SPECIAL HOUSING UNIT RECORD¶
U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS¶
| NEW YORK MCC | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| (Institution) | |||||||||||||
| Rog. No. 76318.054 Inmate Name: EPSTEIN, JEFFREY EDWARD | |||||||||||||
| Teamtaseworker | Regular Unit 5UNT MGR | Celt 5 | |||||||||||
| Violation | Date | N/A | Time | ||||||||||
| N/A or Reason: | Reed: | ReCd: | NA | ||||||||||
| Admittance N/A Authorized: | Date Rel.: | N/A | Time Rel: | N/A | |||||||||
| Pertinent Information: NIA | |||||||||||||
| Separation Information: NIA | |||||||||||||
| Special Housing Unit Cell Number: Z04.206LAD | Inmate Is In: | NIA | DS: | N/A | AD Status | ||||||||
| N/A Is Inmate on Medication: NIA Medical Department Notified: | |||||||||||||
| Date | Shift | Meals | SH | Exercise | Out of cell time | Medical | |||||||
| 8 | D S | (total) | Comments | Staff Sign | OIC Signature | ||||||||
| 06-04-2019 Morn | Y | M | |||||||||||
| 08-04-2019 Day | y | = | |||||||||||
| 0604-2019 Eve | y | = | |||||||||||
| 1:6454019 Morn | v | ||||||||||||
| 0605.2019 Day | y | ||||||||||||
| 06-05.2019 Eve | r | ||||||||||||
| CO.013.2019 Mom | y | ||||||||||||
| 03-013.2019 Day | |||||||||||||
| 06-062019 | Eve | Y | |||||||||||
| y | No | M. | |||||||||||
| 0507.2019 | Morn | y | ME | ||||||||||
| Ce07.2019 Day | v | ||||||||||||
| 0807.2019 Eve | r | No | —.— | ||||||||||
| ceoe-zors Mom | v | I | |||||||||||
| 126-08-2019 Day | v | ||||||||||||
| 06.0112019 Eve | r | I l | |||||||||||
| 013-09•2019 | Morn | v | I | ||||||||||
| 126-08.2019 Day | v | ||||||||||||
| 06.09.2019 Eve | y | M. | — | ||||||||||
| \ | |||||||||||||
| Morn | |||||||||||||
| Day | |||||||||||||
| Eve |
EXPLANATORYNOTES:Pertinent Info: i e.. Epileptic; Diabetic; Suicidal; Assaultive: etc. Meals/SH: Shower - Yes (Y): No (N); Refused (R)Out•of -Cell Time: (LL) Law Ubrary,(LV) Legal Visit, (U) Unit Team. (P) Psychology. (E) Education, (H) Haircut, (C) Chapel, (R) Recreation, (X) Property Issue. (V) (M) Medical. (C) Court, (O) Other - Yes (Y) if applicable / Enter Actual Time Period Stan and End (i.e., 0930 -1030 Irs) in Out of Cell Time Block.¶
Medical: Medical providers will sign the segregation log each shift and the record sheet each time the inmate is seen by a medical provider. At a minimum. the record sheet must be signed at least once each day by the medical provider. Comments: i.e., Conduct, Attitude. etc. Additional comments on reverse side must include date, signature, and title. OIC Signature: OIC must sign all record sheets each shift. (OIC • Unit Officer)¶