APRIL 1994 ### BP-A295.052 SPECIAL HOUSING UNIT REVIEW ### U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS | wave Name | | | Register Number
Unit | | | Institution | | | |--------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------|-------------------------|---------------------|---------------------------------------|----------------------|----------------------|--| | EPSTEIN, JEFFREY EDWARD | | | 76318-054 | | 5 | | NEW YORK MCC | | | Date Entered Special Housing: | | | Reason for Placement | | | | | | | 07-10-2019 | | | PENDING CAPTIANS REVIEW | | | | | | | 1. Subject: (2 or 3 Days) | | | Date Reviewed | | | | | | | 3 Day Review | | | 07-15-2019 | | | | | | | | Action Taken on the Above Date: | | | | | | | | | | Continue in Special Housing Unit | | | | | | | | | Printed Name/Signature: | | | | | | | | | | | | | | | | | | | | II. RECORD REVIEW.
review.) | (To to done weekly in the inmates absence, beginning after the in-person 7 day review, and cord nuing every week between each in-person 30 day | | | | | | | | | DATE | ACTION TAKEN | | REMARKS | | | SIGNATURE | | | | | 07-19-2019 Continue in Special Housing Unit | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | III. Subject (7 or 30 Days) | | | Review By (SRO): | | | Reviewing Authority: | | | | 7 Day Review | | | | | | | | | | | Date inmate appeared for a Speoal Housing Review: | | | | Or Date inmate waived right to appear | | | | | 07.19.2019 | | | | 01-01-111 | | | | | | | Has been seen daily by Medical Staff | El No
Yes: | | | | | | | | | Has been seen daily by responsible officer designated by Warden | | | ❑No | | | | | | | | | Yes; | | | | | | | | Has received prescribed weekly exercise: | ICI No
RI Yes: | | | | | | | | | Proper documentation and jusecation In the Central File (Incident Report. OHO Report copies of Special Housing Review Form): | | | | | | g
❑
No
Yes; | | | if no, why not? | | | | | | | | | | | Is there a written psychiatric a psychologal assessment on the inmate who has spent 30 days in a special housing status? | | | | | | D
yes;
g
No | | | | Is there an additional assessment for every one month interval thereafter? | | | CI No
7' 4 1 Yet | | | | | | if no, why not? | | | | | | | | | | | Action taken on the above date by the Segregation Review Official or the Reviewing Authority: | | | | | | | | | | | | | | | | | | | ❑ | Released from Special Housng; | WI Continue in Special Hoeing | | | | | | | | | Did inmate In Administrative Deletion receive a written copy of Staffs decision and the basis for the finding at each 30 day review? | | | | | | Yes;
❑
No | | | | if no, why not (Should be given provided institutional security not compromised)? | | | | | | | | | | | | | | | | | | | form): | Remarks: (My change in the reason for placement is to be noted in this section. If the reason for placement changes, the inmate must receive a copy of this | | | | | | | | | Date of Next Review | | | | | | | | | | 07-26-2019 | | | | | | | | | | | PrEntPa Marne' and Sin nature of Segregation Review Official or the Reviewing Authority and Date Signed: | | | | | | | | | Record Copy Central Fie | | | | | | | | | | | This form replaces BP-295(52) dated January 1988 | | | | | | | | BP-A295.052 SPECIAL HOUSING UNIT REVIEW APRIL 1994 ## U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS | Inmate Name: | | | | | | | | |-------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------|------------------------------------------|---------|----------------------------------------|-----------|----------------------------| | | | | Register Number | | | | Institution: | | EPSTEIN, JEFFREY EDWARD | | | 76318-064 | | | | NEW YORK MCC | | Date Entered Special Housing: | | | Reason for Placement: | | | | | | 07-29-2019 | | | PENDING DHO FOR CODE 228 SELF-MUTILATION | | | | | | I. Sutract (2 Cr 3 Days) | | | Date Reviewed | | | | | | 3 Day Review | | | 08-01-2019 | | | | | | | Action Taken on the Above Date: | | | | | | | | | Continue in Special Housing Unit | | | | | | | | Printed Name/Signature: | | | | | | | | | | | | | | | | | | H. RECORD REVIEW.
review.) | (To be done weekly in the ornate's absence, beginning after the unperson 7 day review, and continuing every week between each in-person 30 day | | | | | | | | DATE | ACTION TAKEN | | REMARKS | | | SIGNATURE | | | | 08-05-2019 Continue in Special Housing Unit | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | it Subsea: (7 or 30 Days) | | | Review 8y (SRO): | | Reviewing Authority: | | | | 7 Day Review | | | | | | | | | | Date inmate appeared for a Special Housing Review. | | | | Or Date inmate waived right to appear: | | | | | | | | | | | | | | | | | | | | | | | | | 01-01-111 | | | | | | | P1
Has been seen daily by Medical Staff. | El No
Yes: | | | | | | | | HAS been seen daily by responsible officer designated by Warden | | Yes:
❑
g | No | | | | | | Has received prescribed weekly exercise: | E
WI Yet | Na | | | | | | | Proper documentation and justification in the Central File (Incident Report OHO Report, Copies of Special Housing Review Form) | | | | | | Yes:
❑
g | | | | | | | | | | | | Is there a written psychiatric or psychological assessment on the inmate who has Spent 30 days in a special housing status? | | | | | | No
1_.] Yes:
❑
No | | | | | Yes: | E
NO | | | | | | Is there an additional assessment for every one month interval thereafter? | | P1 | | | | | | | | | | | | | | | | Action taken on the above date by the Segregation Review Official or the Reviewing Authority: | | | | | | | | | iJ Released from Special Housing; | I;s71COntinbe in Special Housing | | | | | | | | Did inmate in Administrative Detention receive a written copy of stairs decision and the basis for the finding at each 30 day review? | | | | | | g
Yes;
❑ | | | if no. why not (Should be given provided institutional woody not compromised)? | | | | | | | | | | | | | | | | | | Remarks: (Any change in the reason for placement is bo be noted in this section. If the reason for placement changes the inmate must receive a copy of this | | | | | | No | | | | | | | | | | | 08-05-2019
if no, why not?
if no. why not?
form):
Date of Next Resew:
08-12-2019 | | | | | | | | | | PriAtti Name and Signature of Segregation Renew Maud or the Reviewing Authority and Cobs Sigred. | | | | | | |