Show Me Peace VI Daily Log_New
Date of data you are logging:
Name:
Contact ID
Neighborhood:
Please select...
Dutchtown
The Ville
Walnut Park
Wells Goodfellow
Peabody
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).
2900 Newstead Dope set.
Amber J Mini Market (4101 St. Louis Ave)
Gas station (MLK & Cora)
Gas station (MLK & Vandeventer)
James House (4310 St. Ferdinand)
MLK Plaza (4308 MLK)
Salama 2 Regal Store (2800 Sarah)
Sumner High School (4200 Cottage)
Tandy Rec Center (4206 Kennerly)
None
Somewhere not listed
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
PEABODY - Did you visit any of these HOTSPOTS today?
(Check all that apply).
Salama’s Market
St. Ann Alleyway
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 incidents today?
Yes
No
SHOOTING INCIDENTS
Other SMP staff present:
Bang
Cat
Dee F
Dee R
Domo
Dre
Jason
Jeff
Juan
LaSha
Latoya
Mark
Nate
Nook
Noon
Ny'Sha
Sahir
SiMone
Stadic
Streeter-EL
Tank
Theo
Von
Wes
No one else
Other
Name of other person present:
Date of response:
Time:
Narrative of the situation:
Victim's name (if applicable):
Is there a potential for retaliation?
High
Low
No
LOCATION
Neighborhood:
Baden
College Hill
Dutchtown
Peabody
The Ville
Walnut Park
Wells Goodfellow
Other
Other Neighborhood:
Is the location of the shooting incident within the catchment area?
Yes
No
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 your team attend a shooting responses today?
Yes
No
SHOOTING RESPONSE
Which shooting are you responding to?
What type of shooting incident was it in response to?
Mass shooting
Child non-fatal shooting
Child fatality
Adult non-fatal shooting
Adult fatalit
y
Was it within the 72-hour response window?
Yes
No
Was the victim(s)' family notified or contacted?
Yes
No
Were other community members involved?
Yes
No
Estimated number of people who attended?
Did you have any de-escalations today?
Yes
No
DE-ESCALATION
Other SMP staff present:
Bang
Cat
Dee F
Dee R
Domo
Dre
Jason
Jeff
Juan
LaSha
Latoya
Mark
Nate
Nook
Noon
Ny'Sha
Sahir
SiMone
Stadic
Streeter-EL
Tank
Theo
Von
Wes
No one else
Other
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
Peabody
The Ville
Walnut Park
Wells Goodfellow
Other
Other Neighborhood:
Is the location of the de-escalation within the catchment area?
Yes
No
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:
Bang
Cat
Dee F
Dee R
Domo
Dre
Jason
Jeff
Juan
LaSha
Latoya
Mark
Nate
Nook
Noon
Ny'Sha
Sahir
SiMone
Stadic
Streeter-EL
Tank
Theo
Von
Wes
No one else
Other
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
Peabody
The Ville
Walnut Park
Wells Goodfellow
Other
Other Neighborhood:
Is the location of the mediation within the catchment area?
Yes
No
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:
Bang
Cat
Dee F
Dee R
Domo
Dre
Jason
Jeff
Juan
LaSha
Latoya
Mark
Nate
Nook
Noon
Ny'Sha
Sahir
SiMone
Stadic
Streeter-EL
Tank
Theo
Von
Wes
No one else
Other
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 - FUTURE DEVELOPMENT
What intel did you gather from your engagement today?
What's your strategy this week for addressing homicides or shootings this week?
Any misc. notes or thoughts for the day?
Contact Information