Sexual Abuse Investigation

Please fill out and submit this form for Community Services investigations

PREA Resource Unit

Additional contact information

Email: Community.Services.PREA.Compliance.Manager.DOC@state.mn.us

Phone: (218) 244-4447

Address: Minnesota Department of Corrections

1450 Energy Park Drive

ATTN: PREA Resource Unit

Name of your organization/ or agency

Incident Date (if unknown leave blank)

Date reported*

Investigation commencement date*

Name of Reporter*

Name of Investigator, Title if applicable*

Incident Location*

Allegation Description

Select

Full Name of Victim

Full Name of Perpetrator

Specify if Suspect is Staff or Resident

Outcome*

Substantiated, Unsubstantiated, Unfounded, or Ongoing

Select

Date Victim Notified of Outcome

If the victim has been notified of a completed investigations outcome when did this occur?

Conclusion Date of Investigation

If an investigation has already been conducted, please the date of completion.

Additional Information

Attach Reports and Follow-up

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