This free survey is powered by

Officer Monthly Rating of Offender Progress

Supervising Officer/Case Manager Monthly Rating of Client Progress
0%
Questions marked with an * are required Exit Survey
 
 
* Supervising Officer/Case Manager Name:
   
 
 
* Client Name:
   
 
 
Month
 
 
Year
 
 
1 2 3 4 5 6
Progress Report Month:
 
 
 
Directions: In the next section you will rate the client’s general progress in the area of various contacts over the past 30 days.
 
 
A. CONTACTS
 
 
1. Over the last 30 days, what was the average length (in minutes) of your face-to-face contact(s) with the client: ____ minutes
   
 
 
2. Indicate the number of times you initiated contact with the client during the last 30 days:
Face-to-face visit in the office:
Face-to-face visit in the community:
By telephone:
By email:
By text message:
Other (specify)
 
3. Indicate the number of times the client contacted you during the last 30 days:
By telephone:
By email:
By text message:
Other (specify)
 
4. Please indicate the number of times in the last 30 days that:
the client’s supported network called or sent you a text message:
the client’s treatment provider(s) contacted you:
the client was drug tested:
the client tested positive for drugs:
the client failed to appear for a supervision meeting:
the client failed to appear for a treatment session:
the client failed to appear for court:
 
5. During the last 30 days…
Yes No Don't Know Not Applicable
…has the client participated in community service as planned?
…was the client arrested?
…was the client at the emergency room or in the hospital?
…has the client had a death or serious illness in the family?
 
 
 
Directions: In the next several sections you will rate the client’s progress over the past 30 days in specific content areas. Progress refers to how well the client is addressing the areas that affect success on supervision.
 
 
B. SUPERVISION PROGRESS
 
1. Select the number representing your view of the client’s overall progress on supervision during the past 30 days:

1= Negative; 5=About the Same; 10=Positive
1 2 3 4 5 6 7 8 9 10
Overall Progress
 
 
 
EMPLOYMENT PROGRESS DURING THE PAST 30 DAYS
 
 
2. What is the client’s current employment status? (select one)
 
Unemployed and not looking for employment
 
Unemployed, but looking for employment
 
Employed part-time (____ average number of hours per week)
 
Employed 32 hours or more a week
 
No employment, receives SSI/SSD benefits
 
Other (specify)
 
 
 
If employed part-time, specify the average number of hours per week
   
 
 
 
3. In the past 30 days has the client:
 
Changed jobs
 
Been fired from a job
 
Been laid off from a job
 
No change in employment
 
Other (specify)
 
 
 
4. Select the number representing your view of the client’s employment progress during the past 30 days:

1= Negative; 5=About the Same; 10=Positive
1 2 3 4 5 6 7 8 9 10
Overall Progress
 
 
5. On a scale of 1 to 5, indicate the extent to which the client demonstrated the following characteristics:
Never Rarely Sometimes Often Always Not Applicable
The client has a good relationship with the employer.
The client has difficulties on the job getting along with coworkers.
The client has shown an interest in making this job work.
The client appears to find his/her job satisfying.
The client values getting money from working.
 
 
 
ATTITUDE TOWARD SUPERVISING OFFICER/CASE MANAGER DURING THE PAST 30 DAYS
 
6. Select the number representing your view of the client’s progress in improving attitudes toward his/her supervising officer during the past 30 days:

1= Negative; 5=About the Same; 10=Positive
1 2 3 4 5 6 7 8 9 10
Overall Progress
 
 
7. On a scale of 1 to 5, indicate the degree to which you agree with the following statements:
Strongly Agree Agree Neutral Disagree Strongly Disagree Not Applicable
The client responds to my suggestions.
The client resents working on attitude or motivation.
I have detected that the client does not trust the probation/parole/re-entry system.
The client is very self-centered.
If the client wants something, he/she expects others to deliver it.
The client does not seem interested in finding a way to “set things right” with anyone for the crime he/she committed or for being in prison.
The client seems to think the future is unpredictable and he/she should not plan for anything.
The client does not take responsibility for his crime.
The client seems to enjoy life, even the little things.
The client seems to think he/she can make up for the crime by doing something good.
The client believes that he/she does not owe anything to anyone else.
The client seems to like taking risks.
The client seems to think that he has bad luck.
 
 
7. On a scale of 1 to 5, indicate the degree to which you agree with the following statements:
Strongly Agree Agree Neutral Disagree Strongly Disagree Not Applicable
I believe that the client is trying and working on the plan.
The client seems to think that probation/parole/community supervision is a waste of time.
The client does not seem to have good control over his/her behavior.
The client blames others for his/her behavior.
The client is always looking for ways to get the respect that he/she is due.
The client has a good plan in place to make up transgressions to his/her loved ones.
The client thinks that people in authority are looking out for his/her best interest.
The client believes that he/she can change.
The client seems to think he/she deserves more than other people.
The client is always focusing on today, not the future.
The client appears to be concerned about the people around him/her.
The client does not want to be a criminal anymore.
 
 
 
SOCIAL SUPPORT DURING THE PAST 30 DAYS
 
 
1. How would you best describe the client’s current support networks:
 
The client does not appear to have anyone to depend on.
 
The client appears to have some people he/she can depend on.
 
The client has a strong social support system.
 
 
 
2.  In the past 30 days has the client experienced a problem with at least one person he/she depends on?
 
Yes
 
No
 
Not Sure
 
 
3. Select the number representing your view of the client’s progress on his/her social networks during the past 30 days:

1= Negative; 5=About the Same; 10=Positive
1 2 3 4 5 6 7 8 9 10
Overall Progress
 
 
4. On a scale of 1 to 5, indicate the degree to which you agree with the following statements:
Strongly Agree Agree Neutral Disagree Strongly Disagree Not Applicable
The client gets along with others
The client has someone to depend upon
The client talks positively about the person(s) he/she lives with
The client expresses concern about how well others are doing.
The client had a major fight or disagreement with someone in their network.
The client lives with others that drink or uses drugs.
The client lives with someone who is also on probation, parole, or just out of jail/prison.
The client relies on others to deal with problems.
The client works hard on his relationship with others.
The client gets blamed or fussed at about things others do or did.
The client frequently has disagreements with others.
The client had big arguments or fights lately.
The client depends on friends from prison more than family or peers not involved in the justice system.
The client values his/her friend’s viewpoint more than others.
The client works hard at keeping positive relationships with his/her social network.
 
 
 
HOUSING PROGRESS DURING THE PAST 30 DAYS
 
 
1. How would you best describe the client’s housing stability over the past 30 days?
 
The client’s housing has remained the same over the past 30 days
 
The client has moved within the past 30 days.
 
 
 
If client has moved within the past 30 days, select the option best representing his/her current housing status:
 
Staying with family/friends
 
Rent an apartment/house (alone or with others)
 
Own my home
 
Halfway house
 
Now Homeless (living on the street, in a park, in a bus station, etc.)
 
In a shelter or single-room occupancy hotel
 
Permanent single-room occupancy hotel
 
HIV/AIDS housing/group home
 
Drug treatment facility (how many days______)
 
Other healthcare residential facility or institution (how many days______)
 
Other (specify)
 
 
 
 
Drug treatment facility (how many days______)
   
 
 
 
Other healthcare residential facility or institution (how many days______)
   
 
 
 
2. Note any other major changes in housing:
   
 
 
 
3. Does the client live in an area where a number of other individuals on community supervision live?
 
Yes
 
No
 
 
4. Select the number representing your view of the client’s progress on his/her housing during the past 30 days:

1=Negative; 5=About the Same; 10=Positive
1 2 3 4 5 6 7 8 9 10
Overall Progress
 
 
 
SUPERVISION PLAN DURING THE PAST 30 DAYS
 
1. Select the number representing your view of the client’s progress on meeting any educational requirements during the past 30 days.

1= Negative; 5=About the Same; 10=Positive

Select N/A (not applicable) if the client is not required to participate in educational programming.
1 2 3 4 5 6 7 8 9 10 N/A
Progress in obtaining any educational requirements
 
 
2. Select the number representing your view of the client’s progress in dealing with and maintaining separation from any peers involved in criminal behavior or on probation/parole during the past 30 days.

1= Negative; 5=About the Same; 10=Positive
1 2 3 4 5 6 7 8 9 10 N/A
Progress in dealing with peers that are involved in criminal behavior or on probation/parole
 
 
3. Select the number representing your view of the client’s progress on participation in prosocial leisure or recreational activities during the past 30 days.

1= Negative; 5=About the Same; 10=Positive
1 2 3 4 5 6 7 8 9 10 N/A
Progress in participating in prosocial leisure or recreational activities
 
 
4. Select the number representing your view of the client’s progress on dealing with any alcohol or substance use needs during the past 30 days.

1= Negative; 5=About the Same; 10=Positive
1 2 3 4 5 6 7 8 9 10 N/A
Progress in dealing with alcohol or substance use needs
 
 
5. Select the number representing your view of the client’s progress on coping with any mental health needs or concerns during the past 30 days.

1= Negative; 5=About the Same; 10=Positive
1 2 3 4 5 6 7 8 9 10 N/A
Progress in dealing with mental health needs or concerns
 
 
6. Select the number representing your view of the client’s progress in addressing any other relevant areas during the past 30 days:

1= Negative; 5=About the Same; 10=Positive

Area 1:
1 2 3 4 5 6 7 8 9 10 N/A
Progress in dealing with other issues
 
 
 
Other issue Area 1:
   
 
 
6. Select the number representing your view of the client’s progress in addressing any other relevant areas during the past 30 days:

1= Negative; 5=About the Same; 10=Positive

Area 2: 
1 2 3 4 5 6 7 8 9 10 N/A
Progress in dealing with other issues
 
 
 
Other issue Area 2:
   
 
 
7. Mark any change(s)/actions taken related to this client during the past 30 days:

If yes, please specify
Yes[,]No[,]Not Applicable[,]Specify
Drug testing added as supervision requirement
Increased reporting requirements
Decreased reporting requirements
Treatment program referral: ____ (program type)
Mental health assessment referral
Mental health treatment referral
Referral to a physician or clinic: _____ (reason)
Other change(s): ____(specify)
 
 
 
 
 
 
8. On a scale of 1 to 5 indicate the degree to which you agree with the statements.
Strongly Agree Agree Neutral Disagree Strongly Disagree
The client acts like someone who is involved in the criminal justice system.
The client focuses on the future (after he/she is off on supervision).
The client sees him/herself a new person with new opportunities.
The client reports that the supervision experience is beneficial for him/her.
The client seems to be more positive.
The client understands clearly what he/she is expected to achieve.
The client accepts the challenges before him/her to be crime-free.
The client accepts positive feedback on how he/she can improve his/her situation.
The client follows through on things that he/she says he/she will do.
The client appears to think before he/she acts.
Strongly Agree Agree Neutral Disagree Strongly Disagree
I believe the client will be successful given his/her behavior.
The family or support system of the client has been helpful in his/her supervision process.
The client always seems to have bad luck.
I can trust this client’s word.
I believe the client has a lot of obstacles standing in the way of his/her ability to be successful on supervision.
I believe this client has decided to be a good citizen.