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Positive Achievement Change Tool (PACT) 1.0
Full-Assessment
Assessments.com
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DOMAIN 1: Record of
Referrals |
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Referrals, rather than offenses, are used to assess the persistence of
re-offending by the youth. Include only referrals that resulted in
diversion, adjudication withheld, adjudication, deferred prosecution or
referral to adult court (regardless of whether successfully completed). |
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1.
Age
at first offense:
The age at the time of the offense for which the youth was referred to
juvenile court for the first time on a non-traffic misdemeanor or felony
that resulted in diversion, adjudication withheld, adjudication,
deferred prosecution or referral to adult court.
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O
Over 16
O
16
O
15
O
13 to 14
O
12 and Under |
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Felony and misdemeanor referrals:
Items 2 and 3 are mutually exclusive and should add to the total number
of referrals that resulted in diversion, adjudication withheld,
adjudication, deferred prosecution or referral to adult court. |
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2.
Misdemeanor referrals:
Total number of referrals for which the most serious offense was a
non-traffic misdemeanor that resulted in diversion, adjudication
withheld, adjudication, deferred prosecution or referral to adult court
(regardless of whether successfully completed).
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O
None or one
O
Two
O
Three or four
O
Five or more |
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3.
Felony referrals:
Total number of referrals for a felony offense that resulted in
diversion, adjudication withheld, adjudication, deferred prosecution or
referral to adult court (regardless of whether successfully completed). |
O
None
O
One
O
Two
O
Three or more |
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Against-person or weapon referrals:
Items 4, 5, and 6 are mutually exclusive and should add to the total
number of referrals that involve an against-person or weapon offense,
including sex offenses that resulted in diversion, adjudication
withheld, adjudication, deferred prosecution or referral to adult court
(regardless of whether successfully completed). |
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4.
Weapon referrals:
Total referrals for which the most serious offense was a
firearm/weapon charge or a weapon enhancement finding. |
O
None
O
One or more |
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5.
Against-person misdemeanor referrals:
Total number of referrals for which the most serious offense was an
against-person misdemeanor – a misdemeanor involving threats, force, or
physical harm to another person or sexual misconduct (assault, coercion,
harassment, intimidation, etc.). |
O
None
O
One
O
Two or more |
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6.
Against-person felony referrals:
Number of referrals involving force or physical harm to another
person including sexual misconduct as defined by FDLE as violent
felonies. |
O
None
O
One or two
O
Three or more |
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Sex offense referrals:
Items 7 and 8 are mutually exclusive and should add to the total number
of referrals that involve a sex offense or sexual misconduct that
resulted in diversion, adjudication withheld, adjudication, deferred
prosecution or referral to adult court. |
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7.
Sexual misconduct misdemeanor referrals:
Number of referrals for which the most serious offense was a sexual
misconduct misdemeanor including obscene phone calls, indecent exposure,
obscenity, pornography, or public indecency, or misdemeanors with sexual
motivation. |
O
None
O
One
O
Two or more |
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8.
Felony sex offense referrals:
Referrals for a felony sex offense or involving sexual motivation
including carnal knowledge, child molestation, communication with minor
for immoral purpose, incest, indecent exposure, indecent liberties,
promoting pornography, rape, sexual misconduct, or voyeurism. |
O
None
O
One
O
Two or more |
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9.
Confinements in secure detention where youth was held for at least 48
hours:
Number of times the youth was held for at least 48 hours physically
confined in a detention facility. |
O
None
O
One
O
Two
O
Three or more |
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10.
Commitment orders where youth served at least one day confined under
residential commitment:
Total number of commitment orders and modification orders for which the
youth served at least one day confined under residential commitment. A
day served includes credit for time served. |
O
None
O
One
O
Two or more |
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11.
Escapes:
Total number of attempted or actual escapes that resulted in
adjudication. |
O
None
O
One
O
Two or more |
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12.
Pick Up Orders for failure-to-appear in court or absconding supervision:
Total number of failures-to-appear in court or absconding supervision
that resulted in a pick up order being issued. Exclude failure-to-appear
warrants for non-criminal matters. |
O
None
O
One
O
Two or more |
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DOMAIN
3A: School History |
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1.
Youth
is a special education student or has a formal diagnosis of a special
education need:
(Check all that apply.) |
¨
No special
education need
¨
Learning
¨
Mental retardation
¨
Behavioral
¨
ADHD/ADD |
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2.
History
of expulsions and out of school suspensions since the first grade: |
O
No expel/suspend
O
1 expel/suspend
O
2 or 3 |
O
4 or 5
O
6 or 7
O
More than 7 |
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3.
Age at
first expulsion or suspension:
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O
No expulsions
O
5 to 9 years
old
O
10 to 13 years
old |
O
14 to 15 years
old
O
16 to 18 years
old |
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4.
Youth
has been enrolled in a community school during the last 6 months,
regardless of attendance:
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O
No, graduated/GED
and not attending school, do not complete Domain 3B
O
No, dropped-out
or expelled for more than six months, do not complete Domain 3B
O
Yes, must
complete Domain 3B |
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DOMAIN 3B: Current School
Status |
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O
For Initial
Assessments, current is the
most recent term in last 6 months.
O
For
Re-assessments and Final Assessments,
current is the last 4 weeks in the
most recent term. |
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1.
Youth’s
current school enrollment status, regardless of attendance:
If the youth is in home school as a result of being expelled or
dropping out, check expelled or dropped out; otherwise check enrolled,
if in home school. |
O
Graduated/GED
O
Enrolled
full-time
O
Enrolled
part-time |
O
Suspended
O
Dropped out
O
Expelled |
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2.
Type of
school in which youth is enrolled:
Name of School
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O
Public academic
O
Vocational
O
Alternative
O
GED program |
O
Private
academic
O
Home school
O
College
O
Other
__________ |
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3.
Youth
believes there is value in getting an education: |
O
Believes
getting an education is of value
O
Somewhat
believes education is of value
O
Does not
believe education is of value |
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4.
Youth
believes school provides an encouraging environment for him or her: |
O
Believes school
is encouraging
O
Somewhat
believes school is encouraging
O
Does not
believe school is encouraging |
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5.
Teachers, staff, or coaches the youth likes or feels comfortable talking
with: |
O
Not close to
any teachers, staff, or coaches |
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O
Close to 1
O
Close to 2 |
O
Close to 3
O
Close to 4 or
more |
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6.
Youth’s
involvement in school activities during most recent term:
School leadership; social service clubs; music, dance, drama, art;
athletics; other extracurricular activities. |
O
Involved in 2
or more activities
O
Involved in 1
activity
O
Interested but
not involved in any activities
O
Not interested
in school activities |
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7.
Youth’s
conduct in the most recent term:
Fighting or threatening students; threatening teachers/staff; overly
disruptive behavior; drug/alcohol use; crimes (e.g., theft, vandalism);
lying, cheating, dishonesty. |
O
Recognition for
good behavior
O
No problems
with school conduct
O
Problems
reported by teachers
O
Problem calls
to parents
O
Calls to police |
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8.
Number
of expulsions and suspensions in the most recent term: |
O
No expel/suspend
O
1 expel/suspend |
O
2 or 3
O
More than 3 |
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9.
Youth’s
attendance in the most recent term:
Partial-day absence means attending majority of classes and missing
minority. Full-day absence means missing majority of classes. Habitual
truancy as defined in FS includes 15 unexcused absences in a 90 day
period. |
O
Good
attendance; few excused absences
O
No unexcused
absences
O
Some
partial-day unexcused absences
O
Some full-day
unexcused absences
O
Habitual truant |
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10.
Youth’s
academic performance in the most recent school term:
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O
Honor student
(mostly As)
O
Above 3.0 (mostly As
and Bs)
O
2.0 to 3.0 (mostly Bs
and Cs, no Fs)
O
1.0 to 2.0 (mostly Cs
and Ds, some Fs)
O
Below 1.0 (some Ds and
mostly Fs) |
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11.
Interviewer’s assessment of likelihood the youth will stay in and
graduate from high school or an equivalent vocational school: |
O
Very likely to
stay in school and graduate
O
Uncertain if
youth will stay and graduate
O
Not very likely
to stay and graduate |
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DOMAIN 4A: Historic Use
of Free Time |
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1.
History
of structured recreational activities within the past 5 years:
Youth has participated in structured and supervised pro-social community
activities, such as religious group/church, community group, cultural
group, club, athletics, or other community activities. |
O
Involved in 2
or more structured activities
O
Involved in 1
structured activity
O
Never involved
in structured activities |
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2.
History
of unstructured pro-social recreational activities within the past 5
years:
Youth has engaged in activities that positively occupy the youth's time,
such as reading, hobbies, etc. |
O
Involved in 2
or more pro-social unstructured activities
O
Involved in 1
pro-social unstructured activity
O
Never involved
in pro-social unstructured activities |
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DOMAIN 4B: Current Use of
Free Time |
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O
For Initial
Assessments, current means
behaviors during the last 6 months.
O
For
Re-assessments and Final Assessments,
current means behaviors during the last
4 weeks. |
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1.
Current
interest and involvement in structured recreational activities:
Youth participates in structured and supervised pro-social community
activities, such as religious group/church, community group, cultural
group, club, athletics, or other community activity. |
O
Currently involved
in 2 or more structured activities
O
Currently
involved in 1 structured activity
O
Currently
interested but not involved
O
Currently not
interested in any structured activities |
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2.
Types
of structured recreational activities in which youth currently
participates: (Check all
that apply.)
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¨
None
¨
Community/cultural group
¨
Hobby group or
club
¨
Athletics
¨
Religious
group/church
¨
Volunteer
organization |
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3.
Current
interest and involvement in pro-social unstructured recreational
activities:
Youth engages in activities that positively occupy his or her time, such
as reading, hobbies, etc. |
O
Currently involved
in 2 or more pro-social unstructured activities
O
Currently
involved in 1 pro-social unstructured activity
O
Currently
interested but not involved
O
Not interested
in any pro-social unstructured activities |
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DOMAIN 5A: Employment
History |
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1.
History of employment: |
O
Too young for
employment consideration
O
Never been
employed
O
Has been
employed |
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2.
History of successful employment: |
O
Never
successfully employed
O
Has been
successfully employed |
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3.
History of problems while employed: |
O
Never fired or
quit because of problems
O
Fired or quit
because of poor performance
O
Fired or quit
because he or she could not get along with employer or coworkers |
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4.
History of positive personal relationship(s) with past employer(s) or
adult coworker(s):
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O
Never had any
positive relationships
O
Had 1 positive
relationship
O
Had 2 or more
positive relationships |
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DOMAIN 5B: Current
Employment |
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O
For Initial
Assessments, current means
behaviors during the last 6 months.
O
For
Re-assessments and Final Assessments,
current means behaviors during the last
4 weeks. |
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1.
Understanding of what is required to maintain a job:
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O
Lacks knowledge
of what it takes to maintain a job
O
Has knowledge
of abilities to maintain a job
O
Has
demonstrated ability to maintain a job |
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2.
Current interest in employment:
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O
Currently
employed
O
Not employed
but highly interested in employment
O
Not employed
but somewhat interested
O
Not employed
and not interested in employment
O
Too young for
employment consideration |
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3.
Current employment status:
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O
Not currently
employed
O
Employment is
currently going well
O
Having problems
with current employment |
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4.
Current positive personal relationship(s) with employer(s) or adult
coworker(s):
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O
Not currently
employed
O
Employed but no
positive relationships
O
At least 1
positive relationship |
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DOMAIN 6A: History of
Relationships |
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1.
History
of positive adult non-family relationships not connected to school or
employment:
Adults, who are not teachers and not part of the youth’s family, who
can provide support and model pro-social behavior, such as religious
leader, club member, community person, etc. |
O
No positive
adult relationships
O
1 positive
adult relationship
O
2 positive
adult relationships
O
3 or more
positive adults relationships |
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