installation where the care provider had significant
the names of the installations. Provide dates if known.
opportunities for access to children and youth, enter the age
of the youngest child or youth and the age of the oldest child
or youth in such activities.
21. Dates, Types, and Results of Background Checks. List
the dates, types, and results of background checks
12. Sponsors of Potential Victims from Different Services?
performed on the care provider. Consult the Service's
If a child or youth who is a potential victim but who has not
out-of-home care policy that implements DoD Instruction
been identified as a probable victim has a sponsor in a
1402.5 for the types of background checks that should be
Service different from any sponsor of a child or youth who
and may have been performed.
has been identified as a probable victim, mark "Yes". If the
sponsors of all children or youth who are potential victims
22. Subject Status. Mark the current status of the care
but who have not been identified as probable victims are of
provider within the out-of-home care activity on the
the same Services as the sponsors of all children or youth
installation. Mark the current legal status of the allegations
who have been identified as probable victims, mark "No".
against the care provider.
Section C - Information on Subject of the Allegation.
13. Sex. Enter "M" if the care provider who is the subject of
the allegation is male and "F" if the subject of the allegation
is female.
14. Age. Enter the age of the care provider on his or her
last birthday.
DD FORM 2951 INSTRUCTIONS (BACK), JUN 2012
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