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

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APPENDIX B - Facility Information Form

(To be completed by each facility)

Instructions: Please complete this facility information form and return it with the data collection forms. Only ONE facility information form should be completed for each participating facility. Please print your answers in the spaces provided or check the appropriate box.

3. Name of facility

4. City/Town

5. Province (Please use a two letter abbreviation for your province)

• 6. Types of custody provided (Please check ALL that apply)
  
  
  • Secure custody
  • Open custody
  • Remand
  • Other (specify)

• 7. Gender (Please check the ONE box that BEST describes your facility)
  
  
  • Male Only Facility
    
  • Female Only Facility
    
  • Co-ed Facility

• 8. Description of facility (Please check the ONE box that BEST describes your facility)
  
  
  • Foster/Community Home
    
  • Group Home
    
  • Secure Detention/Custody Facility
    
  • Community Residential Centre
    
  • Training Centre
    
  • Treatment Centre
    
  • Boot Camp
    
  • Forest/Wilderness Camp/Ranch
    
  • Adult Facility
    
  • Other (specify)

9. Facility capacity (Please indicate the total number of permanent beds in your facility)

• 10. Does your facility offer cultural programming specifically for Aboriginal youth?
  
  
  • Yes
    
  • No

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

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