NDOC PREA Volunteer-Contractor (DOC 052) ~5.docx
DOCX document 32 KB Posted
- Attached to
- Cremation Services
- Solicitation number
- 44DOC-S2913
- Issued by
- White Pine County, Nevada
About this file
This document is a PREA Contractor and Volunteer Questionnaire Form from the Nevada Department of Corrections (NDOC). The form is used to comply with the Department of Justice's National Standards to Prevent, Detect, and Respond to Prison Rape. The form requires all contractors and volunteers who may have contact with inmates to complete the questionnaire, and providing false or misleading statements can result in termination from entry into NDOC institutions and rescission of volunteer/contractor status.
The questionnaire asks two key questions: 1) whether the individual has engaged in sexual abuse or been convicted of sexual activity facilitated by force or coercion, and 2) whether the individual has been adjudicated for engaging in inmate sexual harassment, which includes repeated verbal comments of a sexual nature, demeaning gender references, derogatory comments about body or clothing, or repeated profane or obscene language or gestures.
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Other files
| File | Type | Posted |
|---|---|---|
| 44DOC-S2913 - Reference Questionnaire.docx | DOCX document | |
| Proposed Staff Resume 2023-04-13~5.docx | DOCX document | |
| RFP 44DOC-S2913 - Cost Schedule~1.docx | DOCX document | |
| RFP 44DOC-S2913.docx | DOCX document | |
| NDOC Security Regulations Ack (DOC 047)~5.doc | DOC document | |
| PREA AGENCY ZERO TOLERANCE POLICY~3.docx | DOCX document | |
| Quote Instructions.pdf | ||
| Terms and Conditions for Services 2023-04-13~8.pdf | ||
| Background Check Application~4.docx | DOCX document | |
| 44DOC-S2913 - Letter of Intent.pdf | ||
| 44DOC-S2913 - Insurance Schedule~1.pdf | ||
| Attachments for Signatures 2023-04-13~6.pdf | ||
| Standard Form Contract~19.docx | DOCX document |
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Text version
State of Nevada Department of Corrections
PREA Contractor and Volunteer Questionnaire Form
The Nevada Department of Corrections, 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 not enlist the services of any contractor or volunteer who may have contact with inmates. Agency policy requires all contractors and volunteers complete this questionnaire.
Providing false or misleading statements, including material omissions regarding such misconduct shall be grounds for termination from entry into all NDOC institutions and volunteer/contractor status will be rescinded.
1. Have you engaged in sexual abuse in a prison, jail, lockup, community confinement facility, juvenile facility, or other institution, or have you 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, or have you been civilly or administratively adjudicated to have engaged in the activity described in any part of this question?
YES |_| NO |_|
2. Have you been adjudicated as having engaged in any type of inmate Sexual Harassment, which includes as a staff member, volunteer, contractor, or as any type of service provider coming in contact with an inmate in the facilities mentioned in question 1? Sexual Harassment includes but is not limited to:
· Repeated verbal comments of a sexual nature to an inmate; or
· Demeaning references to gender; or
· Derogatory comments about body or clothing; or
· Repeated profane or obscene language or gestures
YES |_| NO |_|
| __________________________________ | __________ | |
| Signature | Date |
Print Name
DOC 052 (12/16)
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