Sections II, III, and IV: if the answer to a question is
"none" or "zero," write "0" or mark the box ( )
provided.
OMB No. 1121-0292: Approval Expires 04/30/2018
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 30 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.
FORM
(4-26-2017)
SSV-3
SURVEY OF SEXUAL VICTIMIZATION, 2016
Name
Number and street or P.O. Box/Route Number
Area code
DATA SUPPLIED BY
Title
OFFICIAL
ADDRESS
TELEPHONE
E-MAIL
ADDRESS
Number
City State ZIP Code
FAX
NUMBER
Area Code Number
U.S. DEPARTMENT OF JUSTICE
BUREAU OF JUSTICE STATISTICS
U.S. DEPT. OF COMMERCE
Economics and Statistics Administration
U.S. CENSUS BUREAU
AND ACTING AS COLLECTION AGENT
Local Jail Jurisdictions
Section I: when exact numeric answers are not available,
provide estimates and mark ( ) the box beside each
figure.
What facilities are included in this data collection?
All confinement facilities usually operated by a local law
enforcement agency that are intended for adults but
sometimes hold juveniles.
If you need assistance, please call Greta Clark at the
U.S. Census Bureau toll–free at 1–888–369–3613,
option 2, or e-mail govs.ssv@census.gov
INCLUDE all jails and city/county correctional centers
that hold inmates beyond arraignment. Report on ALL
inmates, including those held in separate holding or
lockup areas within your facility.
MAIL TO: U.S. Census Bureau, P.O. Box 5000,
Jeffersonville, IN 47199-5000
FAX (TOLL FREE): 1–888–262–3974
What inmates and incidents are included in this
data collection?
Inmates under your custody between January 1, 2016, and
December 31, 2016.
INCLUDE incidents involving inmates under the
authority, custody, or care of your confinement or
community-based facilities or staff.
Burden Statement
INCLUDE special jail facilities (e.g., medical/treatment/
release centers, halfway houses, and work farms).
Reporting instructions:
Please complete the entire SSV-3 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.
Substantiated incidents of sexual violence:
Please complete an Incident Form (Adult, SSV-IA)
for each substantiated incident of sexual victimization.
Returning forms:
Summary Form
(Please correct any error in name, mailing address, and ZIP Code)
EXCLUDE inmates held in other jurisdictions.
Please return your completed summary
and substantiated incident forms by
August 1, 2017.
You may complete these forms online (see
enclosed instructions). Or if you prefer, you may
return these forms by mail or fax.
EXCLUDE privately-operated jails. (These
facilities will be contacted directly for data on
sexual victimization.)
X
X
INCLUDE multi-jurisdictional facilities (e.g., regional jails).
Ana Aranda
PREA Coordinator
1001 Washington Street
Laredo
Texas
78040
956
523-4553
Section II – INMATE-ON-INMATE SEXUAL VICTIMIZATION
FORM SSV-3 (4-26-2017)
1. How many persons under the supervision of your
local jail jurisdiction were—
a. CONFINED in your jail facilities on
December 31, 2016?
b.
INCLUDE new admissions only, i.e., persons officially
booked into and housed in your facilities by formal legal
document and by the authority of the courts or some
other official agency.
EXCLUDE returns from escape, work release, medical
appointments/treatment facilities, and bail or court
appearances.
Section I – GENERAL INFORMATION
INCLUDE repeat offenders booked on new charges.
INCLUDE persons on transfer to treatment facilities
but who remain under your jurisdiction.
INCLUDE persons out to court while under your
jurisdiction.
ADMITTED to your jail facilities during 2016?
INCLUDE persons held for other jurisdictions.
Inmates on
December 31, 2016 . . .
Male Female
New admissions
during 2016 . ........
Male Female
2.
To calculate the average daily population, add the
number of persons for each day during the period
January 1, 2016, through December 31, 2016, and
divide the result by 365.
Between January 1, 2016, and
December 31, 2016, what was the average
daily population of all jail confinement
facilities operated by your jurisdiction?
Average daily
population . ..........
Male Female
EXCLUDE persons housed in facilities operated by
two or more jurisdictions or those held in
privately-operated jails.
EXCLUDE all persons in non-residential
community-based programs run by your jail (e.g.,
electronic monitoring, house arrest, community
service, day reporting, work programs).
Contact between the penis and the vulva or the penis
and the anus including penetration, however slight;
EXCLUDE inmates on AWOL, escape, or long-term
transfer to other jurisdictions.
DEFINITIONS
The survey utilizes the definition of “sexual abuse” as
provided by 28 C.F.R. §115.6 in the National Standards
to Prevent, Detect, and Respond to Prison Rape (under
the Prison Rape Elimination Act of 2003). For purposes
of SSV, sexual abuse is disaggregated into three
categories of inmate-on-inmate sexual victimization.
These categories are:
NONCONSENSUAL SEXUAL ACTS
Sexual contact of any person without his or her consent,
or of a person who is unable to consent or refuse;
AND
OR
Contact between the mouth and the penis, vulva, or
anus;
OR
Penetration of the anal or genital opening of another
person, however slight, by a hand, finger, object, or other
instrument.
ABUSIVE SEXUAL CONTACT
Sexual contact of any person without his or her consent,
or of a person who is unable to consent or refuse;
AND
Intentional touching, either directly or through the clothing,
of the genitalia, anus, groin, breast, inner thigh, or
buttocks of any person.
Page 2
EXCLUDE incidents in which the contact was incidental
to a physical altercation.
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 inmate directed toward another.
12404
583
14800
8417
450
25
FORM SSV-3 (4-26-2017)
4. Between January 1, 2016, and December 31, 2016,
how many allegations of inmate-on-inmate
NONCONSENSUAL SEXUAL ACTS were reported?
Number reported .......
None
If an allegation involved multiple victimizations,
count only once.
Page 3
No
Yes
3. Does your local jail jurisdiction record allegations
of inmate-on-inmate NONCONSENSUAL SEXUAL
ACTS? (See definitions on page 2.)
a. Do you record all reported
occurrences, or only substantiated
ones?
All
b. Do you record attempted
NONCONSENSUAL SEXUAL ACTS or
only completed ones?
Both attempted and completed
Please provide the definition used by your
local jail jurisdiction for inmate-on-inmate
NONCONSENSUAL SEXUAL ACTS in the
space below. Use that definition to complete
Items 4 and 5.
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
occurred.
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
5a through 5d) .........
6. Does your local jail jurisdiction record
allegations of inmate-on-inmate ABUSIVE
SEXUAL CONTACT? (See definitions on page 2.)
None
None
None
None
None
5. Of the allegations reported in Item 4, how
many were — (Please contact the agency or office
responsible for investigating allegations of sexual
victimization in order to fully complete this form.)
02
No
Yes
Can these be counted separately from
allegations of NONCONSENSUAL
SEXUAL ACTS?
01
01
Yes
Please provide an explanation in the space
below and then skip to Item 9.
Skip to Item 9.
7. Between January 1, 2016, and December 31, 2016,
how many allegations of inmate-on-inmate
ABUSIVE SEXUAL CONTACT were reported?
Number reported .....
None
If an allegation involved multiple victimizations, count only
once.
a. Substantiated ........
b. Unsubstantiated .....
c. Unfounded ..........
d. Investigation ongoing .
e. TOTAL (Sum of Items
8a through 8d) ..........
None
None
None
None
None
8. Of the allegations reported in Item 7, how many
were — (Please contact the agency or office responsible for
investigating allegations of sexual victimization in order to
fully complete this form.)
The total should equal the number reported in
Item 7.
Exclude any allegations that were reported as
consensual.
Substantiated only
Completed only
The total should equal the number reported in Item 4.
No
02
01
02
01
01
02
02
Exclude any allegations that were reported as consensual.
FORM SSV-3 (4-26-2017)
Section III – STAFF-ON-INMATE SEXUAL ABUSE
DEFINITIONS
Intentional touching, either directly or through the
clothing, of the genitalia, anus, groin, breast, inner
thigh, or buttocks that is unrelated to official duties or
with the intent to abuse, arouse, or gratify sexual
desire;
The survey utilizes the definition of “sexual abuse” by a
staff member, contractor or volunteer as provided by
28 C.F.R. §115.6 in the National Standards to Prevent,
Detect, and Respond to Prison Rape (under the Prison
Rape Elimination Act of 2003). For purposes of SSV,
sexual abuse is disaggregated into two categories of
staff-on-inmate sexual abuse. These categories are:
STAFF SEXUAL MISCONDUCT
Any behavior or act of a sexual nature directed toward an
inmate by an employee, volunteer, contractor, official
visitor or other agency representative (exclude family,
friends or other visitors).
Sexual relationships of a romantic nature between staff
and inmates are included in this definition. Consensual or
nonconsensual sexual acts include—
OR
Completed, attempted, threatened, or requested
sexual acts;
OR
Occurrences of indecent exposure, invasion of
privacy, or staff voyeurism for reasons unrelated to
official duties or for sexual gratification.
Page 4
STAFF SEXUAL HARASSMENT
Repeated verbal statements, comments or gestures of a
sexual nature to an inmate by an employee, volunteer,
contractor, official visitor, or other agency representative
(exclude family, friends, or other visitors). Include—
Demeaning references to gender; or sexually suggestive
or derogatory comments about body or clothing;
OR
Repeated profane or obscene language or gestures.
a. Substantiated ........
b. Unsubstantiated ......
c. Unfounded ..........
d. Investigation ongoing .
e. TOTAL (Sum of Items
11a through 11d) ........
None
None
None
None
None
11. Of the allegations reported in Item 10, how many
were—
The total should equal the number reported in
Item 10.
10. Between January 1, 2016, and December 31,
2016, how many allegations of
inmate-on-inmate SEXUAL HARASSMENT were
reported?
Number reported .......
None
If an allegation involved multiple victims or
inmate perpetrators, count only once.
9. Does your local jail jurisdiction record
allegations of inmate-on-inmate SEXUAL
HARASSMENT? (See definitions on page 2.)
02
No
Yes
Do you record all reported
allegations or only substantiated
ones?
01
01
Substantiated only
Please provide an explanation in the space
below and then skip to Section III.
All
02
Exclude any allegations that were reported as
consensual.
1
1
1
FORM SSV-3 (4-26-2017)
Page 5
17. Of the allegations reported in Item 16, 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 .........
None
None
None
None
e. TOTAL (Sum of Items 17a
through 17d) ..........
None
d. Investigation ongoing .
15. Does your local jail jurisdiction record
allegations of STAFF SEXUAL HARASSMENT?
(See definitions on page 4.)
Yes
Can these allegations be counted
separately from allegations of
STAFF SEXUAL MISCONDUCT?
Yes
01
01
02
No
Please provide an explanation in the space
below and then skip to Item 18.
02
Skip to Item 18.
16. Between January 1, 2016, and
December 31, 2016, how many allegations of
STAFF SEXUAL HARASSMENT were reported?
Number reported .....
None
If an allegation involved multiple victims or staff,
count only once.
No
The number should equal the number
reported in Item 16.
13. Between January 1, 2016, and
December 31, 2016, how many allegations of
STAFF SEXUAL MISCONDUCT were reported?
Number reported .....
None
If an allegation involved multiple victimizations, or
staff, count only once.
14. Of the allegations reported in Item 10, 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
14a through 14d) ........
None
None
None
None
None
12. Does your local jail jurisdiction record
allegations of STAFF SEXUAL MISCONDUCT?
(See definitions on page 4.)
Yes
Do you record all reported
occurrences, or only substantiated
ones?
All
01
01
02
No
Please provide an explanation in the space
below and then skip to Item 15.
02
Substantiated only
The total should equal the number
reported in Item 13.
FORM SSV-3 (4-26-2017)
Section IV – TOTAL SUBSTANTIATED
INCIDENTS OF SEXUAL VICTIMIZATION
Page 6
18. What is the total number of substantiated
incidents reported in Items 5a, 8a, 11a,
14a, and 17a?
Total substantiated
incidents ............
None
Please complete a Substantiated Incident
Form (Adult, SSV-IA) for each substantiated
incident of sexual victimization.
NOTES
This data was collected using reports left by previous
PREA Coordinator.
Ana Aranda
PREA Coordinator
Clear Fields
Print Form
Save As