ARP Coordinator -a staff member designated by the warden whose responsibility is to coordinate and facilitate the ARP process.
Business Days -Monday through Friday.
Calendar Days -consecutive days including weekends and holidays.
Case Manager -a staff member whose primary responsibilities include a assisting offenders.
Emergency Grievance -a matter in which disposition within the regular time limits would subject the offender or others to substantial risk of personal injury, or cause other serious or irreparable harm.
Grievance -a written complaint on an offender's behalf regarding a policy, condition, action, or incident occurring within an institution that affects the offender personally.
Initiation of the ARP Process -for a particular complaint, the administrative remedy procedure shall commence the day the request is accepted in the ARP process.
Offender -a person incarcerated in a juvenile correctional institution.
Sensitive Issue -a complaint which the offender believes would adversely affect him if it became known at the institution.
Youth Programs Compliance Division (YPCD) -a division located at the Office of Youth Development Headquarters in Baton Rouge. Employees of this division are responsible for monitoring the ARP process.
DPSamp;C-CORRECTIONS SERVICES Number: _____-____-___
JUVENILE ARP FORM Date Received:_________
Name: ____________________ JIRMS Number:______________
Institution: _________________ Housing Unit:_______________
"THIS IS A REQUEST FOR ARP"
(You may ask your case manager or other staff members for help completing this form.)
State your problem (WHO, WHAT, WHEN, WHERE AND HOW) and the remedy requested (what you want to solve the problem):
Problem: ______________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
Remedy requested: ______________________________________
Date of Incident:___________ Today's Date: _________________
This form must be completed within 90 calendar days of the date of the incident and given to the ARP Coordinator or placed in the ARP/grievance box.
Step One-ARP Coordinator's Review and Warden's Response
(Maximum Time For Processing: 21 calendar days)
____ Denied ___Rejected ___Returned ___ Accepted Date: _____
Reason: _______________________________________________
_______ Handled Informally By ___________________________
AC's Recommendation:
Sent to Warden on: _____________AC's Signature: ____________
Warden's response to your ARP Step One request: _____________
______________________________________________________
______________________________________________________
______________________________________________________
Date: _______ Warden's Signature: _______________________
If you are not satisfied with this response, you may go to Step Two. The ARP Coordinator must submit your request to the Secretary within 10 calendar days after you receive the Step One response.
Received Step One on: _______ Juvenile's Signature: __________
Request Step Two: _yes __no Reason for Step Two request: ___
______________________________________________________
Date Step Two request received by AC: _ Date Sent to Secretary: _
AC's Signature: _______________________
Step Two-Secretary's Response
(Maximum Time For Processing: 21 calendar days)
Date Received:
Secretary's response to ARP Step Two request: _______________
____________________________________________________
____________________________________________________
____________________________________________________
Date: __________ _____________________________________
Secretary's Signature
Date received Secretary's response:______ __________________
Juvenile's Signature
If you are not satisfied with this response, you may seek judicial review. A request for judicial review must be submitted to the court within 30 calendar days after receiving the Step Two decision.
Rev. 01-01-02
LOST PROPERTY AGREEMENT
I, _____________(Offender name), JIRMS # ________________, filed an ARP for _____________(description of lost property.) My ARP was filed on ____________. I have received __________as a settlement for my lost property. Since I have received a settlement for my lost property, the State of Louisiana (Department of Public Safety and Corrections [DPSamp;C]) does not owe me anything for my property which was reported lost on _______(Date ARP filed.) I agree to release the State of Louisiana (DPSamp;C) and any of its agents, representatives, officers and employees from any liability for compensation, damages and any other amounts that may be owed to me because my property was lost. I also agree to discharge the State of Louisiana of any liability that may exist. I agree to all the terms of this agreement.
WITNESSES:
_______________________
___________________________
(Signature of Offender)
_______________________ ___________________________
(Date)
Warden's Approval ____________________________________
Secretary's Approval ___________________________________
(Necessary for monetary settlement)
La. Admin. Code tit. 22, § I-713