DOC 1952 Contractor PREA Questionnaire .pdf

PDF 507 KB Posted

Attached to
NNCC Nurse Call Equipment
Solicitation number
44DOC-S3176
Issued by
Washoe County, Nevada

About this file

The document is a Contractor and Volunteer PREA (Prison Rape Elimination Act) Questionnaire issued by the Nevada Department of Corrections (NDOC), designed to screen contractors and volunteers who may have contact with offenders. The form is part of the agency's compliance with the Department of Justice's National Standards to Prevent, Detect, and Respond to Prison Rape (42 U.S.C. § 15601 and 28 C.F.R., §115.17(a)), requiring individuals to complete a detailed screening before being authorized to enter NDOC institutions, facilities, or work release centers.

The questionnaire requires respondents to disclose any history of sexual abuse, sexual misconduct, or sexual harassment in detention facilities or community settings, with yes/no checkbox responses to four specific screening questions. Individuals must provide details if they answer "yes" to any question, and the form includes a clear statement that providing false or misleading information will result in application denial. The document is part of NDOC's comprehensive effort to ensure the safety of offenders by thoroughly vetting contractors and volunteers who may interact with incarcerated populations.

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Text version

Nevada Department of Corrections PREA Management Division DOC 1952 (revised 1/2023) §115.17

Contractor and Volunteer PREA Questionnaire

The Nevada Department of Corrections (NDOC), in compliance with the Department of Justice, National Standards to Prevent, Detect, and Respond to Prison Rape 42 U.S.C. § 15601, et seq. and 28 C.F.R., §115.17 (a), shall require contractors and volunteers who may have contact with offenders to complete this form before they can be authorized to have any contact with any offenders or entry into any of the agencies institutions, facilities or work release centers. Please answer the following questions.

Have you ever:

Engaged in sexual abuse in a prison, jail, lockup, community confinement facility, juvenile facility, or any other place of detention?

☐ Yes ☐ No

Been convicted of engaging or attempting to engage in sexual activity in the community facilitated by force, overt or implied threats of force, or coercion, or if the victim did not consent or was unable to consent or refuse?

☐ Yes ☐ No

Been civilly or administratively adjudicated to have engaged in the activity described above?

☐ Yes ☐ No

Engaged in sexual harassment of any person in the community or confinement setting?

☐ Yes ☐ No

If you answered yes to any of the previous four questions, provide details regarding the incident.

Attach additional pages if necessary.

I affirm that all my responses are true and complete to the best of my knowledge. I also understand that providing false or misleading statements, including material omissions regarding such misconduct shall be grounds for denial of my application.

Signature: Date: ___________________

Print Name:______________________________________

File details come from the government source that posted it. Updated .