Vous êtes sur la page 1sur 2

SOUTH DAKOTA

RISK ASSESSMENT INSTRUMENT (RAI) VERSION 1.1


Last Name:
First Name:
Middle Name:
Ethnicity:
Hispanic
Sex:
Male
Female
DOB:
Non-Hispanic
Race:
African American
Asian
Name of Tribe (if applicable):
Affiliated:
Yes
No
Caucasian
Native American
Enrolled:
Yes
No
Other: _______________________________
Dont Know: Yes
No
Magistrate Warrant : Yes
No
RAI Location: RC
SD
Juvenile Warrant: Yes
No
Referral ID #:
Intake Date:
Intake Time:
Primary (Most Serious) Referral Offense:
Placed By:
Screener:
Screen Date:
Screen Time:
1. Most Serious Current Alleged Offense (Score only the most serious instant offense)
Felony Class A, B, C, 1, and 2.................................................................................................................
Use of firearm in a commission of an offense ..
Felony assault and Felony sex crimes......................................................
All other Felonies..............................................................................................
Assaultive Misdemeanors.............................................................................
Class 1 Misdemeanors....................................................................................
Class 2 Misdemeanors..........................................................
Violation of Probation and/or DOC Violations (alleged violation of the conditions of probation or
aftercare)....
CHINS or status offense.
SCORE.......
2. Adjudication History (Previous 24 months from intake date listed above Score only the most serious)
Two or more prior adjudications for felony offense...................................................................................................
One prior adjudication for a felony offense.....................................................................................................................
Two or more prior adjudications for misdemeanor offenses.............................................
Two or more prior adjudications for probation violations or DOC formal findings......................................
One prior adjudication for any misdemeanor or status offense.............................................................................
No prior adjudications..............................................................................................................................................................
SCORE.......
3. Failure to Appear/Runaway/Escape History (Within the last 24 months Score only the most serious)
One or more escapes from secure confinement or custody......................................................................................
One or more instances of absconding from a non-secure Placement (DSS/DOC placement, group
home, residential facility, treatment facility, or non-secure detention) ............................................................
Two or more reported runaways from home ..............................................................................................
Two or more failure to appear warrants ...........................................................................................................
One or no failure to appear warrants.....
SCORE........................
4. Pending Petitions (Score only most serious)
One or more pending petitions for felonies.......
One or more pending petitions for assaultive misdemeanors....
One or more pending petitions for Class 1 Misdemeanors...
One or more pending petitions for Class 2 Misdemeanors...
One or more pending petitions for a Probation Violation or DOC formal finding...
One or more pending petitions for status or CHINS offense....
No pending petitions.
SCORE.....
5. Aggravating Factors (Score all that apply)
On probation/DOC Aftercare for a Felony Class A, B, C, 1, or 2 offense; felony assault;
or a felony sex crime.
Multiple offenses are alleged for this referral ...................................
Minor appears to be under the influence of drugs/alcohol at arrest (as indicated by law
enforcement, Court Services, or DOC) .......
SCORE..
6. Mitigating Factors (Score all that apply)
Responsible parent, guardian, or custodian can assume responsibility of the minor......
No arrests within the past 12 months....
No history of failure to appear within the past 24 months...
SCORE........
7. TOTAL RISK SCORE................................................................................................................................................................................

15
15
12
8
6
3
2
1
0

6
4
3
2
1
0

3
2
1
1
0
6
4
3
2
1
0
0

1
1
1
-1
-1
-1

INDICATED DECISION: 6 or Below Release:


Screener Comments:

7 to 11 Alternative:

12 or Above Secure Detention:

OVERRIDES (Must be approved by supervisor):


Parent, Guardian, or Custodian is not available or is not suitable to receive the child
(only an override into an alternative)
Minor has failed a detention alternative program
Minor held pending referral to mental health agency
Minor held in custody for another jurisdiction
Victim in the home and there is an immediate safety concern
Other (Be specific):
Approved By:
Date:

Supervisor Comments:

ACTUAL DECISION: Release

Conditional Release

Other Alternative:

Secure Detention: