ANYTOWN POLICE DEPARTMENT
123 Main Street
Anytown, USA 070476
WORK SHEET - ASSESSING COMPETENCY
INCIDENT #: ______INCIDENT TYPE: ______
JUVENILE INFORMATION
1. NAME:______DATE OF BIRTH: ______
PRIMARY LANGUAGE: ______
LANGUAGE INTERVIEW CONDUCTED IN: ______
INTERPRETOR PRESENT: YES _____ NO ____ IF SO WHO: ______
WAS THE JUVENILE GIVEN AN MEANINGFUL/GENUINE OPPORTUNITY TO CONSULT WITH A
PARENT/GUARDIAN/CARING ADULT? YES __ NO __
SUGGESTED QUESTIONS GEARED TOWARD ASSESSING COMPETENCY
QUESTIONS
1. How old are you? ______
2. When is your birthday? ______
3. What year were you born? ______(If the child cannot provide the year, this should be a red flag)
4. What grade are you in? ______(Consider whether the grade is appropriate for the age of the child or whether the child is behind in school)
5. What courses are you studying? ______
(Are the courses appropriate or do they suggest special education placement)
6. How many days of school do you miss in an average week? ______
a. Why? ______
7. How many times each week are you late for school? ______
(Truancy may be an indicator of special education problems)
8. Who are your doctors? ______
a. How often do you see your doctors? ______
b. Why do you see your doctors? ______
9. Have you ever talked with a therapist or psychologist? ______
a. Why? ______
10. Have you ever been in a hospital? ______
a. Why? ______
11. Are you taking any medications? ______
a. What are they? ______
b. Why are you taking them? ______
c. How do the medications make you feel? ______Better? ______Worse?______
ANOTHER VERSION OF QUESTIONS TO ASSESS UNDERSTANDING / COMPENTENCY
Minors Name: ______Age: ______DOB: ______
Booking #: ______Completed By: ______Date Completed: ______
QUESTIONS FOR MINOR:
1. Do you go to school? ______
a. What school? ______
b. What grade? ______
2. Do you know the difference between doing what’s right and doing what’s wrong?
a. Yes: ______b. No: ______
3. Give me an example of something right to do: ______
4. Give me an example of something wrong to do: ______
5. What happens to you when you do something wrong: ______
The following questions refer to the specific crime being investigated. Use SIMPLE WORDS TO DESCRIBE THE OFFENSE i.e.” to take something that doesn’t belong to you” instead of” steal” or “petty theft”, “go into a house without permission to take something that isn’t yours” instead of “burglary, “start a fight or hit someone” instead of “assault” or “battery”, “take someone’s property from them by hitting them or scaring them” instead of “robbery”, “lookout or help” instead of “aiding and abetting.” Ask about the specific sexual activity instead of “oral copulation” or “penetration.” Try to have minor explain their answers. Indicate the words used by investigator to describe the crime.
6. Do you know it is wrong to (specific crime investigated)?
Answer: ______
7. Did you know it was wrong to (specific crime investigated)?
Answer: ______
7a. Before (time frame offense occurred)?
Answer: ______
8. Do you know it is wrong to help someone else (specific crime investigated) ______?
Answer: ______
9. If someone did this to you would it be wrong?
Answer: ______
10. Where you ever taught it was wrong to (specific crime investigated) ______?
Answer: ______
10a. By whom (i.e. : parent, teacher, etc.)
Answer: ______
11. What were you taught about it being wrong to (specific crime investigated) ?
Answer: ______
Conclusion: State whether in your opinion, the subject knows the difference between right and wrong.
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Questions for Parent(s) / Guardian(s) / Teacher / Other (If Applicable)
Name of person questioned: ______
Relationship: ______
Questioned by: ______
In Person: ______Via Telephone : ______
1. What is the minor’s age?
Answer: ______
2. Date of birth?
Answer: ______
3. Have you taught (minor’s name) ______The difference between right and wrong?
Answer: ______
4. Does (minor’s name) ______know it is wrong to (specific crime investigated) ______?
Answer: ______
5. Did he/she know it was wrong before the event?
Answer: ______
6. Has (minor’s name) ______been taught it is wrong to (specific crime investigated) ______?
Answer: ______
7. How and by whom (ie. parent, teachers, etc.)?
Answer: ______
8. Does (minor’s name) ______go to school?
Answer: ______
8a. Where?
Answer: ______
8b. What grade?
Answer: ______
9. Can (minor’s name) ______read?
Answer: ______
10.Can (minor’s name)______Write?
Conclusion: State whether in your opinion, the subject knows the difference between right and wrong.
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MIRANDA COMPREHENSION
Determine if the subject knows the meaning of the following words as per Miranda: silent, court, lawyer, appointed, judge, and write the subject’s answers below. If a word is unknown explain the meaning and document explanation.
Silent: ______
Explanation if needed: ______
Court: ______
Explanation if needed: ______
Lawyer: ______
Explanation if needed: ______
Appointed: ______
Explanation if needed: ______
Judge: ______
Explanation if needed: ______
Was Miranda Given? Yes: ______No: _____
Did minor indicate they heard and understood their rights? Yes: ______No: _____
Did minor give a knowing and intelligent waiver of his/her rights? Yes: ______No: _____
If it is not documented anywhere else in your department records you can use the following to support how they were advised of Miranda.
EXPLANATION OF MIRANDA RIGHTS TO SUBJECT: (example)
Question: You have the right to remain silent? What does that mean?
Answer: I don’t know
Response: It means you don’t have to talk to me if you don’t want to. Now do you understand?
Complete the remainder of Miranda individually.
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