SOP_NUMBER: 508.22-att-3
TITLE: Mental Health Sexual Allegation Follow-Up Report
REFERENCE_CODE: VG55-0001
DIVISION: Mental Health Administration
TOPIC_AREA: 508 Policy - MH Administration/Staff/Certification
EFFECTIVE_DATE: 2018-05-03
WORD_COUNT: 100
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/353103
URL: https://gps.press/sop-data/508.22-att-3/

SUMMARY:
This form is used to document and follow up on sexual allegations involving offenders in GDC custody. Staff complete this report when an offender is involved in a sexual allegation (whether offender-on-offender or staff-on-offender) and place the report in both the offender's medical record and mental health file. The document is confidential and must be retained for 10 years after the offender no longer needs mental health services or completes their sentence.

KEY_TOPICS: mental health evaluation, sexual allegation, offender-on-offender, staff-on-offender, follow-up report, mental health file, medical record, confidential form, sexual misconduct, incident documentation

ATTACHMENTS:
  1. Sexual Allegation Notification and Evaluation Log
     URL: https://gps.press/sop-data/508.22-att-1/
  2. Consent to Sexual Abuse Evaluation
     URL: https://gps.press/sop-data/508.22-att-2/
  3. Mental Health Sexual Allegation Follow-Up Report
     URL: https://gps.press/sop-data/508.22-att-3/
  4. Mental Health Initial Sexual Allegation Evaluation
     URL: https://gps.press/sop-data/508.22-att-4/

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FULL TEXT:
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SOP 508.22
Attachment 3

5/3/18


**GEORGIA DEPARTMENT OF CORRECTIONS** Facility: _______________________________


**MENTAL HEALTH SEXUAL ALLEGATION** Name: _________________________________


**FOLLOW - UP REPORT** GDC #: ________________________________


DOB: _________________________________


Race: _________________  Sex: ___________


This offender was involved with a sexual allegation on _________________ (date).


The allegation was ____________________________________________.
(offender-on-offender; staff-on-offender)


____________________________________________________  ________________________
Signature/Title Date

Printed name: ____________________________________________________
# **CONFIDENTIAL**


Form no. M55-01-03

Retention Schedule: Upon completion, the original form shall be placed in the offender’s medical record (section 5) and mental health file
(section 4). At the end of the offender’s need for mental health services and/or sentence, the mental health file shall be placed within the
offender’s health record and retained for 10 years.