SOP 508.22-att-1: Sexual Allegation Notification and Evaluation Log

Division:
Mental Health Administration/Staff/Certification
Effective Date:
May 3, 2018
Reference Code:
VG55-0001
Topic Area:
508 Policy-MH Administration/Staff/Certification
PowerDMS:
View on PowerDMS
Length:
87 words

Summary

This form is used to document and track sexual allegations reported at correctional facilities, including notification to mental health staff and evaluation information. The log captures details about the alleged victim (offender), the evaluator who assessed them, whether they were already in mental health services or newly added, and notification information about the alleged perpetrator. Facilities must maintain completed logs for 10 years in the mental health area.

Key Topics

  • sexual allegations
  • sexual assault
  • mental health evaluation
  • trauma treatment
  • notification log
  • offender safety
  • SART (Sexual Assault Response Team)
  • evaluation tracking
  • mental health services
  • institutional safety
  • victim assessment

Full Text

SOP 508.22
Attachment 1

5/3/18
# SEXUAL ALLEGATION NOTIFICATION AND EVALUATION LOG

Evaluating Facility: Month: Year:

|Identifying information|Col2|Notification
To MH|Evaluation Information|Col5|Col6|Col7|Col8|Col9|Warden/Designee/SART
Notification|Col11|Alleged
Perpetrator
(check one)|Col13|
|---|---|---|---|---|---|---|---|---|---|---|---|---|
|Offender Name|GDC#|Date|Date|Evaluator
Name|Already
MH
Y/N|Added to
MH
Y/N|Follow-up
Evaluation

Date|Trauma
Treatment

Begin Date|Date/Time|Name|Offender|Staff|
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Form no. M55-01-01

Retention Schedule: Upon completion, this form shall be maintained in the mental health area for 10 years.

Attachments (4)

  1. Sexual Allegation Notification and Evaluation Log (87 words)
  2. Consent to Sexual Abuse Evaluation (343 words)
  3. Mental Health Sexual Allegation Follow-Up Report (100 words)
  4. Mental Health Initial Sexual Allegation Evaluation (616 words)
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