5120:1-3-10 Intake.

(A) The licensed agency shall implement policies and procedures governing intake. A copy of these procedures shall be distributed to all referring agencies and/or courts. The agency’s intake policies shall include, at minimum, information to be gathered on all applicants before admission, criteria for acceptance/rejection and procedures to be followed when accepting or rejecting referrals.

(B) The licensed agency shall complete an initial intake information form on each individual admitted into the facility, which shall include, at a minimum:

(1) Name, institution and/or docket number;

(2) Address;

(3) Date of birth;

(4) Sex;

(5) Race or ethnic origin;

(6) Reason for referral;

(7) Whom to notify in case of emergency;

(8) Date information gathered;

(9) Signature of both offender and employee gathering information;

(10) Name of referring agency or committing authority;

(11) Special medical, dental and mental health needs reported by offender;

(12) Personal physician, if applicable;

(13) Legal status, including jurisdiction, length and conditions of sentence;

(14) Social security number;

(15) Weight and height;

(16) Other identifiable characteristics, (scars, marks, tattoos, etc.);

(17) Photograph of offender for identification;

(18) Official charge(s); and

(19) Marital status.

(20) Spouse’s name, and:

(21) Next of kin.

(C) The licensed agency shall notify the referring authority within five business days of the referral when a prospective offender will be accepted into the program. Placement of offenders throughout the state shall be coordinated through the division of parole and community services, and/or the court. When an applicant is refused admittance to a particular agency, the referring authority shall be notified in writing within five business days from the referral date. The rejection notification shall state the reasons for the rejection.

(D) At the time of intake, agency staff shall discuss with each offender program goals, services available, rules governing conduct, program rules, and possible disciplinary sanctions for rule violations. This orientation shall be documented by employee and offender signatures.

(1) If a language barrier, literacy problem, or any other disability exists which can lead to the offender misunderstanding agency rules and regulations, assistance shall be provided to the offender either by staff or by another qualified individual under the supervision of a staff member.

(2) All program rules, regulations, and disciplinary procedures pertaining to offenders shall be either conspicuously posted in the facility or issued to offenders in printed form.

(E) The licensed agency that operates more than one residential unit shall have a centralized placement coordinator.

R.C. 119.032 review dates: 01/12/2006 and 01/12/2011

Promulgated Under: 119.03

Statutory Authority: 2967.14, 2967.26

Rule Amplifies: 5120.031

Prior Effective Dates: 4/1/82, 4/17/93, 7/1/96, 7/1/2002