EFTA00054977



BP-A0292
APR 16


SPECIAL HOUSING UNIT RECORD

U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS

<table><thead><tr><th rowspan="2">Date</th><th rowspan="2">Shift</th><th colspan="3">Meals</th><th rowspan="2">SH</th><th rowspan="2">Exercise</th><th rowspan="2">Out of cell time (Total min/hrs)</th><th rowspan="2">Comments</th><th rowspan="2">Medical Staff Sign</th><th rowspan="2">OIC Signature</th></tr><tr><th>B</th><th>D</th><th>S</th></tr></thead><tbody><tr><td rowspan="4"></td><td>Morn Day Eve</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Morn Day Eve</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Morn Day Eve</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Morn Day Eve</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-08-2019</td><td>Morn Day Eve</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td rowspan="4"></td><td>Morn Day Eve</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Morn Day Eve</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Morn Day Eve</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Morn Day Eve</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-11-2019</td><td>Morn Day Eve</td><td>Y</td><td></td><td></td><td>N</td><td>Ref</td><td></td><td></td><td>See 2nd page</td><td></td><td></td></tr><tr><td>07-11-2019</td><td>Morn Day Eve</td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-12-2019</td><td>Morn Day Eve</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td>See 2nd page</td><td></td><td></td></tr><tr><td>07-12-2019</td><td>Morn Day Eve</td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-13-2019</td><td>Morn Day Eve</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-13-2019</td><td>Morn Day Eve</td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr></tbody></table>

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 Library,(LV) Legal Visit, (U) Unit Team, (P) Psychology, (E) Education, (H) Haircut, (C) Chapel, (R) Recreation, (X) Property Issue, (V) Visit, (M) Medical, (C) Court, (O) Other – Yes (Y) If applicable / Enter Actual Time-Period Start and End (i.e., 0930 – 1030 hrs) 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)

PDF

Prescribed by P5270

This form replaces BP-292(52) dated AUG 2011.

EFTA00054978

| | |
| :--- | :--- |
| 07-11-2019 | Day shift comments: Health: Voices no medical complaints. |

| | |
| :--- | :--- |
| 07-12-2019 | Day shift comments: Health: Voices no medical complaints. |

EFTA00054979



BP-A0292
APR 16


SPECIAL HOUSING UNIT RECORD

U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS

<table><thead><tr><th rowspan="2">Date</th><th rowspan="2">Shift</th><th colspan="3">Meals</th><th rowspan="2">SH</th><th rowspan="2">Exercise</th><th rowspan="2">Out of cell time<br>(Total min/hrs)</th><th rowspan="2">Comments</th><th rowspan="2">Medical Staff Sign</th><th rowspan="2">OIC Signature</th></tr><tr><th>B</th><th>D</th><th>S</th></tr></thead><tbody><tr><td>07-14-2019</td><td>Morn</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-14-2018</td><td>Day</td><td></td><td>Y</td><td></td><td>N</td><td>No</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-14-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td>N</td><td>No</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-15-2019</td><td>Morn</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-15-2019</td><td>Day</td><td></td><td>Y</td><td></td><td>Y</td><td>No</td><td>01:00</td><td>See 2nd page</td><td></td><td></td><td></td></tr><tr><td>07-15-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td></td><td>No</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-16-2019</td><td>Morn</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td>See 2nd page</td><td></td><td></td></tr><tr><td>07-16-2019</td><td>Day</td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-16-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td></td><td>No</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-17-2019</td><td>Morn</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-17-2019</td><td>Day</td><td></td><td>Y</td><td></td><td>Y</td><td>Ref</td><td>01:00</td><td>See 2nd page</td><td></td><td></td><td></td></tr><tr><td>07-17-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td></td><td>No</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-18-2019</td><td>Morn</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-18-2019</td><td>Day</td><td></td><td>Y</td><td></td><td>N</td><td>Ref</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-18-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td></td><td>No</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-19-2019</td><td>Morn</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td>00:15</td><td>See 2nd page</td><td></td><td></td></tr><tr><td>07-19-2019</td><td>Day</td><td></td><td>Y</td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-19-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td></td><td>No</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-20-2019</td><td>Morn</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-20-2019</td><td>Day</td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-20-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td>N</td><td>No</td><td></td><td></td><td></td><td></td><td></td></tr></tbody></table>

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 Library,(LV) Legal Visit, (U) Unit Team, (P) Psychology, (E) Education, (H) Haircut, (C) Chapel, (R) Recreation, (X) Property Issue, (V) Visit, (M) Medical, (C) Court, (O) Other – Yes (Y) if applicable / Enter Actual Time Period Start and End (i.e., 0930 – 1030 hrs) 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)

Prescribed by P5270

PDF

This form replaces BP-292(52) dated AUG 2011.

EFTA00054980

| | |
| :--- | :--- |
| 07-15-2019 | Day shift comments: Health: Voices no medical complaints. |

| 07-16-2019 | Health: Voices no medical complaints. |

| :--- | :--- |

| | |
| :--- | :--- |
| 07-17-2019 | Day shift comments: Health: Voices no medical complaints. |

| | Day shift comments: |
| :--- | :--- |
| 07-18-2019 | Health: Voices no medical complaints |

| Day shift comments: |
| :--- |
| Health: Voices no medical complaints. |

07-19-2019

EFTA00054981



BP-A0292
APR 16


SPECIAL HOUSING UNIT RECORD

U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS

<table><thead><tr><th>Date</th><th>Shift</th><th colspan="3">Meals</th><th>SH</th><th>Exercise</th><th>Out of cell time<br>(Total minutes)</th><th>Comments</th><th>Medical Staff Sign</th><th>OIC Signature</th></tr><tr><th></th><th></th><th>B</th><th>D</th><th>S</th><td></td><td></td><td></td><td></td><td></td><td></td></tr></thead><tbody><tr><td>07-21-2019</td><td>Morn</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-21-2019</td><td>Day</td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-21-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-22-2019</td><td>Morn</td><td>Y</td><td></td><td></td><td>Y</td><td>No</td><td>01:00</td><td></td><td></td><td></td></tr><tr><td>07-22-2019</td><td>Day</td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-22-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>Morn</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>Day</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>Eve</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>Morn</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>Day</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>Eve</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>Morn</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>Day</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>Eve</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr></tbody></table>

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 Library,(LV) Legal Visit, (U) Unit Team, (P) Psychology, (E) Education, (H) Haircut, (C) Chapel, (R) Recreation, (X) Property Issue, (V) Visit, (M) Medical, (C) Court, (O) Other – Yes (Y) if applicable / Enter Actual Time Period Start and End (i.e., 0930 – 1030 hrs) 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)

Prescribed by P5270

PDF

This form replaces BP-292(52) dated AUG 2011.

EFTA00054982



BP-A0292
APR 16


SPECIAL HOUSING UNIT RECORD

U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS

<table><thead><tr><th rowspan="4">Date</th><th rowspan="2">Shift</th><th colspan="3">Meals</th><th rowspan="2">SH</th><th rowspan="2">Exercise</th><th rowspan="2">Out of cell time<br>(Total minhrs)</th><th rowspan="2">Comments</th><th rowspan="2">Medical Staff Sign</th><th rowspan="2">OIC Signature</th></tr><tr><th>B</th><th>D</th><th>S</th></tr></thead><tbody><tr><td rowspan="3"></td><td>Morn</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Day</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Eve</td><td></td><td></td><td>Y</td><td>N</td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-29-2019</td><td>Morn</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td rowspan="2">07-29-2018</td><td>Day</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Eve</td><td></td><td></td><td>Y</td><td>N</td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-30-2019</td><td>Morn</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-30-2018</td><td>Day</td><td></td><td>Y</td><td></td><td>N</td><td>Ref</td><td></td><td></td><td>See 2nd page</td><td></td><td></td></tr><tr><td>07-30-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td>No</td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-31-2019</td><td>Morn</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>07-31-2019</td><td>Day</td><td></td><td>Y</td><td></td><td>Y</td><td>06:30/07:30 O</td><td>02:00</td><td></td><td>See 2nd page</td><td></td><td></td></tr><tr><td>07-31-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-01-2019</td><td>Morn</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-01-2019</td><td>Day</td><td></td><td>Y</td><td></td><td>N</td><td>Ref</td><td></td><td></td><td>See 2nd page</td><td></td><td></td></tr><tr><td>08-01-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td></td><td>No</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-02-2019</td><td>Morn</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-02-2019</td><td>Day</td><td></td><td>Y</td><td></td><td>Y</td><td>No</td><td>01:00</td><td></td><td>See 2nd page</td><td></td><td></td></tr><tr><td>08-02-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td></td><td>No</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-03-2019</td><td>Morn</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-03-2019</td><td>Day</td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-03-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td>N</td><td>No</td><td></td><td></td><td></td><td></td><td></td></tr></tbody></table>

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 Library,(LV) Legal Visit, (U) Unit Team, (P) Psychology, (E) Education, (H) Haircut, (C) Chapel, (R) Recreation, (X) Property Issue, (V) Visit, (M) Medical, (C) Court, (O) Other – Yes (Y) if applicable / Enter Actual Time Period Start and End (i.e., 0930 – 1030 hrs) 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)

PDF

Prescribed by P5270

This form replaces BP-292(52) dated AUG 2011.



EFTA00054983


| | |
| :--- | :--- |
| 07-30-2019 | Day shift comments: Health: Voices no medical complaints. |

| | |
| :--- | :--- |
| 07-31-2019 | Day shift comments: Health: Voices no medical complaints. |

| | |
| :--- | :--- |
| 08-01-2019 | Day shift comments: Health: Voices no medical complaints. |

| | Day shift comments: |
| :--- | :--- |
| 06-02-2019 | Health: Voices no medical complaints. |

EFTA00054984



BP-A0292
APR 16


SPECIAL HOUSING UNIT RECORD

U.S. DEPARTMENT OF JUSTICE
FEDERAL BUREAU OF PRISONS

<table><thead><tr><th rowspan="2">Date</th><th rowspan="2">Shift</th><th colspan="3">Meals</th><th rowspan="2">SH</th><th rowspan="2">Exercise</th><th rowspan="2">Out of cell time<br>(Total min/hrs)</th><th rowspan="2">Comments</th><th rowspan="2">Medical Staff Sign</th><th rowspan="2">OIC Signature</th></tr><tr><th>B</th><th>D</th><th>S</th></tr></thead><tbody><tr><td>08-04-2019</td><td>Mom</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td rowspan="5"></td></tr><tr><td>08-04-2019</td><td>Day</td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-04-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-05-2019</td><td>Mom</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-05-2019</td><td>Day</td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-05-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td rowspan="5"></td></tr><tr><td>08-06-2019</td><td>Mom</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-06-2019</td><td>Day</td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-06-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td>No</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>09-07-2019</td><td>Mom</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td rowspan="5"></td></tr><tr><td>08-07-2019</td><td>Day</td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-07-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td>No</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-08-2019</td><td>Mom</td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-08-2019</td><td>Day</td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>08-08-2019</td><td>Eve</td><td></td><td></td><td>Y</td><td></td><td></td><td></td><td></td><td></td><td></td><td rowspan="3"></td></tr><tr><td></td><td>Mom</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>Day</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>Eve</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr></tbody></table>

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 Library,(LV) Legal Visit, (U) Unit Team, (P) Psychology, (E) Education, (H) Haircut, (C) Chapel, (R) Recreation, (X) Property Issue, (V) Visit, (M) Medical, (C) Court, (O) Other – Yes (Y) if applicable / Enter Actual Time Period Start and End (i.e., 0930 – 1030 hrs) 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)

Prescribed by P5270

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This form replaces BP-292(52) dated AUG 2011.