Exhibit XIX ADJC Census Report.doc

The document is an Exhibit XIX ADJC (Arizona Department of Juvenile Corrections) Census Report template for out-of-home residential contractors. It requires contractors to report bed space availability for Arizona residential programs to the Community Program Service Office (CPSO). Contractors are instructed to email the completed report twice monthly by 10:00 AM to communityprogramservice@azdjc.gov, with contact information available at 602-527-5267 for training or assistance.

The reporting template requires contractors to document specific details including contractor name, contact information, level of care (such as BHIF, BHRF, Group Home), specialty, gender, age range, number of open beds, location (city), and indication of upcoming discharges. The report is designed to track residential placement capacity for juvenile corrections programs, enabling real-time monitoring of available bed spaces across different residential care settings in Arizona. The document was last revised on 6/20/22 and appears to be a standardized tracking mechanism for juvenile residential service providers.