PREA Questionaire.pdf

Mandatory Pre-Service PREA Questions

As part of a background check required by the Prison Rape Elimination Act 28 CFR 115.17/317, you are required to answer the following questions before having contact with offenders:

1. Have you engaged in sexual abuse in a prison, jail, lockup, community confinement facility, juvenile facility, or other institution (as defined in 42 U.S.C. 1997)?

Yes No

2. 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?

Yes No

3. Have you been civilly or administratively adjudicated to have engaged in the activity described in number 1 and 2 above?

Yes No

4. Have you ever had a substantiated finding of sexual harassment of an offender, resident or student in a prison, jail, lockup, community confinement facility, juvenile facility, or other institution (as defined in 42 U.S.C. 1997)?

Yes No

I affirm that the answers I have provided are accurate and truthful. I understand that material omissions regarding such misconduct, or the provision of materially false information, shall result in my dismissal or removal from the facility/program and a permanent gate closure to all IDOC facilities. I also understand I have a continuing affirmative duty to disclose any such misconduct.

Signature:________________________________________ Date:________________

Printed Name_____________________________________

Contract Employee Volunteer Non-DOC Crew Supervisor

Revised 6/16