California Alternative Custody Form PDF Details

Within the legal framework of the State of California's justice system, the Alternative Custody Program (ACP) stands out as a constructive initiative designed to foster positive societal reintegration for eligible inmates. Administered by the California Department of Corrections and Rehabilitation, the program's foundation is the ACP Application and Voluntary Agreement form, also known as CDCR 2234 (07/12), which outlines the conditions under which inmates may qualify and participate in this alternative to traditional incarceration. Geared primarily towards promoting vital societal values such as parenting, family reunification, and the development of essential life skills, this voluntary program accommodates participants in less restrictive environments. These environments include private residences, transitional care facilities, or residential drug or treatment programs. However, entry into this program is contingent upon meeting predefined eligibility criteria, including specific requirements set forth by the California Code of Regulations (CCR), Title 15, Section 3078.2. Moreover, acceptance into the program implies adherence to a set of rules and regulations applicable to inmates, with the understanding that violation of these rules could result in removal from the program and return to prison to complete the original sentence. This complex framework underscores the program's dual focus: to alleviate the burden on the prison system while supporting eligible inmates in their journey towards successful reintegration into society.

QuestionAnswer
Form NameCalifornia Alternative Custody Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesalternative custody programs in california, california alternative custody, cdcr acp, acp program california 2021

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STATE OF CALIFORNIA

DEPARTMENT OF CORRECTIONS AND REHABILITATION

ACP APPLICATION AND VOLUNTARY AGREEMENT

CDCR 2234 (07/12)

The Alternative Custody Program (ACP) is a voluntary program that promotes parenting, family reunification and the development of life skills while addressing treatment needs. The ACP allows inmates to be housed in a personal residence, a transitional care facility or a residential drug or treatment program instead of serving time in prison. I understand placement into the ACP is based upon meeting specific eligibility criteria and the California Department of Corrections and Rehabilitation has the authority for final placement approval based on bed availability and other factors. While participating in the ACP, I will be subject to applicable rules and regulations governing inmates pursuant to the California Code of Regulations (CCR), Title 15, Division 3. I understand I may be removed from the ACP and returned to prison to serve the remainder of my original sentence for any reason, with or without cause.

I. TO BE COMPLETED BY INMATE

I meet the criteria set forth in the CCR Title 15, section 3078.2 including the following: (Check all that apply)

I am a female

(Select one)

 

 

I have private medical insurance. OR

I agree to apply for any county, state or federal medical coverage for which I may qualify.

 

 

 

 

 

 

I request to reside at the following location:

 

Private Residence

My private residence is located at:

 

(Include street address, city, county and zip code)

 

 

(I understand my residence must have no aggressive animals, no weapons, unobstructed access by law enforcement and will be verified by a Parole Agent.)

The contact person at the above address is:

My relationship to the contact person is:

The contact person’s telephone number is:

Residential Drug or Treatment Program or Transitional Care Facility

I understand that my signature on this document indicates my willingness to voluntarily participate in the ACP.

CDC NUMBER

INMATE NAME (PRINTED)

INMATE SIGNATURE

DATE SIGNED

HOUSING UNIT

II. FOR USE BY INSTITUTION COUNSELING STAFF

Does the participant have a qualifying disability requiring effective communication?

Yes

No

If yes, cite the source document and/or observation(s):

___________________________________________________________________

What type of accommodation/assistance was provided to achieve effective communication to the best of the inmate’s ability?

COUNTY OF LAST LEGAL RESIDENCE

COUNTY OF COMMITMENT

INSTITUTION

EPRD

INMATE

INMATE

REASON, IF INELIGIBLE

 

 

 

 

 

 

 

ELIGIBLE

INELIGIBLE

 

 

 

 

 

 

 

 

 

 

CORRECTIONAL COUNSELOR NAME (PRINT)

CORRECTIONAL COUNSELOR SIGNATURE

DATE SIGNED

PHONE NUMBER

 

 

 

 

 

 

III. FOR USE BY ACP PROGRAM MANAGER

ACP PROGRAM NAME

ACP PROGRAM ADDRESS

PHONE NUMBER

ASSIGNED PAROLE UNIT

IV. FOR USE BY PAROLE UNIT

DISTRICT/UNIT

 

RECEIVING AGENT ASSIGNED TO INVESTIGATE

 

 

 

COMMENTS:

 

 

 

 

 

 

 

 

 

DATE ASSIGNED

DATE DUE

AGENT’S RECOMMENDATION

 

 

 

 

 

 

 

Proposed residence meets criteria

Yes

No

 

PAROLE AGENT NAME (PRINT)

PAROLE AGENT SIGNATURE

 

DATE SIGNED

 

 

 

 

 

 

 

 

 

 

UNIT SUPERVISOR APPROVAL

 

 

 

PHONE NUMBER

 

COMMENTS:

Concur with agent’s recommendation

Yes

No

 

 

 

 

 

UNIT SUPERVISOR NAME (PRINT)

UNIT SUPERVISOR SIGNATURE

 

DATE SIGNED

 

 

 

 

 

 

UPON COMPLETION OF PRIVATE RESIDENCE VERIFICATION - RETURN THIS FORM TO THE SENDING INSTITUTION C&PR OFFICE

 

 

 

 

 

 

*EPRD means Earliest Possible Release Date

 

 

 

 

Distribution: Original to c-file; copy to inmate

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2. Immediately after this part is filled out, proceed to type in the suitable information in all these - INMATE ELIGIBLE, INMATE INELIGIBLE, REASON IF INELIGIBLE, CORRECTIONAL COUNSELOR NAME PRINT, CORRECTIONAL COUNSELOR SIGNATURE, DATE SIGNED, PHONE NUMBER, III FOR USE BY ACP PROGRAM MANAGER, ACP PROGRAM NAME, ACP PROGRAM ADDRESS, PHONE NUMBER, ASSIGNED PAROLE UNIT, DISTRICTUNIT, RECEIVING AGENT ASSIGNED TO, and COMMENTS.

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