### BP-A0348 ADMINISTRATIVE DETENTION ORDER

JAN17

### U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS

|                                          |                                                                                                                                                  |                     |           | NEW YORK MCC                                                                                                                                                       |
|------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------|---------------------|-----------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------|
|                                          |                                                                                                                                                  |                     |           | Inslibton                                                                                                                                                          |
|                                          |                                                                                                                                                  |                     |           | Date/Time: 07-29-2019 12:21                                                                                                                                        |
| IH<br>nil UnitOfficer<br>TO: Sp          |                                                                                                                                                  |                     |           |                                                                                                                                                                    |
| IEUTENANT<br>FROM:                       |                                                                                                                                                  | (Nameftitte)        |           |                                                                                                                                                                    |
| SUBJECT: Placement°,                     | EPSTEIN. JEFFREY EDWARD                                                                                                                          | Reg. No             | 78318-054 | in Administrabve Detention                                                                                                                                         |
| ✓                                        | (a) Is pending an investigation for a violation of Bureau regulations:                                                                           |                     |           |                                                                                                                                                                    |
| (b) Is pending an SIS investigation.     |                                                                                                                                                  |                     |           |                                                                                                                                                                    |
|                                          | (c) Is pending investigation or trial for a criminal act;                                                                                        |                     |           |                                                                                                                                                                    |
|                                          | (d) Is lobe admitted to Administrative Detention                                                                                                 |                     |           |                                                                                                                                                                    |
|                                          | (1) Since the inmate has requested admission (or protection;                                                                                     |                     |           |                                                                                                                                                                    |
|                                          | I hereby request placement in Administrative Detention for my own protection.                                                                    |                     |           |                                                                                                                                                                    |
|                                          | Inmate Signature/Register No.:                                                                                                                   |                     |           |                                                                                                                                                                    |
|                                          | Staff Witness Printed NameSignature:                                                                                                             |                     |           |                                                                                                                                                                    |
|                                          | the necessary Information will be forwarded for an appropriate hearing by the SRO.                                                               |                     |           | (2) Since a serious threat exists to individual's safety as perceived by staff, although person has not requested admission; referral of                           |
| (e)                                      | Is pending transferor is In holdover status during transfer.                                                                                     |                     |           |                                                                                                                                                                    |
| (0                                       | Is pending classification; or                                                                                                                    |                     |           |                                                                                                                                                                    |
| (9)<br>designee.                         | Is terminating confinement in Disciplinary Segregation and has been ordered into Administrative Detention by the Warden's                        |                     |           |                                                                                                                                                                    |
|                                          | population poses a serious threat to Me. property, self, staff, other inmates. or to the security or orderly running of the institution because' |                     |           | II is this Correctional Supervisors decision based on all the circumstances that the above named ni mate's continued presence in the general                       |
| PENDING UDC FOR CODE 228 SELF-MUTILATION |                                                                                                                                                  |                     |           |                                                                                                                                                                    |
|                                          | Therefore, the above named Inmate is to be placed in Administrative Detention until further notice. The Inmate received a copy of this Order on  |                     |           |                                                                                                                                                                    |
| (date! time)                             |                                                                                                                                                  |                     |           |                                                                                                                                                                    |
| Staff Witness Signature/PrintedName      |                                                                                                                                                  |                     |           | Date                                                                                                                                                               |
|                                          | Supervisor 24 hour review of placement: Signature/Printed name                                                                                   |                     |           |                                                                                                                                                                    |
| documented here.                         |                                                                                                                                                  |                     |           | In the case of DHO action, reference to that Order Is outfitted In other cases. the Correctional supervisor will make an independent review and decision, which Is |
|                                          | - Administrative Detention Unit; Copy — Psychology; Copy • Central File                                                                          |                     |           | Record Copy - Inmate Concerned (not necessary if placement is a result of holdover status); Copy Captain; Copy • Unit Manager, Copy • Operation Supervisor         |
| POF                                      |                                                                                                                                                  | Prescribed by P5270 |           | (Replaces BP-A0308 of JAN 88.)                                                                                                                                     |