Free STANDARD INDIANA - Indiana

STANDARD INDIANA PROBATION REPORTS:

PRELIMINARY INQUIRY, PREDISPOSITIONAL REPORT, & MODIFICATION REPORT Instruction Manual

Indiana Judicial Center 30 S. Meridian Street, Suite 900 Indianapolis, Indiana 46204-3564 June 18, 2009

TABLE OF CONTENTS
I. Introduction ......................................................................................................................... 4

II. Purpose and Philosophy ...................................................................................................... 6 III. Preliminary Inquiry Instructions a. Section 1 i. Report Header ........................................................................................... 7 ii. Juvenile's Personal Information ................................................................ 7 b. Section 2 ­ Juvenile's Current Status i. Current Delinquent Act(s) Information ..................................................... 8 ii. Detention Information ............................................................................... 9 iii. IV-E Findings ­ Reasonable Efforts/Best Interests ................................... 9 c. Section 3 ­ Juvenile's Background i. Prior Legal History .................................................................................. 10 ii. Family Information ................................................................................. 11 iii. Siblings .................................................................................................... 11 iv. School Information .................................................................................. 11 v. Employment Information ........................................................................ 12 vi. Health Information .................................................................................. 12 vii. Substance Abuse Information ................................................................. 12 d. Section 4 ­ Evaluation & Recommendation i. Evaluation/Summary ............................................................................... 12 ii. Recommendation ..................................................................................... 13 iii. Permanency Plan ..................................................................................... 13 IV. Predispositional Report Instructions a. Section 1 i. Report Header ......................................................................................... 14 ii. Juvenile's Personal Information .............................................................. 14 b. Section 2 ­ Juvenile's Current Status i. Current Delinquent Act(s) Information ................................................... 14 ii. Client/Parent Statement ........................................................................... 14 iii. Victim Impact Statement ......................................................................... 15 c. Section 3 ­ Juvenile's Background i. Prior Legal History .................................................................................. 16 ii. Family Information ................................................................................. 16 iii. Siblings .................................................................................................... 16 iv. School Information .................................................................................. 16 v. Employment Information ........................................................................ 16 vi. Health Information .................................................................................. 16 vii. Substance Abuse Information ................................................................. 16 d. Section 4 ­ Financial Information i. Income ..................................................................................................... 16 ii. Child Related Expenses ........................................................................... 17 iii. Additional Financial Information ............................................................ 17 iv. Additional Financial Information if Recommending Placement............. 17 e. Section 5 ­ Additional Information

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i. Home Environment ................................................................................. 18 ii. Prior Services & Adjustment Pending Disposition ................................. 19 f. Section 6 ­ Statement of Needs i. Summary of Risk & Needs Assessments ................................................ 19 g. Section 7 ­ Evaluation & Recommendation i. IV-E Findings ­ Reasonable Efforts/Best Interests ................................. 19 ii. Permanency Plan ..................................................................................... 19 iii. Evaluation/Summary ............................................................................... 20 iv. Statement of DCS Concurrence/Alternative Recommendation .............. 21 v. Probation Recommendation .................................................................... 21 V. Modification Report Instructions ...................................................................................... 22

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INTRODUCTION
The following is the Standard Preliminary Inquiry, Predispositional Report, Modification Report and Instruction Manual. Although originally created in 1995 in response to the state-wide need for standardization, it has been modified to meet the new statutory requirements created as a result of House Enrolled Act 1001. These standard reports provide a format for collecting and reporting information useful to the juvenile court judicial officer in considering the disposition of a juvenile. Preliminary Inquiry The fields contained in the preliminary inquiry report should be considered MINIMUM information. If a jurisdiction has the need or desire to include additional information, it may be added to the report in whatever section is appropriate. However, none of the fields contained in this standard report may be deleted and must remain in the same section of the standard report. The preliminary inquiry should provide the court with basic information regarding an offender. Per statute, this information is also shared with the prosecutor to assist them in determining whether further action is required. It is understood that this information received from the parent(s) and juvenile will not always be able to be verified prior to the report's submission to court. However, probation officers should attempt to gather and verify all information at this stage of the proceedings whenever possible. Predispositional Report In order to simplify the report preparation process, the PDR was created to mirror the Preliminary Inquiry as much as possible. This may allow jurisdictions to utilize the original PI on a case and subsequently modify the document to be used as a PDR. This will minimize the time spent retyping much of the information. The primary differences in the PDR from the PI are as follows: 1. The Detention Information section was removed as that section in the PI addresses the initial detention/release decision only; 2. The IV-E Findings were moved to the end of the report as it applies to disposition recommendations in the PDR instead of detention decisions in the PI; and 3. New sections were added including Client/Parent Statement, Victim Impact Information, Financial Information, Home Environment, Prior Services & Adjustment During Pending Disposition, Summary of Risk & Needs Assessments, & Statement of DCS Concurrence/Alternative Recommendation. At a minimum, each section of the PDR must contain the shaded headers and fields included in the standard PDR form. Jurisdictions may choose to add additional information in certain sections based on the needs in their jurisdiction. However, because of statutory requirements, jurisdictions are strongly encouraged to follow the outline of the following sections verbatim: · Financial Information · IV-E Findings; Reasonable Efforts/Best Interests · Permanency Plan · Evaluation/Summary The committee members also understand that many juvenile court judges will proceed to disposition at the initial hearing and the parties will choose to waive the predispositional report. In this instance, the preliminary inquiry may serve as the predispositional report.

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Modification Report The modification report is designed to provide the Court with updated information on the youth's situation. It is not meant to repeat the same information that was contained in the PDR unless it may directly impact the modification decision. As with the PDR, the Modification Report must contain the shaded headers and fields in each section. Jurisdictions may choose to add additional information to certain sections based on the needs in their jurisdiction. However, because of statutory requirements, jurisdictions are strongly encouraged to follow the outline of the following sections verbatim: · Financial Information · IV-E Findings; Reasonable Efforts/Best Interests · Permanency Plan · Evaluation/Summary

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PURPOSE AND PHILOSOPHY
The original Preliminary Inquiry (PI) and Predispositional Report (PDR) were created in 1994 in accordance with the wishes of judges and probation officers. Based on statutory changes over the years, the reports have been modified. While working on those updates, it was also the belief of many probation officers and judges that a standard Modification Report would help ensure that statutory requirements are met. Subsequently, a standard Modification Report was also created. The primary use of the preliminary inquiry is to provide the court with basic information regarding the offender. Based on this information, an appropriate decision may be made regarding probable cause and detention/release options. It may also serve as a predispositional report in those instances in which the court proceeds to disposition at the time of the initial hearing. It should also be noted that a preliminary inquiry and the intake process are separate functions. Intake is the detention/release decision made by the probation officer and any related paperwork. The preliminary inquiry is the report prepared by the probation officer to be submitted to the court. The primary use of the predispositional report is to provide information to the Court which is essential to the judge in making an appropriate disposition. Complete and accurate information about all aspects of the case, with a recommendation when appropriate, enhances the Court's ability to order a disposition which represents the best interests of the juvenile, the family, and the community. The purpose of developing a standard PDR is to ensure that each juvenile who comes before the Juvenile Court for disposition has a statewide standard report. Having a standard report format will help all members in the juvenile justice/corrections system in the execution of their responsibilities. Once the disposition has been entered, the PDR becomes the cornerstone of a juvenile intervention plan. Information it contains can be used to develop risk assessments, needs assessments, and classification status. Whether the juvenile is on probation or committed to an institution, good intervention and proper treatment for the juvenile relies on a quality prepared PDR. Additional information can be attached so that as a juvenile progresses through the juvenile justice system, each successive correctional component will have the benefit of a complete juvenile profile. The primary use of the modification report is very similar to the purpose of the PDR in that it is designed to provide the Court information essential to the judge in making an appropriate decision. However, because it is being used to modify an existing disposition, the modification report should be used to only report new and/or updated information; it is not designed to repeat details already included in the original PDR.

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PRELIMINARY INQUIRY INSTRUCTIONS
The objective of this standard preliminary inquiry is to make a significant amount of necessary information available to the juvenile court judge at first glance. It is recognized that many times this information will not be complete and/or verified depending on each jurisdiction's processes. However, it is important that the preliminary inquiry is as complete and accurate as possible at this stage. SECTION 1 Report Header FIELD Date Prepared Case No.(s) EXPLANATION Enter the date the report was completed. Give complete case number. (Example: 45D01-9208-JD-563). If the PI is being written for more than one case, list all appropriate case numbers. Do not use abbreviations or other inter-office case numbers. Note: Administrative Rule 8 - Uniform Case Numbering System, Supreme Court of Indiana requires all courts to use the terminology of "Case" number rather than "cause" number, although some courts still refer to case number as cause number. Enter the Juvenile's full name Enter the date of the next hearing Enter the name of the probation officer who completed the report This category provides the reader with a complete listing of all the sources of information used in completing the report. Be specific and do not use local jargon which would not be understood by others.

In the Matter of Scheduled Court Date Report Prepared By Sources of Information

Juvenile's Personal Information FIELD Legal Name Alias(es)/Nickname(s) Custodial Person(s) or Agency EXPLANATION Indicate the juvenile's true and legal name Self-explanatory Indicate the person or persons who currently have legal and/or physical custody of the juvenile. This person or persons may be the natural parent(s), step-parent(s), aunt/uncle, detention center, sheltercare facility, or other persons with whom the child is currently living and is being cared for. If placed out of the home, the address and date of placement should be reported in Custody Status under the DELINQUENT ACTS section. Give the complete current address for the juvenile Self-explanatory Self-explanatory Self-explanatory Juvenile's social security number

Street Address City State Zip SSN

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DOB Age, Race, Gender

Month, day and year of birth All self-explanatory SECTION 2 ­ JUVENILE'S CURRENT STATUS

Current Delinquent Act(s) Information FIELD Alleged Offense(s) and Date Committed I.C. Code and Class of Offense EXPLANATION Include all charges as alleged or filed and the date committed for each offense. Note the Indiana Criminal Code for each offense and the class of the alleged or filed offense if it were committed by an adult. Enter the class of the offense on the line and select whether it was a felony or misdemeanor. NOTE: Jurisdictions can add as many lines as necessary for the alleged offense and related code information so that each offense is included in this report. Indicate the agency who referred the juvenile to the court on the current charge(s). Indicate the juvenile's current custody status (i.e., in detention; in shelter care; with a relative or other person). Jurisdictions may also choose to list checkboxes in this section to include their standard responses. These may include but are not limited to release to parent/guardian, detained, and released to shelter care. List any other persons and their case numbers who have been charged in connection with this offense. You may wish to also give a status or short summary of any disposition(s), if known or you may utilize the "Evaluation/Summary" section for this purpose. The purpose of this section is to provide the reader with a summary of the incident. The narrative should focus on details that describe the juvenile's behavior and be free of unnecessary terminology and superfluous facts. Keep in mind that probation officers complete this section by using the Delinquency Petition, the Probable Cause Affidavit and/or various types of Police reports--all documents prepared for a different purpose than ours. Probation uses the documents as the basis for identifying the delinquent behavior, assessing risks and needs, as well as assessing for the safety of the child and the community. If you are not able to narrate the official version because of time limits or the length of the Affidavit and police report, it may be appropriate to state the following: "See attached probably cause affidavit". This will give direction to the reader as to where to find the official version. If this method is used it will be necessary to attach that information to the preliminary inquiry, as indicated.

Referring Agency Custody Status

Co-Offender(s) Status/Case No.

Particulars of:

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Detention Information FIELD Was the youth detained If "yes" Reason for detention Parent/Guardian notified of detention hearing In unable to contact parent/guardian, describe the attempts made EXPLANATION Select yes or no Give the date, time, and location they were detained Select the reason the youth was detained. NOTE: The reasons for detention are set by statute and should not be altered in any way Select yes or no If the parents were not able to be contacted after the arrest, describe the attempts made to contact them. This would include details as to who was contacted, by what means they were contacted (i.e., phone, dispatch, etc.), and any other details that show the efforts probation made to contact the parent/guardian.

IV-E Findings ­ Reasonable Efforts/Best Interests This section is to be completed only if the youth was detained. FIELD Provide a description of services available before the removal of the child and the efforts made to provide these services EXPLANATION All services should be included in this narrative regardless of whether they were court ordered or not. Services may include government assistance, community-based programs or services the parents coordinated, or school-based services. Jurisdictions may choose to create a standard list of services that the probation officer can just choose from when completing the report. If this is done, it is important to also include an "Other" option where other services can be included that are not in the standard list. Options may include but are not limited to: · Anger Control · Psychological evaluation · Bonding assessments · Respite care · Clothing banks · Sex abuse treatment · Crisis shelter care · Shelter care · Day care services · Substance abuse services · Domestic violence services · Support groups · Food pantries · Township trustee services · Homebased counseling · Vocational rehabilitation services · Homebased parenting education · Intensive Family Preservation · Homemaker services · Housing assistance · Public assistance · Job training & employment · Food stamps · Medical & health services · Counseling services · Outpatient · TANF counseling/mental health · Parenting support services services · Prior CHINS services · Parenting assessments with · Prior Probation services · Diversion contract or without psych · Parenting classes · Prior CHINS Informal Adjustment contract · Psychiatric evaluation and treatment

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Provide an explanation why these efforts did not prevent removal of the child

Explain why these efforts were reasonable

The safety of the child precludes the immediate use of family services to prevent removal of the child because It is in the best interests of the child to be removed from the home environment and remaining in the home would be contrary to the health and welfare of the child because

Indicate the reason(s) why the child still needs removed from the home. As with the section above, jurisdictions may choose to create checklists within the report to simplify the process but should include an "Other" option for situations that do not fit one of the standard responses. Reasons may include but are not limited to: · Child continues to engage in aggressive and/or violent behavior · Child continues to disregard reasonable rules of the home · Child was uncooperative with probation services · Parent was uncooperative with probation services · Child committed new delinquent act · Child continues to abuse illegal substances · Child's continued illegal substance use places his/her physical and mental health in danger Like the questions above, jurisdictions may develop standard responses for the officer to choose from. Examples may include but are not limited to: · Prior services were implemented to address the juvenile's dangerous and/or delinquent behavior · Efforts were reasonable as determined by risk/needs assessment tool · Reasonable Efforts were precluded by the emergency nature of the detainment Standard responses may include but are not limited to: · Parent could not be located · Child was under the influence of alcohol/drugs; continued use of illegal substances places juvenile's physical and/or mental health in danger Standard responses may include but are not limited to: · Juvenile's actions pose danger to self and others · Parent is unable/unwilling to cooperate with services

SECTION 3 ­ JUVENILE'S BACKGROUND Prior Legal History FIELD Date of Referral Charge(s) Case No. Disposition EXPLANATION Indicate the date the juvenile was referred to the court on prior charges Indicate the nature of the prior referrals Indicate the case number for each prior referral Indicate the date of disposition and action taken (i.e. probation, commitment to DOC, etc.). Further details can be included in the "Additional information" section.

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Family Information The purpose of this section is to record information regarding the juvenile's parent(s), stepparent(s) and significant others. All people residing in the child's home should be included in this section by duplicating the "Other" section as many times as necessary. The specific person's name should be included in the heading for each section (i.e., "Mother's Name: Jane Doe"). FIELD Mother's/Father's Name DOB Race Marital Status Address Home Phone: Alternate Phone: Employment EXPLANATION The juvenile's biological parent. If unknown, state this. If the juvenile was adopted, the adoptive parent's name may be placed here. Month, day, and year of birth The race of the child's parent Indicate the marital status of the child's parent The parent's current home address - street, city, state, zip code The parent's home phone number, including area code An alternate phone number for the child's parent such as a cell phone number or work number The parent's place of employment and/or type of employment. If not currently employed, state this, including parent's usual type of employment, if applicable (i.e., unemployed clerical worker, unemployed due to disability, etc.). Detail the parent's criminal history and past involvement with DCS. Criminal history should include as many details as possible at this stage including offense, date of offense, and sentence. Select yes or no. This field must appear in the father's section only. Select the correct response based on how paternity was established. This field must appear in the father's section only.

Known Criminal or DCS History Paternity Established If yes

Separate, identical sections should be added for each family member in the home. The person's name and relationship should be listed in the header of that sections (i.e., "Other: Janis Doe, Maternal Grandmother). Siblings FIELD Name Relationship Age Address Legal History EXPLANATION List the sibling's name List the relationship (i.e., brother, sister, step-brother, step-sister, half-brother, etc.) List the sibling's age List the current address, including city, state, and zip Select yes or no. Details can be added in the "Evaluation/Summary" section if needed or jurisdictions may choose to add an "Additional Information" question to this section.

School Information FIELD School of the child's EXPLANATION Indicate the home school district, not the specific school

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LEGAL SETTLEMENT School currently attending or last attended Grade Status Is the child classified as special education School performance Employment Information FIELD Employed Employer: Other employment information Health Information FIELD Physical Health Concerns Mental Health Concerns Prescribed medications: - Compliant - Comments

Indicate the name of the school the juvenile currently attends or the one last attended. Indicate his/her current grade level (i.e., 7th grade). Select either Attending, Currently Suspended, Expelled, Not Attending. Jurisdictions may alter the options in this field to meet their needs. Select yes or no This is a narrative section to document details regarding the child's behavior, grades, and/or attendance.

EXPLANATION Select Yes or No Note the child's current place of employment. If the employer has more than locale, note which location (i.e., McDonald's ­ 38th & Lafayette Road) Note any details about the position held, hours, pay, etc.

EXPLANATION Select Yes or No. If yes, note any details of those concerns in the narrative section including diagnosis, limitations, etc. Select Yes or No. If yes, note any specific details including diagnosis, past/current counseling, etc. Select Yes or No Include the name of the medication as well as the dosage. Also note the specific condition the medication addresses (i.e., Asthma)

Substance Abuse Information FIELD History of Usage Additional Information EXPLANATION Select Yes or No Include any details about usage including drug of choice, frequency, age at first use, date of last use, prior treatment, etc.

SECTION 4 ­ EVALUATION & RECOMMENDATION Evaluation/Summary This section provides an opportunity for the writer to state any impressions he/she may have regarding the child or any other pertinent area. This section should also include any concerns he/she has regarding the detention or release decision. Other areas may include family interaction,

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youth's attitude, and any previous topic discussed which the writer feels would have any impact on the judicial officer's decision. The statements in this section should form a basis for the recommendations. Recommendation FIELD Preliminary Inquiry Recommendation Custody recommendation Comments EXPLANATION Select one of the five recommendations. Jurisdictions should not alter the choices as they are set by statute. Select the probation recommendation for the next hearing. This may be a detention and/or initial hearing. Jurisdictions may alter these options to meet the release/detention programs in their area. Note any comments that are pertinent to the above recommendations. This may include why the officer feels the recommendation is appropriate. However, it should be very concise as the more detailed basis should be contained in the Evaluation/Summary section noted above. This question is provided for those cases in which a recommendation for disposition is made at the time of the initial hearing. Examples could include probation, community service work, fees, or any other special condition which would be applicable. This section may also be utilized to request that the case be set for disposition in order to complete a predispositional report if the writer feels the juvenile's history should be investigated more thoroughly.

Recommendation if case proceeds to disposition

Permanency Plan This section will only be completed if the child has been removed from the home or removal is being recommended. This includes secure detention, shelter care, or any other situation in which the youth was not returned to the home. FIELD Plan Estimated Date for Permanency Plan Permanency Plan Court Hearing due date EXPLANATION Select the permanency plan for the youth. Jurisdictions should not alter these options in any way as they are the standard plans accepted by the Department of Child Services. The estimated date for the permanency plan must never be longer than one year. Enter the date the Permanency Plan Hearing must occur. Per statute, this must occur no more than 12 months from the date of first removal. This includes secure detention stays.

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PREDISPOSITIONAL REPORT (PDR) INSTRUCTIONS
The standard predispositional report (PDR) mirrors the standard preliminary inquiry (PI) in most sections. Subsequently, jurisdictions with the technological capabilities may choose to start with an existing PI and then edit it accordingly so that it can then serve as a PDR. In most cases, the probation officer should have additional details in most of the sections that can be added to the original information submitted in the PI. At this stage, probation officers are expected to make every attempt to verify all information provided. The instructions for the PDR also mirror the instructions for the PI. However, additional details and new information should now exist that did not at the time of the preliminary inquiry. At this stage, probation officers are expected to make every attempt to verify all information.

SECTION 1 Report Header See PI Instructions Juvenile's Personal Information See PI Instructions SECTION 2 ­ JUVENILE'S CURRENT STATUS Current Delinquent Act(s) Information See PI Instructions Client/Parent Statement FIELD Client Statement EXPLANATION The purpose of this section is twofold: (1) it affords the juvenile the opportunity to make a statement about their behavior and the extent of his/her involvement in the offense(s), and (2) it affords the probation officer the opportunity to probe into the mind of the juvenile in order to determine the level which they comprehend the seriousness of their situation. This determination is a key element in assessing the likelihood of future illegal behavior. The juvenile may make his/her own written statement. If the juvenile's statement is taken by the probation officer during an interview, attempt to take direct quotations. Ask the juvenile if he/she was under the influence of drugs or alcohol during the commission of the offense. Also, if other persons are involved, inquire into what this particular juvenile's role was in the offense(s). If there is significant difference between the juvenile's version and the official version, this should be noted. If the juvenile will not admit his/her involvement in the offense, note

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this in your report. You may try to elicit information as to how he/she perceives his/her innocence. Another purpose of this section is to gain an understanding of the juvenile's attitude toward his/her offense and victim. Also, be observant for what the potential may be for improved behavior based primarily upon his/her statement. (Example: Is the juvenile remorseful, does he/she exhibit regret and understanding into his/her charge(s) and the resulting consequences.) Inquire as to what the juvenile's attitude is toward the victim and what was his/her motivation for the offense. The purpose of this section is to determine the level of responsibility and the degree of positive influence that exists in the parent-child relationship. That determination can be revealed by learning how the parents have responded to the child's illegal behavior. This is another key element in assessing future behavior.

Parent Statement

Victim Impact Information The use of a Victim Impact Statement and related information in the predispositional report and dispositional proceeding is not mandated by statute in Indiana, as it is for an adult sentencing. However, the Probation Officers Advisory Board of the Judicial Conference of Indiana recommends that these statutory victim impact guidelines also be followed in preparing the predispositional report. The guidelines for this statement are set forth in IC 35-38-1-8.5. The purpose of this statement is to enable the victim or victim's representative to have an opportunity to make either an oral or written statement to the Court in reference to the impact of the delinquent behavior and its resulting effect(s) on the victim's life. This is also an opportunity for you as a PDR writer and probation officer to gain some understanding into the effect(s) the delinquent behavior has had or is having on the victim(s). The victim(s) can give you their opinion, comments, etc. either in writing or verbally. If taking an oral statement you should reduce the comments to written form. Use direct quotes when possible. Any letter or other correspondence received from the victim(s) may be attached to the report with reference being made that it is attached therein. Ensure that the victim has the opportunity to report any information, especially the financial, emotional, and physical effects of the delinquent behavior on the victim. FIELD Victim Statement EXPLANATION If there is no victim in the case, indicate "Not applicable". If probation attempted to contact the victim but was not successful, indicate "None obtained". If a statement was obtained, either verbally or in writing, the officer may either summarize the statement, quote it directly, or attach it to the PDR. If there is any financial loss to the victim it needs to be addressed at this time with specific amount of the loss given. If you were unable to contact the victim, note any efforts that were made.

Additional Information

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SECTION 3 ­ JUVENILE'S BACKGROUND Prior Legal History See PI Instructions Family Information See PI Instructions Siblings See PI Instructions School Information See PI Instructions Employment Information See PI Instructions Health Information See PI Instructions Substance Abuse Information See PI Instructions SECTION 4 ­ FINANACIAL INFORMATION The objective of this section is to provide the court with a profile of the family's current assets, expenses, and income. This information is especially significant in matters where the court must determine indigency, ability to pay for various court-referred services, attorney's fees, restitution on behalf of the juvenile, etc. Per statute, probation must provide the court with the information necessary to complete a Child Support Guidelines worksheet as well as the information necessary to make a IV-E eligibility decision. Financial information MUST be submitted for each and every person in the home including siblings. Income FIELD Earned Income EXPLANATION When entering earned income, it is extremely important that the officer indicate both the amount and the frequency of that pay (i.e., hourly, weekly, monthly, etc.). If the individual has more than 1 source of income, each source should be listed separately. Earned income is: · Payment received in the form of wages, salaries, commissions or profit from activities the individual is engaged in · In-kind earnings, such as goods or services, received in lieu of wages (The dollar value of the work would be established by the employer) · Profits from the sale of farm crops, livestock or poultry

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Child Support Order payee (list children) Social Security/SSI Other unearned income

Compensation from jury duty Tips (when the hourly wage of an employee is less than minimum wage, the possibility of tips is likely) If the individual RECEIVES child support for any of their children, list the name of the child and the amount received. RSDI or SSI If the individual has more than 1 source of income, each source should be listed separately. Both the type and the amount of that income must be listed (i.e., TANF - $100/month).
· ·

Unearned income is: · Income not acquired by current employment or services · These can be benefits or compensation fro service or prior employment such as disability, Railroad Retirement benefits, Department of Veteran Affairs pensions, unemployment compensation, payments based on need (TANF, food stamps, etc.), investment income, gifts and inheritances. Child Related Expenses FIELD Child care cost Child's share of health insurance EXPLANATION If there is a childcare cost associated with the child in front of the court, the officer must list the amount of that cost, including frequency, and the name of the individual who pays that cost. If the child is being covered by a health care plan paid for by a parent/guardian, the amount paid for his/her coverage must be listed as well as the name of the individual who pays for it. In order to determine this amount, it is necessary to look at the coverage provided by that employer. Parents should be able to report to the officer the difference in cost for the two insurance plans. For example, if the parent has "individual + 1" coverage and that is the only child covered by the plan, the difference in cost would be reported. If the parent has a "family" plan because there are multiple children covered, there would be no cost directly attributable to this individual child. Select whether the child is covered by Medicaid or a private insurer. If it is a private insurer, please note the name of that company.

Insurance type

Additional Financial Information FIELD Number of children in the home Number of overnights for this child with non-custodial parent EXPLANATION This pertains specifically to the number of children of the PARENT who are in the home. It does not include non-relatives living in the home. Select the number of nights the child spends with his/her noncustodial parent per year. These ranges have been established by the Child Support Guidelines Worksheet and should not be altered.

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Additional Financial Information if Recommending Placement This section should be used to document any assets/resources the family has. Both the current value of that asset and the specific name of the owner must be documented. FIELD Assets Current Value Owner EXPLANATION Assets include bank accounts, vehicles, insurance policies, retirement accounts, savings bonds, or cash on hand. Note the approximately value of that asset at the time of this report. Note the specific name of the individual who owns the asset. If it is a joint asset (i.e., joint checking account), make sure and list both names as the owner. SECTION 5 ­ ADDITIONAL INFORMATION Home Environment FIELD Home and Neighborhood EXPLANATION The objective of the section is to summarize information concerning the juvenile's home and neighborhood environment. Is there some correlation or relationship between the juvenile's environment and his/her delinquent behavior? The objective of this section is to examine and summarize the youth's adjustment in the home. Sample questions may include: · Does he abide by the rules his parent's have established? · Does he have a curfew? · Are the rules and expectations established by his parents appropriate? This information can be very meaningful to the court in evaluating the socialization of the juvenile. The juvenile and his/her parents should be encouraged to provide this information. The objective is to help assess the juvenile's morals/values, how these might relate to his/her current and past behaviors, etc. Typical questions might include: 1. What is the family's religious or spiritual affiliation? (e.g., Christian, Moslem, Native American, Jewish, etc.) Which denomination? 2. Name of Church/Mosque/Synagogue/Temple? 3. What is the length of membership and frequency of attendance? 4. What is the child's attitude (positive/negative) regarding his/her family's religion, or does he/she have different beliefs/practices? 5. What significance, if any, has religion had in the juvenile's life? 6. Has the juvenile ever been involved in a religious cult or experienced ritualistic abuse? The purpose of this section is to allow for an opportunity to report and contrast information concerning the juvenile's upbringing, and thereafter provide some evaluation of the results of the juvenile's social orientation in relation to his/her delinquent

Home Adjustment

Religious Orientation

Social Orientation

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behavior. Important events such as complications at birth, adjustment to kindergarten and elementary school, ability to make friends and the resulting friendships, religious vs. non-religious upbringing, hero figures, gang affiliation, etc. are just a few of the many factors which lend to the formation of the juvenile's "social orientation." Was he or she ever physically or sexually abused? Has he or she ever witnessed such abuse? Questions such as these need to be asked and explored, yet reported in an evaluative summary. Prior Services & Adjustment Pending Disposition FIELD Other Agency Involvement/Prior Services Provided EXPLANATION The objective of this section is to report on current or former services which are being, or have been, provided by other agencies within the community (i.e., Youth Services Bureau, private residential placements, Big Brother/Big Sister, church/religious assistance programs, etc.). See Appendix B, Worksheet, for example questions In this section, the officer should summarize the child's adjustment pending disposition. If release conditions were imposed by the court, the officer must indicate the child's level of compliance with those conditions. School and home issues should also be addressed such as school attendance and behavior, following curfew, etc.

Adjustment during pendency of Action

SECTION 6 ­ STATEMENT OF NEEDS Summary of Risk & Needs Assessment Per statute, probation is required to complete a risk and needs assessment for each case at the time of disposition. The results of these assessments should be summarized in this section. Risk assessments/reassessments must be completed a minimum of every 90 days. Subsequently, it may not be necessary to complete a new form if a child is already on probation and has had an assessment form completed within the past 90 days. As required by the Judicial Conference of Indiana, jurisdictions must use one of the approved risk assessment instruments.

SECTION 7 ­ EVALUATION & RECOMMENDATION IV-E Findings ­ Reasonable Efforts/Best Interests This section should only be completed if DCS funded services are being requested. For further details on the individual questions, see PI Instructions. Permanency Plan This section should only be completed if the child has been removed from the home or removal is being recommended. This includes secure detention. See PI Instructions for further details.

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Evaluation/Summary FIELD Evaluation EXPLANATION A Probation Officer has interviewed the juvenile, contacted family members, treatment providers, etc. and should be in a good position to make evaluation for the court. The purposes of this category should be used to: (1) Outline the results of the investigation in a way that the reader can comprehend the causative factors contributing to the child's delinquent behavior; (2) Measure the probability of future delinquency against the potential for rehabilitation; (3) To research and define the services utilized in the past and assess and determine what services will be needed in the future; and (4) Compare and contrast other pertinent information regarding treatment of codefendants, feeling of the victim/family members/community at large, etc. In order to achieve the objective of this category, it is suggested that the predispositional report writer employ an analytical approach for each case. 1. Identify the individuals and events that influenced the child during the formative years. 2. Use statements, facts, and impressions to describe what kind of person the child appears to be in light of known behavior. 3. State any concerns that your analysis reveals which might impact on the safety of the community or the child. 4. Indicate the areas of need that, if effectively addressed by appropriate court intervention, would contribute to the child's potential for future law abiding behavior. 5. Determine which forms of treatment are needed and identify services and facilities that can address the problems of the child. Dispositional Options Considered & Evaluation of Each Option The probation officer must include a listing and evaluation of every dispositional option considered. Jurisdictions may choose to develop a list of standard options and then allow the officer to evaluate each individually. Options may include but are not limited to: · Supervision by Probation Department with no services · Supervision by Probation Department with community-based services in the home · Remove the child from the home and place in another home (i.e., relative care or foster care) · Remove the child from the home and place in a shelter care facility · Remove the child from the home and place in a private facility for children (i.e., group home or residential facility) · Remove the child from the home and place in a secure detention facility for __ days · Award wardship to the Department of Correction

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Officers must address each option individually and note why the option is or is not appropriate. Statement of DCS Concurrence/Alternative Recommendation This section is only to be completed if the case was submitted to a DCS Service Consultant prior to disposition. Although it is best to summarize the DCS Consideration Report, officers may choose to note "please refer to the attached (included/incorporated, etc.) DCS Consideration Report". If jurisdictions choose to summarize the report, the officer must note whether or not the Service Consultant concurred with the probation recommendation, the specific recommendation made by probation and the alternative recommendation offered by the Service Consultant (if provided). Probation Recommendation The purpose of this category is to make a sound and logical recommendation for the disposition of this case based upon the conclusions that have been drawn from the Evaluation/Summary in accordance with the procedures adopted by the court of jurisdiction. Jurisdictions may develop their own style for this section. However, it is not necessary to justify your recommendation in this section as that information should be noted in the other sections of the report. Specifically, the Statement of Risk & Needs and the Evaluation sections should contain the information necessary to justify probation's recommendation. In addition, the Dispositional Options section should also contain similar information. Subsequently, it is recommended that this final section be kept as concise and direct as possible, noting only the specific recommendations.

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MODIFICATION REPORT INSTRUCTIONS
The Modification Report was designed to be used solely for modification hearings. Per statute, the modification report mirrors certain sections of the PDR. However, because the case has already been through the disposition process, many of the historical details surrounding family, school, and delinquent history has been eliminated. The focus, instead, is on the child's immediate needs, his/her compliance with the conditions of probation, and the additional services necessary to help the child succeed. As with the PI and PDR, the sections outlined in this report are considered minimum information each jurisdiction must include. However, additional information can be added based on the needs of each jurisdiction. Subsequently, if a Court decides that it would like the child's delinquent history included in each report, they may add that to this standard format. Although several sections in the standard PDR have been eliminated from the modification report, only two new sections have been added. Subsequently, please refer to the PDR instructions when completing a Modification Report. The new sections are as follows: Reason for Modification Request This section is to outline the basis of the modification request. The officer should include details regarding the child's non-compliance with existing conditions of probation. This may include new offenses and/or technical violations. Family/Living Situation A summary of the child's current family and living situation should be provided, including who they are currently residing with. Any issues or behavior problems in the home should be noted.

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