Risk Assessment Hattie." l.1 ..-. ..fuh???37,7- .. Name: ION ndei - Gender: Marl us: Agency: Male Single DAI . ., I 233:7.4.? .- .H.. v? a -- n'h- . V. av?i? mm a? Mom: 1??Case ifier: Scale Set: Screener: Wisconsin Core - Community Languagg Current Charges El Homicide Weapons Assault? Kr?s'oi' Robbery Burglary Cl Property/Larceny CI Fraud Cl Drug Traf?cking/Sales . Cl Drug Possession/Use Other Sex Offense with Force Cl Sex Offense w/o Force . 1. Do an current offenses involve family violence? El No Yes 2. Which offense cat ory represents the most serious current offense? Cl Misdemeanor Non-violent Felony El Violent Felony 3. Was this person on probation or aroie at the time of the current offense? El Probation Parole Both Neither 4. Based on the screener?s observations, is this person a suspected or admitted gang member? No Yes 5. Number of nding charges or holdsthe current top charge felony property or fraud? El No Yes Criminal History Exclude the current case for these questions. 7. How many times has this person been arrested before as an adult or juvenile (criminai arrests only)? 5 8. How man rior ?uveniie felony offense arrests? 2 9. How manBrior juvenile violent felony offense arrests? 1 2+ 10. How man rior commitments to a juvenile institution? Cl 0 1 - 2+ 02m: ltm?lhminte, Inc. All rights reservul. w- .- ?44' ?we?u- Note to Screener: The following Criminal History Summary questions require you to add up the total number of specific types of offenses In the person?s criminal history. Count an offense type if it was among the charges or counts within an arrest event. Exclude the current case for the following questiOns. 711. How rnanEimes has this erson been arrested for a felony property offense that included an element of violence12. How man rior murder/voluntary manslaughter offense arrests as an adult? El 0 1 2 3+ 13. How manEprior felony assault offense arrests {not murder, sex, or domestic violence) as an adult14. How man rior misdemeanor assault offense arrests (not sex or domestic violence) as an adult? 0 1 2 3+ . 15. How man rior family violence offense arrests as an adult? 0:11 2 83+ 16. How man rior sex offense arrests (with force) as an adult17. How man rior weapons offense arrests as an adult18. How man rior drug traf?cking/sales offense arrests as an adult19. How man rior drug possession/use offense arrests as an adult? 1 i 2 Ci 3+ 20. How manEimes has this rson been sentenced to jail fer 30 days or more? [301 203E214 5+ 21. How man times has this rson been sentenced (new commitment) to state or federal prison? C101 2E3D4 5+ 22. How has this rson been sentenced to probation as an adult? 001.]28384 5+ Include the current case for the following question(s). 23. Has this person, while incarcerated in jail or prison, ever received serious or administrative disciplinary infractions fer htin [threatening other Inmates or staff? No Yes 24. What was the age of this person when he or she was ?rst arrested as an adult or juvenile (criminal arrests only)? 14 Non-Compliance Include the current case for these questions. 25. How man times has this erson violated his or her parole? Elam 283E342 5+ 26. How manbtimes has this erson been returned to custody while on parole? @0131 253134 15+ 27. How manbtimes has thiEierson had a new charge/arrest while on probation? E3081 2038M 5+ 28. How manEimes has thigerson?s probation been violated or revoked? 2D3l34 5+ was?: @1131]. mm, lit. AH rights reserved-.. 29. How man times has this rson failed to appear for a scheduled criminal court hearing? 0131 25384 5+ 30. How manElm has the person been arrested/charged w/new crime while on pretrial release (includes current)? 2 3+ Family Criminality 31. 32. 33. 34. 35. 36. 37. 38. The next few questions are about the family or caretakers that mainly raised you when growing up. Which of the following best describes who principally raised you? Both Natural Parents Natural Mother Only Natural Father Only Ci Relativels) Cl Adoptive Parent(s) Cl Foster Parent(s) Other arrangement if you lived with from parents and th later separated how old were you at the time? Less than orolderljooes NotApply Was your father (or father ?gure who principally raised you) ever arrested, that you know of? No El Yes Was your mother (or mother ?gure who principally raised you) ever arrested, that you Know of? No [3 Yes Were our brothers or sisters ever arrested, that you know of? Cl No Yes Was your wife/husband/partner ever arrested, that you know of? No Yes Did a rent or parent ?gure who raised you ever have a drug or alcohol problem? No Yes Was one of your parents (or parent ?gure who raised you) ever sent to jail or prison? El No Yes Peers 39. 41. 42. 43. Please think of your friends and the people you hung out with in the past few (3-6) months. How maltylof your frien?acqualntances have ever been arrested? Cl None Few Half Most . How man of your friends acquaintances served time in jail or prison? None Few Half Most How man?of your friends acquaintances are gang members? 13 None Few Half Most l-low manf your friends/aoquaintances are taking illegal drugs regularly (more than a couple times a month)? None Few Half Cl Most Have you ever been a gang membergang member? Substance Abuse ?2011 Hotlhpohie, inc. NI rights reserved. What are your usual habits in using alcohol and drugs? ?Page? ?lrm?m- - 45. Do you think your current/past legal problems are partly because of alcohol or drugs? No Cl Yes 46. Were Eu using alcohol or under the in?uence when arrested for your current offense? No Yes 47. Were ou using drugs or under the in?uence when arrested for your current offense? No Yes 48. Are you currently in formal treatment for alcohol or drugs such as counseling, outpatient, inpatient, residential? No Yes 49. Have you ever been in formal treatment for alcohol such as counseling, outpatient, inpatient, residential? No Yes 50. Have you ever been in formal treatment for such as counseling, outpatient, inpatient, residential? No Yes 51. Do you think you would benefit from getting treatment for alcohol? No Yes 52. Do youthink you would bene?t from getting treatment for drugs? No Li Yes 53. Did you use heroin, cocaine, crack or methamphetamines as a juvenile? No Yes Residence/Stability 54. How often dcgou have contact with your family may be in person, hone, mail)? No family Never [3 Less than once/month Once per week Daily 55. How often have ou moved in the last twelve months? DNeverlZ1 56. Do you have a regular living situation (an address where you usually stay and can be reached)? No [3 Yes 57. How long have you been living at your current address? 0-5 mo. 6-11 mo. 1-3 yrs. CI 4-5 yrs. [3 6+ yrs. 58. Is there a telephone at this residence (a cell phone is an appropriate alternative)? '3 No Yes 59. Can you provide a veri?able residential address? No Yes 60. How long have you been living in that community or neighborhood? Clo-2 mo. [3 3-5 mo. Cl 6-11 mo. IE 1+ yrs. 61. Do you live with family?natural parents, primary person who raised you, blood relative, spouse, children, or boy/girl friend if living together for more than 1 yearyou live with friends? No Yes 63. Do you live alone? No Yes 64. Do you have an alias {do you sometimes call yourself by another name)? No I: Yes Social Environment Think of the neighborhood where you lived during the past few (3-6) months. 65. Is there much crime in your neighborhood? El No CI Yes Sun version 8.1.18.1: 02011 liar-thwarts. Inc. All rights reserved. . m. up. t" . 66. Do some of your friends or family feel they must carry a weapon to protect themselves in your neighborhood? No Yes 67. In your neighborhood, have some of your friends or family been crime victims? No El Yes 68. Do some of the people in your neighborhood feel they need to carry a weapon for protectionget drugs in your neighborhood? No Yes 70. Are there gangs in your neighborhood? No l3 Yes Education Think of your school experiences when you were growing up. 71. Did you complete your high school diploma or No Yes 72. What was your ?nal grade completed in school? 9 73. What were ur usual grades in high school? DADB Did NotAttend 74. Were Eu ever suspended or expelled from school? Cl No Yes 75. Did you?fail or repeat a grade level? El No Yes 76. How often did you have con?icts with teachers at school? Never El Sometimes Often 77. How man?times did you skip classes while in school? Never Sometimes CI Often 78. How strongly do you ree or dlsa ree with the followin I always behaved myself in school? C) Strongly Disagree Disagree Not Sure Agree Strongly Agree 79. How o?en did you get In while at school? Never Sometimes Often Vocation (Work) Please think of your past work experiences, job experiences, and ?nancial situation. 80. Do you have a job? No Yes 81. Do you currently have a skill, trade or profession at which you usually ?nd work? No Yes 82. Can you verify your employer or school (if attending)? [21 No Yes 83. How much have you worked or been enrolled in school in the last 12 months? El 12 Months Full-time Cl 12 Months Part-time Ci 5+ Months Full-time 0 to 6 Months 84. Have ever been ?red from a job? No -. Yes 85. About how many times have you been ?red from a job? 0 .344?: ?2011 Wane. Inc. All rights reserved. . .. 86. Ri ht now, do you feel you need more training in a new job or career skillyou were to get (or have) a good job how would you rate your chance of being successful? Good [j Fair 88. How often do you have con?icts with friends/famin over money? Often Sometimes 12} Never 89. How hard ABOVE minimum wage compared to others? [3 Easier Same Harder Much Harder 90. {low often do you have barely enough money to get by? Often Sometimes Cl Never 91. Has an one accused you of not paying child support? No Yes 92. How often do you have trouble paying bills? Often Sometimes Never 93. Do you fre uently get jobs that don?t pay more than minimum wage? Often Sometimes Ea Never 94. How often do you worry about ?nancial Survival? Cl Often Sometimes El Never Leisure/Recreation Thinking of your leisure time in the past few (3-6) months, how often did you have the following feelings? 95. How often did you feel bored? Never Several timeslmo Several times/wk [3 Daily 96. How often did you feel you have nothing to do in your spare time? Never El Several times/mo El Several timeslwk Cl Daily 97. How much do you agree or disagree with the following - You feel unhappy at times? Strongly Disagree Disagree Not Sure Cl Agree [3 Strongly Agree 98. Do you feel discouraged at times? Strongly Disagree Disagree Cl Not Sure Cl Agree Cl Strongly Agree 99. How much do you agree or disagree with the following -You are often restless and bored? Strongly Disagree Disagree Not Sure Agree Strongly Agree 100. Do you often become DOred with your usual activities? No Yes Cl Unsure 101. Do you feel that the things you do are boring or dull? El No Yes Unsure 102. is it dif?cult for you to keep your mind on one thing for a long time? No Cl Yes Ci Unsure Social Isolation Think of your social situation with friends, family, and other people in the past few (3-6) months. Did you have many friends or were you more of a loner? How much do you agree or disagree with these statements? 103. have friends who hel me when I have troubles." Strongly Disagree Disagree Not Sure Agree Strongly Agree 104. feel lonely." Strongly Disagree Cl Disagree Cl Not Sure Cl Agree Strongly Agree Inc. All rights reserved. 105. have friends who en oy doing things with me." Strongly Disagree Disagree Cl Not Sure Cl Agree Strongly Agree 106. "No one really knows me very well." Strongly Disagree Disagree [1 Not Sure Cl Agree Strongly Agree 107. feel very close to some of my friends." Strongly Disagree Disagree [3 Not Sure Agree [3 Strongly Agree 108. olten feel left out of things." [3 Stroneg Disagree Disagree Not Sure Cl Agree Cl Strongly Agree 109. can ?nd companionship when I want." Strongly Disagree Disagree Ci Not Sure Agree Strongly Agree 110. have a best friend I can talk with about eve ing.? l3 Strongly Disagree '3 Disagree Cl Not Sure Agree Strongly Agree 111. have never felt sad about things in my life." Strongly Disagree [3 Disagree Not Sure Agree Cl Strongly Agree Criminal Personality The next few statements are about what you are like as a person, what your thoughts are, and how other people see you. There are no ?right or wrong' answers. Just indicate how much you agree or disagree with each statement. 112. am seen by others as cold and unfeeling.? Strongly Disagree Disagree [3 Not Sure El Agree Strongly Agree 113. always practice what i preach." Strongly Disagree Disagree Not Sure Agree Strongly Agree 114. "The trouble With getting close to eople is that they start making demands on you." Strongly Disagree [3 Disagree Not Sure [3 Agree Cl Strongly Agree 115. have the ability to ?sweet talk" people to get what I want.? Strongly Disagree [3 Disagree Ci Not Sure Agree Cl Strongly Agree 116. have played sick to et out of something." Cl Strongly Disagree Disagree [3 Not Sure Agree Cl Strongly Agree 117. ?I'm really good at talking my way out of problems." Strongly Disagree Disagree CI Not Sure Agree Ci Strongly Agree 118. have gotten involved in things I later wished I could have gotten out of." Cl Strongly Disagree Disagree Cl Not Sure Agree Cl Strongly Agree 119. feel bad if] break a romise I have made to someone.? Strongly Disagree Disagree Not Sure Agree Strongly Agree 120. "To get ahead in life ou must alwa put yourself ?rst." Cl Strongly Disagree is Disagree L4 Not Sure Agree Strongly Agree Anger 121. ?Some peeple see me as a violent arson." Strongly Disagree Disagree Not Sure Agree Strongly Agree 122. get into trouble because I do thin 5 without thinking." Cl Strongly Disagree Disagree Not Sure Cl Agree [1 Strongly Agree 123. ?1 almost never lose temper." Strongly Disagree Disagree [3 Not Sure Agree Strongly Agree 124. "If people make me angry or lose my temper, I can be dangerous." Strongly Disagree Li. Disagree Not Sure Cl Agree Strongly Agree ?2011 "smite. Inc. All rights reserved. 125. "1 have never intenselrEdisiiked an one." Strongly Disagree 4 Disagree . Not Sure Agree ?3 Strongly Agree 126. have a short temper and can get angry quidg.? Strongly Disagree Disagree Cl Not SUre Agree Strongly Agree Criminal Attitudes The next statements are about your feelings and beliefs about various things. Again, there are no or wrong' answers. Just indicate how much you agree or disagree with each statement. 12?. hungry person has a right to steal." Strongly Disagree Disagree Cl Not Sure [3 Agree Strongly Agree 128. "When peeple get into trouble with the law it?s because they have no chance to get a decent job.? Strongly Disagree i3 Disagree Not Sure [3 Agree Strongly Agree 129. "When people do minor offenses or use drugs they don't hurt anyone except themselves." Strongly Disagree C1 Disagree Not Sure Agree El Strongly Agree 130. ?If someone insults my?friends, family or group they are asking for trouble." Strongly Disagree L.- Disagree Not Sure [3 Agree Ci Strongly Agree 131. ?When things are stolen from rich r?pjeople they won't miss the stuff because insurance will cover the loss." Strongly Disagree Disagree Not Sure {3 Agree Strongly Agree 132. have felt very ang at someoneor at something." Cl Strongly Disagree Disagree Cl Not Sure Agree Cl Strongly Agree 133. "Some people must be treated rou hly or beaten up just to send them a clear message." Strongly Disagree Disagree Not Sure [3 Agree Strongiy Agree 134. won't hesitate to hit or threaten eople if the have done something to hurt my friends or family." Strongly Disagree Ci Disagree 4 Not Sure Agree [3 Strongly Agree 135. ?The law doesn't help average pee Ie.? Strongly Disagree Disagree Not Sure [3 Agree CI Strongly Agree 136. ?Many people get into trouble or use drugs because society has given them no education, jobs or future." Strongly Disagree Disagree Ci Not Sure Agree Strongly Agree 137. "Some people just don't deserve an respect and should be treated like animals." 31 Strongly Disagree Ci Disagree Not Sure Agree Strongly Agree