## Suicide Watch Chronological Log
### Inmate Companions Log
| Name
of
inmate
on watch:
Institution: | D:
E
W
O
L
L
A
S
M
E
T | | | s
s
e
attr
M
e | | |
|----------------------------------------------------------------------------------------|------------------------------------------------------|----|--------|-------------------------------|--|--|
| Date
Watch
Began
/
Ended | Y I
L
N
O | | | d
ci
ui
S | | |
| To
be
completed
by
Chief
Psychologist
at conclusion
Booklet
of | | of | watch: | | | |
SWCL - INMATE
STAPLE LOCAL PROCEDURES HERE
Check one of the following:
❑ This is the initial log book for this suicide watch.
Enter date and time watch began:
This is a continuation log book for this watch.
Enter date and time this watch book was initiated:
Instructions to Observer: Document your observations every minutes. Legibly print and sign your name at the beginning of your shift.
| Suicide Watch Observation Log | | | | | |
|-------------------------------|--------------------------------------------------------------------|----------|--|--|--|
| Name of Inmate
on watch: | apstein
Reg #: | | | | |
| Time | Observations: Briefly note your observations. Initial all entries. | Initials | | | |
| :40 Am | uilist
M
orcuali-
xam
-0 | | | | |
| :US mi | REID
mina
.
ON | | | | |
| ದ
2
AM | le . 11 0
117ma
601
M | | | | |
| 811
gm | at
611
415
M | | | | |
| | nim | | | | |
| 30m | MAG
M | | | | |
| | na
-16004
11 | | | | |
| 11 | 1561)
41
m | | | | |
| rw | 17/10
IM
w | | | | |
| ( Am | takes
44 | | | | |
| S
m | | | | | |
| | 10
M | | | | |
| ್ಕೋ | | | | | |
| | | | | | |
| : 30 | 60
W | | | | |
| ાં તે ર | M
ma
COV | | | | |
| రు
um | W | | | | |
| AM | Cel
TV D
M | | | | |
| 530
an | turn Junia
8
18-1
Cor
ખ
র্তা | | | | |
| નાનુ
AM | Cur
など
Then
w
ખ | | | | |
| (0
m
0 | -
ar/
n
G
M
met | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
Note to all observers: Legibly print and sign your name at the beginning of your shift.
.
# Suicide Watch Chronological Log
### Staff Suicide Watch Observers Only
Name of inmate on watch:
Ep54-elin. J.
Register #:
Institution:
MOT', New \leyK
Date Watch Began / Ended
July 23,'2.01C1 J-v)/ iq
To be completed by Chief Psychologist at conclusion of watch:
Booklet of
SWCL - STAFF
#### STAPLE LOCAL PROCEDURES HERE
#### Check one of the following:
This is the initial log book for this suicide watch.
Enter date and time watch began:
#### July 23)20in a+ (.MOAN
This a continuation log book for this watch.
. . " Eriter date and time this watch book was
Instructions to Observer:
Document your observations every )5 minutes.
Legibly print and sign your name at the beginning of your shift.
| | Suicide Watch Observation Log | |
|---------|------------------------------------------------------------------|--|
| | Rea #: | |
| | Observations: Briefly note your observations. Initial all entrie | |
| 1.40AM | Inmate brought down to suicide cell #4 | |
| 1.45AM | Inmate lying on bea | |
| 2.00AM | Inmate sitting on bed talking | |
| 2:15AM | Inmate States his cellmate tried to Kill him | |
| 2:30AM | Inmate sitting on bed trying to remember | |
| | What happened | |
| 2:45 AM | Inmate sitting on bed | |
| 3.00 AM | Inmate sitting on bed | |
| 3.10AM | takes pictures of inmate | |
| 3:30AM | Inmate Sitting on bed | |
| 3.45 AM | Inmate sitting on bed | |
| 4:00AM | Inmate Sitting on hed | |
| 4. 15AM | Inmate Sitting on bed | |
| 4:30AM | Inmate Standing at acor talking | |
| 4.45AM | nmate Starting at door talkim | |
| 5:00AM | nmate sitting on bed | |
| 5.15AM | inmate standing at door | |
| 5:30AM | Inmate Standing at door | |
| 5:45 AM | Inmate standing at door
11 | |
| 6.00AM | Inmate Standing at door | |
| 6.15AM | nmate standin
at door | |
| 6:30AM | nmate standing at door | |
| 6'.45AM | nmate standing at door | |
| 7:00 AM | Inmate standing at door | |
| | | |
Note to all observers: Legibly print and sign your name at the beginning of your shift.