A One-Day Snapshot of Aboriginal Youth in Custody Across Canada : Phase II

APPENDIX A - Youth Information Form

(A separate form needs to be completed for EACH youth in your facility)

Instructions: Please fully complete one data collection form for EACH youth in your facility on Snapshot Day. Please print your answers in the spaces provided or check the appropriate box.

Institutional Information

  • 1. Name of facility

  • 2. Province (Please use a two letter abbreviation)

Demographic Information

  • 3. Age (indicate age on Snapshot Day)

  • 4. Gender

  • 5. Languages spoken (Please check ALL that apply)

Legal Information

  • 6. Legal Status of Youth (Please check ALL that apply)

  • 7. If serving a custodial sentence : Most Serious Offence (Please consult the Seriousness Index attached as Appendix A to determine the youth's most serious offence and enter the three digit numerical code)

    Most Serious Offence (MSO)

  • 8. If on remand : Most Serious Charge (Please consult the Seriousness Index attached as Appendix A to determine the youth's most serious charge and enter the three digit numerical code)

    Most Serious Charge (MSC)

  • 9. Date of Admission (Please indicate the date of the youth's FIRST admission to custody for the specific MSO or MSC indicated above)

  • 10. Legislation (Please indicate if the youth is serving YOA or YCJA sentence)

  • 11. AGGREGATE Custody Sentence (Please record the total number of days for the aggregate YOA sentence OR the total number of days of the CUSTODIAL PORTION for the aggregate YCJA sentence )

  • 12. Has an application been approved to maintain the youth in custody beyond the ordered number of days?

  • 12.1 If yes, how many additional days has the youth served?

  • 12.2 If yes, how many additional days remain?

Aboriginal Status Information

13. Aboriginal Status

  • Non-Aboriginal
  • Aboriginal

IF THE YOUTH IS ABORIGINAL, PLEASE COMPLETE THE REMAINDER OF THIS QUESTIONNAIRE

IF THE YOUTH IS NON-ABRORIGINAL STOP HERE

Information on Aboriginal Youth Only

  • 14. Aboriginal Identity

    • First Nations
    • Metis
    • Inuit
    • Innu
    • Inuvialuit
    • Unknown
    • Other (specify)
  • 15. Aboriginal Status

    • Status Indian
    • Non-status Indian
  • 16. Living Arrangements (Please indicate status prior to admission to custody)

    • Dual-parent
    • Lone-parent
    • Extended family
    • Foster parents
    • Group home
    • Transient/living on the streets
    • Other (specify)
  • 17. Child Welfare Status (Please indicate status prior to admission to custody)

    • Ward of the State
    • Active Child Welfare File - NOT a Ward of the State
    • No child welfare involvement
  • 18. Social Assistance (Please indicate if the youth resided in a family that received social assistance as the primary source of income)

    • Yes
    • No
  • 19. First Conviction (Please indicate the age of the youth at their first conviction)

  • 20. Education (Please indicate the highest grade COMPLETED in school)

  • 21. Diagnosis of Foetal Alcohol Syndrome/Foetal Alcohol Effects

    • Confirmed diagnosis (obtained from medical records)
    • Suspected (obtained from custodial file)
    • Suspected (obtained from self-report)
    • No information available
  • 22. Substance abuse problems
    • Confirmed problem
    • Suspected
    • No information available
  • 23. Suicide (PRIOR to current CUSTODY admission)

    • Previous attempts
    • Previous suicidal thoughts
    • No information available
  • 24. Suicide (WITHIN CUSTODY during current sentence)

    • Attempts
    • Suicidal thoughts
    • No information available
  • 25. Self-Harm (WITHIN CUSTODY during current sentence)

    • Yes (self-cutting/slashing/burning, etc.)
    • No
    • No information available

Geographical Information

  • 26. In which city, town or reserve did the youth spend the longest period of time during the two years preceding his or her current admission? (Please exclude time spent in custody)

    • 26.1 Location of residence

    • 26.2 Province (Please use a two letter abbreviation)

  • 27. In which city, town or reserve did the youth commit or allegedly commit the offence that led to the current admission? If the youth has more than one charge or conviction, please specify the location where the most serious charge or conviction took place

    • 27.1 Location of offence

    • 27.2 Province (Please use a two letter abbreviation)

  • 28. In which city, town or reserve does the youth plan to locate upon release?

    • 28.1 Location of release

    • 28.2 Province (Please use a two letter abbreviation)

If you have any questions when completing this form please contact:

Jeff Latimer Senior Research Officer Research and Statistics Division Department of Justice Canada (613) 957-9589 jlatimer@justice.gc.ca

Serious Index

The following Index is used by the Canadian Centre for Justice Statistics in order to calculate the Most Serious Charge/Offence. The seriousness of an offence is ranked according to offence type and the potential impact on the person. Offences are ordered from most to least serious.

Please select the most serious charge (MSC) or offence (MSO) for each youth, for the current custody or remand admission. If there is only one offence, then that offence is the MSC/MSO. If there is more than one offence, then the MSC/MSO is determined by the following offence severity scale. For instance, if a youth committed "break and enter" and "theft under," the MSO would be the break and enter. You would then enter numerical code 031 as the youth's most serious charge/offence. The number of offences does not matter. For example, if a youth was convicted for multiple "theft under" offences but only one "break and enter", the MSO remains "break and enter".

Offences Against the Person

  • 001 -Murder, First degree
  • 002 -Murder, Second degree
  • 003 -Manslaughter
  • 004 -Criminal Negligence Causing Death
  • 005 -Other related offences causing death
  • 006 -Attempted Murder
  • 007 -Conspire to Commit Murder
  • 008 -Aggravated sexual assault
  • 009 -Kidnapping
  • 010 -Hostage Taking
  • 011 -Robbery
  • 012 -Extortion
  • 013 -Other Violent Violations
  • 014 -Sexual Assault with a Weapon
  • 015 -Aggravated Assault - Level 3
  • 016 -Discharge Firearm with intent
  • 017 -Sexual Assault
  • 018 -Assault with weapon or causing bodily harm - level 2
  • 019 -Unlawfully causing bodily harm
  • 020 -Criminal negligence causing bodily harm
  • 021 -Abduction under 14
  • 022 -Abduction contravening a custody order
  • 023 -Abduction - no custody order
  • 024 -Infanticide
  • 025 -Assault - level 1
  • 026 -Assault against peace-public officer
  • 027 -Abduction under 16
  • 028 -Other sexual crimes
  • 029 -Other assaults
  • 030 -Criminal harassment

Break and Enter

031 - Break and Enter

Controlled Drug and Substance Act

  • 032 - Trafficking - Heroin
  • 033 - Trafficking - Cocaine
  • 034 - Trafficking - Other N.C.A
  • 035 - Trafficking - Cannabis
  • 036 - Importation - Heroin
  • 037 - Importation - Cocaine
  • 038 - Importation - Other N.C.A.
  • 039 - Importation - Cannabis
  • 040 - Trafficking - Controlled drugs
  • 041 - Trafficking - Restricted Drugs
  • 042 - Possession - Heroin
  • 043 - Possession - Cocaine
  • 044 - Possession - Other N.C.A.
  • 045 - Possession - Cannabis
  • 046 - Cultivation - Cannabis
  • 047 - Possession Restricted Drugs

Other Criminal Code Offences

048 - Offensive Weapons - Explosives

Criminal Code Traffic Violations

  • 049 - Dangerous Operation Causing Death
  • 050 - Impaired Operation/Related Violations Causing Death

Offences Against Property

051 - Arson

Other Criminal Code Offences

  • 052 - Counterfeiting Currency
  • 053 - Firearms and Other Offensive Weapons (Part III C.C.)
  • 054 - Offences Related to Currency (Part XII C.C.)

Criminal Code Traffic Violations

  • 055 - Dangerous Operation Causing Bodily Harm
  • 056 - Impaired Operation/Related Violations Causing bodily Harm

Offences Against Property

  • 057 - Theft over
  • 058 - Fraud
  • 059 - Possession of Stolen Goods
  • 060 - Mischief - Property Damage

Other Criminal Code Offences

  • 061 - Offence Against Public Order (Part II C.C.)
  • 062 - Prostitution - Procuring
  • 063 - Offences Against the Rights of Property (Part IX C.C.)

Other Criminal Code Offences

  • 064 - Offensive Weapons - Prohibited
  • 065 - Offensive Weapons - Restricted
  • 066 - Offensive Weapons - Firearms Transfer/Serial Numbers
  • 067 - Offensive Weapons - Other
  • 068 - Offences Against the Administration of Law and Justice (Part IV C.C.)
  • 069 - Fraudulent Transactions Relating to Contracts and Trade (Part X C.C.)
  • 070 - Wilful and forbidden Acts in Respect of Certain Property (Part XI C.C.)
  • 071 - Attempts, Conspiracies, Accessories (Part XII C.C.)

Criminal Code Traffic Violations

  • 072 - Dangerous Operation of Motor Vehicle, Vessel or Aircraft
  • 073 - Impaired Operation of Motor Vehicle, Vessel or Aircraft over 80 MG
  • 074 - Failure to Provide a Breath Sample
  • 075 - Failure to Provide a Blood Sample
  • 076 - Other Criminal Code

Other Federal Statute Violations

  • 077 - Canada Shipping Act
  • 078 - Income Tax Act
  • 079 - Customs Act
  • 080 - Competition Act
  • 081 - Immigration Act
  • 082 - Bankruptcy Act

Other Criminal Code Offences

  • 083 - Prostitution - Bawdy House
  • 084 - Gaming and Betting - Other Gaming and Betting
  • 085 - Bail Violations
  • 086 - Escape Custody
  • 087 - Public Morals
  • 088 - Obstruct Public Peace Officer
  • 089 - Prisoner Unlawfully at large
  • 090 - Fail to appear
  • 091 - Sexual Offences, Public Morals and Disorderly conduct (Part V C.C.)
  • 092 - Invasion of Privacy (Part VI C.C.)
  • 093 - Offences against the person and reputation (Part VIII C.C.)

Criminal Code Traffic Violations

  • 094 - Failure to stop or remain
  • 095 - Driving while prohibited

Other Federal Statute Violations

  • 096 - Excise Act
  • 097 - Young Offenders Act

Other Criminal Code Offences

  • 098 - Prostitution - Other Prostitution
  • 099 - Gaming and Betting - Betting House
  • 100 - Gaming and Betting - Gaming house
  • 101 - Disturb the Peace
  • 102 - Indecent Acts
  • 103 - Trespass at Night
  • 104 - Breach of Probation
  • 105 - Threatening/Harassing Phone Calls
  • 106 - Disorderly Houses, Gaming and Betting (Part VII C.C.)
  • 107 - All other Criminal Code (includes Part XII.2 C.C.)

Other Federal Statutes

108 - Other Federal Statutes

Provincial Statute Violations

  • 109 - Other provincial statute violations
  • 110 - Securities Act
  • 111 - Liquor Act
  • 112 - Highway Traffic Act (or equivalent)
  • 113 - Fail to Stop or Remain
  • 114 - Dangerous Driving without due care and attention
  • 115 - Driving while disqualified or license suspended
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