Hispanic or Latino 2 Not Hispanic or Latino 98 information missing for this

Hispanic or latino 2 not hispanic or latino 98

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1.____ Hispanic or Latino 2.____ Not Hispanic or Latino 98.___ information missing for this case 99.___ information not being collected 43. What is the alleged offender’s age in years? 1._____(AGE IN YEARS) 98.___ information missing for this case 99.___ information not being collected
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Page 10 of 34 44. If alleged offender’s age is unknown, was he/she ? 1.____ a child 2.____ an adolescent 3.____ an adult 98.___ information missing for this case 99.___ information not being collected 45. Was the alleged offender living with the child at the time of the abuse? 1.____ yes 2.____ no 98.___ information missing for this case 99.___ information not being collected 46. Was the alleged offender reported to be under the influence of alcohol or drugs at the time of the alleged abuse? 1.____ no 2.____ yes, alcohol 3.____ yes, other drugs (SPECIFY:_______________________________) 4.____ yes, alcohol and other drugs 98.___ information missing for this case 99.___ information not being collected 47. Was the alleged offender reported to have given alcohol or drugs to the child as part of the abusive act? 1.____ no 2.____ yes, alcohol 3.____ yes, other drugs (SPECIFY:________________________________________________) 4.____ yes, alcohol and other drugs 98.___ information missing for this case 99.___ information not being collected 48. At the time of the very first investigative interview, had an alleged offender been identified? 1.____ yes 2.____ no 98.___ information missing for this case 99.___ information not being collected 49. If yes, had the alleged offender been arrested or otherwise detained? 1.____ yes 2.____ no 98.___ information missing for this case 99.___ information not being collected
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Page 11 of 34 50. At the time of the very first investigative interview, had any court issued a restraining order to protect the child from the alleged offender? 1.____ yes 2.____ no 98.___ information missing for this case 99.___ information not being collected 51. What was the alleged offender’s initial response to the allegation of abuse? 1.____ denies all wrongdoing 2.____ neither denies nor admits 3.____ admits abusive act, but takes no responsibility 4.____ admits and takes full responsibility for the abusive act 98.___ information missing for this case 99.___ information not being collected 52. What was the alleged offender’s final response to the allegation of abuse? 1.____ denies all wrongdoing 2.____ neither denies nor admits 3.____ admits abusive act, but takes no responsibility 4.____ admits and takes full responsibility for the abusive act 98.___ information missing for this case 99.___ information not being collected 53. Was there more than one alleged offender involved in the abuse? 1.____ yes 2.____ no 98.___ information missing for this case 99.___ information not being collected 54. If more than one alleged offender was reported, how many others were identified? 1. _______ (NUMBER OF OTHER PERPETRATORS) 98.___ information missing for this case 99.___ information not being collected V. DISCLOSURE AND REPORTING 55. What was the first indicator that the child might have been abused? (CHECK ONE): 1.____ child disclosure 2.____ child behavior 3.____ psychopathological symptoms ( e.g., anxiety, depression) 4.____ overt physical signs (e.g., bruises) 5.____ medical evidence 6.____ witness 7.____ contact with suspected or known offender
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Page 12 of 34 8.____ other (SPECIFY:____________________________________________________________) 98.___ information missing for this case 99.___ information not being collected 56. Did the child involved in the abuse, make a disclosure of that experience?
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