Case Review Form

District:
Client name:
IDOC #:
Supervision level:
LSI date and score:
PPO:
Date case assigned:
Reviewer:
Review date:Review type: check all that applyFRONT LOADED (New cases first 90 days)SUPERVISION CASE REVIEW(Date assigned up to 1 year)CRITICAL INCIDENT CASE REVIEW(Prior 12 months)DIRECT
OBSERVATION
Officer’s overall Recidiviz % across all practices:
State’s overall Recidiviz % across all practices:
Officer’s summary of their efforts to supervise this case
(the officer’s summary is mandatory for critical incident reviews):
QUALITY REVIEW
Quality review points that should be considered by the reviewing supervisor:
Officer’s effective use of EPICS
Officer’s effective use of available community resources
Officer’s overall approach to increase client motivation and change (examples of this would be rapport building, effective intervention use, effective use of rewards and sanctions, etc.)
Officer’s effective use of coach vs. referee (approach)
Officer’s use of risk, need and responsivity to include effective case planning. Please use specific examples.
Opportunities for case improvement and follow up:
(identification of available resources; EPICS utilization, accurate assessments, knowledge of client’s deficits/criminogenic needs and strengths, etc.)
DIRECT OBSERVATION
A direct observation case review is to be completed annually. Supervisors can deem the most appropriate means to effectively conduct the review:
(field work, observing EPICS, observing client meetings, body camera footage, etc.)
FRONT LOADED (New cases first 90 days) SUPERVISON REVIEW
Standards
Met
Not Met
Waived-N/A
72 Hour/ Initial contact
14 day/ Sign up
Treatment referral
Face to Face contact
30 day/ Residence verification
30 day/ Employment verification
45 day/ LSI-R
45 day/ SO assessment
Initial sign updocuments reviewed and signed, conditions noted and goals developed
SUPERVISON REVIEW
Standards
Met
Not Met
Waived-N/A
Recidiviz identified tasks met—case specific
Residence verification/home contact
Treatment
SO specific: assessments
SO specific: polygraph
By signing this case review both the officer and the supervisor attest that the strengths or areas of improvement have been discussed.
PPO Signature:
Date:
Reviewer Signature:
Date:

IDAHO DEPARTMENT OF CORRECTION
PROBATION AND PAROLE

CASE REVIEW FORM

Client Name: IDOC #:
Supervision Level: LSI Date:
PPO: Date Case Assigned:
Reviewer: Review Date:

Review Type: check all that apply
☐ Front load
☐ Regular ☐ 105--MUST
COMPLETE BOTH
(New Cases)
(Review of past
(Critical Incident)
year)
*Attach 105 to case
review

Front Loaded (New Case) Supervision Review
Standard Meets Does Not N/A Waived
Meet
72 Hour/ Initial Contact
14 day/ Sign Up
Treatment Referral
30 day/ Residence Verification
30 day/ Employment Verification
45 day/ LSI-R
45 day/ SO Assessment
Initial Case Update: Documents reviewed and signed,
conditions noted and goals developed

Supervision Review
Standard Meets Does Not N/A Waived
Meet
Face to Face Contact
Field Contact
Residence Verification
Employment Verification
Substance Testing
Treatment
Assessments
Yearly Review for discharge or transfer to LSU
WBOR
Polygraph

SOP 701.04.02.010
(Revised 12/28/2020)

Details for standards not met:

Quality Review
Suggest coaching points: CIS Documentation-clear, concise, unbiased; Sanctions/Rewards timely and
applied correctly; Barriers to client success; Progress towards client success; Case plan to LSI with
periodic review; Meaningful conversations; Reinforcing prosocial behaviors; Financial responsibilities;
Victim restoration; Customer service

What was done well in this case:

What can be done to improve in this case:

PPO Signature: Date:

Reviewer Signature: Date:

SOP 701.04.02.010
(Revised 12/28/2020)