Face Sheet Only to IAD

IAD Tracking Copy

Risk Management
Advisement
For reporting a Level 4 force incident, use a
Level 4 Use of Force Report (TF-967g)
US !F F!R" R#!RT
Oakland Police Department
TF-967 (Rev. May 10)
F O R C E L E V E L S
Indicate the highest force level sed!
Investigations shall "e condcted at the highest level #hen mltiple levels of force are sed!
Check
One
$evel % Force $evel & Force $evel ' Force
Incident (m"er

RD (m"er

)se of Force Control (o!

IAD Case (o!

Part % * +$ist additional S",ects on a )se of Force Contination Report-

Incident Date

Day

Time

Location

CP Beat

.% S",ect/s (ame

e!

Race

D"B

#dd$e%% "a&'and City()i*

Contact +,m-e$

.& S",ect/s (ame

e!

Race

D"B

#dd$e%% "a&'and City()i*

Contact +,m-e$

.' S",ect/s (ame

e!

Race

D"B

#dd$e%% "a&'and City()i*

Contact +,m-e$

Part & 0 $ist all involved mem"ers1employees2 indicate the s",ect+s-2 and all the Force Type+s- sed "y nmeric identifier +Chart on "ack page-!
+$ist additional Mem"ers13mployees on a )se of Force Contination Report-
Mem"er13mployee
Serial
(o!
Force Type .
S",ect .
Force )sed on
Reglarly Assigned
Spervisor
Reglarly Assigned
Division Commander
.1

./

.0

.1

Part ' 0 $ist all #itnesses to the se of force! +If more space is needed or to list additional #itnesses on a )se of Force Contination Report-
Li%t mem-e$% and em*'oyee% -e2o$e *$ivate *e$%on 3itne%%e%. I2 t4e$e a$e no &no3n *$ivate *e$%on 3itne%%e%5 %*eci2y 6+" 7+"8+ 8IT+99: in t4e
:.1 8itne%% +ame: -o!.
4itness Information +Inclde Rank 5 Serial (o!2 or Agency Affiliation if appropriate-
.% 4itness (ame

e!

Race

D"B

#dd$e%% OR #;ency #22i'iation "a&'and City()i*

Contact +,m-e$

.& 4itness (ame

e!

Race

D"B

#dd$e%% OR #;ency #22i'iation "a&'and City()i*

Contact +,m-e$

.' 4itness (ame

e!

Race

D"B

#dd$e%% OR #;ency #22i'iation "a&'and City()i*

Contact +,m-e$

.6 4itness (ame

e!

Race

D"B

#dd$e%% OR #;ency #22i'iation "a&'and City()i*

Contact +,m-e$

Part 6
<"F Re*o$t P$e*a$ed By e$ia' +o.

Date o2 Re*o$t

,*e$vi%o$ +oti2ied e$ia' +o

Date ( Time +oti2ied
/
Subject #1
US !F F!R"
$%RR%T&' R#!RT
Oakland Police Department
TF-967a (Rev. May 10)
Date o2 Incident
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Incident +o.(RD +o.
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found
. 1 Mem-e$(9m*'oyee=% +ame e$ia' +o.
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.1 ,->ect=% +ame
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Part 7 * Assessment and Compliance * To "e completed "y the preparer of the )se of Force or In0Cstody Death Report
Assessment Isses8
Cond,ct a t4o$o,;4 $evie3 o2 a'' doc,ment%5 inte$vie3%5 and evidence to -e inc',ded in t4e <%e o2 Fo$ce Re*o$t *ac&et to en%,$e com*'etene%%5
acc,$acy5 and ?,a'ity and a%%e%% t4e 2o''o3in;@
1. Ae% +o 8a% t4e o$i;ina' detention o$ %,-%e?,ent a$$e%t 'a32,'B
/. Ae% +o 8a% t4e ty*e and amo,nt o2 2o$ce o->ective'y $ea%ona-'e and ,%ed *$o*o$tiona' to t4e $e%i%tance enco,nte$edB
0. Ae% +o 8a% t4e ty*e and amo,nt o2 2o$ce $e'ated to a 'e;itimate 'a3-en2o$cement o->ective t4e mem-e$(em*'oyee 3a%
attem*tin; to ac4ieveB
1. Ae% +o 8a% t4e 2o$ce $ea%ona-'y de-e%ca'atedB
C. Ae% +o 8a% ve$-a' *e$%,a%ion ,%ed to attem*t to $e%o've t4e %it,ation 3it4o,t 2o$ceB
Any 9(O: response re;ires an e<planation in the (arrative Section!
DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD
The follo#ing recommendation is "ased on the facts revealed "y the se of force investigation!
Check the appropriate "o< and docment the analysis in the (arrative +Part =-!
The se of force #as I( Compliance OR
The se of force #as O)T of Compliance
E Mi%cond,ct E I#D +oti2ied.
E C$imina' Mi%cond,ct E T4e inve%ti;ation $evea'ed c$imina' mi%cond,ct and t4e a**$o*$iate commande$ 4a% -een noti2ied in acco$dance
3it4 t4e *$ovi%ion% o2 DF" M-1.1.
Training and1or Tactical Isses
I con%ide$ed and di%c,%%ed5 a% nece%%a$y5 any t$ainin;(tactica' i%%,e% invo'vin; t4e avai'a-i'ity and *$actica'ity o2 ot4e$ 2o$ce o*tion% 3it4 invo'ved
*e$%onne' and doc,mented t4e i%%,e% in t4e +a$$ative -e'o3.
Ae% +o E Recommendations1Comments
T4e inve%ti;ation $evea'ed t$ainin; and(o$ tactica' i%%,e%.
I2 a Leve' 1-/ incident5 doc,ment 2o$ $evie3 -y t4e a**$o*$iate Boa$d.
I2 a Leve' 0 incident5 Divi%ion Commande$ %4a'' en%,$e t$ainin; i% cond,cted and(o$ t$ainin; i% $e?,e%ted 2$om t4e T$ainin; ection 34en it
cannot -e accom*'i%4ed at t4e divi%ion 'eve'. (Doc,ment t4e ci$c,m%tance%5 and t4e *e$%on and date o2 $e2e$$a' to t4e T$ainin; ection in t4e
+a$$ative ection).
Part = 0 (arrative 0 To inc',de an ana'y%i% o2 t4e inve%ti;ation. Fo$ additiona' %*ace5 ,%e a <%e o2 Fo$ce Contin,ation Re*o$t (TF-967-)
(Li%t additiona' invo'ved and 3itne%% *e$%onne'5 ot4e$ 3itne%%e%5 and evidence -e2o$e t4e na$$ative.) Doc,ment $i%& mana;ement i%%,e% in t4e
+a$$ative ection -e'o3.
SU((ST) *%)RS ()elete +eaders and te,t as necessar-)
&. %))&T&!$%L #RS!$$L (If applicable)
On scene at the time of the use of force incident but not involved in or a witness to the use of
force
&&. %))&T&!$%L /&T$SSS (If space is needed)
To the use of force List OPD personnel frst
&&&. #RS!$$L %SS&($) T! %SS&ST
At the scene
&'. %))&T&!$%L #RS!$S $!T % /&T$SS (If applicable)
Re*o$tin; Mem-e$ e$ia' +o.
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Date o2 Re*o$t
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,*e$vi%o$ e$ia' +o.
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Pa;e 0 o2 7
US !F F!R"
$%RR%T&' R#!RT
Oakland Police Department
TF-967a (Rev. May 10)
Date o2 Incident
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not found
Incident +o.(RD +o.
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not found / Error:
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found
. 1 Mem-e$(9m*'oyee=% +ame e$ia' +o.
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.1 ,->ect=% +ame
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'. 0R($"1 #RS!$$L
List AMR, OD, and hospital personnel
'&. $!T&F&"%T&!$S
Document date!time commander notifed and face sheet notifcation emailed"
'&&. )S"R&#T&!$ !F &$"&)$T S"$
Describe where the incident occurred" #nclude li$htin$, visibilit%, and weather conditions"
'&&&. SU00%R1 !F &$"&)$T
The summar% is intended to $ive reviewers an overall picture of the incident, the actions of all
involved parties contemporaneous to the incident" Do not summari&e each interview and!or
statement"
&2. &$'ST&(%T&!$
'hat %ou did and directed, and what happened when %ou arrived( such as separatin$ o)cers
prior to interviewin$"
2. "&'&L&%$ /&T$SS ST%T0$T(S) 3 "%$'%SS
Detailed description of what was seen and b% whom" Discuss the results of a canvass or wh% one
was not conducted"
2&. SU00%R1 !F '&)$"
Provide a summar% and anal%sis of evidence collected" Document who too* photos at the scene"
Provide a description +or document if photos ta*en, of the presence or absence of in-uries to
the sub-ect or an% OPD personnel involved in the use of force incident" Photos must be ta*en of
the sub-ect of the force and involved o)cers re$ardless of in-ur%, other evidence collected
+clothin$, weapons, biolo$ical,, electronic weapon download information, etc" Document
electronic weapon download, if applicable" Document the reason wh% no evidence was
collected"
2&&. &$4UR&S 3 0)&"%L "%R !R TR%T0$T #R!'&))
Describe in-uries and who sustained them" Describe hospital treatment performed +include
medical release documents, if available," Indicate by an afrmative statement that no one
was injured"
2&&&. )&S"R#%$"&S
Discuss discrepancies discovered durin$ the investi$ation, and whether the% were resolved or
remain unresolved" Indicate by an afrmative statement that no discrepancies were
encountered.
2&'. %$%L1S&S !F US !F F!R"
.ased on the evidence, witness statement+s,, and o)cer statement+s,, document whether the
force was within polic%" #ndicate whether the force was de/escalated or stopped when resistance
de/escalated or stopped" 0valuate whether the force was consistent with in-uries and compare
electronic weapon download to electronic weapon information reported b% o)cers"
2'. TR%&$&$( #!&$T(S)
Discuss how personnel could have improved the outcome of the incident b% utili&in$ alternative
force or tactical options" #ndicate what corrective action was administered1 and!or
Re*o$tin; Mem-e$ e$ia' +o.
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Date o2 Re*o$t
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source not
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,*e$vi%o$ e$ia' +o.
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Pa;e 1 o2 7
US !F F!R"
$%RR%T&' R#!RT
Oakland Police Department
TF-967a (Rev. May 10)
Date o2 Incident
Error: Reference source
not found
Incident +o.(RD +o.
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not found / Error:
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found
. 1 Mem-e$(9m*'oyee=% +ame e$ia' +o.
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.1 ,->ect=% +ame
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recommended to address the Trainin$ Point+s," Indicate by an afrmative statement that
no training points were discovered"
*Document any supervisor initiated feld-level corrective action in te member/employee!s
"upervisory #otes $ile%
Re*o$tin; Mem-e$ e$ia' +o.
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Date o2 Re*o$t
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source not
found
,*e$vi%o$ e$ia' +o.
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Pa;e C o2 7
US !F F!R" "*"5L&ST
!a6land #olice )epart7ent
TF-967d (Rev. May 10)
Date of Incident
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source not found
Incident (o!
rror8
Reference
source not
found
RD (o!
9$$o$@
Re2e$ence
%o,$ce not
2o,nd
S",ect Mem"er13mployee Serial (o!
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Investigating Spervisor Serial (o!
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T4i% c4ec&'i%t i% to -e ,%ed -y *$e*a$e$%. Com*'ete and attac4 t4i% c4ec&'i%t to t4e FRO(T o2 Leve' / G 0 <%e o2 Fo$ce Re*o$t *ac&et%.
Inve%ti;ato$% %4a'' c4ec& t4e a**$o*$iate -o! to indicate a 6Ta%&: 4a% -een com*'eted and(o$ doc,mented in t4e "22en%e(,**'ementa' o$ <%e o2 Fo$ce
Re*o$t o$ inc',ded in t4e <%e o2 Fo$ce *ac&et.
C4ec& t4e a**$o*$iate -o!. Detail any 9(o: response in the Comment Section or any clarification2 #hen necessary2 in the (arrative2 as indicated!
Part % 0 I(>3STI?ATI>3 ST3PS R3@)IR3D FOR A( O(0SC3(3 S)P3R>ISOR1COMMA(D3R1I(>3STI?ATOR FOR $3>3$ &0' I(CID3(TS
1. Ae% +o
Re%*onded to t4e ,%e o2 2o$ce incident %cene.
(Leve' /-0)
9. Ae% +o 8itne%% %tatement% ta&en (Leve' /-0) +(#
/. Ae% +o
Dete$mined t4e a**$o*$iate $e*o$tin; 'eve'.
(#'' Leve'%)
10. Ae% +o
9n%,$ed invo'ved and 3itne%% *e$%onne' %,-mitted
t4e $e?,i$ed "22en%e o$ ,**'ementa' Re*o$t%.
0. Ae% +o
#'' ,%e% o2 2o$ce5 doc,mented in "22en%e and
,**'ementa' Re*o$t%5 a$e 'i%ted on <"F Face
4eet.
11. Ae% +o In>,$ie% I2 ye%5 to 34om@
"PD *e$%onne'
,->ect(%)
1/. Ae% +o Medica' %e$vice $e?,e%ted.
1. Ae% +o
#vai'a-'e *$ivate *e$%on 3itne%%e% 3e$e identi2ied
and inte$vie3ed. (Leve' /-0)
+o 7no3n 3itne%%e%
10. Ae% +o
9n%,$ed %,->ect 3a% t$an%*o$ted to a
medica' 2aci'ity 2o$ medica' eva',ation
34en a ca$otid $e%t$aint 3a% a**'ied.
+(#
C. Ae% +o
e*a$ated and inte$vie3ed invo'ved and 3itne%%
*e$%onne'. (Leve' /-0)
11. Ae% +o 9vidence co''ected. +one
6. Ae% +o
9n%,$ed a $ea%ona-'e canva% 3a% cond,cted.
(Leve' /)
1C. Ae% +o Tec4nician on %cene.
7. Ae% +o Inte$vie3ed t4e %,->ect(%) o2 t4e ,%e o2 2o$ce. 16. Ae% +o P4oto% ta&enB
Di;ita'
Fi'm
H. Ae% +o Identi2ied invo'ved and 3itne%% *e$%onne'. 17. Ae% +o
Comm,nication% ection contacted to en%,$e t4e
incident i% $e*o$ted on t4e I#D Dai'y Incident Lo;.
Part & 0 R3PORT DOC)M3(TATIO(
Ae%
OFF3(S3 A(D S)PP$3M3(TA$ R3PORTS R3>I343D FOR COMP$3T3(3SS2 ACC)RACA2 A(D @)A$ITA!
(O 9BOI$3RP$AT3: OR 9PAT: $A(?)A?3 4ITCO)T D3SCRIPTI>3 OR 3DP$A(ATORA D3TAI$S OF TC3 ACTIO(!
(OT38 DOC)M3(T A(A I(>3STI?ATI>3 3$3M3(TS I(T3(TIO(A$$A (OT DOC)M3(T3D I( TC3 COMM3(T S3CTIO(!
Part &a * OFF3(S31S)PP$3M3(TA$ OR )S3 OF FORC3 R3PORT SCA$$ I(C$)D3 TC3 FO$$O4I(? D3TAI$S
1. Ae% +o ,mma$y o2 t4e incident. 6. Ae% +o ,mma$y o2 evidence co''ected.
/. Ae% +o ,mma$y o2 *e$tinent %tatement%. 7. Ae% +o Detai' in>,$ie% and medica' t$eatment. +(#
0. Ae% +o ,mma$y o2 inte$vie3% 34en %tatement not ta&en H. Ae% +o "$i;ina' $ea%on 2o$ *o'ice *$e%ence.
1. Ae% +o De%c$i*tion o2 t4e ,%e o2 2o$ce.
9. Ae% +o
Ci$c,m%tance% o$ *$eci*itatin; act% t4at 'ead to t4e
,%e o2 2o$ce.
C. Ae% +o
84en "C i% ,%ed5 t4e n,m-e$ o2 -,$%t%5
d,$ation o2 eac4 -,$%t5 t4e a**$o!imate
di%tance 2$om t4e %,->ect5 and t4e
'ocation o2 %*$ay contact.
+(#
10. Ae% +o
#$$e%t a**$ova' *$o*e$'y doc,mented on C#R and in
"22en%e Re*o$t.
Part &" * )S3 OF FORC3 R3PORT DOC)M3(TATIO( SCA$$ I(C$)D3 TC3 FO$$O4I(? D3TAI$S +See R4M )0% for inclsive list-
1. Ae% +o #na'y%i% o2 evidence. 0. Ae% +o Di%c$e*ancie% Fo,nd (Detai' in +a$$ative)
/. Ae% +o Revie3ed doc,mentation 2o$ di%c$e*ancie%. I2 Ae%5 detai' 4o3 $e%o'ved o$ i2 ,n$e%o'ved in +a$$ative
Part ' 0 R3@)IR3D FOR TC3 )OF R3PORT PACE3T * The preparer and revie#ers shall ensre the )OF Report packet is complete!
1. Ae% +o "$i;ina' <"F Re*o$t H. Ae% +o Fie'd Contact Ca$d +(#
/. Ae% +o Co*y o2 "22en%e(,**'ementa' $e*o$t% 9. Ae% +o Medica' Re*o$t +(#
0. Ae% +o tatement%
10. Ae% +o
"t4e$ doc,ment% *e$tinent to t4e inve%ti;ation.
De%c$i-e in Comment ection.
1. Ae% +o Co*y o2 C.#.R.
C Ae% +o Dai'y Detai'
11. Ae% +o P4oto%
Di;ita' E Inc',de *4oto CD in *ac&et
Fi'm E Re?,e%ted to deve'o* to CD
6. Ae% +o C#D *,$;e
7.
Ae% +o Ta%e$ do3n'oad in2o$mation. +(# 1/. Ae% +o Tec4nician Re*o$t Inc',ded
C4ec&'i%t P$e*a$ed By e$ia' +o.
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Date o2 Re*o$t
9$$o$@ Re2e$ence %o,$ce
not 2o,nd
Pa;e 6 o2 7
US !F F!R" "*"5L&ST
!a6land #olice )epart7ent
TF-967d (1/(06)
,->ect Mem-e$(9m*'oyee e$ia' +o.
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Re?,e%ted
Part 6 * TRACEI(? * Report preparer shall for#ard only the )OF FAC3 SC33T to the follo#ing as indicated8
IAD +$evel & 5 '- BFO Admin +$evel & 5 '-
Div! Cmdr! +$evel & 5 '- Depty Chief +$evel & 5 '-
C4ec&'i%t P$e*a$ed By
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e$ia' +o.
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Revie3in; ,*e$vi%o$(Commande$
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e$ia' +o.
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