EmailMeForm
Prevention of Sexual Violence
Name
*
First
Last
Today's Date
*
MM
/
DD
/
YYYY
Site/House Location
*
Administrator
Orientation
Bloomington
Bossen 1
Bossen 2
5th Ave
Chicago
Christian Park
Crosstown
Dupont
Fremont
Jurdy
Minneapolis
Oliver
Pillsbury
Pleasant
Queen
Running Park
Sander 1
Sander 2
Washburn
Wings
1. Are vulnerable adults at a higher risk of sexual violence and abuse?
*
Yes
No
2. Is it appropriate for a Zumbro House employee to talk about sexually explicit topics with a resident?
*
Yes
No
3. Bodily Autonomy is when an individual has the right to govern their body without influence and pressure.
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Yes
No
4. If a resident requests privacy while using the bathroom, the DSP should shut the door and wait outside the bathroom?
Yes
No
5. Consent can be given by word or action and an individual may remove consent at any time during the sexual act either verbally or non-verbally.
*
Yes
No
6. A Zumbro House Employee is allowed to have sexual relations with a Zumbro House resident?
*
Yes
No