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San Francisco Domestic Violence Death Review Team (DVDRT) Pilot Report

NCJ Number
Date Published
May 2023
57 pages

This document reports on the Domestic Violence Death Review Team’s process and methodology, details on the incident being reviewed and a chronology of events, contributing factors, and provides recommendations; it also includes for appendices, detailing participants, California Penal Code Section 11163.3, San Francisco Police Department Special Victims Unit Referral Card, and a domestic violence lethality screening questionnaire for first responders.


This Domestic Violence Death Review Team (DVDRT) Pilot was created under the provisions of the California Penal Code 11163.3, in order to fulfill a commitment to review domestic violence-related fatalities, strengthen system policies and procedures, and identify prevention strategies that will reduce future incidents of domestic violence-related injuries and deaths. The DVDRT fulfills a need in San Francisco, as the city lacks staffing for a dedicated Death Review Team. This DVDRT Pilot provides an overview of the DVDRT process and methodology for their investigation into a murder case from October 2014; it lays out details of the event as well as DVDRT’s analysis of evidence and case-related data, and notes the aspects of the event that the DVDRT focused on include: computer-aided dispatch (CAD) systems; real-time assistance for police officers in crime scene evaluation; broad interaction and information gathering; the ability of the police department to enforce physical separation when physical violence has occurred; custodial treatment of intoxicated individuals; ; real-time assistance for police from domestic violence advocates; providing closure and well-being assistance to 911 call-takers and dispatchers; availability and use of body-worn video (BWV) cameras; and in multiple responses to the victim’s address, the efficient and thorough transfer of information to later-responding officers.

Date Published: May 1, 2023