Show Me Peace VI Daily Log_New
Date of data you are logging:
Name:
Please select...
Amir
Bang
Cat
Charles
Chyna
Dee
Juan
Mark
Nook
Noon
Norky
Sento
Stadic
Streeter-EL
Tank
Tavon
Ty
Von
Wes
Someone Else
Your Name:
Neighborhood:
Please select...
Dutchtown
The Ville
Walnut Park
Wells Goodfellow
I'm off work.
Yes
SECTION 1 - COMMUNITY ACTIVITY
How many HOTSPOTS did you visit today?
WP - Did you visit any of these HOTSPOTS today?
(Check all that apply).
ACME
Generation X Mini Mart
Gregory Carter Park
McNeals Liquor
Mobile Gas
Oriole
Phillips 66 (Union & Bircher)
Phillips 66 (W. Florissant and Robin)
Quarter Jays
Regal Market
Mobile (Union & 70)
Somewhere not listed
None
V - Did you visit any of these HOTSPOTS today?
(Check all that apply).
Hurns Lounge (3600 Hebert)
Colt Brilliant & Vandeventer
Bikers Corner
Vandeventer & North Market
3900 Garfield Dope set
B Market Gas Station (3940 St. Louis Ave.)
Old Midtown (2816 Vandeventer)
Tandy Rec Center (4206 Kennerly)
(Sumner High School) 4200 Cottage
James House (4310 St. Ferdinand)
4400 elmbank. 2 homicides
4400 Ashland
2900 Newstead Dope set.
Gas station (MLK & Vandeventer)
Gas station (MLK & Cora)
Somewhere not listed
None
D - Did you visit any of these HOTSPOTS today?
(Check all that apply).
Village Too
Eagle Mart
Family Dollar
Laundromat
Osage Market
Moto Mart
Phillips 66
Marquette Park
Amberg Park
Somewhere not listed
None
WGF - Did you visit any of these HOTSPOTS today?
(Check all that apply).
5800 Cote Brilliante
5900 Cote Brilliante
Mobil Gas Station (Clara & MLK)
5800 Lotus
DJ's Package Liquor (Page & Hodiamont)
Somewhere not listed
None
HOTSPOT DETAILS
What specific areas need attention?
Please list the name and address:
How would you categorize this HOTSPOT?
Gas station
Convenience/liquor store
House
Street
Other place of business
Please describe the
TYPE
other place of business:
Reason why:
Did you have any shooting responses today?
Yes
No
SHOOTING RESPONSE
Other SMP staff present:
Amir
Bang
Cat
Charles
Chyna
Dee
Jason
Juan
LaSha
Latoya
Mark
Nook
Noon
Norky
Ny'Sha
Sahir
Sento
Stadic
Streeter-EL
Tank
Tavon
Ty
Von
Wes
Other
No one else
Name of other person present:
Date of response:
Time:
Narrative of the situation:
Which shooting are you responding to?
Victim's name (if applicable):
Is there a potential for retaliation?
High
Low
No
LOCATION
Neighborhood:
Baden
College Hill
Dutchtown
The Ville
Walnut Park
Wells Goodfellow
Other
Other Neighborhood:
Is the location of the shooting response within the catchment area?
Yes
No
Zone:
1
2
3
4
Hundred block:
Street name & nearest intersection:
Location description
(check all that apply)
:
Abandoned Building
Business
Church
Grocery Store
Open Area
Playground/Rec Center
Public Transportation
Residence
Restaurant/Bar
School
Shopping Center/Mall
Site Office
Street Corner
Vacant Lot
Other
Location description other:
Is this location a hotspot?
Yes
No
BACKGROUND
What is the relationship between parties?
Personal
Random
What is the nature of the conflict?
Historical
Random
Targeted
Likely causes
(check all that apply):
Domestic Conflict
Drugs
Family Dispute
Gang Territory
Group Conflict
Intimate Partner Conflict
Miscommunication
Monetary Dispute
Social Conflict
Other
Other cause:
Incident type
(check all that apply):
Fatal Shooting
Non-Fatal Shooting
School Shooting
Neighborhood Shooting
Domestic Violence
Mass Shooting
Fatal Stabbing
Non-Fatal Stabbing
Other Firearm Related Assault
Flourishing/Brandishing Weapon
Other
No Injuries
Other type:
Was the incident retaliatory?
Yes
No
Unknown
Did social media lead to escalation?
Yes
No
Unknown
Did anyone appear to be on drugs or intoxicated?
Yes
No
Was this related to an anniversary?
Yes
No
Was someone recently released from incarceration believed to be involved?
Yes
No
OUTCOME
What was the actual outcome?
Resolved
Resolved with conditions
Temporarily resolved
Not resolved
Ongoing
Other outcome:
Additional information/what does follow-up look like?:
Did you have any de-escalations today?
Yes
No
DE-ESCALATION
Other SMP staff present:
Amir
Bang
Cat
Charles
Chyna
Dee
Jason
Juan
LaSha
Latoya
Mark
Nook
Noon
Norky
Ny'Sha
Sahir
Sento
Stadic
Streeter-EL
Tank
Tavon
Ty
Von
Wes
No one else
Date of de-escalation:
Time:
Narrative of the situation:
Is this related to a shooting/homicide?
Yes
No
Unknown
Victim's name (if applicable):
If yes, what incident is it related to?
Is there a potential for retaliation?
High
Low
No
Expected outcome if SMP was not present:
Please select...
Imminent fatality with parties involved
On-going conflict with possibility of causality to innocent bystanders
Potential escalation with individuals or a group
Physical altercation
Shooting
Other
LOCATION
Neighborhood:
Baden
College Hill
Dutchtown
The Ville
Walnut Park
Wells Goodfellow
Other
Other Neighborhood:
Is the location of the de-escalation within the catchment area?
Yes
No
Zone:
1
2
3
4
Hundred block:
Street name or intersection:
Zip code:
Location description
(check all that apply)
:
Abandoned Building
Business
Church
Grocery Store
Open Area
Playground/Rec Center
Public Transportation
Residence
Restaurant/Bar
School
Shopping Center/Mall
Site Office
Street Corner
Vacant Lot
Other
Location description other:
Is this location a hotspot?
Yes
No
BACKGROUND
What is the relationship between parties?
Personal
Random
What is the nature of the conflict?
Historical
Random
Targeted
Likely causes
(check all that apply):
Domestic Conflict
Drugs
Family Dispute
Gang Territory
Group Conflict
Intimate Partner Conflict
Miscommunication
Monetary Dispute
Social Conflict
Other
Other cause:
Incident type
(check all that apply):
Fatal Shooting
Non-Fatal Shooting
School Shooting
Neighborhood Shooting
Domestic Violence
Mass Shooting
Fatal Stabbing
Non-Fatal Stabbing
Other Firearm Related Assault
Flourishing/Brandishing Weapon
Other
No Injuries
Other type:
Was the incident retaliatory?
Yes
No
Unknown
Did social media lead to escalation?
Yes
No
Unknown
Did anyone appear to be on drugs or intoxicated?
Yes
No
Was this related to an anniversary?
Yes
No
Was someone recently released from incarceration believed to be involved?
Yes
No
OUTCOME
What was the actual outcome?
Resolved
Resolved with conditions
Temporarily resolved
Not resolved
Ongoing
Other
Other outcome:
Additional information:
Did you have any mediations today?
Yes
No
MEDIATION
Other SMP staff present:
Amir
Bang
Cat
Charles
Chyna
Dee
Jason
Juan
LaSha
Latoya
Mark
Nook
Noon
Norky
Ny'Sha
Sahir
Sento
Stadic
Streeter-EL
Tank
Tavon
Ty
Von
Wes
No one else
Date of mediation:
Time:
Narrative of the mediation:
Is this related to a shooting/homicide?
Yes
No
Unknown
If yes, what incident is it related to?
Victim's name (if applicable):
Is there a potential for retaliation?
High
Low
No
LOCATION
Neighborhood:
Baden
College Hill
Dutchtown
The Ville
Walnut Park
Wells Goodfellow
Other
Other Neighborhood:
Is the location of the mediation within the catchment area?
Yes
No
Zone:
1
2
3
4
Hundred block:
Street name or intersection:
Zip code:
Mediation location description:
Abandoned Building
Business
Church
Grocery Store
Open Area
Playground/Rec Center
Public Transportation
Residence
Restaurant/Bar
School
Shopping Center/Mall
Site Office
Street Corner
Vacant Lot
Other
Location description other:
Is this location a hotspot?
Yes
No
BACKGROUND
What is the relationship between parties?
Personal
Random
What is the nature of the conflict?
Historical
Random
Targeted
Likely causes
(check all that apply):
Domestic Conflict
Drugs
Family Dispute
Gang Territory
Group Conflict
Intimate Partner Conflict
Miscommunication
Monetary Dispute
Social Conflict
Other
Other cause:
Did social media lead to escalation?
Yes
No
Unknown
OUTCOME
What was the actual outcome?
Resolved
Resolved with conditions
Temporarily resolved
Not resolved
Ongoing
Other outcome:
Additional information/what are the next steps?
Did you have any follow-ups today?
Yes
No
INCIDENT FOLLOW-UP
Other SMP staff present:
Amir
Bang
Cat
Charles
Chyna
Dee
Jason
Juan
LaSha
Latoya
Mark
Nook
Noon
Norky
Ny'Sha
Sahir
Sento
Stadic
Streeter-EL
Tank
Tavon
Ty
Von
Wes
No one else
Date of follow-up:
Time:
Is this related to a shooting/homicide?
Yes
No
Unknown
If yes, what incident is it related to?
Victim's name (if applicable):
OUTCOME + NEXT STEPS
Is the location of the follow-up within the catchment area?
Yes
No
Hundred block:
Street name or intersection
Zip code:
Follow-up location description:
Abandoned Building
Business
Church
Grocery Store
Open Area
Playground/Rec Center
Public Transportation
Residence
Restaurant/Bar
School
Shopping Center/Mall
Site Office
Street Corner
Vacant Lot
Other
Location description other:
Is this location a hotspot?
Yes
No
Narrative of the situation/follow-up:
What was the intention of the follow-up?
What were the results?
What do you anticipate the next steps are?
Additional information:
What are the names of the blocks or streets you canvassed today?
How much pub ed did you pass out?
Where did you pass out pub ed?
(Please be specific.)
Did you attend any community meetings, activities or events today?
Yes
No
EVENTS
Name of the event:
Location of the event (i.e. Tandy Rec Center or 4800 Florissant Ave):
Explain event, meeting and activity details (Add time, how many staff were present and brief description):
What was SMP's role in the event?
Attended
Co-Hosted
Organized/Hosted
Presented
Tabled
Vendor
Other
How many other organizations attended?
What was the approximate attendance?
SECTION 2 - RELATIONSHIPS & CASELOAD
How many key individuals have you talked to today?
How many participants are currently on your caseload?
Out of your participants, how many did you contact today?
How many new participants did you enroll today?
Did you have any check-ins with participants today?
Yes
No
CHECK-INS
This is to capture check-ins with your caseload.
Participant:
What type of check-in:
Phone Call
Text Message
In Person
How long was your check in?
5 minutes
15 minutes
30 minutes
45 minutes
1 hour
1 hour and 15 minutes
1 hour and 30 minutes
General description of check-in:
Did you make any referrals today?
Yes
No
REFERRALS
I.e. Ms. Velma or MV on Maffit and Belt 000-000-0000 - she would like the team to check-in at rowdy younger new neighbors house or she needs information on social services in the area.
Name:
What type of referral?:
Bill Assistance
Food Distribution
Hospital
Housing
ID Voucher
Jobs
Mental Health
Rehab
Social Services
Vocational Training
Other Services
What organization did you refer them to?
Who should follow up?:
Me
Site Supervisor
Outreach Team/Resources
Contact information:
Please explain situation/needs:
Is immediate follow-up needed?:
Yes
No
SECTION 3 - PERSONAL & FUTURE DEVELOPMENT
What's something new you learned today?
What goal did you set for yourself to improve this week?
Any misc. notes or thoughts for the day?
Contact Information