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Please read the
following notes before using the form.
Notes:
- You don't
have to answer any question(s) you don't want to answer,
and, of course, you don't have to answer questions that
don't pertain to your situation.
- If more than
one officer responded to your call, you can choose to
answer in regard to just one officer, or you can answer
in regard to both, referring to them as officer #1 and
officer #2.
- Feel free
to put your comments, explanations, and things you want
to remember, in the spaces between the questions or in
the space provided at the end of the form.
Date____________
Crime Report
#_______________________
Date and Approximate
Time of Call to Police________________
Name of Police
Department____________________
Your Name________________________
Part I:
Evaluation of the Police Response to Your Domestic Violence
Call
The Interview:
Did
you feel the officer showed concern for you and your safety?
Yes____ No____
Did the officer
make sure that you could tell your story safely and comfortably
(by giving you enough time, privacy, encouragement, or whatever
else you needed to tell your story)?
Yes____ No____
If you do not
speak English well, did the officer provide you with a professional
translator (either a fully bilingual officer or a telephone
translator - not a family member or neighbor)?
Yes____ No____
Did the officer
ask you about the history of abuse in the relationship?
Yes____ No____
Did the officer
ask you whether the abuser had ever been abusive to the
children?
Yes____ No____
Abusive to pets?
Yes____ No____
Did the officer
ask you specific information about any threats made against
you?
Yes____ No____
Did the officer
ask you if your partner has ever forced you to have sex
when you didn't want to have sex?
Yes____ No ____
Weapons:
Did
the officer ask you if the abuser ever used weapons against
you?
Yes____ No____
Did the officer
ask if the abuser has guns or has access to guns?
Yes____ No____
If you told the
officer the abuser has guns, did the officer remove the
guns?
Yes____ No____
(Different states have different laws about officers'
authority to remove firearms - ask about the law in your
state.)
Your Injuries
and Evidence:
Did
the officer ask about all your injuries?
Yes____ No____
Did the officer
take pictures of all your injuries or arrange to have pictures
taken?
Yes____ No________
Did the police
make arrangements to take another set of pictures of your
injuries later?
Yes____ No____
Did the officer
collect, or take pictures of, all physical evidence (such
as knives, broken furniture, broken phone lines, message
tapes, etc.)? Yes____ No____
Witnesses:
Did
the officer get a statement from each of the children who
are old enough to talk?
Yes____ No____
If you were present,
do you feel the officer interviewed your children with sensitivity
(away from the perpetrator, with age-appropriate questions,
at eye level with the children, and with a caring tone,
etc.)
Yes____ No____
Did the officer
ask you about the possibility of other witnesses?
Yes____ No____
Did the police
interview other possible witnesses or make an attempt to
interview those witnesses?
Yes____ No____ Don't Know______
Arrest:
If the abuser was present, did the officer arrest the
abuser?
Yes____ No______ Don't Know ________
If the abuser
left the scene, did the officer ask you for complete information
about the possible whereabouts of the abuser?
Yes____ No____
Protective
Orders:
Did
the officer ask you if you have a protective order against
the abuser? (A protective order can also be called a restraining
order, stay away order, or no contact order.)
Yes____ No____
If you have a
protective order, did the officer ask to see the order?
Yes____ No____
If you didn't
have a restraining order, did the officer offer you an Emergency
Protective Order?
Yes____ No____ Doesn't Apply _____
(In some states officers don't have the power to write
protective orders. Ask about the law in your state.)
Did the officer
issue you an Emergency Protective Order?
Yes____ No____
Information:
Did
the officer give you verbal information on the services
available to you?
Yes____ No____
Did the officer
give you written information on the services available to
you?
Yes____ No____
Did the officer
give you the crime report number?
Yes____ No____
Did the officer
ask you if you had any questions?
Yes____ No____
If you had questions,
did the officer answer your questions to your satisfaction?
Yes____ No____
Did the officer
adequately explain to you what will happen next and when
it will happen?
Yes____ No_____
Part II: EVALUATION
OF THE DOMESTIC VIOLENCE POLICE REPORT
Note:
California Family Code Section 6228 and similar laws in
other states give domestic violence victims the right to
obtain a copy of the domestic violence police report. You
can request a copy of the report from the police department
or from the district attorney's office. Under these laws,
the respective law enforcement agency is required to give
the victim a complete copy of the police report.
If your state doesn't give you a right to the report or
if for any other reason you haven't yet gotten a copy of
the police report, go to the comments section at the end
of this section.
Did the police
write up a domestic violence crime report?
Yes____ No____
Does the police
report accurately reflect the story you told to the officer?
Yes____ No____
Does the police
report accurately describe the history of abuse?
Yes____ No____
If the abuser
has a history with law enforcement, did the police attach
a copy of the abuser's criminal justice history to the domestic
violence report?
Yes_____ No _____
If you told the
officer about abuse to the children or to pets, does the
police report accurately describe that abuse?
Yes____ No _____
Does the police
report accurately describe incidents of forced sex?
Yes____ No____
Does the police
report accurately describe all your injuries?
Yes____ No____
Are all threats
against you correctly quoted in the police report?
Yes____ No____
Does the police
report accurately record the statements of the children?
Yes____ No____
Does the police
report contain the statements of the other witnesses?
Yes____ No____
Does the police
report accurately list all the physical evidence available
(pictures, weapons, broken furniture, broken telephone lines,
message machine recordings, etc.)?
Yes____ No____
Overall, does
the police report seem fair to you in the way it was written?
Yes____ No____
Overall, does
the police report seem complete in covering the incident?
Yes____ No____
Do you feel that
the recommended charges on the report are adequate to cover
what happened to you? (See the list of domestic violence-related
crimes listed below.)
Yes ____ No _____
Your Comments:
(You can use the space below to list the corrections
you feel need to be made in your case and/or to write your
comments on what you think the officer did that was helpful
to you and what you think the officer can do to improve.)
Other Domestic
Violence Related Crimes:
California Penal
Code Section 13730, and many other state codes, require
that police write a domestic violence report on all domestic
violence related incidents. In addition to acts that are
covered by the domestic violence section of the penal code,
here is a list of other crimes that when committed by an
intimate partner are 'domestic violence related' and hence
must be written up on a domestic violence report form.
If you are not
from California, it's most likely your state has equivalent
crimes listed under different Penal Code sections.
California
Penal Code Sections:
136.1 Intimidating or Dissuading a Witness.
166 Violation of a Court Order
148 Resisting Arrest
187 Murder
203 Mayhem
205 Aggravated Mayhem
206 Torture
207 Kidnapping
211 Robbery
236 False Imprisonment
240 Assault
242/243(a) Battery
243(e) Battery on a Spouse, Non-Cohabiting Former Spouse,
Co-Parent, etc.
243(d) Battery with Serious Bodily Injury
245 Assault with a Deadly Weapon or with Force Likely to
result in Great Bodily Injury
246 Shooting at an Inhabited Dwelling
261 Forcible Rape
261.5 Statutory Rape
262 Rape of a Spouse
273.5 Spousal Abuse
273.6 Violation of a Domestic Violence Restraining Order
273(a) Abusing or Endangering of a Child (Felony)
273(b) Abusing or Endangering of a Child (Misdemeanor)
278 Taking, Enticing Away, Withholding, or Concealing Child
by Person without Right of Custody
278.5 Taking, Enticing Away, Withholding, or Concealing
Child in Order to Deprive Lawful Custodian of Custody
286 Sodomy
288a Oral Copulation
289 Penetration with a Foreign Object
368 Elder Abuse
417(a) Brandishing a Weapon
418 Forcible Entry into the Home of Another
422 Terrorist Threats
459/460 Residential Burglary
591 Malicious Destruction of a Telephone
594(b) Vandalism
597 Animal Abuse
602.5 Trespassing
603 Forcible Entry with Damage to Property
646.9 Stalking
12020(a) Possession of a Dangerous/Deadly Weapon
12021(a) Felon in Possession of a Firearm
12021(c) Possession of Firearm with Prior Misdemeanor Conviction
for Spousal Battery/Abuse
12025(a) Possession of a Concealed Weapon
12031 Possession of a Loaded Firearm
HS11550 Under the Influence
Note: The following is a suggested design for
a victim survey of your local police department response
to domestic violence.
One obvious
design that can be used by victim advocates is to simply
routinely ask victims if they would be willing to fill out
the evaluation form, anonymously or not. Then you can compile
and analyze the data you receive.
A more scientific
way to design this study is to select a start date and time.
Then, using the police department dispatch records, pull
the next 50 (or whatever number) domestic violence calls
for service. Have an interviewer call each one of the case
victims and ask the victim if she or he would be willing
to be interviewed for the survey.
Probably the
best choice of time and date for case selection is around
four weeks prior to the time the interviewing will be done.
Using this time frame gives most victims time to be somewhat
stabilized at the time of interviewing and, at the same
time, their memory of the police response will still be
fresh.
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